Search results for: hospital room/wards
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3493

Search results for: hospital room/wards

1423 Potentially Inappropriate Prescribing in Elderly Population

Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

Abstract:

Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

Procedia PDF Downloads 551
1422 Removal of Diesel by Soil Washing Technologies Using a Non-Ionic Surfactant

Authors: Carolina Guatemala, Josefina Barrera

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A large number of soils highly polluted with recalcitrant hydrocarbons and the limitation of the current bioremediation methods continue being the drawback for an efficient recuperation of these under safe conditions. In this regard, soil washing by degradable surfactants is an alternative option knowing the capacity of surfactants to desorb oily organic compounds. The aim of this study was the establishment of the washing conditions of a soil polluted with diesel, using a nonionic surfactant. A soil polluted with diesel was used. This was collected near to a polluted railway station zone. The soil was dried at room temperature and sieved to a mesh size 10 for its physicochemical and biological characterization. Washing of the polluted soil was performed with surfactant solutions in a 1:5 ratio (5g of soil per 25 mL of the surfactant solution). This was carried out at 28±1 °C and 150 rpm for 72 hours. The factors tested were the Tween 80 surfactant concentration (1, 2, 5 and 10%) and the treatment time. Residual diesel concentration was determined every 24 h. The soil was of a sandy loam texture with a low concentration of organic matter (3.68%) and conductivity (0.016 dS.m- 1). The soil had a pH of 7.63 which was slightly alkaline and a Total Petroleum Hydrocarbon content (TPH) of 11,600 ± 1058.38 mg/kg. The high TPH content could explain the low microbial count of 1.1105 determined as UFC per gram of dried soil. Within the range of the surfactant concentration tested for washing the polluted soil under study, TPH removal increased proportionally with the surfactant concentration. 5080.8 ± 422.2 ppm (43.8 ± 3.64 %) was the maximal concentration of TPH removed after 72 h of contact with surfactant pollution at 10%. Despite the high percentage of hydrocarbons removed, it is assumed that a higher concentration of these could be removed if the washing process is extended or is carried out by stages. Soil washing through the use of surfactants as a desorbing agent was found to be a viable and effective technology for the rapid recovery of soils highly polluted with recalcitrant hydrocarbons.

Keywords: diesel, hydrocarbons, soil washing, tween 80

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1421 Radio Labeling and Characterization of Cysteine and Its Derivatives with Tc99m and Their Bio-Distribution

Authors: Rabia Ashfaq, Saeed Iqbal, Atiq ur Rehman, Irfanullah Khan

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An extensive series of radiopharmaceuticals have been explored in order to discover a better brain tumour diagnostic agent. Tc99m labelling with cysteine and its derivatives in liposomes shows effective tagging of about 70% to 80 %. Due to microscopic size it successfully crossed the brain barrier in 2 minutes which gradually decreases in 5 to 15 minutes. HMPAO labelled with Tc99m is another important radiopharmaceutical used to study brain perfusion but it comes with a flaw that it’s only functional during epilepsy. 1, 1 ECD is purely used in Tc99m ECD formulation; because it not only tends to cross the blood brain barrier but it can be metabolized which can be easily entrapped in human brain. Radio labelling of Cysteine with Tc99m at room temperature was performed which yielded no good results. Hence cysteine derivatives with salicylaldehyde were prepared that produced about 75 % yield for ligand. In order to perform it’s radio labelling a suitable solvent DMSO was selected and physical parameters were performed. Elemental analyser produced remarkably similar results for ligand as reported in literature. IR spectra of Ligand in DMSO concluded in the absence of SH stretch and presence of N-H vibration. Thermal analysis of the ligand further suggested its decomposition pattern with no distinct curve for a melting point. Radio labelling of ligand was performed which produced excellent results giving up to 88% labelling at pH 5.0. Clinical trials using Rabbit were performed after validating the products reproducibility. The radiopharmaceutical prepared was injected into the rabbit. Dynamic as well as static study was performed under the SPECT. It showed considerable uptake in the kidneys and liver considering it suitable for the Hypatobilliary study.

Keywords: marcapto compounds, 99mTc - radiolabeling, salicylaldicysteine, thiozolidine

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1420 Automated Parking System

Authors: N. Arunraj, C. P. V. Paul, D. M. D. Jayawardena, W. N. D. Fernando

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Traffic congestion with increased numbers of vehicles is already a serious issue for many countries. The absence of sufficient parking spaces adds to the issue. Motorists are forced to wait in long queues to park their vehicles. This adds to the inconvenience faced by a motorist, kept waiting for a slot allocation, manually done along with the parking payment calculation. In Sri Lanka, nowadays, parking systems use barcode technology to identify the vehicles at both the entrance and the exit points. Customer management is handled by the use of man power. A parking space is, generally permanently sub divided according to the vehicle type. Here, again, is an issue. Parking spaces are not utilized to the maximum. The current arrangement leaves room for unutilized parking spaces. Accordingly, there is a need to manage the parking space dynamically. As a vehicle enters the parking area, available space has to be assigned for the vehicle according to the vehicle type. The system, Automated Parking System (APS), provides an automated solution using RFID Technology to identify the vehicles. Simultaneously, an algorithm manages the space allocation dynamically. With this system, there is no permanent parking slot allocation for a vehicle type. A desktop application manages the customer. A Web application is used to manage the external users with their reservations. The system also has an android application to view the nearest parking area from the current location. APS is built using java and php. It uses LED panels to guide the user inside the parking area to find the allocated parking slot accurately. The system ensures efficient performance, saving precious time for a customer. Compared with the current parking systems, APS interacts with users and increases customer satisfaction as well.

Keywords: RFID, android, web based system, barcode, algorithm, LED panels

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1419 The Effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions

Authors: Pramote Thangkratok

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The aims of this experimental study were to investigate the effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions. In addition, to compare bleeding and hematoma occurrences at the Access site between experimental and control groups. The randomized controlled trial (RCT) was conducted in 70 patients who underwent Cardiovascular Angiography and Interventions via the femoral artery and received post procedural care at the intermediate cardiac care unit, Bangkok Heart Hospital. From December 2015 to February 2016. The control group (35 patients) was to get standard care after the intervention, whereas the experimental group (35 patients) was Reverse Trendelenburg Position 30-45 degrees. The groups were not significantly different in terms of demographic characteristics, Age, Gender, BMI, blood pressure, heart rate. While not significantly different from each other, the intensity of back pain control group had a significantly higher pain score than experimental group. Vascular complications in terms of bleeding and hematoma were not significantly different between the control and experimental groups. The findings show that Reverse Trendelenburg Position after Cardiovascular Angiography and Interventions would reduce or prevent the back pain without increasing the chance of bleeding and hematoma.

Keywords: reverse trendelenburg position, back pain, cardiovascular angiography, cardiovascular interventions

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1418 A Four-Year Study of Thyroid Carcinoma in Hail Region: Increased Incidence

Authors: Laila Seada, Hanan Oreiby, Fawaz Al Rashid, Ashraf Negm

Abstract:

Background and Objective: In most areas of the world, the incidence of thyroid cancer has been increasing over the last decade, mostly due to a combination of early detection of the neoplasm resulting from sensitive procedures and increased population exposure to radiation and unrecognized carcinogens. Methods: Cases of thyroid cancer have been retrieved from the cancer registry at King Khalid Hospital during the period from August 2012 to April 2016. Age, gender and histopathologic types have been recorded. Results: Thyroid carcinoma ranked as the second most common malignancy in females (25%) after breast cancer (31%). It constituted 20.8% of all newly diagnosed cancer cases. As for males, it ranked the 4th type of malignancy after gastrointestinal cancer, lymphomas and soft tissue sarcomas. Mean age for females and males was 38.7 +/- 13.2 and 60.25 +/- 11.5 years, respectively, and the difference between the two groups was statistically significant (p value = 0.0001). Fifty-five (82%) were papillary carcinomas including 10 follicular variant of papillary (FVPC), and eight papillary micro carcinomas (PMC) and two tall cell/oncocytic variants. Follicular carcinomas constituted two (3.1%), while two (3.1%) were anaplastic, and two (3.1%) were medullary. Conclusion: Thyroid cancer incidence in Hail is ranking as the 2nd most common female malignancy similar to other regions in the Kingdom. However, this high incidence contrasts with much lower rates worldwide.

Keywords: thyroid, hail, papillary, microcarcinoma

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1417 Egg Hatching Inhibition Activity of Volatile Oils Extracted from Some Medicinal and Aromatic Plants against Root-Knot Nematode Meloidogyne hapla

Authors: Anil F. Felek, Mehmet M. Ozcan, Faruk Akyazi

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Volatile oils of medicinal and aromatic plants are important for managing nematological problems in agriculture. In present study, volatile oils extracted from five medicinal and aromatic plants including Origanum onites (flower+steam+leaf), Salvia officinalis (leaf), Lippia citriodora (leaf+seed), Mentha spicata (leaf) and Mentha longifolia (leaf) were tested for egg hatching inhibition activity against root-knot nematode Meloidogyne hapla under laboratory conditions. The essential oils were extracted using water distillation method with a Clevenger system. For the homogenisation process of the oils, 2% gum arabic solution was used and 4 µl oils was added into 1ml filtered gum arabic solution to prepare the last stock solution. 5 ml of stock solution and 1 ml of M. hapla egg suspension (about 100 eggs) were added into petri dishes. Gum arabic solution was used as control. Seven days after exposure to oils at room temperature (26±2 °C), the cumulative hatched and unhatched eggs were counted under 40X inverted light microscope and Abbott’s formula was used to calculate egg hatching inhibition rates. As a result, the highest inhibition rate was found as 54% for O. onites. In addition, the other inhibition rates varied as 31.4%, 21.6%, 23.8%, 25.67% for the other plants, S. officinalis, M. longifolia, M. spicata and L. citriodora, respectively. Carvacrol was found as the main component (68.8%) of O. onites followed by Thujone 27.77% for S. officinalis, I-Menthone 76.92% for M. longifolia, Carvone 27.05% for M. spicata and Citral 19.32% for L. citriodora.

Keywords: egg hatching, Meloidogyne hapla, medicinal and aromatic plants, root-knot nematodes, volatile oils

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1416 The Multifunctional Medical Centers’ Architectural Shaping

Authors: Griaznova Svetlana, Umedov Mekhroz

Abstract:

The current healthcare facilities trend is the creation of multidisciplinary large-scale centers to provide the maximum possible services in one place, minimizing the number of possible instances in the path of patient treatment. The multifunctional medical centers are mainly designed in urban infrastructure for good accessibility. However, many functions and connections define the building shape, often make it inharmonious, that greatly destroys the city's appearance. The purpose of the research is to scientifically substantiate the factors influencing the shaping, the formation of architectural solutions principles, the formation of recommendations and principles for the multifunctional medical centers' design. The result of the research is the elaboration of architectural and planning solutions principles and the determination of factors affecting the multifunctional healthcare facilities shaping. Research method: Study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research. An integrated approach to the study of existing international experience of multidisciplinary medical centers. Elaboration of graphical analysis and diagrams based on the system analysis of the processed information. Identification of methods and principles of functional zoning of nuclear medicine centers.

Keywords: health care, multifunctionality, form, medical center, hospital, PET, CT scan

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1415 Prevalence and Determinants of the Use of CAM and Its Association with Quality of Life in a Sample of Lebanese Breast Cancer Patients: A Cross Sectional Study

Authors: Farah Naja, Romy Abi Fadel, Yasmin Aridi, Aya Zarif, Dania Hariri, Mohammad Alameddine, Anas Mugharbel, Maya Khalil, Zeina Nahleh, Arafat Tfayli

Abstract:

The objective of this study is to assess the prevalence and determinants of CAM use among breast cancer patients in Beirut, Lebanon. A secondary objective is to evaluate the association between CAM use and quality of life (QOL). A cross-sectional survey was conducted on 180 breast cancer patients recruited from two major referral centers in Beirut. In a face to face interview, participants completed a questionnaire comprised of three sections: socio-demographic and lifestyle characteristics, breast cancer condition, and CAM use. The assessment of QOL was carried using the FACT-B Arabic version. Prevalence of CAM use since diagnosis was 40%. CAM use was negatively associated with age, treatment at a philanthropic hospital and positively associated with having an advanced stage of disease. The most commonly used CAM was ‘Special food’ followed by ‘Herbal teas’. Only 4% of CAM users cited health care professionals as influencing their choice of CAM. One in four patients disclosed CAM use to their treating physician. There was no significant association between CAM use and QOL. The use of CAM therapies among breast cancer patients is prevalent in Lebanon. Efforts should be dedicated at educating physicians to discuss CAM use with their patients and advising patients to disclose of their use with their physicians.

Keywords: breast cancer, complementary and aLternative medicine, Lebanon, quality of life

Procedia PDF Downloads 583
1414 Autonomous Flight Control for Multirotor by Alternative Input Output State Linearization with Nested Saturations

Authors: Yong Eun Yoon, Eric N. Johnson, Liling Ren

Abstract:

Multirotor is one of the most popular types of small unmanned aircraft systems and has already been used in many areas including transport, military, surveillance, and leisure. Together with its popularity, the needs for proper flight control is growing because in most applications it is required to conduct its missions autonomously, which is in many aspects based on autonomous flight control. There have been many studies about the flight control for multirotor, but there is still room for enhancements in terms of performance and efficiency. This paper presents an autonomous flight control method for multirotor based on alternative input output linearization coupled with nested saturations. With alternative choice of the output of the multirotor flight control system, we can reduce computational cost regarding Lie algebra, and the linearized system can be stabilized with the introduction of nested saturations with real poles of our own design. Stabilization of internal dynamics is also based on the nested saturations and accompanies the determination of part of desired states. In particular, outer control loops involving state variables which originally are not included in the output of the flight control system is naturally rendered through this internal dynamics stabilization. We can also observe that desired tilting angles are determined by error dynamics from outer loops. Simulation results show that in any tracking situations multirotor stabilizes itself with small time constants, preceded by tuning process for control parameters with relatively low degree of complexity. Future study includes control of piecewise linear behavior of multirotor with actuator saturations, and the optimal determination of desired states while tracking multiple waypoints.

Keywords: automatic flight control, input output linearization, multirotor, nested saturations

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1413 Alumina Supported Copper-manganese Catalysts for Combustion of Exhaust Gases: Catalysts Characterization

Authors: Krasimir I. Ivanov, Elitsa N. Kolentsova, Dimitar Y. Dimitrov, Georgi V. Avdeev, Tatyana T. Tabakova

Abstract:

In recent research copper and manganese systems were found to be the most active in CO and organic compounds oxidation among the base catalysts. The mixed copper manganese oxide has been widely studied in oxidation reactions because of their higher activity at low temperatures in comparison with single oxide catalysts. The results showed that the formation of spinel CuxMn3−xO4 in the oxidized catalyst is responsible for the activity even at room temperature. That is why most of the investigations are focused on the hopcalite catalyst (CuMn2O4) as the best copper-manganese catalyst. Now it’s known that this is true only for CO oxidation, but not for mixture of CO and VOCs. The purpose of this study is to investigate the alumina supported copper-manganese catalysts with different Cu/Mn molar ratio in terms of oxidation of CO, methanol and dimethyl ether. The catalysts were prepared by impregnation of γ-Al2O3 with copper and manganese nitrates and the catalytic activity measurements were carried out in continuous flow equipment with a four-channel isothermal stainless steel reactor. Gas mixtures on the input and output of the reactor were analyzed with a gas chromatograph, equipped with FID and TCD detectors. The texture characteristics were determined by low-temperature (- 196 oС) nitrogen adsorption in a Quantachrome Instruments NOVA 1200e (USA) specific surface area&pore analyzer. Thermal, XRD and TPR analyses were performed. It was established that the active component of the mixed Cu-Mn/γ–alumina catalysts strongly depends on the Cu/Mn molar ratio. Highly active alumina supported Cu-Mn catalysts for CO, methanol and DME oxidation were synthesized. While the hopcalite is the best catalyst for CO oxidation, the best compromise for simultaneous oxidation of all components is the catalyst with Cu/Mn molar ratio 1:5.

Keywords: supported copper-manganese catalysts, CO, VOCs oxidation, combustion of exhaust gases

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1412 Drug Reaction with Eosinophilia and Systemic Symptoms (Dress) Syndrome Presenting as Multi-Organ Failure

Authors: Keshari Shrestha, Philip Vatterott

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Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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1411 Estimation of Particle Size Distribution Using Magnetization Data

Authors: Navneet Kaur, S. D. Tiwari

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Magnetic nanoparticles possess fascinating properties which make their behavior unique in comparison to corresponding bulk materials. Superparamagnetism is one such interesting phenomenon exhibited only by small particles of magnetic materials. In this state, the thermal energy of particles become more than their magnetic anisotropy energy, and so particle magnetic moment vectors fluctuate between states of minimum energy. This situation is similar to paramagnetism of non-interacting ions and termed as superparamagnetism. The magnetization of such systems has been described by Langevin function. But, the estimated fit parameters, in this case, are found to be unphysical. It is due to non-consideration of particle size distribution. In this work, analysis of magnetization data on NiO nanoparticles is presented considering the effect of particle size distribution. Nanoparticles of NiO of two different sizes are prepared by heating freshly synthesized Ni(OH)₂ at different temperatures. Room temperature X-ray diffraction patterns confirm the formation of single phase of NiO. The diffraction lines are seen to be quite broad indicating the nanocrystalline nature of the samples. The average crystallite size are estimated to be about 6 and 8 nm. The samples are also characterized by transmission electron microscope. Magnetization of both sample is measured as function of temperature and applied magnetic field. Zero field cooled and field cooled magnetization are measured as a function of temperature to determine the bifurcation temperature. The magnetization is also measured at several temperatures in superparamagnetic region. The data are fitted to an appropriate expression considering a distribution in particle size following a least square fit procedure. The computer codes are written in PYTHON. The presented analysis is found to be very useful for estimating the particle size distribution present in the samples. The estimated distributions are compared with those determined from transmission electron micrographs.

Keywords: anisotropy, magnetization, nanoparticles, superparamagnetism

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1410 Catalytic Synthesis and Characterization of N-(4-(Tert-Butyl) Benzyl)-1-(4-Tert-Butyl) Phenyl)-N-Methyl Methanaminium Chloride from Tert-Butyl Benzyl Derivatives

Authors: Muhammad A. Muhammad

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Butenafine (N-4-tert-butyl benzyl-N-methyl-1-naphthylene methylamine hydrochloride) is a benzylamine antimycotic (antifungal) agent that has a broad spectrum of action. The quest for improved antimycotic action brought about many research on the structure-activity properties of butenafine in relation to other antifungal agents. Of all those research, only little or no effort was recorded on the substituents attached to the aromatic systems in butenafine. In this research, N-(4-(tert-butyl) benzyl)-1-(4-tert-butyl) phenyl)-N-methyl methanaminium chloride, which is a butenafine analogue was synthesised from tert-butyl benzyl derivatives, by reductive amination using various solvents through a direct approach, where 1,2-dichloroethane gave the best solvent action at 40 °C (Yield: 75%) and of all the reducing agents used, sodium borohydride was found to give the best reducing action in the presence of silica chloride at room temperature (Yield: 50%). Characterization of the compound by 1H NMR showed a singlet peak of 18 hydrogen atoms with a chemical shift at 1.3-1.5 ppm for the presence of 6 methyl groups in the two tert-butyl substituents, the 13C NMR also indicated the presence of the two tert-butyl substituents by the peak with a chemical shift at 31-32 ppm for the six methyl carbon atoms, the IR indicated the presence of a tertiary ammonium ion by a strong band at 2460 cm-1 and finally the EIS-MS confirmed the molar mass of the compound by a mass to charge ratio of 324.2693. These results suggested that the target molecule was actually synthesised and therefore, 1,2-dichloroethane is a good solvent for this synthesis, and the most suitable reducing agent is sodium borohydride.

Keywords: antimicrobial agents, antimycotic agents, butenafine, chemotherapeutic agents, semisynthetic agents

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1409 Clinicopathological Findings of Partuberclosis in Camels: Possible Steps for Control Strategy

Authors: A. M. Almujalli, G. M. Al-Ghamdi

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Mycobacterium avium subspecies paratuberculosis causes paratuberculosis, a chronic debilitating granulomatous enteritis, in camels as well as domestic and wild ruminants. The clinical manifestation of the disease in camel is not well characterized, therefore this study was aimed to investigate the clinical and pathological pictures of camels that are suffering from partuberculosis. Twelve young camels that were presented to the Veterinary Teaching Hospital, King Faisal University were investigated. Clinical and pathological examination were performed. The results revealed highly significant increase in creatinine, blood urea nitrogen, magnesium, AST and ALT in diseased camels, while glucose, total protein and albumin were highly significantly decreased in diseased camels when compared to healthy ones. Post-mortem testing indicated thickening, corrugation of the intestinal wall, folded mucosa, enlarged and oedemated ileocaecal and mesenteric lymph nodes. The microscopic findings detected short, blunt and distorted intestinal villi with hyperactive goblet cells of the villi and the crypts of lieberkuhn contained mucin droplets. The lamina propria was heavily infiltrated with mononuclear cells mostly macrophages. This clinical picture of paratuberculosis may be used to initiate control strategy to limit the spread of the disease in camel herds.

Keywords: camel, partuberclosis, control, Saudi Arabia

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1408 The Whole Is Greater than ‘Them’ and ‘Us’: The Effect of a Shared Workplace of Israeli-Jews and Non-Israeli Palestinians Physicians on Mutual Attitudes

Authors: Idit Miller

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This paper examines the effect of a common organizational identity on intergroup relations of Israeli-Jews and non-Israeli Palestinians medical interns who are employed together within the Israeli hospitals, while asymmetrical relationships and ongoing conflict between the two groups still exist. Using mixed theory, which included the Intergroup contact, Othering, and the Common social identity theories, the study examines the intra-organizational identities dynamic involved within the hospital department and its effects on intergroup relations. In-depth, semi-structured interviews with the Palestinian and Jews physicians were conducted. Findings show three social identity responses are being constructed during the shared employment: Them vs. Us construction, Them vs. Us deconstruction, and an 'Organizational Us' reconstruction. Despite the inequality inherent within the intergroup relations, by holding a universal identity and using a deconstruction pattern, positive emotions are demonstrated by both sides. The adoption of a shared professional super-identity is found as an essential component for fostering and maintaining positive attitudes between the parties. This finding strengthens the significance of a long-term continuous intergroup contact inside the organization and especially between two polarized groups.

Keywords: common social identity theory, intergroup contact theory, inequality, intergroup conflict, othering theory

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1407 Numerical Simulation of a Combined Impact of Cooling and Ventilation on the Indoor Environmental Quality

Authors: Matjaz Prek

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Impact of three different combinations of cooling and ventilation systems on the indoor environmental quality (IEQ) has been studied. Comparison of chilled ceiling cooling in combination with displacement ventilation, cooling with fan coil unit and cooling with flat wall displacement outlets was performed. All three combinations were evaluated from the standpoint of whole-body and local thermal comfort criteria as well as from the standpoint of ventilation effectiveness. The comparison was made on the basis of numerical simulation with DesignBuilder and Fluent. Numerical simulations were carried out in two steps. Firstly the DesignBuilder software environment was used to model the buildings thermal performance and evaluation of the interaction between the environment and the building. Heat gains of the building and of the individual space, as well as the heat loss on the boundary surfaces in the room, were calculated. In the second step Fluent software environment was used to simulate the response of the indoor environment, evaluating the interaction between building and human, using the simulation results obtained in the first step. Among the systems presented, the ceiling cooling system in combination with displacement ventilation was found to be the most suitable as it offers a high level of thermal comfort with adequate ventilation efficiency. Fan coil cooling has proved inadequate from the standpoint of thermal comfort whereas flat wall displacement outlets were inadequate from the standpoint of ventilation effectiveness. The study showed the need in evaluating indoor environment not solely from the energy use point of view, but from the point of view of indoor environmental quality as well.

Keywords: cooling, ventilation, thermal comfort, ventilation effectiveness, indoor environmental quality, IEQ, computational fluid dynamics

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1406 Optimizing Scribe Resourcing to Improve Hospitalist Workloads

Authors: Ahmed Hamzi, Bryan Norman

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Having scribes help document patient records in electronic health record systems can improve hospitalists’ productivity. But hospitals need to determine the optimum number of scribes to hire to maximize scribe cost effectiveness. Scribe attendance uncertainty due to planned and unplanned absences is a primary challenge. This paper presents simulation and analytical models to determine the optimum number of scribes for a hospital to hire. Scribe staffing practices vary from one context to another; different staffing scenarios are considered where having extra attending scribes provides or does not provide additional value and utilizing on-call scribes to fill in for potentially absent scribes. These staffing scenarios are assessed for different scribe revenue ratios (ratio of the value of the scribe relative to scribe costs) ranging from 100% to 300%. The optimum solution depends on the absenteeism rate, revenue ratio, and desired service level. The analytical model obtains solutions easier and faster than the simulation model, but the simulation model is more accurate. Therefore, the analytical model’s solutions are compared with the simulation model’s solutions regarding both the number of scribes hired and cost-effectiveness. Additionally, an Excel tool has been developed to facilitate decision-makers in easily obtaining solutions using the analytical model.

Keywords: hospitalists, workload, optimization cost, economic analysis

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1405 Structure and Magnetic Properties of Low-Temperature Synthesized M-W Hexaferrite Composites

Authors: Young-Min Kang

Abstract:

M-type Sr-hexaferrites (SrFe12O19) is one of the most utilized materials in permanent magnets due to their low price, outstanding chemical stability, and appropriate hard magnetic properties. For a M-type Sr-hexaferrite with a saturation magnetization (MS) of ~74.0 emu/g the practical limits of remanent flux density (Br) and maximum energy product (BH) max are ~4.6 kG and ~5.3 MGOe. Meanwhile, W-type hexaferrite (SrFe18O27) with higher MS ~81emu/g can be a good candidate for the development of enhanced ferrite magnet. However the W-type hexaferrite is stable at the temperature over 1350 ºC in air, and thus it is hard to control grain size and the coercivity. We report here high-MS M-W composite hexaferrites synthesized at 1250 ºC in air by doping Ca, Co, Mn, and Zn into the hexaferrite structures. The hexaferrites samples of stoichiometric SrFe12O19 (SrM) and Ca-Co-Mn-Zn doped hexaferrite (Sr0.7Ca0.3Fen-0.6Co0.2Mn0.2Zn0.2Oa) were prepared by conventional solid state reaction process with varying Fe content (10 ≤ n ≤ 17). Analysis by x-ray diffraction (XRD) and field emission scanning electron microscopy (FE-SEM) were performed for phase identification and microstructural observation respectively. Magnetic hysteresis curves were measured using vibrating sample magnetometer (VSM) at room temperature (300 K). Single M-type phase could be obtained in the non-doped SrM sample after calcinations at the range of 1200 ºC ~ 1300 ºC, showing MS in the range of 72 ~ 72.6 emu/g. The Ca-Co-Mn-Zn doped SrM with Fe content, 10 ≤ n ≤ 13, showed both M and W-phases peaks in the XRD after respective calcinations at 1250 ºC. The sample with n=13 showed the MS of 70.7, 75.3, 78.0 emu/g, respectively, after calcination at 1200, 1250, 1300 ºC. The high MS over that of non-doped SrM (~72 emu/g) is attributed to the volume portion of W-phase. It is also revealed that the high MS W-phase could not formed if only one of the Ca, Co, Zn is missed in the substitution. These elements are critical to form the W-phase at the calcinations temperature of 1250 ºC, which is 100 ºC lower than the calcinations temperature for non-doped Sr-hexaferrites.

Keywords: M-type hexaferrite, W-type hexaferrite, saturation magnetization, low-temperature synthesis

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1404 Role of Chloride Ions on The Properties of Electrodeposited ZnO Nanostructures

Authors: L. Mentar, O. Baka, M. R. Khelladi, A. Azizi

Abstract:

Zinc oxide (ZnO), as a transparent semiconductor with a wide band gap of 3.4 eV and a large exciton binding energy of 60 meV at room temperature, is one of the most promising materials for a wide range of modern applications. With the development of film growth technologies and intense recent interest in nanotechnology, several varieties of ZnO nanostructured materials have been synthesized almost exclusively by thermal evaporation methods, particularly chemical vapor deposition (CVD), which generally require a high growth temperature above 550 °C. In contrast, wet chemistry techniques such as hydrothermal synthesis and electro-deposition are promising alternatives to synthesize ZnO nanostructures, especially at a significantly lower temperature (below 200°C). In this study, the electro-deposition method was used to produce zinc oxide (ZnO) nanostructures on fluorine-doped tin oxide (FTO)-coated conducting glass substrate from chloride bath. We present the influence of KCl concentrations on the electro-deposition process, morphological, structural and optical properties of ZnO nanostructures. The potentials of electro-deposition of ZnO were determined using the cyclic voltammetry. From the Mott-Schottky measurements, the flat-band potential and the donor density for the ZnO nanostructure are determined. Field emission scanning electron microscopy (FESEM) images showed different sizes and morphologies of the nanostructures which depends on the concentrations of Cl-. Very netted hexagonal grains are observed for the nanostructures deposited at 0.1M of KCl. X-ray diffraction (XRD) study confirms the Wurtzite phase of the ZnO nanostructures with a preferred oriented along (002) plane normal to the substrate surface. UV-Visible spectra showed a significant optical transmission (~80%), which decreased with low Cl-1 concentrations. The energy band gap values have been estimated to be between 3.52 and 3.80 eV.

Keywords: Cl-, electro-deposition, FESEM, Mott-Schottky, XRD, ZnO

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1403 Effect of Rehabilitation on Outcomes for Persons with Traumatic Brain Injury: Results from a Single Center

Authors: Savaş Karpuz, Sami Küçükşen

Abstract:

The aim of this study is to investigate the effectiveness of neurological rehabilitation in patients with traumatic brain injury. Participants were 45 consecutive adults with traumatic brain injury who were received the neurologic rehabilitation. Sociodemographic characteristics of the patients, the cause of the injury, the duration of the coma and posttraumatic amnesia, the length of stay in the other inpatient clinics before rehabilitation, the time between injury and admission to the rehabilitation clinic, and the length of stay in the rehabilitation clinic were recorded. The differences in functional status between admission and discharge were determined with Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Functional Ambulation Scale (FAS) and levels of cognitive functioning determined with Ranchos Los Amigos Scale (RLAS). According to admission time, there was a significant improvement identified in functional status of patients who had been given the intensive in-hospital cognitive rehabilitation program. At discharge time, the statistically significant differences were obtained in DRS, FIM, FAS and RLAS scores according to admission time. Better improvement in functional status was detected in patients with lower scores in DRS, and higher scores FIM and RLAS scores at the entry time. The neurologic rehabilitation significantly affects the recovery of functional status after traumatic brain injury.

Keywords: traumatic brain injury, rehabilitation, functional status, neurological

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1402 Interpretation of Medical Negligence under Consumer Laws

Authors: Ashfaq M. Naikwadi

Abstract:

Decided cases of medical negligence, mostly are not settled in the lower courts. Majority of them reach up to the apex courts. This is mostly due to different interpretations of the term medical negligence. After studying various cases of medical negligence it is found that in most of the cases the doctors/hospitals are not held liable. There are different interpretations of law concerning medical services. Globally the principles deciding medical negligence are same, viz. Legal duty of care - breach of that duty - direct causation resulting in damages. Since ordinary negligence is not punishable by law, doctors/hospitals have defenses to save themselves from liability. Complaints of negligence come to the courts whose judges mostly are not oriented with medical services or health sciences. Matters of medical negligence are decided on the basic principles of reasonableness and prudence or by relying on the expert’s opinion. Deciding reasonableness or prudence is a complex issue in case of medical services. Again expert opinion is also questionable as an expert in case of medical negligence is appointed from the same field and same faculty. There is a chance of favoritism to the doctor/hospital. The concept of vicarious liability is not widely applied to in many of the medical negligence cases. Established cases used as precedents were studied to understand the basic principles in deciding medical negligence. This paper evaluates the present criteria in interpreting medical negligence and concludes with suggesting reforms required to be made in deciding matters of medical negligence under the consumer laws.

Keywords: consumer, doctors, laws, medical negligence

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1401 Study of Some Biological Profiles as Limiting Factors of Male Fertility in the Region of Batna, Algeria

Authors: Bousnane Nour El Houda, Chennaf Ali, Yahia Mouloud, Benbia Souhila

Abstract:

Male infertility or the inability of a man to procreate is a major public health problem, where it is a leading cause of marital discord in several countries such Algeria. The objective of this work is to study some biological profiles of infertile men from the city of Batna/Algeria and to identify the causes of infertility in a population of infertile males to improve its management and to establish a good therapeutic strategy through a study that lasted 10 months in the Department of Urology of the University Hospital of Banta and on a population of 140 infertile subjects. For every man, series of assessments was performed to determine the exact causes of infertility. We found 102 cases of primary infertility against 38 cases of secondary infertility; the average age of men was 39.7 years, with a predominance of the age group (46-50 years). 34.29% of subjects had genital infections against 17.14% with varicocele. 132 men presented spermiologiques abnormalities; a asthénospermie (AS) in 27.27% of the cases, astheno-terato spermiea (OATS) 11.36% while Azoospermes showed 5.07%. Genital infections are the main causes of infertility (34.29%) of the cases. The results of spermocytogramme showed a predominance of head abnormalities (41.70%), while the flagellum abnormalities presented 33.83%. The dosage of the seminal plasma carnitine showed no pathological cases, which makes it difficult to know their association with infertility. By against some disturbances Fructose and Zinc have been reported.

Keywords: male infertility, spermogramme, spermocytogramme, biological profils

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1400 Review of Correlation between Tacrolimus Pharmacotherapy and Infection after Organ Transplantation

Authors: Zahra Tolou-Ghamari

Abstract:

Introduction: After allogeneic organ transplantation, in order to lower the rate of rejectiontacrolimus is given. In fact, infection is reported as the most complication of tacrolimus that might be associated with higher susceptibility by its’ long term use. Aim: This study aims to review the association between the occurrence of infections after organ transplantation following the administration of tacrolims. Materials and Methods: Scientific literature on the pharmacotherapy of tacrolimus after organ transplantation and infections were searched using PUBMED.Gov (https://pubmed.ncbi.nlm.nih.gov/), Web of Science, and Scopus. Results: In order to prevent acute and chronic rejection, the potent immunosuppressive drug tacrolimus administered as a calcineurin inhibitor after organ transplantation. Its’ most frequent infectious complication is reported as urinary tract infection. Virulent strain of recombinant Literiamonocytogenes, in addition to an increase in bacterial burden in the liver and spleen tissues, was reported in the animal experimental study. The consequence of aggressive events and recipients total area under the cureve exposure to immunosuppressive could be as considered as surrogate markers for individual infection’s risk evaluation. Conclusion: Transplant surgery and duration of hospital stay could determinate the risk of infection during the first month of organ transplantation. Despite administration of antiviral drugs, opportunistic infection such as cytomegalovirus could increase the risk of infection during month 1 to year after transplantation.

Keywords: transplant, infection, tacrolimus, kidney

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1399 Vietnamese Indigenous Healing’s Implication for Vietnamese Women Counseling in Korea

Authors: Youngsub Oh, Youngsoon Kim

Abstract:

As the second largest group among international marriages in Korea, Vietnamese married immigrant women have been exposed to psychological crisis like divorce and family violence. The purpose of this study is to understand how to counsel those women from the perspective of indigenous healing as their own psychological problem-solving way. To this end, this study reviewed Vietnamese cultural literatures on their mentality as well as Vietnamese medical literatures on indigenous healing. The research results are as follows: First, cultural foundations that have formed Vietnamese mentality are Confucian value system, reserved communication, and religious pluralism. These cultural backgrounds play an important role in understanding their own therapeutic tradition. Second, Vietnamese indigenous healing considers cause of mental disease as a collapse of balance between mind and body and environment. Thus, indigenous treatment deals with psychological problems through a recovery of the balance from the holistic perspective. In fact, indigenous healing has been actively practiced in everyday place as well as hospital until today. The implications of Vietnamese indigenous healing for multicultural counseling in Korea are as follows: First, Korean counselors need to interactively understand their own assumptions on indigenous healing as well as counselees’ own assumptions. Second, a variety of psychological intervention strategies can be drawn from Vietnamese indigenous healing. Third, indigenous healing needs to be integrated with modern techniques of counseling and psychotherapy, as both treatments are not mutually exclusive but complementary.

Keywords: indigenous healing, Korea, multicultural counseling, Vietnamese married immigrant women

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1398 Comparative Study of Dose Calculation Accuracy in Bone Marrow Using Monte Carlo Method

Authors: Marzieh Jafarzadeh, Fatemeh Rezaee

Abstract:

Introduction: The effect of ionizing radiation on human health can be effective for genomic integrity and cell viability. It also increases the risk of cancer and malignancy. Therefore, X-ray behavior and absorption dose calculation are considered. One of the applicable tools for calculating and evaluating the absorption dose in human tissues is Monte Carlo simulation. Monte Carlo offers a straightforward way to simulate and integrate, and because it is simple and straightforward, Monte Carlo is easy to use. The Monte Carlo BEAMnrc code is one of the most common diagnostic X-ray simulation codes used in this study. Method: In one of the understudy hospitals, a certain number of CT scan images of patients who had previously been imaged were extracted from the hospital database. BEAMnrc software was used for simulation. The simulation of the head of the device with the energy of 0.09 MeV with 500 million particles was performed, and the output data obtained from the simulation was applied for phantom construction using CT CREATE software. The percentage of depth dose (PDD) was calculated using STATE DOSE was then compared with international standard values. Results and Discussion: The ratio of surface dose to depth dose (D/Ds) in the measured energy was estimated to be about 4% to 8% for bone and 3% to 7% for bone marrow. Conclusion: MC simulation is an efficient and accurate method for simulating bone marrow and calculating the absorbed dose.

Keywords: Monte Carlo, absorption dose, BEAMnrc, bone marrow

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1397 Status and Image of the Nurse as Perceived by the Public

Authors: Salam Hadid, Mohammad Khatib

Abstract:

The International Council of Nurses-ICN defined nursing as a sphere integrating autonomous and collaborative care intended for the individual, family and community within and outside of the care setting. Nursing as a care profession has developed broadly over recent decades in terms of its essentials, expertise and primarily academically. Despite the impressive growth of the profession, there is still extreme diversity in the public’s perceptions and opinions of the profession and its professionals and in the knowledge on the fundamentals of its true function and spheres of engagement. The current study examines the existing knowledge among the general population regarding the nursing profession. The population consisted of 498 respondents, 236 women and 262 men, age 18-81. The respondents noted that nursing focuses on the technical, and the emotional aspects and promotion of health for the patient are not the nurse’s responsibility. Most of the respondents saw nurses working mainly in hospital and community-based clinic settings. They considered nursing to be a high prestige profession in general, but less prestigious among respondents exposed to healthcare provision. Most of the respondents considered nursing to be a humane profession but without independence and with no need for academic studies. The findings are incompatible with the definition of nursing and its spheres of action as defined in the ICN Code of Ethics. Two suggestions are to work through nursing schools addressing the student nurses, as ambassadors for the profession. The second is using the healthcare encounter between the nursing staff and the public to improve the image of nurses.

Keywords: ethics, nurse image, public, nursing

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1396 An Advanced Method of Plant Preservation and Colour Retention of Herbarium Specimens

Authors: Abduraheem K., Suboohi Nasrin

Abstract:

Herbaria are specimens of preserved plants, which are very delicate and cellulosic in nature. While these collections are very useful for the enrichment of knowledge and are considered as natural heritage of our entire world, it is very important to preserve and conserve them. The significance is not only to prevent the herbaria from the deterioration of biological agencies but also to preserve its colours and retain natural colour. Colour is not only characteristic of a plant, but it can also help to identify closely related species or to distinguish a plant from a collection of herbaria. Keeping this in mind, a selective solution has been prepared for the conservation and preservation of herbarium in the present study. In this, the quantity of all the selected chemicals, i.e., formaldehyde and copper sulphate was kept constant, and the solution was prepared by dissolving it in distilled water by increasing the amount of picric acid (1, 2, 3, 4, and 5 ml). Fresh specimens of roses and bougainvillea were washed with distilled water and kept in the above solution for 10 to 15 minutes at room temperature. After 10 minutes, the specimen was removed from the solution, dried with the help of paper, and then pressed under the plant press. Blotting sheets were used to absorb the moisture content and were changed every 2 to 3 days to protect against fungal growth. The results revealed that all solutions had insecticidal properties and protected the herbarium specimen against pests. While in the case of colour retention, solution-1 and 2 were not satisfactory colour preservation, and solutions-3 and 5 maintained the colour of rose and bougainvillea leaves for 15 to 20 days and for a month, respectively. After that, the colour begins to fade, and the process is faster in rose leaves than in bougainvillea. And it was also observed that the colour of young leaves started to fade before that of older leaves. When the leaves of rose and bougainvillea are treated with Solution-4, then the colour of rose leaves is maintained for six months.

Keywords: solutions, colour retention, preservation and conservation, leaves of roses and bougainvillea

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1395 Design of an Innovative Geothermal Heat Pump with a PCM Thermal Storage

Authors: Emanuele Bonamente, Andrea Aquino

Abstract:

This study presents an innovative design for geothermal heat pumps with the goal of maximizing the system efficiency (COP - Coefficient of Performance), reducing the soil use (e.g. length/depth of geothermal boreholes) and initial investment costs. Based on experimental data obtained from a two-year monitoring of a working prototype implemented for a commercial building in the city of Perugia, Italy, an upgrade of the system is proposed and the performance is evaluated via CFD simulations. The prototype was designed to include a thermal heat storage (i.e. water), positioned between the boreholes and the heat pump, acting as a flywheel. Results from the monitoring campaign show that the system is still capable of providing the required heating and cooling energy with a reduced geothermal installation (approx. 30% of the standard length). In this paper, an optimization of the system is proposed, re-designing the heat storage to include phase change materials (PCMs). Two stacks of PCMs, characterized by melting temperatures equal to those needed to maximize the system COP for heating and cooling, are disposed within the storage. During the working cycle, the latent heat of the PCMs is used to heat (cool) the water used by the heat pump while the boreholes independently cool (heat) the storage. The new storage is approximately 10 times smaller and can be easily placed close to the heat pump in the technical room. First, a validation of the CFD simulation of the storage is performed against experimental data. The simulation is then used to test possible alternatives of the original design and it is finally exploited to evaluate the PCM-storage performance for two different configurations (i.e. single- and double-loop systems).

Keywords: geothermal heat pump, phase change materials (PCM), energy storage, renewable energies

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1394 An Unusual Presentation of Uveal Melanoma

Authors: Natasha Goh, Sebastian Brown

Abstract:

Purpose: This case report describes an unusual presentation of uveal melanoma. Method: Case notes, imaging, and histopathological specimen were reviewed for this case report. Result: The patient is a 62-year-old lady of Chinese heritage who had been receiving follow-up at the eye clinic of a tertiary hospital. She had a longstanding history of poor vision in her right eye after sustaining trauma to the eye at age 3. She was found to have a carotid-cavernous sinus fistula in the right eye in 2009 and underwent stenting in China. Unfortunately, this was unsuccessful and resulted in a painful blind eye. She had represented with headaches, worsening eye pain, and ptosis in Sydney in 2016. Her CT angiogram showed a calcified vascular structure in the orbit and globe, and she was offered a digital subtraction angiography by the neurosurgical team, which she ultimately declined. She had since been followed up at the eye clinic for the pthisical eye. Due to chronic ocular pain and recurrent conjunctivitis, the decision was made for an evisceration in 2021. The specimen was sent for routine histopathological examination and returned positive for uveal melanoma. The patient was subsequently referred to a melanoma center for further follow-up, which comprised serial imaging and radiotherapy treatment. Conclusion: Clinicians should bear in mind that uveal melanomas may present in a longstanding phthisical eye and in patients with no or little apparent risk factors.

Keywords: uveal melanoma, pthisical eye, carotid cavernous fistula, uveal melanoma risk factors

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