Search results for: oral delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2942

Search results for: oral delivery

842 Importance of Field Hospitals in Trauma Management: An Experience from Nepal Earthquake

Authors: Krishna Gopal Lageju

Abstract:

On 25th April 2015, a 7.6 magnitude earthquake struck Gorkha district of Nepal, which resulted over 8,790 deaths and 22,300 injuries. In addition, almost one-third of the country’s healthcare service has been disrupted. A total of 1,211 health facilities became non-operational, due to 446 completely and other 765 partially damaged. Nearly 84 percent (375 out of 446) of the completely damaged health facilities are in the 14 most affected districts. As a result, the ability of health facilities to respond to health care needs has been harshly affected. In addition, 18 health workers lost their lives and 75 are injured, which added further challenges in the delivery of health services. Thus, to address the immediate health needs in the most devastated areas, Nepal Red Cross Society (NRCS) in coordination with IFRC and Nepal Government, 8 Field hospitals established with surgical capacities, where around 492 international Emergency Response Units (ERUs) Members are mobilized for 3 months period. More than 54,000 patients have been treated in the Red Cross operated field hospitals. Trauma cases accounted 9,180 (17%) of the total patients off which 1,285 (14%) are major surgical cases. Most of the case loads 44,830 (83%) are outpatients and 9,180 patients got inpatients service. Similarly, 112 births have been performed in the field hospitals. Inpatient mortality rate remained 1.5% (21 deaths), many of them are presented with critical injuries or illnesses. No outbreak has been seen during the ERU operation. Deployment of ERUs together with national health workers are very important to address the immediate health needs of the affected communities. This will ease for transition and handover of emergency service and equipments to local provider. Likewise, capacity building of local staff as on the job training on various clinical teachings would be another important issue to look at before phasing out such services.

Keywords: trauma management, critical injuries, earthquake, health

Procedia PDF Downloads 236
841 Chrysin-Loaded PLGA-PEG Nanoparticles Designed for Enhanced Inhibitory Effect on the Breast Cancer Cell Line

Authors: Faraz Zarghami, Elham Anari, Nosratollah Zarghami, Yones Pilehvar-Soltanahmadi, Abolfazl Akbarzadeh, Sepideh Jalilzadeh-Tabrizi

Abstract:

The development of nanotherapy has presented a new method of drug delivery targeted directly to the neoplasmic tissues, to maximize the action with fewer dose requirements. In the past two decades, poly(lactic-co-glycolic acid) (PLGA) has frequently been investigated by many researchers and is a popular polymeric candidate, due to its biocompatibility and biodegradability, exhibition of a wide range of erosion times, tunable mechanical properties, and most notably, because it is a FDA-approved polymer. Chrysin is a natural flavonoid which has been reported to have some significant biological effects on the processes of chemical defense, nitrogen fixation, inflammation, and oxidation. However, the low solubility in water decreases its bioavailability and consequently disrupts the biomedical benefits. Being loaded with PLGA-PEG increases chrysin solubility and drug tolerance, and decreases the discordant effects of the drug. The well-structured chrysin efficiently accumulates in the breast cancer cell line (T47D). In the present study, the structure and chrysin loading were delineated using proton nuclear magnetic resonance (HNMR), Fourier-transform infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM), and the in vitro cytotoxicity of pure and nanochrysin was studied by the MTT assay. Next, the RNA was exploited and the cytotoxic effects of chrysin were studied by real-time PCR. In conclusion, the nanochrysin therapy developed is a novel method that could increase cytotoxicity to cancer cells without damaging the normal cells, and would be promising in breast cancer therapy.

Keywords: MTT assay, chrysin, flavonoids, nanotherapy

Procedia PDF Downloads 247
840 Cannabis Sativa L as Natural Source of Promising Anti-Alzheimer Drug Candidates: A Comprehensive Computational Approach Including Molecular Docking, Molecular Dynamics, ADMET and MM-PBSA Studies

Authors: Hassan Nour, Nouh Mounadi, Oussama Abchir, Belaidi Salah, Samir Chtita

Abstract:

Cholinesterase enzymes are biological catalysts essential for the transformation of acetylcholine, which is a neurotransmitter implicated in memory and learning, into acetic acid and choline, altering the neurotransmission process in Alzheimer’s disease patients. Therefore, inhibition of cholinesterase enzymes is a relevant strategy for the symptomatic treatment of Alzheimer’s disease. The current investigation aims to explore potential cholinesterase (ChE) inhibitors through a comprehensive computational approach. Forty-nine phytoconstituents extracted from Cannabis sativa L. were in-silico screened using molecular docking and pharmacokinetic and toxicological analysis to evaluate their possible inhibitory effect on the cholinesterase enzymes. Two phytoconstituents belonging to cannabinoid derivatives were revealed to be promising candidates for Alzheimer's therapy by acting as cholinesterase inhibitors. They have exhibited high binding affinities towards the cholinesterase enzymes and showed their ability to interact with key residues involved in cholinesterase enzymatic activity. In addition, they presented good ADMET profiles allowing them to be promising oral drug candidates. Furthermore, molecular dynamics (MD) simulations were executed to explore their interaction stability under mimetic biological conditions and thus support our findings. To corroborate the docking results, the binding free energy corresponding to the more stable ligand-ChE complexes was re-estimated by applying the MM-PBSA method. MD and MM-PBSA studies affirmed that the ligand-ChE recognition is a spontaneous reaction leading to stable complexes. The conducted investigations have led to great findings that would strongly guide the pharmaceutical industries toward the rational development of potent anti-Alzheimer agents.

Keywords: Alzheimer’s disease, molecular docking, Cannabis sativa L., cholinesterase inhibitors, molecular dynamics, ADMET, MM-PBSA

Procedia PDF Downloads 74
839 A Mixed-Methods Approach to Developing and Evaluating an SME Business Support Model for Innovation in Rural England

Authors: Steve Fish, Chris Lambert

Abstract:

Cumbria is a geo-political county in Northwest England within which the Lake District National Park, a UNESCO World Heritage site is located. Whilst the area has a formidable reputation for natural beauty and historic assets, the innovation ecosystem is described as ‘patchy’ for a number of reasons. The county is one of the largest in England by area and is sparsely populated. This paper describes the needs, development and delivery of an SME business-support programme funded by the European Regional Development Fund, Lancaster University and the University of Cumbria. The Cumbria Innovations Platform (CUSP) Project has been designed to respond to the nuanced needs of SMEs in this locale, whilst promoting the adoption of research and innovation. CUSP utilizes a funnel method to support rural businesses with access to university innovation intervention. CUSP has been built on a three-tier model: Communicate, Collaborate and Create. The paper describes this project in detail and presents results in terms of output indicators achieved, a beneficiary telephone survey and wider economic forecasts. From a pragmatic point-of-view, the paper provides experiences and reflections of those people who are delivering and evaluating knowledge exchange. The authors discuss some of the benefits, challenges and implications for both policy makers and practitioners. Finally, the paper aims to serve as an invitation to others who may consider adopting a similar method of university-industry collaboration in their own region.

Keywords: regional business support, rural business support, university-industry collaboration, collaborative R&D, SMEs, knowledge exchange

Procedia PDF Downloads 113
838 Protective Effect of Probiotic Lactic Acid Bacteria on Thioacetamide-Induced Liver Fibrosis in Rats: Histomorphological Study

Authors: Chittapon Jantararussamee, Malai Taweechotipatr, Udomsri Showpittapornchai, Wisuit Pradidarcheep

Abstract:

Hepatic fibrosis is characterized by collagen accumulation in hepatic lobules following wound healing process. If lefts untreated, it could progress into hepatic cirrhosis, portal hypertension, and liver failure. Probiotics comprise of lactic acid bacteria which are crucial components of the intestinal microflora and possess many beneficial properties. The objective of this study is to investigate the hepatoprotective effects of probiotic lactic acid bacteria (mixture of Lactobacillus paracasei, Lactobacillus casei, and Lactobacillus confusus at a ratio of 1: 1: 1) on thioacetamide-induced liver fibrotic rats in term of histomorphology study. Twenty-four male Wistar rats were randomly divided into four groups with 6 rats each: (A) control, (B) fibrotic, (C) fibrotic+probiotic, and (D) probiotic. Group (A) received daily oral administration of distilled water. Group (B and C) were induced by intraperitoneal injection of thioacetamide (TAA) (200 mg/kg BW) 3 times per week for consecutive 8 weeks. In probiotic-treated group (C and D), the number of a mixture of the viable microbial cells at 10⁹ CFU/ml was administered orally daily. After sacrifice, liver tissues were collected and processed for routine histological technique and stained with Sirius red. It was found that the fibrotic rats showed hepatic injury marked by area of inflammation, hydropic degeneration of hepatocytes, and accumulation of myofibroblast-like cells. The collagen fibers were substantially accumulated in the hepatic lobules. Moreover, probiotic-treated group significantly reduced the accumulation of collagen in rats treated by TAA. The liver damage was found to be lesser in the probiotic-treated group. It was noted that the liver tissues of control and probiotics groups were shown to be normal. Administration with probiotic lactic acid bacteria could improve the histomorphology in fibrotic liver and be useful for prevention of hepatic disorders.

Keywords: liver fibrosis, probiotics, lactic acid bacteria, thioacetamide

Procedia PDF Downloads 123
837 The Impact of Smart Educational Aids in Learning Listening Among Pupils with Attention and Listening Problems

Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Aayah Al Yaari, Ayman Al Yaari, Montaha Al Yaari, Sajedah Al Yaari, Fatehi Eissa

Abstract:

The recent rise of smart educational aids and the move away from traditional listening aids are leading to a fundamental shift in the way in which individuals with attention and listening problems (ALP) manipulate listening inputs and/or act appropriately to the spoken information presented to them. A total sample of twenty-six ALP pupils (m=20 and f=6) between 7-12 years old was selected from different strata based on gender, region and school. In the sample size, thirteen (10 males and 3 females) received the treatment in terms of smart classes provided with smart educational aids in a listening course that lasted for four month-semester while others did not (they studied the same course by the same instructor but in ordinary class). A pretest was administered to assess participants’ levels, and a posttest was given to evaluate their attention and listening comprehension performance, namely in phonetic and phonological tests with sociolinguistic themes that have been designed for this purpose. Test results were analyzed both psychoneurolinguistically and statistically. Results reveal a remarkable change in pupils’ behavioral listening where scores witnessed a significant difference in the performance of the experimental ALP group in the pretest compared to the posttest (Pupils performed better at the pretest-posttest on phonetics than at the two tests on phonology). It is concluded that smart educational aids designed for listening skills help not only increase the listening command of pupils with ALP to understand what they listen to but also develop their interactive listening capability and, at the same rate, are responsible for increasing concentrated and in-depth listening capacity. Plus, ALP pupils become able to grasp the audio content of text recordings, including educational audio recordings, news, oral stories and tales, views, spiritual/religious text and general knowledge. However, the pupils have not experienced individual smart audio-visual aids that connect listening to other language receptive and productive skills, which could be the future area of research.

Keywords: language skills, implementing, listening skill, attention, smart aids

Procedia PDF Downloads 37
836 Chitosan Doped Curcumin Gold Clusters Flexible Nanofiber for Wound Dressing and Anticancer Activities

Authors: Saravanan Govindaraju, Kyusik Yun

Abstract:

The purpose of this study is to develop the chitosan doped curcumin gold cluster nanofiber for wound healing and skin cancer drug delivery applications. Chitosan is a typical marine polysaccharide composed of glucosamine and n-acetyl glucosamine biodegradable and biocompatible polymer. Curcumin is a natural bioactive molecule obtained from Curcuma longo, it mostly occurs in some Asian countries like India and China. It has naturally antioxidant, antimicrobial, wound healing and anticancer property. Due to this advantage, we prepared a combination of natural polymer chitosan with Curcumin and gold nanocluster nanofiber (CH-CUR-AuNCs nanofibers). The prepared nanofiber was characterized by using Fourier transform infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM). Antibacterial studies were performed with E.coli and S.aureus. Antioxidant assay, drug release test, and cytotoxicity will be evaluated. Prepared nanofiber emits low intensity of red fluorescent. The FTIR confirm the presence of chitosan and Curcumin in the nanofiber. In vitro study clearly shows the antibacterial activity against the gram negative and gram positive bacteria. Particularly, synthesised nanofibers provide better antibacterial activity against gram negative than gram positive. Cytotoxicity study also provides better killing rate in cancer cell, biocompatible with normal cell. Prepared CH-CUR-AuNCs nanofibers provide the better killing rate to bacterial strains and cancer cells. Finally, prepared nanofiber can be possible to use for wound healing dressing, patch for skin cancer and other biomedical applications.

Keywords: curcumin, chitosan, gold clusters, nanofibers

Procedia PDF Downloads 255
835 Cerebrum Maturity Damage Induced by Fluoride in Suckling Mice

Authors: Hanen Bouaziz, Françoise Croute, Najiba Zeghal

Abstract:

In order to investigate the toxic effects of fluoride on cerebrum maturity of suckling mice, we treated adult female mice of Swiss Albinos strain by 500 ppm NaF in their drinking water from the 15th day of pregnancy until the day 14 after delivery. All mice were sacrificed on day 14 after parturition. During treatment, levels of thiobarbituric acid reactive substances, the marker of lipid peroxidation extend, increased, while the activities of the antioxidant enzymes such as glutathione peroxidase, superoxide dismutase and catalase and the level of glutathione decreased significantly in cerebellum compared with those of the control group. These results suggested that fluoride enhanced oxidative stress, thereby disturbing the antioxidant defense of nursing pups. In addition, acetylcholinesterase activity in cerebellum was inhibited after treatment with fluoride. In cerebellum of mice, migration of neurons from the external granular layer to the internal granular layer occurred postnatally. Key guidance signals to these migrating neurons were provided by laminin, an extracellular matrix protein fixed to the surface of astrocytes. In the present study, we examined the expression and distribution of laminin in cerebellum of 14-day-old mice. Immunoreactive laminin was disappeared by postnatal day 14 in cerebellum parenchyma of control pups and was restricted to vasculature despite the continued presence of granular cells in the external granular layer. In contrast, in cerebellum of NaF treated pups, laminin was deposited in organised punctuate clusters in the molecular layer. These data indicated that the disruption of laminin distribution might play a major role in the profound derangement of neuronal migration observed in cerebellum of NaF treated pups.

Keywords: acetylcholinesterase activity, cerebellum, laminin, oxidative stress, suckling mice

Procedia PDF Downloads 392
834 Effect of Social Stress on Behavioural and Physiological Responses and its Assessment by non-Invasive Method in Zebu Cattle

Authors: Baishali Deb, Hari Om Pandey, Shrilla Elangbam, Mukesh Singh, Ayon Tarafdar, A. K. S. Tomar, A. K. Pandey, Triveni Dutt

Abstract:

The goal of the present investigation was to determine the impact of social stress on behavioural characteristics, physiological responses, and haemato-biochemical indicators under various social environments in Tharparkar cattle. Serum cortisol and faecal cortisol metabolites analysis were used to determine the stress level of Tharparkar cattle. Social isolation and social mixing were the two different social circumstances used to evaluate the animals. In both the experiments i.e., social isolation and social mixing, the lying period of animals decreased significantly (p<0.05) while standing period significantly (p<0.05) increased. Frequency and duration of activities like idling, walking, exploration, oral manipulation, and elimination increased significantly (p<0.05) in Tharparkar cattle after being subjected to social isolation and social mixing. Time spent in grooming (self-grooming and allo-grooming) in respect to social isolation significantly increased during isolation and post-reunion, whereas there was a significant (p<0.05) decline in the grooming behaviour especially allo-grooming during mixing of the animals. Feeding and rumination time also decreased significantly (p<0.05) in animals during both the experiments. Physiological parameters such as respiration rate, heart rate and pulse rate increased during the treatment periods. There was no significant difference in the haematological parameters for both the experiments. There was significant (p<0.05) increase in serum cortisol and faecal cortisol metabolites (FCM) concentration in animals subjected to social stress. Therefore, it can be concluded that social stress strongly impacts the behaviour and physiological parameters of the animals, causing stress and nervousness, proving that social stress is a valid psychological stress in animals. The higher concentration of FCM in Tharparkar cattle subjected to social stress, further supported by higher serum cortisol and behaviour manifestations, suggest that FCM could be used to assess stress response as a non-invasive method.

Keywords: social stress, fecal cortisol metabolites, non-invasive, animal welfare, behaviour

Procedia PDF Downloads 103
833 Development of Electronic Services in Georgia: Analysis of Current Situation

Authors: Dato Surmanidze, Dato Antadze, Tornike Partenadze

Abstract:

Public online services in Georgia are concentrated on main target segments: public administration, business, population, non-governmental and other interested organizations. Therefore, the strategy of digital Georgia is focused on providing G2C, G2B/B2G, G2NGO and G2G services. In G2C framework sophisticated and high-technological online services have been developed in order to provide passports, identity cards, documentations concerning residence and civil acts (birth, marriage, divorce, child adoption, change of name and surname, death, etc) as well as other services. Websites like my.gov.ge and sda.gov.ge have distance services like electronic application, processing and decision making. In line with international standards automatic services like electronic tenders, product catalogues, invoices and payment have been developed. This creates better investment climate for foreign companies in Georgia in the framework of G2B politics. The website mybusiness.gov.ge creates better conditions for local business. Among electronic services is e-NRMS (electronic system for national resource management) which was introduced by the Ministry of Finance of Georgia. The system was created in order to ensure management of national resources by state and business organizations. It is integrated with bank services and provides G2C, G2B and B2G representatives with electronic services. Also a portal meteo.gov.ge was created which gives electronic services concerning air, geological, environmental and pollution issues. Also worknet.gov.ge should be mentioned which is an electronic hub of information management for employers and employees. The information portal of labor market will facilitate receipt of information, its analysis and delivery to interested people like employers and employees. However, nowadays it’s been two years that only employees portal is activated. Therefore, awareness about the portal, its competitiveness and success is undermined.

Keywords: electronic services, public administration, information technology, information society

Procedia PDF Downloads 264
832 Investigating the Suitability of Utilizing Lyophilized Gels to Improve the Stability of Ufasomes

Authors: Mona Hassan Aburahma, Alaa Hamed Salama

Abstract:

Ufasomes “unsaturated fatty acids liposomes” are unique nano-sized self-assembled bilayered vesicles that can be easily created from the readily available unsaturated fatty acid. Ufasomes are formed due to weak associative interaction of the fully ionized and unionized fatty acids into bilayers structures. In the ufasomes constructs, the fatty acid molecules are oriented with their hydrocarbon tails directed toward the membrane interior and the carboxyl groups are in contact with water. Although ufasomes can be employed as a safe vesicular carrier for drugs, the extreme instability of their aqueous dispersions hinders their effective use in drug delivery field. Accordingly, in our study, lyophilized gels containing ufasomes were prepared using a simple assembling technique form the readily available oleic acid to overcome the colloidal instability of the ufasomes dispersions and convert them into accurate unit dosage forms. The influence of changing cholesterol percentage relative to oleic acid on the ufasomes vesicles were investigated using factorial design. The optimized oleic acid ufasomes comprised nanoscaled spherical vesicles. Scanning electron micrographs of the lyophilized gels revealed that the included ufasomes were intact, non-aggregating, and preserved their spherical morphology. Rheological characterization (viscosity and shear stress versus shear rate) of reconstituted ufasomal lyophilized gel ensured the ease of application. The capability of the ufasomes, included in the gel, to penetrate deep through the mucosa layers was illustrated using ex-vivo confocal laser imaging, thereby, highlighting the feasibility of stabilizing ufasomes using lyophilized gel platforms.

Keywords: ufasomes, lyophilized gel, confocal scanning microscopy, rheological characterization, oleic acid

Procedia PDF Downloads 399
831 Evaluation of Complications Observed in Porcelain Fused to Metal Crowns Placed at a Teaching Institution

Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

Abstract:

Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

Procedia PDF Downloads 197
830 Unfolding the Affective Atmospheres during the COVID-19 Pandemic Crisis: The Constitution and Performance of Affective Governance in Taiwan

Authors: Sang-Ju Yu

Abstract:

This paper examines the changing essences and effects of ‘affective atmosphere’ during the COVID-19 pandemic crisis, which have been facilitated and shaped the ‘affective governance’ in Taiwan. Due to long-term uncertainty and unpredictability, the COVID-19 pandemic not only caused unprecedented global crisis but triggered the public’s negative emotional responses. This paper unravels how the shortage of Personal Protective Equipment and the proliferating fake news heightened people’s fear and anxiety and how specific affective atmospheres can be provoked and manipulated to harness emotional appeals of citizens strategically in Taiwan. Through the in-depth interviews with diverse stakeholders involved, it unfolds the dynamics and strategies of affective governance, wherein public emotions and concerns are now given significant consideration in both policy measures and the affective expression of leadership, spatial arrangement, service delivery, and the interaction with citizens. Addressing psychosocial and emotional needs has become the core of crisis response mechanisms suited to dynamic affective atmospheres and pandemic situation. This paper also demonstrates that epidemic prevention and control is not merely the production of neutral or rational policy-making processes, as it is dominated by multiple emotions resulted from unexpected and salient events at different moments. It provides explicit insight into how different prevention scenarios operated effectively through political and affective mobilisation to strengthen emotional bonding and collective identity which energises collective action. Basically, successful affective governance calls for both negative and positive emotions, for both scientific and political decision-making, for both community and bureaucracy, and both quality and efficiency of private–public collaboration.

Keywords: affective atmospheres, affective governance, COVID-19 pandemic, private-public collaboration

Procedia PDF Downloads 88
829 Nursing Documentation of Patients' Information at Selected Primary Health Care Facilities in Limpopo Province, South Africa: Implications for Professional Practice

Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

Abstract:

Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

Procedia PDF Downloads 182
828 Comparative Analysis of Data Gathering Protocols with Multiple Mobile Elements for Wireless Sensor Network

Authors: Bhat Geetalaxmi Jairam, D. V. Ashoka

Abstract:

Wireless Sensor Networks are used in many applications to collect sensed data from different sources. Sensed data has to be delivered through sensors wireless interface using multi-hop communication towards the sink. The data collection in wireless sensor networks consumes energy. Energy consumption is the major constraints in WSN .Reducing the energy consumption while increasing the amount of generated data is a great challenge. In this paper, we have implemented two data gathering protocols with multiple mobile sinks/elements to collect data from sensor nodes. First, is Energy-Efficient Data Gathering with Tour Length-Constrained Mobile Elements in Wireless Sensor Networks (EEDG), in which mobile sinks uses vehicle routing protocol to collect data. Second is An Intelligent Agent-based Routing Structure for Mobile Sinks in WSNs (IAR), in which mobile sinks uses prim’s algorithm to collect data. Authors have implemented concepts which are common to both protocols like deployment of mobile sinks, generating visiting schedule, collecting data from the cluster member. Authors have compared the performance of both protocols by taking statistics based on performance parameters like Delay, Packet Drop, Packet Delivery Ratio, Energy Available, Control Overhead. Authors have concluded this paper by proving EEDG is more efficient than IAR protocol but with few limitations which include unaddressed issues likes Redundancy removal, Idle listening, Mobile Sink’s pause/wait state at the node. In future work, we plan to concentrate more on these limitations to avail a new energy efficient protocol which will help in improving the life time of the WSN.

Keywords: aggregation, consumption, data gathering, efficiency

Procedia PDF Downloads 487
827 A Study on Pattern of Acute Poisoning in Patients Admitted to Emergency Wards in a Tertiary Care Hospital

Authors: Sathvika Reddy, Devi Revathi

Abstract:

Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

Procedia PDF Downloads 158
826 Natural Gas Flow Optimization Using Pressure Profiling and Isolation Techniques

Authors: Syed Tahir Shah, Fazal Muhammad, Syed Kashif Shah, Maleeha Gul

Abstract:

In recent days, natural gas has become a relatively clean and quality source of energy, which is recovered from deep wells by expensive drilling activities. The recovered substance is purified by processing in multiple stages to remove the unwanted/containments like dust, dirt, crude oil and other particles. Mostly, gas utilities are concerned with essential objectives of quantity/quality of natural gas delivery, financial outcome and safe natural gas volumetric inventory in the transmission gas pipeline. Gas quantity and quality are primarily related to standards / advanced metering procedures in processing units/transmission systems, and the financial outcome is defined by purchasing and selling gas also the operational cost of the transmission pipeline. SNGPL (Sui Northern Gas Pipelines Limited) Pakistan has a wide range of diameters of natural gas transmission pipelines network of over 9125 km. This research results in answer a few of the issues in accuracy/metering procedures via multiple advanced gadgets for gas flow attributes after being utilized in the transmission system and research. The effects of good pressure management in transmission gas pipeline network in contemplation to boost the gas volume deposited in the existing network and finally curbing gas losses UFG (Unaccounted for gas) for financial benefits. Furthermore, depending on the results and their observation, it is directed to enhance the maximum allowable working/operating pressure (MAOP) of the system to 1235 PSIG from the current round about 900 PSIG, such that the capacity of the network could be entirely utilized. In gross, the results depict that the current model is very efficient and provides excellent results in the minimum possible time.

Keywords: natural gas, pipeline network, UFG, transmission pack, AGA

Procedia PDF Downloads 89
825 Associations between Sleep Problems and Disordered Eating in Japanese Adolescents: A Cross-Sectional Study

Authors: Takaharu Hirai, Yuta Mitobe, Hiromi Hirai

Abstract:

Introduction: Eating disorders (ED) are serious psychiatric disorders that affect individuals, especially adolescents. It has been suggested that nonclinical ED-like characteristics are related to sleep problems. However, studies exploring the association between potential ED and sleep disorders have primarily been conducted in Europe and the United States. We conducted a survey of Japanese adolescents to investigate this claim. Method: In this cross-sectional study, 398 school-aged adolescents, aged 12–18 years old, matched for gender ratio, responded to a self-administered questionnaire survey. We used the Eating Attitudes Test-26 (EAT-26) and the Athens Insomnia Scale (AIS) to measure potential ED and sleep problems, respectively. In this study, participants with an EAT-26 total score of 0–19 points were classified as non-ED, while those with scores of 20 points or higher were classified as potential ED. Result: Of the 398 participants, 17 (4.3%) had an EAT-26 total score of 20 or higher. Among boys, the rate was 6 of 199 participants (3%), and among girls, the rate was 11 of 182 participants (6%). There were 89 participants (22.4%) with an AIS score of 6 points or higher, of which 36 (17.6%) were boys, and 53 (27.5%) were girls. Adolescents with potential ED had significantly higher rates of daytime sleep problems than those without ED. Further, while examining the types of sleep problems, adolescents with potential ED had greater problems with a sense of well-being and physical and mental functioning during the day. In contrast, no significant associations were found between potential ED and sleep initiation, awakenings during the night, early morning awakening, total sleep duration, or overall quality of sleep. Finally, nocturnal and daytime sleep scores were significantly associated with dieting, bulimia, and oral control EAT-26 sub-scores. Discussion: While Japanese adolescents with possible ED do not experience nighttime sleep problems, they do experience problems related to well-being and mental and physical functioning, which are indicators of daytime sleep problems. This may assist with early detection of disordered eating in adolescents. The study suggested that professionals working towards adolescent mental health issues need an approach that comprehensively integrates both sleep problems and potential ED.

Keywords: adolescents, potential eating disorders, sleep problems, eating attitudes test-26

Procedia PDF Downloads 169
824 Analysis of the Effect of Increased Self-Awareness on the Amount of Food Thrown Away

Authors: Agnieszka Dubiel, Artur Grabowski, Tomasz Przerywacz, Mateusz Roganowicz, Patrycja Zioty

Abstract:

Food waste is one of the most significant challenges humanity is facing nowadays. Every year, reports from global organizations show the scale of the phenomenon, although society's awareness is still insufficient. One-third of the food produced in the world is wasted at various points in the food supply chain. Wastes are present from the delivery through the food preparation and distribution to the end of the sale and consumption. The first step in understanding and resisting the phenomenon is a thorough analysis of the everyday behaviors of humanity. This concept is understood as finding the correlation between the type of food and the reason for throwing it out and wasting it. Those actions were identified as a critical step in the start of work to develop technology to prevent food waste. In this paper, the problem mentioned above was analyzed by focusing on the inhabitants of Central Europe, especially Poland, aged 20-30. This paper provides an insight into collecting data through dedicated software and an organized database. The proposed database contains information on the amount, type, and reasons for wasting food in households. A literature review supported the work to answer research questions, compare the situation in Poland with the problem analyzed in other countries, and find research gaps. The proposed article examines the cause of food waste and its quantity in detail. This review complements previous reviews by emphasizing social and economic innovation in Poland's food waste management. The paper recommends a course of action for future research on food waste management and prevention related to the handling and disposal of food, emphasizing households, i.e., the last link in the supply chain.

Keywords: food waste, food waste reduction, consumer food waste, human-food interaction

Procedia PDF Downloads 111
823 Ethnobotanical Medicines for Treating Snakebites among the Indigenous Maya Populations of Belize

Authors: Kerry Hull, Mark Wright

Abstract:

This paper brings light to ethnobotanical medicines used by the Maya of Belize to treat snake bites. The varying ecological zones of Belize boast over fifty species of snakes, nine of which are poisonous and dangerous to humans. Two distinct Maya groups occupy neighboring regions of Belize, the Q’eqchi’ and the Mopan. With Western medical care often far from their villages, what traditional methods are used to treat poisonous snake bites? Based primarily on data gathered with native consultants during the authors’ fieldwork with both groups, this paper details the ethnobotanical resources used by the Q’eqchi’ and Mopan traditional healers. The Q’eqchi’ and Mopan most commonly rely on traditional ‘bush doctors’ (ilmaj in Mopan), both male and female, and specialized ‘snake doctors’ to heal bites from venomous snakes. First, this paper presents each plant employed by healers for bites for the nine poisonous snakes in Belize along with the specific botanical recipes and methods of application for each remedy. Individual chemical and therapeutic qualities of some of those plants are investigated in an effort to explain their possible medicinal value for different toxins or the symptoms caused by those toxins. In addition, this paper explores mythological associations with certain snakes that inform local understanding regarding which plants are considered efficacious in each case, arguing that numerous oral traditions (recorded by the authors) help to link botanical medicines to episodes within their mythic traditions. Finally, the use of plants to counteract snakebites brought about through sorcery is discussed inasmuch as some snakes are seen as ‘helpers’ of sorcerers. Snake bites given under these circumstances can only be cured by those who know both the proper corresponding plant(s) and ritual prayer(s). This paper provides detailed documentation of traditional ethnomedicines and practices from the dying art of traditional Maya healers and argues for multi-faceted diagnostic techniques to determine toxin severity, the presence or absence of sorcery, and the appropriate botanical remedy.

Keywords: ethnobotany, Maya, medicine, snake bites

Procedia PDF Downloads 234
822 Reinforcement-Learning Based Handover Optimization for Cellular Unmanned Aerial Vehicles Connectivity

Authors: Mahmoud Almasri, Xavier Marjou, Fanny Parzysz

Abstract:

The demand for services provided by Unmanned Aerial Vehicles (UAVs) is increasing pervasively across several sectors including potential public safety, economic, and delivery services. As the number of applications using UAVs grows rapidly, more and more powerful, quality of service, and power efficient computing units are necessary. Recently, cellular technology draws more attention to connectivity that can ensure reliable and flexible communications services for UAVs. In cellular technology, flying with a high speed and altitude is subject to several key challenges, such as frequent handovers (HOs), high interference levels, connectivity coverage holes, etc. Additional HOs may lead to “ping-pong” between the UAVs and the serving cells resulting in a decrease of the quality of service and energy consumption. In order to optimize the number of HOs, we develop in this paper a Q-learning-based algorithm. While existing works focus on adjusting the number of HOs in a static network topology, we take into account the impact of cells deployment for three different simulation scenarios (Rural, Semi-rural and Urban areas). We also consider the impact of the decision distance, where the drone has the choice to make a switching decision on the number of HOs. Our results show that a Q-learning-based algorithm allows to significantly reduce the average number of HOs compared to a baseline case where the drone always selects the cell with the highest received signal. Moreover, we also propose which hyper-parameters have the largest impact on the number of HOs in the three tested environments, i.e. Rural, Semi-rural, or Urban.

Keywords: drones connectivity, reinforcement learning, handovers optimization, decision distance

Procedia PDF Downloads 103
821 Highway Waste Management in Zambia Policy Preparedness and Remedies: The Case of Great East Road

Authors: Floyd Misheck Mwanza, Paul Boniface Majura

Abstract:

The paper looked at highways/ roadside waste generation, disposal and the consequent environmental impacts. The dramatic increase in vehicular and paved roads in the recent past in Zambia, has given rise to the indiscriminate disposal of litter that now poses a threat to health and the environment. Primary data was generated by carrying out oral interviews and field observations for holistic and in–depth assessment of the environment and the secondary data was obtained from desk review method, information on effects of roadside wastes on environment were obtained from relevant literatures. The interviews were semi structured and a purposive sampling method was adopted and analyzed descriptively. The results of the findings showed that population growth and unplanned road expansion has exceeded the expected limit in recent time with resultant poor system of roadside wastes disposal. Roadside wastes which contain both biodegradable and non-biodegradable roadside wastes are disposed at the shoulders of major highways in temporary dumpsites and are never collected by a road development agency (RDA). There is no organized highway to highway or street to street collection of the wastes in Zambia by the key organization the RDA. The study revealed that roadside disposal of roadside wastes has serious impacts on the environment. Some of these impacts include physical nuisance of the wastes to the environment, the waste dumps also serve as hideouts for rodents and snakes which are dangerous. Waste are blown around by wind making the environment filthy, most of the wastes are also been washed by overland flow during heavy downpour to block drainage channels and subsequently lead to flooding of the environment. Most of the non- biodegradable wastes contain toxic chemicals which have serious implications on the environmental sustainability and human health. The paper therefore recommends that Government/ RDA should come up with proper orientation and environmental laws should be put in place for the general public and also to provide necessary facilities and arrange for better methods of collection of wastes.

Keywords: biodegradable, disposal, environment, impacts

Procedia PDF Downloads 335
820 Treatment of Porphyromonas gingivalis Induced Gingivitis in Albino Rats with Tetracycline-Loaded Nanochitosan, an Immunohistochemical Analysis

Authors: Rania Hanafi Said, Rasha Mohamed Taha

Abstract:

Background: By using nanoparticles as drug delivery, it may be possible to avoid the drawbacks of systemic antibiotic dosing, including bacterial antibiotic resistance. The goal of this study was to see how well tetracycline loaded on nanochitosan worked to treat gingival inflammation in albino rats caused by Porphyromonas gingivalis. The study analyzed immunohistochemically the localization of the pro-inflammatory cytokine Interleukin-1beta (IL-1β). Material and methods: In this study, fifty mature male albino rats weighing 150 to 180 grams each were used. They were randomly divided into five groups. We checked for weight changes in rats. Ten male albino rats were included in Group I, which served as a negative control group. Ten rats were included in Group II, where they were exposed once to Porphyromonas. Group III contained ten rats, which were treated the same as Group II plus daily injections of diluted tetracycline powder at the infection sites. Ten rats in Group IV received the same procedure as those in Group II before receiving daily injections of nanochitosan at the injection sites. Finally, Group V, which had ten rats. Following the same protocol as Group II, they received localized injections of tetracycline loaded on nanochitosan once daily. Rats' gingivae were extracted and prepared after they were anesthetized. The biopsies were examined histologically and immunohistochemically by light microscopy. Results: Groups I and V had a nearly normal histological appearance of gingival tissue. In Groups II, III, and IV, degeneration was seen because the epithelial cells were bigger, collagen fibers were pulling away from the lamina propria connective tissue, and the basement membranes had come to an end. There was no discernible difference between groups V and I when they were examined immunohistochemically. Conclusion: The use of nano chitosan as a tetracycline carrier is a novel technique to overcome the drug's rising level of resistance.

Keywords: Immunohistochemistry, Nanochitosan, porphyromonas gingivitis, Tetracycline

Procedia PDF Downloads 77
819 The Development of Nursing Model for Pregnant Women to Prevention of Early Postpartum Hemorrhage

Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

Abstract:

Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

Procedia PDF Downloads 94
818 Attraction and Retention of Newly Graduated Medical Doctors to Deprived Regions in Ghana: A Qualitative Case Study

Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

Abstract:

Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

Procedia PDF Downloads 103
817 Preparation and Optimization of Curcumin-HPβCD Complex Bioadhesive Vaginal Films for Vaginal Candidiasis by Factorial Design

Authors: Umme Hani, H. G. Shivakumar, M. D. Younus Pasha

Abstract:

The purpose of this work was to design and optimize a novel vaginal drug delivery system for more effective treatment against vaginal candidiasis. To achieve a better therapeutic efficacy and patient compliance in the treatment for vaginal candidiasis, herbal antifungal agent Curcumin which is 2.5 fold more potent than fluconazole at inhibiting the adhesion of candida albicans has been formulated in a bio-adhesive vaginal film. Curcumin was formulated in bio-adhesive film formulations that could be retained in the vagina for prolonged intervals. The polymeric films were prepared by solvent evaporation and optimized for various physicodynamic and aesthetic properties. Curcumin HPβCD (Hydroxypropyl β Cyclodextrin) was first developed to increase the solubility of curcumin. The formation of the Curcumin HPβCD complex was characterized by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and FT-IR and evaluated for its solubility. Curcumin HPβCD complex was formulated in a bio-adhesive film using hydroxypropyl methyl cellulose (HPMC) and Carbopol 934P and characterized. DSC and FT-IR data of Curcumin HPβCD indicate there was complex formation between the drug and HPβCD. The little moisture content (8.02±0.34% w/w) was present in the film, which helps them to remain stable and kept them from being completely dry and brittle. The mechanical properties, tensile strength, and percentage elongation at break reveal that the formulations were found to be soft and tough. The films showed good peelability, relatively good swelling index, and moderate tensile strength and retained vaginal mucosa up to 8 h. The developed Curcumin vaginal film could be a promising safe herbal medication and can ensure longer residence at the vagina and provide an efficient therapy for vaginal candidiasis.

Keywords: curcumin, curcumin-HPβCD complex, bio-adhesive vaginal film, vaginal candidiasis, 23 factorial design

Procedia PDF Downloads 376
816 Ethical Considerations in the Execution of Post-Fuel Subsidy Removal Support Initiatives in Kwara State, Nigeria: A Focus from Islamic Principles

Authors: Muhammad Jum’at Dasuki

Abstract:

This study investigates the ethical implications of post-fuel subsidy removal support initiatives in Kwara State, Nigeria, with a focus on the application of Islamic principles. The contentious issue of subsidy removal carries significant social and economic consequences, emphasizing the crucial role of ethical considerations in policy implementation. The research provides a comprehensive background on fuel subsidy removal in Nigeria and its implications. Examining post-fuel subsidy removal palliative measures in Kwara State, the study focuses on design and implementation challenges, ethical considerations, transparency, equity, and public trust. Utilizing a case study approach offers insights and best practices. The methodology includes primary sources through in-depth oral interviews and secondary sources like textbooks and journals, aiming for a holistic understanding of the ethical dimensions of support initiatives within the context of Islamic principles in Kwara State. The objective is to contribute to policy decisions and community development. The study recommends an ethically sound implementation of post-fuel subsidy removal support initiatives, emphasizing transparency, accountability, and inclusivity. It advocates for the inclusiveness of governmental palliatives, reaching both civil servants and common individuals in the state. Continuous distribution during fuel subsidy removal challenges is deemed vital. Additionally, extending free or subsidized transportation beyond higher institutions to the general populace is suggested. Consideration should also be given to reducing governmental hospital bills or providing free health services. The study underscores the importance of Islamic ethics in Nigerian governance and employs a case study approach to assess palliative measures in Kwara State, offering practical insights for policymakers and stakeholders.

Keywords: considerations, ethical, palliative, post-fuel subsidy removal

Procedia PDF Downloads 33
815 Review and Analysis of Sustainable-Based Risk Management in Humanitarian Supply Chains

Authors: Marinko Maslaric, Maja Jokic

Abstract:

When searching for fast and long term responses, sustainable logistics and supply chain applications have developed irrefutable theories and hypotheses towards market requirements. Nevertheless, there are certain misunderstandings on how the implementation of sustainability principles (social, economical, and environmental) and concepts should work in practice, more specifically, within a humanitarian supply chain management context. This paper will focus on the review and analysis of risk management concepts in humanitarian supply chain in order to identify their compliance with sustainable principles. In this direction, the study will look for strategies that suggest: minimization of environmental impacts throughout the reduction of resources consumption, depreciation of logistics costs, including supply chain ones, minimization of transportation and service costs, elaboration of quality performance of supply chain and logistics, and reduction of supply chain delivery time. On the side of meeting all defense, trades and humanitarian logistics needs, the research will be aligned to UN Sustainable Development Goals, standards, and performances. It will start with relevant strategies for identification of risk indicators and it will end with suggestion of valuable strategic approaches for their minimization or total prevention. Finally, a content analysis will propose a suitable methodological structure for the creation of most sustainable strategy in risk management of humanitarian supply chain. Content analysis will accompany thorough, consistent and methodical approach of literature review for potential disaster risk management plan. Thereupon, the propositions of this research will look for contemporary literature gaps, with respect to operate the literature analysis and to suggest the appropriate sustained risk low master plan. The indicated is here to secure the high quality of logistics practices in hazardous events.

Keywords: humanitarian logistics, sustainability, supply chain risk, risk management plan

Procedia PDF Downloads 229
814 Vitamin D Supplementation Potentiates the Clinical Benefits of Metformin and Pioglitazone in Indian Women with Polycystic Ovary Syndrome

Authors: Mohd Asharf Ganie, Aafia Rashid, Mohd Afzal Zargar, Showkat Ali Zargar, Syed Mudasar, Tabasum Parvaiz, Zafar Amin Shah

Abstract:

Accumulating evidence suggests that Vitamin D deficiency (VDD) might at least contribute to the metabolic co-morbidities in PCOS. Hence, we aimed to study the effect of vitamin D supplementation in co-prescription with insulin sensitizers like metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. In this open label randomized, controlled trial a total of 120 women with PCOS diagnosis (AE-PCOS 2009 Criteria) were assigned to four treatment groups (n= 30 in each): group I (metformin 1 gm/day in combination with cholecalciferol 4000 IU/day), group II (pioglitazone 30 mg/day in combination with cholecalciferol 4000 IU/day), group III (metformin 1 gm /day) and group IV (pioglitazone 30 mg/day). Vitamin D supplementation was given as 60,000 units every two weeks for 24 weeks. All the subjects were routinely evaluated for clinical, biochemical, hormonal and insulin sensitivity parameters in addition to various safety parameters especially serum calcium levels at baseline and after 24 weeks of the treatment. Our results indicate that 95.5% of PCOS women were vitamin D deficient at baseline. Serum 25 (OH) D levels increased significantly (p < 0.001) in groups I and II without any adverse effects after 24 weeks of oral administration of 4000 IU cholecalciferol daily. However, serum 25 (OH) D levels remained unchanged in group III and IV. By six months, number of menstrual cycles per year increased whereas Ferriman-Gallwey score, serum total testosterone and HOMA-IR decreased significantly (P < 0.001) in the treatment groups supplemented with cholecalciferol as compared to those treated either drug alone. No significant beneficial changes were observed on weight, BMI, blood pressure, glucose tolerance and serum lipids in any of the groups supplemented with cholecalciferol. We conclude that daily dose of 4000 IU cholecalciferol might be a useful adjunct in complex treatment of PCOS with fewer adverse events. Furthermore, pioglitazone and cholecalciferol combination seems to be marginally better although there was no statistical significance.

Keywords: PCOS, vitamin D supplementation, insulin resistance, spironolactone, metformin, pioglitazone

Procedia PDF Downloads 374
813 Ethanol Chlorobenzene Dosimetr Usage for Measuring Dose of the Intraoperative Linear Electron Accelerator System

Authors: Mojtaba Barzegar, Alireza Shirazi, Saied Rabi Mahdavi

Abstract:

Intraoperative radiation therapy (IORT) is an innovative treatment modality that the delivery of a large single dose of radiation to the tumor bed during the surgery. The radiotherapy success depends on the absorbed dose delivered to the tumor. The achievement better accuracy in patient treatment depends upon the measured dose by standard dosimeter such as ionization chamber, but because of the high density of electric charge/pulse produced by the accelerator in the ionization chamber volume, the standard correction factor for ion recombination Ksat calculated with the classic two-voltage method is overestimated so the use of dose/pulse independent dosimeters such as chemical Fricke and ethanol chlorobenzene (ECB) dosimeters have been suggested. Dose measurement is usually calculated and calibrated in the Zmax. Ksat calculated by comparison of ion chamber response and ECB dosimeter at each applicator degree, size, and dose. The relative output factors for IORT applicators have been calculated and compared with experimentally determined values and the results simulated by Monte Carlo software. The absorbed doses have been calculated and measured with statistical uncertainties less than 0.7% and 2.5% consecutively. The relative differences between calculated and measured OF’s were up to 2.5%, for major OF’s the agreement was better. In these conditions, together with the relative absorbed dose calculations, the OF’s could be considered as an indication that the IORT electron beams have been well simulated. These investigations demonstrate the utility of the full Monte Carlo simulation of accelerator head with ECB dosimeter allow us to obtain detailed information of clinical IORT beams.

Keywords: intra operative radiotherapy, ethanol chlorobenzene, ksat, output factor, monte carlo simulation

Procedia PDF Downloads 471