Search results for: rural surgery
Commenced in January 2007
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Edition: International
Paper Count: 2790

Search results for: rural surgery

450 Euthanasia with Reference to Defective Newborns: An Analysis

Authors: Nibedita Priyadarsini

Abstract:

It is said that Ethics has a wide range of application which mainly deals with human life and human behavior. All ethical decisions are ultimately concerned with life and death. Both life and death must be considered dignified. Medical ethics with its different topics mostly deals with life and death concepts among which euthanasia is one. Various types of debates continue over Euthanasia long since. The question of putting an end to someone’s life has aroused controversial in legal sphere as well as in moral sphere. To permit or not to permit has remained an enigma the world over. Modern medicine is in the stage of transcending limits that cannot be set aside. The morality of allowing people to die without treatment has become more important as methods of treatment have become more sophisticated. Allowing someone to die states an essential recognition that there is some point in any terminal illness when further curative treatment has no purpose and the patient in such situation should allow dying a natural death in comfort, peace, and dignity, without any interference from medical science and technology. But taking a human life is in general sense is illogical in itself. It can be said that when we kill someone, we cause the death; whereas if we merely let someone die, then we will not be responsible for anyone’s death. This point is often made in connection with the euthanasia cases and which is often debatable. Euthanasia in the pediatric age group involves some important issues that are different from those of adult issues. The main distinction that occurs is that the infants and newborns and young children are not able to decide about their future as the adult does. In certain cases, where the child born with some serious deformities with no hope of recovery, in that cases doctor decide not to perform surgery in order to remove the blockage, and let the baby die. Our aim in this paper is to examine, whether it is ethically justified to withhold or to apply euthanasia on the part of the defective infant. What to do with severely defective infants from earliest time if got to know that they are not going to survive at all? Here, it will deal mostly with the ethics in deciding the relevant ethical concerns in the practice of euthanasia with the defective newborns issues. Some cases in relation to disabled infants and newborn baby will be taken in order to show what to do in a critical condition, that the patient and family members undergoes and under which condition those could be eradicated, if not all but some. The final choice must be with the benefit of the patient.

Keywords: ethics, medical ethics, euthanasia, defective newborns

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449 Strategies For Management Of Massive Intraoperative Airway Haemorrhage Complicating Surgical Pulmonary Embolectomy

Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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448 The Effectiveness of Laughing Qigong for Women with Breast Cancer in Community

Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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447 Development of PVA/polypyrrole Scaffolds by Supercritical CO₂ for Its Application in Biomedicine

Authors: Antonio Montes, Antonio Cozar, Clara Pereyra, Diego Valor, Enrique Martinez de la Ossa

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Tissues and organs can be damaged because of traumatism, congenital illnesses, or cancer and the traditional therapeutic alternatives, such as surgery, cannot usually completely repair the damaged tissues. Tissue engineering allows regeneration of the patient's tissues, reducing the problems caused by the traditional methods. Scaffolds, polymeric structures with interconnected porosity, can be promoted the proliferation and adhesion of the patient’s cells in the damaged area. Furthermore, by means of impregnation of the scaffold with beneficial active substances, tissue regeneration can be induced through a drug delivery process. The objective of the work is the fabrication of a PVA scaffold coated with Gallic Acid and polypyrrole through a one-step foaming and impregnation process using the SSI technique (Supercritical Solvent Impregnation). In this technique, supercritical CO₂ penetrates into the polymer chains producing the plasticization of the polymer. In the depressurization step a CO₂ cellular nucleation and growing to take place to an interconnected porous structure of the polymer. The foaming process using supercritical CO₂ as solvent and expansion agent presents advantages compared to the traditional scaffolds’ fabrication methods, such as the polymer’s high solubility in the solvent or the possibility of carrying out the process at a low temperature, avoiding the inactivation of the active substance. In this sense, the supercritical CO₂ avoids the use of organic solvents and reduces the solvent residues in the final product. Moreover, this process does not require long processing time that could cause the stratification of substance inside the scaffold reducing the therapeutic efficiency of the formulation. An experimental design has been carried out to optimize the SSI technique operating conditions, as well as a study of the morphological characteristics of the scaffold for its use in tissue engineerings, such as porosity, conductivity or the release profiles of the active substance. It has been proved that the obtained scaffolds are partially porous, conductors of electricity and are able to release Gallic Acid in the long term.

Keywords: scaffold, foaming, supercritical, PVA, polypyrrole, gallic acid

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446 Study on Spatial Structure and Evolvement Process of Traditional Villages’ Courtyard Based on Clannism

Authors: Liang Sun, Yi He

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The origination and development of Chinese traditional villages have a strong link with clan society. Thousands of traditional villages are constituted by one big family who have the same surname. Villages’ basic social relationships are built on the basis of family kinship. Clan power controls family courtyards’ spatial structure and influences their evolvement process. Compared with other countries, research from perspective of clanism is a particular and universally applicable manner to recognize Chinese traditional villages’ space features. This paper takes traditional villages in astern Zhejiang province as examples, especially a single-clan village named Zoumatang. Through combining rural sociology with architecture, it clarifies the coupling relationship between clan structure and village space, reveals spatial composition and evolvement logic of family courtyards. Clan society pays much attention to the patrilineal kinship and genealogy. In astern Zhejiang province, clan is usually divided to ‘clan-branches-families’ three levels. Its structural relationship looks like pyramid, which results in ‘center-margin’ structure when projecting to villages’ space. Due to the cultural tradition of ancestor worship, family courtyards’ space exist similar ‘center-margin’ structure. Ancestor hall and family temple are respectively the space core of village and courtyard. Other parts of courtyard also shows order of superiority and inferiority. Elder and men must be the first. However, along with the disintegration of clan society, family courtyard gradually appears fragmentation trend. Its spatial structure becomes more and more flexible and its scale becomes smaller and smaller. Living conditions rather than ancestor worship turn out to be primary consideration. As a result, there are different courtyard historical prototype in different historic period. To some extent, Chinese present traditional villages’ conservation ignore the impact of clan society. This paper discovers the social significance of courtyard’s spatial texture and rebuilds the connection between society and space. It is expected to promote Chinese traditional villages’ conservation paying more attention to authenticity which defined in the historical process and integrity which built on the basis of social meaning.

Keywords: China, clanism, courtyard, evolvement process, spatial structure, traditional village

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445 Everyday Life Information Seeking among Female Students: A Survey of University and Private Hostels at Lahore

Authors: Sadaf Rafiq, Muhammad Waqas, Shakeel Ahmad Khan, Nisar Ahmad

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Everyday life information seeking (ELIS) is considered as the mastery of life. It plays an important role in daily problem solving activities. Female students living in university hostels need variety of information to fulfil their everyday information needs. To find accurate and timely information is really challenging for females students who move from rural areas for educational purposes. These challenges involve culture differences, stress, financial issues, homesickness, diet needs and change in sleeping and eating habits. These complications create numerous problems for female students to adjust themselves in new and unfamiliar environment. Although the Internet has increased the ease of seeking everyday life information to survive successfully but there is still uncertainty to fully rely on the quality of information available on the web. Pakistan is an underdeveloped country where limited budget is allocated for educational institutions to enable them in developing well established hostels for their students. Female students who pursue for higher education has to stay at hostels for years to obtain education goals. It really becomes very difficult for them to spend life in hostels if they are not properly facilitated with relevant information sources to acquire everyday life information. The proposed study attempts to investigate the everyday life information seeking behavior of female students who are living in university and private hostels of Lahore. It investigates the various sources of information used by female students. It also identifies the problems faced by the female students in accessing everyday life information. The results of this study will be helpful for university management to understand their information need and provide required information sources which are essential for them to spend a comfortable, successful and peaceful life in hostels and achieve their educational goals. To achieve the objectives of the study, we will use quantitative research approach by using questionnaire as a data collection tool. The population of this study will be the university students living in public and private hostels of Lahore, Pakistan. This study will increase the understanding of everyday life information seeking behavior of female students living in hostels. Results of the study will be helpful for hostel administrations to better understand the students’ everyday life information needs and provide high quality of information services and living environment.

Keywords: everyday, information seeking, hostel, female

Procedia PDF Downloads 129
444 Correlation Study between Clinical and Radiological Findings in Knee Osteoarthritis

Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

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443 Development of Composition and Technology of Vincristine Nanoparticles Using High-Molecular Carbohydrates of Plant Origin

Authors: L. Ebralidze, A. Tsertsvadze, D. Berashvili, A. Bakuridze

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Current cancer therapy strategies are based on surgery, radiotherapy and chemotherapy. The problems associated with chemotherapy are one of the biggest challenges for clinical medicine. These include: low specificity, broad spectrum of side effects, toxicity and development of cellular resistance. Therefore, anti-cance drugs need to be develop urgently. Particularly, in order to increase efficiency of anti-cancer drugs and reduce their side effects, scientists work on formulation of nano-drugs. The objective of this study was to develop composition and technology of vincristine nanoparticles using high-molecular carbohydrates of plant origin. Plant polysacharides, particularly, soy bean seed polysaccharides, flaxseed polysaccharides, citrus pectin, gum arabic, sodium alginate were used as objects. Based on biopharmaceutical research, vincristine containing nanoparticle formulations were prepared. High-energy emulsification and solvent evaporation methods were used for preparation of nanosystems. Polysorbat 80, polysorbat 60, sodium dodecyl sulfate, glycerol, polyvinyl alcohol were used in formulation as emulsifying agent and stabilizer of the system. The ratio of API and polysacharides, also the type of the stabilizing and emulsifying agents are very effective on the particle size of the final product. The influence of preparation technology, type and concentration of stabilizing agents on the properties of nanoparticles were evaluated. For the next stage of research, nanosystems were characterized. Physiochemical characterization of nanoparticles: their size, shape, distribution was performed using Atomic force microscope and Scanning electron microscope. The present study explored the possibility of production of NPs using plant polysaccharides. Optimal ratio of active pharmaceutical ingredient and plant polysacharids, the best stabilizer and emulsifying agent was determined. The average range of nanoparticles size and shape was visualized by SEM.

Keywords: nanoparticles, target delivery, natural high molecule carbohydrates, surfactants

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442 Evaluation of the Surveillance System for Rift Valley Fever in Ruminants in Mauritania, 2019

Authors: Mohamed El Kory Yacoub, Ahmed Bezeid El Mamy Beyatt, Djibril Barry, Yanogo Pauline, Nicolas Meda

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Introduction: Rift Valley Fever is a zoonotic arbovirosis that severely affects ruminants, as well as humans. It causes abortions in pregnant females and deaths in young animals. The disease occurs during heavy rains followed by large numbers of mosquito vectors. The objective of this work is to evaluate the surveillance system for Rift Valley Fever. Methods: We conducted an evaluation of the Rift Valley Fiver surveillance system. Data were collected from the analysis of the national database of the Mauritanian Network of Animal Disease Epidemiological Surveillance at the Ministry of Rural Development, of RVF cases notified from the whole national territory, of questionnaires and interviews with all persons involved in RVF surveillance at the central level. The quality of the system was assessed by analyzing the quantitative attributes defined by the Centers for Disease Control and Prevention. Results: In 2019, 443 cases of RVF were notified by the surveillance system, of which 36 were positive. Among the notified cases of Rift Valley Fever, the 0- to the 3-year-old age group of small ruminants was the most represented with 49.21% of cases, followed by 33.33%, which was recorded in large ruminants in the 0 to 7-year-old age group, 11.11% of cases were older than seven years. The completeness of the data varied between 14.2% (age) and 100% (species). Most positive cases were recorded between October and November 2019 in seven different regions. Attribute analysis showed that 87% of the respondents were able to use the case definition well, and 78.8% said they were familiar with the reporting and feedback loop of the Rift Valley Fever data. 90.3% of the respondents found it easy, while 95% of them responded that it was easy for them to transmit their data to the next level. Conclusions: The epidemiological surveillance system for Rift Valley Fever in Mauritania is simple and representative. However, data quality, stability, and responsiveness are average, as the diagnosis of the disease requires laboratory confirmation and the average delay for this confirmation is long (13 days). Consequently, the lack of completeness of the recorded data and of description of cases in terms of time-place-animal, associated with the delay between the stages of the surveillance system can make prevention, early detection of epidemics, and the initiation of measures for an adequate response difficult.

Keywords: evaluation, epidemiological surveillance system, rift valley fever, mauritania, ruminants

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441 The Comparison Study of Human Microbiome in Chronic Rhinosinusitis between Adults and Children

Authors: Il Ho Park, Joong Seob Lee, Sung Hun Kang, Jae-Min Shin, Il Seok Park, Seok Min Hong, Seok Jin Hong

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Introduction: The human microbiota is the aggregate of microorganisms, and the bacterial microbiome of the human digestive tract contributes to both health and disease. In health, bacteria are key components in the development of mucosal barrier function and in innate and adaptive immune responses, and they also work to suppress the establishment of pathogens. In human upper airway, the sinonasal microbiota might play an important role in chronic rhinosinusitis (CRS). The purpose of this study is to investigate the human upper airway microbiome in CRS patients and to compare the sinonasal microbiome of adults with children. Materials and methods: A total of 19 samples from 19 patients (Group1; 9 CRS in children, aged 5 to 14 years versus Group 2; 10 CRS in adults aged 21 to 59 years) were examined. Swabs were collected from the middle meatus and/or anterior ethmoid region under general anesthesia during endoscopic sinus surgery or tonsillectomy. After DNA extraction from swab samples, we analysed bacterial microbiome consortia using 16s rRNA gene sequencing approach (the Illumina MiSeq platform). Results: In this study, relatively abundance of the six bacterial phyla and tremendous genus and species found in substantial amounts in the individual sinus swab samples, include Corynebacterium, Hemophilus, Moraxella, and Streptococcus species. Anaerobes like Fusobacterium and Bacteroides were abundantly present in the children group, Bacteroides and Propionibacterium were present in adults group. In genus, Haemophilus was the most common CRS microbiome in children and Corynebacterium was the most common CRS microbiome in adults. Conclusions: Our results show the diversity of human upper airway microbiome, and the findings will suggest that CRS is a polymicrobial infection. The Corynebacterium and Hemophilus may live as commensals on mucosal surfaces of sinus in the upper respiratory tract. The further study will be needed for analysis of microbiome-human interactions in upper airway and CRS.

Keywords: microbiome, upper airway, chronic rhinosinusitis, adult and children

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440 Clinical Empathy: The Opportunity to Offer Optimal Treatment to People with Serious Illness

Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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439 Management of First Trimester Miscarriage

Authors: Madeleine Cox

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Objective; analyse patient choices in management of first trimester miscarriage, rates of complications including repeat procedure. Design: all first trimester miscarriages from a tertiary institution on the Gold Coast in a 6 month time frame (July to December 2021) were reviewed, including choice of management, histopathology, any representations or admissions, and potential complications. Results: a total of 224 first trimester miscarriages were identified. Of these, 183 (81%) opted to have surgical management in the first instance. Of the remaining patients, 18 (8%) opted to have medical management, and 28 (12.5%) opted to have expectant management. In total, 33(15%) patients required a repeat treatment for retained products. 1 had medical management for a small volume PROC post suction curette. A significant number of these patients initially opted for medical management but then elected to have shorter follow up than usual and went on to have retained products noted. 5 women who had small volumes of RPOC post medical or surgical management had repeat suction curette, however, had very small volumes of products on scan and on curette and may have had a good result with repeated misoprostol administration. It is important to note that whilst a common procedure, suction curettes are not without risk. 2 women had significant blood loss of 1L and 1.5L. A third women had a uterine perforation, a rare but recognised complication, she went on to require a laparoscopy which identified a small serosal bowel injury which was closed by the colorectal team. Conclusion: Management of first trimester miscarriage should be guided by patient preference. It is important to be able to provide patients with their choice of management, however, it is also important to have a good understanding of the risks of each management choice, chances of repeated procedure, appropriate time frame for follow up. Women who choose to undertake medical or expectant management should be supported through this time, with appropriate time frame between taking misoprostol and repeat scan so that the true effects can be evaluated. Patients returning for scans within 2-3 days are more likely to be booked for further surgery, however, may reflect patients who did not have adequate counselling or simply changed their mind on their preferred management options.

Keywords: miscarriage, gynaecology, obstetrics, first trimester

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438 African Traditional Method of Social Control Mechanism: A Sociological Review of Native Charms in Farm Security in Ayetoro Community, Ogun State, Nigeria

Authors: Adebisi A. Sunday, Babajide Adeokin

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The persistent rise in farm theft in rural region of Nigeria is attributed to the lack of adequate and effective policing in the regions; thus, this brought about the inevitable introduction of native charms on farmlands as a means of fortification of harvests against theft in Ayetoro community. The use of charm by farmers as security on farmlands is a traditional crime control mechanism that is largely based on unwritten laws which greatly influenced the lives of people, and their attitudes toward the society. This research presents a qualitative sociological study on how native charms are deployed by farmers for protection against theft. The study investigated the various types of charms that are employed as security measures among farmers in Ayetoro community and the rationale behind the use of these mechanisms as farm security. The study utilized qualitative method to gather data in the research process. Under the qualitative method, in-depth interview method was adopted to generate a robust and detailed data from the respondents. Also the data generated were analysed qualitatively using thematic content analysis and simple description which was preceded by transcription of data from the recorder. It was revealed that amidst numerous charms known, two major charms are used on farmlands as a measure of social control in Ayetoro community, Ogun state South West Nigeria. Furthermore, the result of this study showed that, the desire for safekeeping of harvest from pilferers and the heavy punishments dispense on offenders by native charms are the reasons why farmers deploy charms on their farms. In addition, findings revealed that the adoption of these charms for protection has improved yields among farmers in the community because the safety of harvest has been made possible by virtue of the presence of various charms in the farm lands. Therefore, based on the findings of this study, it is recommended that such measures should be recognized in mainstream social control mechanisms in the fight against crime in Nigeria and the rest of the world. Lastly, native charms could be installed in all social and cooperate organisation and position of authority to prevent theft of valuables and things hold with utmost importance.

Keywords: Ayetoro, farm theft, mechanism, native charms, Pilferer

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437 Collagen Gel in Hip Cartilage Repair: in vivo Preliminary Study

Authors: A. Bajek, J. Skopinska-Wisniewska, A. Rynkiewicz, A. Jundzill, M. Bodnar, A. Marszalek, T. Drewa

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Traumatic injury and age-related degenerative diseases associated with cartilage are major health problems worldwide. The articular cartilage is comprised of a relatively small number of cells, which have a relatively slow rate of turnover. Therefore, damaged articular cartilage has a limited capacity for self-repair. New clinical methods have been designed to achieve better repair of injured cartilage. However, there is no treatment that enables full restoration of it. The aim of this study was to evaluate how collagen gel with bone marrow mesenchymal stem cells (MSCs) and collagen gel alone will influence on the hip cartilage repair after injury. Collagen type I was isolated from rats’ tails and cross-linked with N-hydroxysuccinimide in 24-hour process. MSCs were isolated from rats’ bone marrow. The experiments were conducted according to the guidelines for animal experiments of Ethics Committee. Fifteen 8-week-old Wistar rats were used in this study. All animals received hip joint surgery with a total of 30 created cartilage defects. Then, animals were randomly divided into three groups and filled, respectively, with collagen gel (group 1), collagen gel cultured with MSCs (group II) or left untreated as a control (control group). Immunohistochemy and radiological evaluation was carried out 11 weeks post implantation. It has been proved that the surface of the matrix is non-toxic, and its porosity promotes cell adhesion and growth. However, the in vivo regeneration process was poor. We observed the low integration rate of biomaterial. Immunohistochemical evaluation of cartilage after 11 weeks of treatment showed low II and high X collagen expression in two tested groups in comparison to the control one, in which we observed the high II collagen expression. What is more, after radiological analysis, we observed the best regeneration process in control group. The biomaterial construct and mesenchymal stem cells, as well as the use of the biomaterial itself was not sufficient to regenerate the hip cartilage surfaces. These results suggest that the collagen gel based biomaterials, even with MSCs, are not satisfactory in repar of hip cartilage defect. However, additional evaluation is needed to confirm these results.

Keywords: collafen gel, MSCs, cartilage repair, hip cartilage

Procedia PDF Downloads 440
436 Evaluation of the Conditions of Managed Aquifer Recharge in the West African Basement Area

Authors: Palingba Aimé Marie Doilkom, Mahamadou Koïta, Jean-michel Vouillamoz, Angelbert Biaou

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Most African populations rely on groundwater in rural areas for their consumption. Indeed, in the face of climate change and strong demographic growth, groundwater, particularly in the basement, is increasingly in demand. The question of the sustainability of water resources in this type of environment is therefore becoming a major issue. Groundwater recharge can be natural or artificial. Unlike natural recharge, which often results from the natural infiltration of surface water (e.g. a share of rainfall), artificial recharge consists of causing water infiltration through appropriate developments to artificially replenish the water stock of an aquifer. Artificial recharge is, therefore, one of the measures that can be implemented to secure water supply, combat the effects of climate change, and, more generally, contribute to improving the quantitative status of groundwater bodies. It is in this context that the present research is conducted with the aim of developing artificial recharge in order to contribute to the sustainability of basement aquifers in a context of climatic variability and constantly increasing water needs of populations. In order to achieve the expected results, it is therefore important to determine the characteristics of the infiltration basins and to identify the areas suitable for their implementation. The geometry of the aquifer was reproduced, and the hydraulic properties of the aquifer were collected and characterized, including boundary conditions, hydraulic conductivity, effective porosity, recharge, Van Genuchten parameters, and saturation indices. The aquifer of the Sanon experimental site is made up of three layers, namely the saprolite, the fissured horizon, and the healthy basement. Indeed, the saprolite and the fissured medium were considered for the simulations. The first results with FEFLOW model show that the water table reacts continuously for the first 100 days before stabilizing. The hydraulic charge increases by an average of 1 m. The further away from the basin, the less the water table reacts. However, if a variable hydraulic head is imposed on the basins, it can be seen that the response of the water table is not uniform over time. The lower the basin hydraulic head, the less it affects the water table. These simulations must be continued by improving the characteristics of the basins in order to obtain the appropriate characteristics for a good recharge.

Keywords: basement area, FEFLOW, infiltration basin, MAR

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435 Effectiveness of Adrenal Venous Sampling in the Management of Primary Aldosteronism: Single Centered Cohort Study at a Tertiary Care Hospital in Sri Lanka

Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

Abstract:

Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

Procedia PDF Downloads 50
434 The First Transcriptome Assembly of Marama Bean: An African Orphan Crop

Authors: Ethel E. Phiri, Lionel Hartzenberg, Percy Chimwamuromba, Emmanuel Nepolo, Jens Kossmann, James R. Lloyd

Abstract:

Orphan crops are underresearched and underutilized food plant species that have not been categorized as major food crops, but have the potential to be economically and agronomically significant. They have been documented to have the ability to tolerate extreme environmental conditions. However, limited research has been conducted to uncover their potential as food crop species. The New Partnership for Africa’s Development (NEPAD) has classified Marama bean, Tylosema esculentum, as an orphan crop. The plant is one of the 101 African orphan crops that must have their genomes sequenced, assembled, and annotated in the foreseeable future. Marama bean is a perennial leguminous plant that primarily grows in poor, arid soils in southern Africa. The plants produce large tubers that can weigh as much as 200kg. While the foliage provides fodder, the tuber is carbohydrate rich and is a staple food source for rural communities in Namibia. Also, the edible seeds are protein- and oil-rich. Marama Bean plants respond rapidly to increased temperatures and severe water scarcity without extreme consequences. Advances in molecular biology and biotechnology have made it possible to effectively transfer technologies between model- and major crops to orphan crops. In this research, the aim was to assemble the first transcriptomic analysis of Marama Bean RNA-sequence data. Many model plant species have had their genomes sequenced and their transcriptomes assembled. Therefore the availability of transcriptome data for a non-model crop plant species will allow for gene identification and comparisons between various species. The data has been sequenced using the Ilumina Hiseq 2500 sequencing platform. Data analysis is underway. In essence, this research will eventually evaluate the potential use of Marama Bean as a crop species to improve its value in agronomy. data for a non-model crop plant species will allow for gene identification and comparisons between various species. The data has been sequenced using the Ilumina Hiseq 2500 sequencing platform. Data analysis is underway. In essence, this researc will eventually evaluate the potential use of Marama bean as a crop species to improve its value in agronomy.

Keywords: 101 African orphan crops, RNA-Seq, Tylosema esculentum, underutilised crop plants

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433 Exploring the Applicability of a Rapid Health Assessment in India

Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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432 Strengthening Functional Community-Provider Linkages: Lessons from the Challenge Initiative for Healthy Cities Program in Indore, India

Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

Abstract:

Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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431 Periplasmic Expression of Anti-RoxP Antibody Fragments in Escherichia Coli.

Authors: Caspar S. Carson, Gabriel W. Prather, Nicholas E. Wong, Jeffery R. Anton, William H. McCoy

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Cutibacterium acnes is a commensal bacterium found on human skin that has been linked to acne. C. acnes can also be an opportunistic pathogen when it infiltrates the body during surgery. This pathogen can cause dangerous infections of medical implants, such as shoulder replacements, leading to life-threatening blood infections. Compounding this issue, C. acnes resistance to many antibiotics has become an increasing problem worldwide, creating a need for special forms of treatment. C. acnes expresses the protein RoxP, and it requires this protein to colonize human skin. Though this protein is required for C. acnes skin colonization, its function is not yet understood. Inhibition of RoxP function might be an effective treatment for C. acnes infections. To develop such reagents, the McCoy Laboratory generated four unique anti-RoxP antibodies. Preliminary studies in the McCoy Lab have established that each antibody binds a distinct site on RoxP. To assess the potential of these antibodies as therapeutics, it is necessary to specifically characterize these antibody epitopes and evaluate them in assays that assess their ability to inhibit RoxP-dependent C. acnes growth. To provide material for these studies, an antibody expression construct, Fv-clasp(v2), was adapted to encode anti-RoxP antibody sequences. The author hypothesizes that this expression strategy can produce sufficient amounts of >95% pure antibody fragments for further characterization of these antibodies. Four anti-RoxP Fv-clasp(v2) expression constructs (pET vector-based) were transformed into E. coli BL21-Gold(DE3) cells and a small-scale expression and purification trial was performed for each construct to evaluate anti-RoxP Fv-clasp(v2) yield and purity. Successful expression and purification of these antibody constructs will allow for their use in structural studies, such as protein crystallography and cryogenic electron microscopy. Such studies would help to define the antibody binding sites on RoxP, which could then be leveraged in the development of certain methods to treat C. acnes infection through RoxP inhibition.

Keywords: structural biology, protein expression, infectious disease, antibody, therapeutics, E. coli

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430 Development and Compositional Analysis of Functional Bread and Biscuit from Soybean, Peas and Rice Flour

Authors: Jean Paul Hategekimana, Bampire Claudine, Niyonsenga Nadia, Irakoze Josiane

Abstract:

Peas, soybeans and rice are crops which are grown in Rwanda and are available in rural and urban local markets and they give contribution in reduction of health problems especially in fighting malnutrition and food insecurity in Rwanda. Several research activities have been conducted on how cereals flour can be mixed with legumes flour for developing baked products which are rich in protein, fiber, minerals as they are found in legumes. However, such activity was not yet well studied in Rwanda. The aim of the present study was to develop bread and biscuit products from peas, soybeans and rice as functional ingredients combined with wheat flour and then analyze the nutritional content and consumer acceptability of new developed products. The malnutrition problem can be reduced by producing bread and biscuits which are rich in protein and are very accessible for every individual. The processing of bread and biscuit were made by taking peas flour, soybeans flour and rice flour mixed with wheat flour and other ingredients then a dough was made followed by baking. For bread, two kind of products were processed, for each product one control and three experimental samples in different three ratios of peas and rice were prepared. These ratios were 95:5, 90:10 and 80:20 for bread from peas and 85:5:10, 80:10:10 and 70:10:20 for bread from peas and rice. For biscuit, two kind of products were also processed, for each product one control sample and three experimental samples in three different ratios were prepared. These ratios are 90:5:5,80:10:10 and 70:10:20 for biscuit from peas and rice and 90:5:5,80:10:10 and 70:10:20 for biscuit from soybean and rice. All samples including the control sample were analyzed for the consumer acceptability (sensory attributes) and nutritional composition. For sensory analysis, bread from of peas and rice flour with wheat flour at ratio 85:5:10 and bread from peas only as functional ingredient with wheat flour at ratio 95:5 and biscuits made from a of soybeans and rice at a ratio 90:5:5 and biscuit made from peas and rice at ratio 90:5:5 were most acceptable compared to control sample and other samples in different ratio. The moisture, protein, fat, fiber and minerals (Sodium and iron.) content were analyzed where bread from peas in all ratios was found to be rich in protein and fiber compare to control sample and biscuit from soybean and rice in all ratios was found to be rich in protein and fiber compare to control sample.

Keywords: bakery products, peas and rice flour, wheat flour, sensory evaluation, proximate composition

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429 The School Governing Council as the Impetus for Collaborative Education Governance: A Case Study of Two Benguet Municipalities in the Highlands of Northern Philippines

Authors: Maria Consuelo Doble

Abstract:

For decades, basic public education in the Philippines has been beleaguered by a governance scenario of multi-layered decision-making and the lack of collaboration between sectors in addressing issues on poor access to schools, high dropout rates, low survival rates, and poor student performance. These chronic problems persisted despite multiple efforts making it appear that the education system is incapable of reforming itself. In the mountainous rural towns of La Trinidad and Tuba, in the province of Benguet in Northern Philippines, collaborative education governance was catalyzed by the intervention of Synergeia Foundation, a coalition made up of individuals, institutions and organizations that aim to improve the quality of education in the Philippines. Its major thrust is to empower the major stakeholders at the community level to make education work by building the capacities of School Governing Councils (SGCs). Although mandated by the Department of Education in 2006, the SGCs in Philippine public elementary schools remained dysfunctional. After one year of capacity-building by Synergeia Foundation, some SGCs are already exhibiting active community-based multi-sectoral collaboration, while there are many that are not. With the myriad of factors hindering collaboration, Synergeia Foundation is now confronted with the pressing question: What are the factors that promote collaborative governance in the SGCs so that they can address the education-related issues that they are facing? Using Emerson’s (2011) framework on collaborative governance, this study analyzes the application of collaborative governance by highly-functioning SGCs in the public elementary schools of Tuba and La Trinidad. Findings of this action research indicate how the dynamics of collaboration composed of three interactive and iterative components – principled engagement, shared motivation and capacity for joint action – have resulted in meaningful short-term impact such as stakeholder engagement and decreased a number of dropouts. The change in the behavior of stakeholders is indicative of adaptation to a more collaborative approach in governing education in Benguet highland settings such as Tuba and La Trinidad.

Keywords: basic public education, Benguet highlands, collaborative governance, School Governing Council

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428 Determinants of Household Food Security in Addis Ababa City Administration

Authors: Estibe Dagne Mekonnen

Abstract:

In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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427 Variability of the Arbuscular Mycorrhizal Fungi Communities Associated with Wild Agraz Plants (Vaccinium meridionale Swartz) in the Colombian Andes

Authors: Gabriel Roveda-Hoyos, Margarita Ramirez-Gomez, Adrian Perez, Diana Paola Serralde

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The objective of this study was to determine the variability of arbuscular mycorrhizal fungi (HFMA) communities associated with wild agraz plants (Vaccinium meridionale Swartz) in the Colombian Andes. This species is one of the most promising fruits within the genus Vaccinium because of the high content of anthocyanins and antioxidants in its fruits, and like other species of the Ericaceae family, it depends on the association with HFM for its development in the natural environment. In this study, the presence of mycorrhizae in wild communities of V. meridionale was evaluated, and their relationship with the edaphic and climatic conditions of the study area was analyzed. Sampling was conducted in the rural area of the municipalities of Raquira, and Chiquinquira, Chia, and Tabio in the departments of Cundinamarca and Boyaca, Colombia. Seven sites were selected, and in each site, 5 plants were randomly selected, root and soil samples were taken from each plant in the rhizosphere zone for the quantification of colonization and the presence of spores. The samples were collected on different soils, taxonomic orders Entisols, Inceptisols, and Alfisols, located at altitudes between 2,600 and 3,000 above sea level in the Eastern Cordillera of Colombia. The physicochemical characteristics of the soil were compared with the density of spores and the percentage of presence of mycorrhizae in the roots and variables with the morphometric and physiological characteristics of the plants. Four types of mutual associations were found: arbuscular mycorrhizae, ectendomycorrhiza, ericoid mycorrhizae, and endophytic septate fungi. The main results obtained show a predominance of spores of the genera Glomus and Acaulsopora, in most of the soils analyzed. The spore density of Glomeromycete fungi in the soil varied considerably between the different sites; it was higher ( > 50 spores/g of dry soil) in soil samples with lower bulk density and higher content of organic matter; in these soils a higher cation exchange capacity was found, as well as of nitrogen, calcium, magnesium, manganese and zinc concentration. It can be concluded that Vaccinium meridionale is able to establish in a natural way, association with HFMA.

Keywords: Ericaceae, Arbuscular mycorrhizae, Andes, soils, Glomus sp.

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426 Fine Needle Aspiration Biopsy of Thyroid Nodules

Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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425 Extensive Cerebral Venous Thrombosis after Resection of Third Ventricle Colloid Cyst

Authors: Naim Izet Kajtazi

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Context: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Process: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a six-month history of headaches, blurred vision, and vomiting presented to our clinic three days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of a third ventricle colloid cyst and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventricular CC excision under neuronavigation through a right frontal craniotomy. Twelve days post-operatively, the patient developed further headaches, followed by a generalized tonic-clonic seizure that led to no postictal neurological deficits. Nonetheless, computed tomography venography of the brain revealed extensive thrombosis of the superior sagittal sinus, inferior sagittal sinus, right sigmoid sinus, and right internal jugular vein. A newly diagnosed CVT was treated with intravenous heparin. The patient was discharged with warfarin, which was discontinued after 12 months. Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Outcome: Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Relevance: A preoperative venous study should be performed in all cases to gain a better understanding of the venous anatomy. We advocate meticulous microsurgical techniques to protect the venous system surrounding the foramen of Monro and reduce the amount of retraction during surgery.

Keywords: CVT, seizures, third ventricle colloid cyst, MRI of brain

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424 Spatial Analysis as a Tool to Assess Risk Management in Peru

Authors: Josué Alfredo Tomas Machaca Fajardo, Jhon Elvis Chahua Janampa, Pedro Rau Lavado

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A flood vulnerability index was developed for the Piura River watershed in northern Peru using Principal Component Analysis (PCA) to assess flood risk. The official methodology to assess risk from natural hazards in Peru was introduced in 1980 and proved effective for aiding complex decision-making. This method relies in part on decision-makers defining subjective correlations between variables to identify high-risk areas. While risk identification and ensuing response activities benefit from a qualitative understanding of influences, this method does not take advantage of the advent of national and international data collection efforts, which can supplement our understanding of risk. Furthermore, this method does not take advantage of broadly applied statistical methods such as PCA, which highlight central indicators of vulnerability. Nowadays, information processing is much faster and allows for more objective decision-making tools, such as PCA. The approach presented here develops a tool to improve the current flood risk assessment in the Peruvian basin. Hence, the spatial analysis of the census and other datasets provides a better understanding of the current land occupation and a basin-wide distribution of services and human populations, a necessary step toward ultimately reducing flood risk in Peru. PCA allows the simplification of a large number of variables into a few factors regarding social, economic, physical and environmental dimensions of vulnerability. There is a correlation between the location of people and the water availability mainly found in rivers. For this reason, a comprehensive vision of the population location around the river basin is necessary to establish flood prevention policies. The grouping of 5x5 km gridded areas allows the spatial analysis of flood risk rather than assessing political divisions of the territory. The index was applied to the Peruvian region of Piura, where several flood events occurred in recent past years, being one of the most affected regions during the ENSO events in Peru. The analysis evidenced inequalities for the access to basic services, such as water, electricity, internet and sewage, between rural and urban areas.

Keywords: assess risk, flood risk, indicators of vulnerability, principal component analysis

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423 Anaesthetic Management of Congenitally Corrected Transposition of Great Arteries with Complete Heart Block in a Parturient for Emergency Caesarean Section

Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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422 Mapping Man-Induced Soil Degradation in Armenia's High Mountain Pastures through Remote Sensing Methods: A Case Study

Authors: A. Saghatelyan, Sh. Asmaryan, G. Tepanosyan, V. Muradyan

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One of major concern to Armenia has been soil degradation emerged as a result of unsustainable management and use of grasslands, this in turn largely impacting environment, agriculture and finally human health. Hence, assessment of soil degradation is an essential and urgent objective set out to measure its possible consequences and develop a potential management strategy. Since recently, an essential tool for assessing pasture degradation has been remote sensing (RS) technologies. This research was done with an intention to measure preciseness of Linear spectral unmixing (LSU) and NDVI-SMA methods to estimate soil surface components related to degradation (fractional vegetation cover-FVC, bare soils fractions, surface rock cover) and determine appropriateness of these methods for mapping man-induced soil degradation in high mountain pastures. Taking into consideration a spatially complex and heterogeneous biogeophysical structure of the studied site, we used high resolution multispectral QuickBird imagery of a pasture site in one of Armenia’s rural communities - Nerkin Sasoonashen. The accuracy assessment was done by comparing between the land cover abundance data derived through RS methods and the ground truth land cover abundance data. A significant regression was established between ground truth FVC estimate and both NDVI-LSU and LSU - produced vegetation abundance data (R2=0.636, R2=0.625, respectively). For bare soil fractions linear regression produced a general coefficient of determination R2=0.708. Because of poor spectral resolution of the QuickBird imagery LSU failed with assessment of surface rock abundance (R2=0.015). It has been well documented by this particular research, that reduction in vegetation cover runs in parallel with increase in man-induced soil degradation, whereas in the absence of man-induced soil degradation a bare soil fraction does not exceed a certain level. The outcomes show that the proposed method of man-induced soil degradation assessment through FVC, bare soil fractions and field data adequately reflects the current status of soil degradation throughout the studied pasture site and may be employed as an alternate of more complicated models for soil degradation assessment.

Keywords: Armenia, linear spectral unmixing, remote sensing, soil degradation

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421 Study of Polychlorinated Dibenzo-P-Dioxins and Dibenzofurans Dispersion in the Environment of a Municipal Solid Waste Incinerator

Authors: Gómez R. Marta, Martín M. Jesús María

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The general aim of this paper identifies the areas of highest concentration of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) around the incinerator through the use of dispersion models. Atmospheric dispersion models are useful tools for estimating and prevent the impact of emissions from a particular source in air quality. These models allow considering different factors that influence in air pollution: source characteristics, the topography of the receiving environment and weather conditions to predict the pollutants concentration. The PCDD/Fs, after its emission into the atmosphere, are deposited on water or land, near or far from emission source depending on the size of the associated particles and climatology. In this way, they are transferred and mobilized through environmental compartments. The modelling of PCDD/Fs was carried out with following tools: Atmospheric Dispersion Model Software (ADMS) and Surfer. ADMS is a dispersion model Gaussian plume, used to model the impact of air quality industrial facilities. And Surfer is a program of surfaces which is used to represent the dispersion of pollutants on a map. For the modelling of emissions, ADMS software requires the following input parameters: characterization of emission sources (source type, height, diameter, the temperature of the release, flow rate, etc.) meteorological and topographical data (coordinate system), mainly. The study area was set at 5 Km around the incinerator and the first population center nearest to focus PCDD/Fs emission is about 2.5 Km, approximately. Data were collected during one year (2013) both PCDD/Fs emissions of the incinerator as meteorology in the study area. The study has been carried out during period's average that legislation establishes, that is to say, the output parameters are taking into account the current legislation. Once all data required by software ADMS, described previously, are entered, and in order to make the representation of the spatial distribution of PCDD/Fs concentration and the areas affecting them, the modelling was proceeded. In general, the dispersion plume is in the direction of the predominant winds (Southwest and Northeast). Total levels of PCDD/Fs usually found in air samples, are from <2 pg/m3 for remote rural areas, from 2-15 pg/m3 in urban areas and from 15-200 pg/m3 for areas near to important sources, as can be an incinerator. The results of dispersion maps show that maximum concentrations are the order of 10-8 ng/m3, well below the values considered for areas close to an incinerator, as in this case.

Keywords: atmospheric dispersion, dioxin, furan, incinerator

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