Search results for: percent depth dose
5564 Estimation Model for Concrete Slump Recovery by Using Superplasticizer
Authors: Chaiyakrit Raoupatham, Ram Hari Dhakal, Chalermchai Wanichlamlert
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This paper is aimed to introduce the solution of concrete slump recovery using chemical admixture type-F (superplasticizer, naphthalene base) to the practice, in order to solve unusable concrete problem due to concrete loss its slump, especially for those tropical countries that have faster slump loss rate. In the other hand, randomly adding superplasticizer into concrete can cause concrete to segregate. Therefore, this paper also develops the estimation model used to calculate amount of second dose of superplasticizer need for concrete slump recovery. Fresh properties of ordinary Portland cement concrete with volumetric ratio of paste to void between aggregate (paste content) of 1.1-1.3 with water-cement ratio zone of 0.30 to 0.67 and initial superplasticizer (naphthalene base) of 0.25%- 1.6% were tested for initial slump and slump loss for every 30 minutes for one and half hour by slump cone test. Those concretes with slump loss range from 10% to 90% were re-dosed and successfully recovered back to its initial slump. Slump after re-dosed was tested by slump cone test. From the result, it has been concluded that, slump loss was slower for those mix with high initial dose of superplasticizer due to addition of superplasticizer will disturb cement hydration. The required second dose of superplasticizer was affected by two major parameter, which were water-cement ratio and paste content, where lower water-cement ratio and paste content cause an increase in require second dose of superplasticizer. The amount of second dose of superplasticizer is higher as the solid content within the system is increase, solid can be either from cement particles or aggregate. The data was analyzed to form an equation use to estimate the amount of second dosage requirement of superplasticizer to recovery slump to its original.Keywords: estimation model, second superplasticizer dosage, slump loss, slump recovery
Procedia PDF Downloads 1995563 Effect of Depth on Texture Features of Ultrasound Images
Authors: M. A. Alqahtani, D. P. Coleman, N. D. Pugh, L. D. M. Nokes
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In diagnostic ultrasound, the echo graphic B-scan texture is an important area of investigation since it can be analyzed to characterize the histological state of internal tissues. An important factor requiring consideration when evaluating ultrasonic tissue texture is the depth. The effect of attenuation with depth of ultrasound, the size of the region of interest, gain, and dynamic range are important variables to consider as they can influence the analysis of texture features. These sources of variability have to be considered carefully when evaluating image texture as different settings might influence the resultant image. The aim of this study is to investigate the effect of depth on the texture features in-vivo using a 3D ultrasound probe. The left leg medial head of the gastrocnemius muscle of 10 healthy subjects were scanned. Two regions A and B were defined at different depth within the gastrocnemius muscle boundary. The size of both ROI’s was 280*20 pixels and the distance between region A and B was kept constant at 5 mm. Texture parameters include gray level, variance, skewness, kurtosis, co-occurrence matrix; run length matrix, gradient, autoregressive (AR) model and wavelet transform were extracted from the images. The paired t –test was used to test the depth effect for the normally distributed data and the Wilcoxon–Mann-Whitney test was used for the non-normally distributed data. The gray level, variance, and run length matrix were significantly lowered when the depth increased. The other texture parameters showed similar values at different depth. All the texture parameters showed no significant difference between depths A and B (p > 0.05) except for gray level, variance and run length matrix (p < 0.05). This indicates that gray level, variance, and run length matrix are depth dependent.Keywords: ultrasound image, texture parameters, computational biology, biomedical engineering
Procedia PDF Downloads 2955562 The Effect of Low and High Dose Curcumin Supplementation on Prevention and Treatment of Sarcopenia: The Concept of Hormesis
Authors: Sevana Daneghian, Leila Chodari, Sahar Mehranfar, Shadi Mohammadpour-Asl, Diman Mahdi
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Sarcopenia is an age-related muscle disease. Lack of antioxidant protection, and cumulative oxidative damage to skeletal muscle are recognized mechanisms. Curcumin is a hormetin as it has a stimulating effect in low doses and an inhibitory effect in high doses. The purpose of this study was to examine the effects of four weeks of curcumin supplementation in presarcopenic and sarcopenic rats, and likelihood of potential negative effects while co-exist with sarcopenia. The rats were divided into 7 groups: young sham rats, 18 months old; presarcopenic control, supplemented with 400 and 1500 mg/kg/day, 24 months old; Sarcopenia control, sarcopenia supplemented with 400 and 1500 mg/kg/day. MDA levels were significantly reduced in the low-dose pre-sarcopenic group compared to the control group. Compared to the corresponding control groups, SOD levels decreased in the groups treated with low-dose presarcopenic supplementation and increased in the high-dose sarcopenic supplemented. GPx levels increased at both doses only in the sarcopenic group compared to the control group. SIRT-1 only increased at low doses in the sarcopenic groups and PGC-1α in both pre-sarcopenia groups compared to the corresponding control. IGF-1 increased compared to the control group at both doses in the pre-sarcopenic group and at high doses in sarcopenic group. Considering the hormetic effects of curcumin, it can be argued that, curcumin supplementation has some positive effects not only at low but also at high doses in both groups. This means that the high doses of curcumin have no negative synergistic effects in addition to oxidative stress during sarcopenia and high-dose supplementation in patients already suffering from high oxidative stress due to sarcopenia is safe and could be considered hormetic.Keywords: curcumin, hormesis, sarcopenia, muscular atrophy, PGC protein, Sirtuins
Procedia PDF Downloads 395561 Dynamic Conformal Arc versus Intensity Modulated Radiotherapy for Image Guided Stereotactic Radiotherapy of Cranial Lesion
Authors: Chor Yi Ng, Christine Kong, Loretta Teo, Stephen Yau, FC Cheung, TL Poon, Francis Lee
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Purpose: Dynamic conformal arc (DCA) and intensity modulated radiotherapy (IMRT) are two treatment techniques commonly used for stereotactic radiosurgery/radiotherapy of cranial lesions. IMRT plans usually give better dose conformity while DCA plans have better dose fall off. Rapid dose fall off is preferred for radiotherapy of cranial lesions, but dose conformity is also important. For certain lesions, DCA plans have good conformity, while for some lesions, the conformity is just unacceptable with DCA plans, and IMRT has to be used. The choice between the two may not be apparent until each plan is prepared and dose indices compared. We described a deviation index (DI) which is a measurement of the deviation of the target shape from a sphere, and test its functionality to choose between the two techniques. Method and Materials: From May 2015 to May 2017, our institute has performed stereotactic radiotherapy for 105 patients treating a total of 115 lesions (64 DCA plans and 51 IMRT plans). Patients were treated with the Varian Clinac iX with HDMLC. Brainlab Exactrac system was used for patient setup. Treatment planning was done with Brainlab iPlan RT Dose (Version 4.5.4). DCA plans were found to give better dose fall off in terms of R50% (R50% (DCA) = 4.75 Vs R50% (IMRT) = 5.242) while IMRT plans have better conformity in terms of treatment volume ratio (TVR) (TVR(DCA) = 1.273 Vs TVR(IMRT) = 1.222). Deviation Index (DI) is proposed to better facilitate the choice between the two techniques. DI is the ratio of the volume of a 1 mm shell of the PTV and the volume of a 1 mm shell of a sphere of identical volume. DI will be close to 1 for a near spherical PTV while a large DI will imply a more irregular PTV. To study the functionality of DI, 23 cases were chosen with PTV volume ranged from 1.149 cc to 29.83 cc, and DI ranged from 1.059 to 3.202. For each case, we did a nine field IMRT plan with one pass optimization and a five arc DCA plan. Then the TVR and R50% of each case were compared and correlated with the DI. Results: For the 23 cases, TVRs and R50% of the DCA and IMRT plans were examined. The conformity for IMRT plans are better than DCA plans, with majority of the TVR(DCA)/TVR(IMRT) ratios > 1, values ranging from 0.877 to1.538. While the dose fall off is better for DCA plans, with majority of the R50%(DCA)/ R50%(IMRT) ratios < 1. Their correlations with DI were also studied. A strong positive correlation was found between the ratio of TVRs and DI (correlation coefficient = 0.839), while the correlation between the ratio of R50%s and DI was insignificant (correlation coefficient = -0.190). Conclusion: The results suggest DI can be used as a guide for choosing the planning technique. For DI greater than a certain value, we can expect the conformity for DCA plans to become unacceptably great, and IMRT will be the technique of choice.Keywords: cranial lesions, dynamic conformal arc, IMRT, image guided radiotherapy, stereotactic radiotherapy
Procedia PDF Downloads 2415560 Current Status of Inclusive Education for Students with Disabilities in Punjab, Pakistan
Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf
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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.Keywords: inclusion, identification, assessment, funding, facilities, evaluation
Procedia PDF Downloads 1385559 Removal of Maxilon Red Dye by Adsorption and Photocatalysis: Optimum Conditions, Equilibrium, and Kinetic Studies
Authors: Aid Asma, Dahdouh Nadjib, Amokrane Samira, Ladjali Samir, Nibou Djamel
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The present work has for main objective the elimination of the textile dye Maxilon Red (MR) by two processes, adsorption on activated clay followed by photocatalysis in presence of ZnO as a photocatalyst. The influence of the physical parameters like the initial pH, adsorbent dose of the activated clay, the MR concentration and temperature has been studied. The best adsorption yield occurs at neutral pH ~ 7 within 60 min with an uptake percentage of 97% for a concentration of 25 mg L⁻¹ and a dose of 0.5 g L⁻¹. The adsorption data were suitably fitted by the Langmuir model with a maximum capacity of 176 mg g⁻¹. The MR adsorption is well described by the pseudo second order kinetic. The second part of this work was dedicated to the photocatalytic degradation onto ZnO under solar irradiation of the residual MR concentration, remained after adsorption. The effect of ZnO dose and MR concentration has also been investigated. The parametric study showed that the elimination is very effective by this process, based essentially on the in situ generation of free radicals *OH which are non-selective and very reactive. The photodegradation process follows a first order kinetic model according to the Langmuir-Hinshelwood model.Keywords: maxilon red, adsorption, photodegradation, ZnO, coupling
Procedia PDF Downloads 1865558 Dose Determination of Tenebrio molitor (Mealworm) Extract as an Anti-Diabetic Agent
Authors: Muhammad Al Rizqi Dharma Fauzi, Dwi Yulian Fahruddin Shah, Andre Pratama, Ari Hasna Widyapuspa, Ganden Supriyanto
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Diabetes mellitus is still known as one of diseases which give a big amount of death in the world. From 2012 to 2014, diabetes is estimated to have resulted in 1.5 to 4.9 million deaths each year. In this paper, we present our research in the analysis and dose determination of Tenebrio molitor (Mealworm) extract as an anti-diabetic agent which is believed by Indonesian people as a traditional treatment to prevent and treat diabetes. We found that Tenebrio molitor extract has a potential as an anti-diabetic agent by in vitro test to Mus musculus which were divided into six group of treatment. Our dose determination analysis gave a conclusion that at 2,5 g/mL of concentration of the extract would give the optimal result in healing a wound given to Mus musculus which were induced by aloxane monohydrate. These results show that Tenebrio molitor extract is potential to be used as an Anti-Diabetic agent.Keywords: diabetes, extraction, Tenebrio molitor, traditional medicine
Procedia PDF Downloads 4055557 A Comparative Study on Primary Productivity in Fish Cage Culture Unit and Fish Pond in Relation to Different Level of Water Depth
Authors: Pawan Kumar Sharma, J. Stephan Sampath Kumar, D. Manikandavelu, V. Senthil Kumar
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The total amount of productivity in the system is the gross primary productivity. The present study was carried out to understand the relationship between productivity in the cages and water depth. The experiment was conducted in the fish cages installed in the pond at the Directorate of Sustainable Aquaculture, Thanjavur, Tamil Nadu Dr. J. Jayalalithaa Fisheries University, Tamil Nadu (10° 47' 13.1964'' N; 79° 8' 16.1700''E). Primary productivity was estimated by light and dark bottle method. The measurement of primary productivity was done at different depths viz., 20 cm, 40 cm, and 60 cm. Six Biological Oxygen Demand bottles of 300 ml capacity were collected and tagged. The productivity was obtained in mg O2/l/hr. The maximum dissolved oxygen level at 20 cm depth was observed 5.62 ± 0.22 mg/l/hr in the light bottle in pond water while the minimum dissolved oxygen level at 20 cm depth in a cage was observed 3.62 ± 0.18 mg/l/hr in dark bottle. In the same way, the maximum and minimum value of dissolved oxygen was observed at 40, and 60 cm depth and results were compared. A slight change in pH was observed in the cage and pond. The maximum gross primary productivity observed was 1.97 mg/l/hr in pond at 20 cm depth while minimum gross primary productivity observed was 0.82±0.16 mg/l/hr in a cage at 60 cm depth. The community respiration was also variable with the depth in both cage and pond. Maximum community respiration was found 1.50±0.19 mg/l/hr in pond at 20 cm depth. A strong positive linear relationship was observed between primary productivity and fish yields in ponds. The pond primary productivity can contribute substantially to the nutrition of farm-raised aquaculture species, including shrimp. The growth of phytoplankton’s is dependent on the sun light, availability of primary nutrients (N, P, and K) in the water body and transparency, so to increase the primary productivity fertilization through organic manure may be done that will clean to the pond environment also.Keywords: cage aquaculture, water depth, net primary productivity, gross primary productivity, community respiration
Procedia PDF Downloads 2045556 Optimization of Flip Bucket Dents in Order to Reduce Scour Hole Depth (Plunge Pool) Using a Comprehensive Physical Model
Authors: Majid Galoie, Khodadad Safavi, Abdolreza Karami Nejad, Reza Roshan
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Scour downstream of a flip bucket in a plunge pool is caused by impingement of water jet force. In order to reduce this force and consequently reduce scour hole depth, flip buckets may equip by dents. The minimum scour hole depth might be occurred by optimization of dents (number, shape, placement) on flip buckets. In this study, a comprehensive physical model has been developed and various options for dents have been investigated. The experimental data for each dent option such as scour hole depth, angle of impingement jet, piezometric pressure in tail-water and jet trajectory have been measured for various discharges. Finally, the best option can be found by analysis of the experimental results which has been expressed in this paper.Keywords: scouring process, plunge pool, scour hole depth, physical model, flip bucket
Procedia PDF Downloads 3945555 The Usefulness of Premature Chromosome Condensation Scoring Module in Cell Response to Ionizing Radiation
Authors: K. Rawojć, J. Miszczyk, A. Możdżeń, A. Panek, J. Swakoń, M. Rydygier
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Due to the mitotic delay, poor mitotic index and disappearance of lymphocytes from peripheral blood circulation, assessing the DNA damage after high dose exposure is less effective. Conventional chromosome aberration analysis or cytokinesis-blocked micronucleus assay do not provide an accurate dose estimation or radiosensitivity prediction in doses higher than 6.0 Gy. For this reason, there is a need to establish reliable methods allowing analysis of biological effects after exposure in high dose range i.e., during particle radiotherapy. Lately, Premature Chromosome Condensation (PCC) has become an important method in high dose biodosimetry and a promising treatment modality to cancer patients. The aim of the study was to evaluate the usefulness of drug-induced PCC scoring procedure in an experimental mode, where 100 G2/M cells were analyzed in different dose ranges. To test the consistency of obtained results, scoring was performed by 3 independent persons in the same mode and following identical scoring criteria. Whole-body exposure was simulated in an in vitro experiment by irradiating whole blood collected from healthy donors with 60 MeV protons and 250 keV X-rays, in the range of 4.0 – 20.0 Gy. Drug-induced PCC assay was performed on human peripheral blood lymphocytes (HPBL) isolated after in vitro exposure. Cells were cultured for 48 hours with PHA. Then to achieve premature condensation, calyculin A was added. After Giemsa staining, chromosome spreads were photographed and manually analyzed by scorers. The dose-effect curves were derived by counting the excess chromosome fragments. The results indicated adequate dose estimates for the whole-body exposure scenario in the high dose range for both studied types of radiation. Moreover, compared results revealed no significant differences between scores, which has an important meaning in reducing the analysis time. These investigations were conducted as a part of an extended examination of 60 MeV protons from AIC-144 isochronous cyclotron, at the Institute of Nuclear Physics in Kraków, Poland (IFJ PAN) by cytogenetic and molecular methods and were partially supported by grant DEC-2013/09/D/NZ7/00324 from the National Science Centre, Poland.Keywords: cell response to radiation exposure, drug induced premature chromosome condensation, premature chromosome condensation procedure, proton therapy
Procedia PDF Downloads 3525554 Application of Taguchi Techniques on Machining of A356/Al2O3 Metal Matrix Nano-Composite
Authors: Abdallah M. Abdelkawy, Tarek M. El Hossainya, I. El Mahallawib
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Recently, significant achievements have been made in development and manufacturing of nano-dispersed metal matrix nanocomposites (MMNCs). They gain their importance due to their high strength to weight ratio. The machining problems of these new materials are less widely investigated, thus this work focuses on machining of them. Aluminum-Silicon (A356)/ MMNC dispersed with alumina (Al2O3) is important in many applications include engine blocks. The final finish process of this application depends heavily on machining. The most important machining parameter studied includes: cutting force and surface roughness. Experimental trails are performed on the number of special samples of MMNC (with different Al2O3%) where the relation between Al2O3% and cutting speed, feed rate and cutting depth with cutting force and surface roughness were studied. The data obtained were statistically analyzed using Analysis of variance (ANOVA) to define the significant factors on both cutting force and surface roughness and their level of confident. Response Surface Methodology (RSM) is used to build a model relating cutting conditions and Al2O3% to the cutting force and surface roughness. The results have shown that feed and depth of cut have the major contribution on the cutting force and the surface roughness followed by cutting speed and nano-percent in MMNCs.Keywords: machinability, cutting force, surface roughness, Ra, RSM, ANOVA, MMNCs
Procedia PDF Downloads 3695553 Comparison of Depth of Cure and Degree of Conversion between Opus Bulk Fill and X-Tra Fill Bulk Fill Composites
Authors: Yasaman Samani, Ali Golmohammadi
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Introduction: The degree of conversion and depth of cure affects the clinical success of resin composite restorations directly. One of the main challenges in achieving a successful composite restoration is the achievement of sufficient depth of cure. The insufficient polymerization may lead to a decrease in the physical/mechanical and biological properties of resin composites and, as a result of that, unsuccessful composite restoration. Thus, because of the importance of studying and evaluating the depth of cure and degree of conversion in bulk-fill composites, we decided to evaluate and compare the degree of conversion and depth of cure in two bulk-fill composites; x-tra fill (Voco, Germany) and Opus Bulk fill APS (FGM, Brazil). Materials and Methods: Composite resin specimens (n=10) per group were prepared as cylinder blocks (4×8 mm) with bulk-fill composites, x-tra fil (Voco, Germany) designated as Group A, and Opus Bulk fill APS (FGM, Brazil) designated as Group B. Depth of cure was determined according to “ISO 4049; Depth of Cure” method, In which each specimen were cured (iLED, Woodpecker, China) 40 seconds and FTIR spectroscopy method was used to estimate the degree of conversion of both the bulk-fill composites. The degree of conversion of monomer to polymer was estimated individually in the coronal half (Group A1 and B1) and pulpal half (Group A2 and Group B2) by dividing each specimen into two halves. The data were analyzed using a Student’s t-test and one-way ANOVA at a 5% level of significance. Results: The mean depth of cure in x-tra fil (Voco, Germany) was 3.99 (±0.16), and for Opus Bulk fill, APS (FGM, Brazil) was 2.14 (±0.3). The degree of conversion percentage in Group A1 was 82.7 (±6.1), in group A2 was 73.4 (±5.2), in group B1 was 63.3 (±4.7) and in Group B2 was 56.5 (±7.7). Statistical analysis revealed a significant difference in the depth of cure between the two bulk-fill composites with x-tra fil (Voco, Germany) higher than Opus Bulk fill APS (FGM, Brazil) (P<0.001). The degree of conversion percentage also showed a significant difference, Group A1 being higher than A2 (P=0.0085), B1, and B2 (P<0.001). Group A2 was also higher than B1 (P=0.003) and B2 (P<0.001). There was no significant difference between B1 and B2 (P=0.072). Conclusion: The results indicate that x-tra fill has more depth of cure and a higher percentage of the degree of conversion than Opus Bulk fill APS. The coronal half of x-tra fil had the highest depth of cure percentage (82.66%), and the pulpal half of Opus Bulk fill APS had the lowest percentage (56.45%). Even though both bulk-fill composite materials had an acceptable degree of conversion (55% and higher), x-tra fill has shown better results.Keywords: depth of cure, degree of conversion, bulk-fill composite, FTIR
Procedia PDF Downloads 1025552 Enhancement of Solar Energy Storage by Nanofluid-Glass Impurities Mixture
Authors: Farhan Lafta Rashid, Khudhair Abass Dawood, Ahmed Hashim
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Recent advancements in nanotechnology have originated the new emerging heat transfer fluids called nanofluids. Nanofluids are prepared by dispersing and stably suspending nanometer sized solid particles in conventional heat transfer fluids. Past researches have shown that a very small amount of suspending nano-particles have the potential to enhance the thermo physical, transport, and radiative properties of the base fluid. At this research adding very small quantities of nano particle (TiO2) to pure water with different weights percent ranged 0.1, 0.2, 0.3, and 0.4 wt.%, we found that the best weight percent is 0.2 that gave more heat absorbed. Then adding glass impurities ranged 10, 20, and 30 wt. Percentage to the nano-fluid in order to enhance the absorbed heat so energy storage. The best glass weights percent is 0.3.Keywords: energy storage, enhancement absorbed heat, glass impurities, solar energy
Procedia PDF Downloads 4335551 Analytical Solution of Specific Energy Equation in Exponential Channels
Authors: Abdulrahman Abdulrahman
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The specific energy equation has many applications in practical channels, such as exponential channels. In this paper, the governing equation of alternate depth ratio for exponential channels, in general, was investigated towards obtaining analytical solution for the alternate depth ratio in three exponential channel shapes, viz., rectangular, triangular, and parabolic channels. The alternate depth ratio for rectangular channels is quadratic; hence it is very simple to solve. While for parabolic and triangular channels, the alternate depth ratio is cubic and quartic equations, respectively, analytical solution for these equations may be achieved easily for a given Froud number. Different examples are solved to prove the efficiency of the proposed solution. Such analytical solution can be easily used in natural rivers and most of practical channels.Keywords: alternate depth, analytical solution, specific energy, parabolic channel, rectangular channel, triangular channel, open channel flow
Procedia PDF Downloads 1985550 Activities for Increasing Childhood Vaccination Coverage of the Refugee and Migrant Population, Greece, European Program PHILOS, 2017
Authors: C. Silvestros, K. Mellou, T. Georgakopoulou, A. Koustenis, E. Kokkinou, C. Botsi, A. Terzidis
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'PHILOS – Emergency health response to refugee crisis' is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP) funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. One of the main objectives of the program is the immunization coverage of the target – population to assure the prevention of vaccine-preventable diseases. The program foresees vaccination needs assessment of children hosted at camps at the mainland and implementation of interventions to cover the vaccination gaps in co-operation with the Ministry of Health. The National Immunization Advisory Committee in Greece recommended that MMR (Measles, Mumps, and Rubella), PCV (Pneumococcal conjugate vaccine) and HEXA (diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b) vaccines should be performed in priority. Recording was completed at 24 camps (May - June 2017); 3381 children (0-18 years) were recorded. The median number of children hosted at each camp was 95 (range: 5-553). For 68% of the children, the WHO vaccination booklet was available. 44%, 48.5% and 61% of the children were vaccinated with at least one dose of PCV, HEXA, and MMR, respectively. The proportion of vaccinated children for the three vaccines mentioned above is significantly lower for the remaining doses; PCV (second dose 8%, third dose 1.3%), HEXA (second dose 13%, third dose 2.7%, forth dose 0.1%) and MMR (second dose 23%). None of the 37 (10 from Afghanistan, 3 from Bangladesh, 23 from Pakistan, 1 from Syria) recorded unaccompanied children did not have a WHO vaccination booklet and were considered unvaccinated. There is no differentiation in vaccination coverage among different ethnicities. Massive catch up vaccination was performed at 4 camps, and 671 vaccinations were performed (245 PCV, 307 HEXA, and 119 MMR). Similar interventions are planned for all camps of the country. Recording reveled gaps in vaccination coverage of the population, mainly because of the mobility of the population, the influx of refugees- which is still ongoing- and new births. Mass vaccination campaigns are considered vital in order to increase vaccination coverage, and continuous efforts are needed in order all children living at the camps to have full access to the National Childhood Immunization Program.Keywords: vaccine preventable, refugee–migrants camps, vaccination coverage, PCV, MMR, HEXA
Procedia PDF Downloads 1845549 Evaluating Viability of Solar Tubewell Irrigation Technology
Authors: Junaid N. Chauhdary, Bernard A. Engel, Allah Bakhsh
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Solar powered tubewells can be a reliable and affordable source of supplying irrigation water compared with electric or diesel operated tubewells due to frequent load shedding and soaring energy prices. A study was conducted on a solar tubewell installed at the Water Management Research Center (WMRC), University of Agriculture, Faisalabad to investigate the viability of a solar powered tubewell in terms of discharge and benefit cost ratio. The tubewell discharge was 50 m3hr-1 with a total dynamic head of 30 m. The depth of bore was 31 m (14 m blind + 17 m screen) with a casing diameter of 15.2 cm (6 inches). A 3-stage submersible pump of 10.2 cm (4 inch) diameter was lowered in the casing to a depth of 22 m. The pump was powered from 21 solar panels of 200 W capacity each. The tubewell peak discharge was observed as 6 and 7 hr day-1 in winter and summer, respectively. The breakeven analysis of the solar tubewell showed that the payback period of the solar tubewell was 1.5 years of its 10 year usable life with an IRR (internal rate of return) of 69 %. The BCR (benefit cost ratio) of the solar tubewell at 2, 4, 6, and 8 percent discount rate were 3.75, 3.45, 3.19 and 2.96, respectively. The NPV (net present value) of the solar tubewell at 2, 4, 6, and 8 % discount rates were 1.89, 1.65, 1.45 and 1.27 million rupees, respectively. These results indicated that the solar powered tubewells are a viable option as well as environmentally friendly and can be adopted by the farmers due to their affordable payback period.Keywords: benefit cost ratio, internal rate of return (IRR), net present value (NPV), solar tubewell
Procedia PDF Downloads 2085548 Dosimetric Comparison of Conventional Plans versus Three Dimensional Conformal Simultaneously Integrated Boost Plans
Authors: Shoukat Ali, Amjad Hussain, Latif-ur-Rehman, Sehrish Inam
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Radiotherapy plays an important role in the management of cancer patients. Approximately 50% of the cancer patients receive radiotherapy at one point or another during the course of treatment. The entire radiotherapy treatment of curative intent is divided into different phases, depending on the histology of the tumor. The established protocols are useful in deciding the total dose, fraction size, and numbers of phases. The objective of this study was to evaluate the dosimetric differences between the conventional treatment protocols and the three-dimensional conformal simultaneously integrated boost (SIB) plans for three different tumors sites (i.e. bladder, breast, and brain). A total of 30 patients with brain, breast and bladder cancers were selected in this retrospective study. All the patients were CT simulated initially. The primary physician contoured PTV1 and PTV2 in the axial slices. The conventional doses prescribed for brain and breast is 60Gy/30 fractions, and 64.8Gy/36 fractions for bladder treatment. For the SIB plans biological effective doses (BED) were calculated for 25 fractions. The two conventional (Phase I and Phase II) and a single SIB plan for each patient were generated on Eclipse™ treatment planning system. Treatment plans were compared and analyzed for coverage index, conformity index, homogeneity index, dose gradient and organs at risk doses.In both plans 95% of PTV volume received a minimum of 95% of the prescribe dose. Dose deviation in the optic chiasm was found to be less than 0.5%. There is no significant difference in lung V20 and heart V30 in the breast plans. In the rectum plans V75%, V50% and V25% were found to be less than 1.2% different. Deviation in the tumor coverage, conformity and homogeneity indices were found to be less than 1%. SIB plans with three dimensional conformal radiotherapy technique reduce the overall treatment time without compromising the target coverage and without increasing dose to the organs at risk. The higher dose per fraction may increase the late effects to some extent. Further studies are required to evaluate the late effects with the intention of standardizing the SIB technique for practical implementation.Keywords: coverage index, conformity index, dose gradient, homogeneity index, simultaneously integrated boost
Procedia PDF Downloads 4765547 Standardization Of Miniature Neutron Research Reactor And Occupational Safety Analysis
Authors: Raymond Limen Njinga
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The comparator factors (Fc) for miniature research reactors are of great importance in the field of nuclear physics as it provide accurate bases for the evaluation of elements in all form of samples via ko-NAA techniques. The Fc was initially simulated theoretically thereafter, series of experiments were performed to validate the results. In this situation, the experimental values were obtained using the alloy of Au(0.1%) - Al monitor foil and a neutron flux setting of 5.00E+11 cm-2.s-1. As was observed in the inner irradiation position, the average experimental value of 7.120E+05 was reported against the theoretical value of 7.330E+05. In comparison, a percentage deviation of 2.86 (from theoretical value) was observed. In the large case of the outer irradiation position, the experimental value of 1.170E+06 was recorded against the theoretical value of 1.210E+06 with a percentage deviation of 3.310 (from the theoretical value). The estimation of equivalent dose rate at 5m from neutron flux of 5.00E+11 cm-2.s-1 within the neutron energies of 1KeV, 10KeV, 100KeV, 500KeV, 1MeV, 5MeV and 10MeV were calculated to be 0.01 Sv/h, 0.01 Sv/h, 0.03 Sv/h, 0.15 Sv/h, 0.21Sv/h and 0.25 Sv/h respectively with a total dose within a period of an hour was obtained to be 0.66 Sv.Keywords: neutron flux, comparator factor, NAA techniques, neutron energy, equivalent dose
Procedia PDF Downloads 1825546 Knowledge and Adoption of Agricultural Biotechnology among Small-Scale Farmers in Taraba State Nigeria
Authors: A. H. Paul, L. J. Gizaki, E. P. Ejimbi
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The study was carried out to determine the level of knowledge and adoption of agricultural biotechnology in Taraba state. Purposive and simple sampling techniques were used to select respondents. Questionnaires were administered to 90 respondents. Data were analyzed using descriptive and inferential statistics. The results showed that the majority (73.3%) of the respondents were small-scale farmers, whereas 24.4 percent were engaged in secondary occupations. The mean farm size was 1-5 ha. The majority (72.2%) had one form of formal education or another. About 84 percent (84.4%) had been farming for at least 10 years. There was a mean household size of 6-10 persons. Many (97.8%) of the respondents were knowledgeable about biotechnology, and about 70.0 percent (70.1%) reported that the biotechnology products which they had adopted were very good for animals and human consumption. The result of Pearson’s correlation (r = 0.699) was significant at the 0.01 alpha level. Therefore, the hypothesis that there is no significant relationship between knowledge and adoption of agricultural biotechnology was rejected. It was concluded that the agricultural biotechnologies that were adopted were very safe for animals, humans, and the environment. It was recommended that the government should employ more extension agents to help educate farmers about agricultural biotechnology.Keywords: agricultural, adoption, biotechnology, knowledge
Procedia PDF Downloads 1385545 The Study of the Mutual Effect of Genotype in Environment by Percent of Oil Criterion in Sunflower
Authors: Seyed Mohammad Nasir Mousavi, Pasha Hejazi, Maryam Ebrahimian Dehkordi
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In order to study the Mutual effect of genotype × environment for the percent of oil index in sunflower items, an experiment was accomplished in form of complete random block designs in four iteration in four diverse researching station comprising Esfahan, Birjand, Sari, and Karaj. Complex variance analysis showed that there is an important diversity between the items under investigation. The results pertaining the coefficient variation of items Azargol and Vidoc has respectively allocated the minimum coefficient of variations. According to the results extrapolated from Shokla stability variance, the Items Brocar, Allison and Fabiola, are among the stable genotypes for oil percent respectively. in the biplot GGE, the location under investigations divided in two super-environment, first one comprised of locations naming Esfahan, Karaj, and Birjand, and second one were such a location as Sari. By this point of view, in the first super-environment, the Item Fabiola and in the second Almanzor item was among the best items and crops.Keywords: sunflower, stability, GGE bipilot, super-environment
Procedia PDF Downloads 5465544 Predictive Value of Primary Tumor Depth for Cervical Lymphadenopathy in Squamous Cell Carcinoma of Buccal Mucosa
Authors: Zohra Salim
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Objective: To access the relationship of primary tumor thickness with cervical lymphadenopathy in squamous cell carcinoma of buccal mucosa. Methodology: A cross-sectional observational study was carried out on 80 Patients with biopsy-proven oral squamous cell carcinoma of buccal mucosa at Dow University of Health Sciences. All the study participants were treated with wide local excision of the primary tumor with elective neck dissection. Patients with prior head and neck malignancy or those with prior radiotherapy or chemotherapy were excluded from the study. Data was entered and analyzed on SPSS 21. Chi-squared test with 95% C.I and 80% power of the test was used to evaluate the relationship of tumor depth with cervical lymph nodes. Results: 50 participants were male, and 30 patients were female. 30 patients were in the age range of 20-40 years, 36 patients in the range of 40-60 years, while 14 patients were beyond age 60 years. Tumor size ranged from 0.3cm to 5cm with a mean of 2.03cm. Tumor depth ranged from 0.2cm to 5cm. 20% of the participants reported with tumor depth greater than 2.5cm, while 80% of patients reported with tumor depth less than 2.5cm. Out of 80 patients, 27 reported with negative lymph nodes, while 53 patients reported with positive lymph nodes. Conclusion: Our study concludes that relationship exists between the depth of primary tumor and cervical lymphadenopathy in squamous cell carcinoma of buccal mucosa.Keywords: squamous cell carcinoma, tumor depth, cervical lymphadenopathy, buccal mucosa
Procedia PDF Downloads 2375543 Influence of Pier Modification Techniques for Reducing Scour around Bridge Piers
Authors: Rashid Farooq, Abdul Razzaq Ghumman, Hashim Nisar Hashmi
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Bridge piers often fail all over the world and the whole structure may be endangered due to scouring phenomena. Scouring has been linked to catastrophic failures that lead into the loss of human lives. Various techniques have been employed to extenuate the scouring process in order to assist the bridge designs. Pier modifications plays vital role to control scouring at the vicinity of the pier. This experimental study aims at monitoring the effectiveness of pier modification and temporal development of scour depth around a bridge pier by providing a collar, a cable or openings under the same flow conditions. Provision of a collar around the octagonal pier reduced more scour depth than that for other two configurations. Providing a collar around the octagonal pier found to be the best in reducing scour. The scour depth in front of pier was found to be 19.5% less than that at the octagonal pier without any modifications. Similarly, the scour depth around the octagonal pier having provision of a cable was less than that at pier with provision of openings. The scour depth around an octagonal pier was also compared with a plain circular pier and found to be 9.1% less.Keywords: Scour, octagonal pier, collar, cable
Procedia PDF Downloads 2655542 Factors Associated with Ketamine Use in Pancreatic Cancer Patient in a Single Hospice Center
Authors: Kyung Min Kwom, Young Joo Lee
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Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer
Procedia PDF Downloads 2335541 Determination of Natural Gamma Radioactivity in Sand along the Black Sea Coastal Region of Giresun, North Turkey
Authors: A. Karadeniz, Belgin Kucukomeroglu
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In this study natural gamma radioactivity levels are determined on sands along the coastal regions of Giresun/Turkey. The coast of Giresun about 290 km long in investigated to collect 101 sand samples. Natural and artificial radioactivity concentrations of sand samples were measured by using HPGe gamma spectrometry. The average activity concentrations of 238U, 232Th, 40K and 137Cs on sand samples of Giresun were found to be 10.83±2.92 Bq/kg, 21.28±3.22 Bq/kg, 6.42±1.06 Bq/kg, 230.94±10.67 Bq/kg respectively. The average activity concentrations for these radionuclides were compared with the reported data of other parts of Turkey and other countries. The average absorbed dose rate for Giresun was calculated to be 38.68 nGy/h respectively. This value is significantly lower than the World averaged value of 60 nGy/h. The external annual effective dose rate concentration in Giresun was found to be 0.047 mSv/y respectively. This result is much lower than the recommeded limit of 5 mSv/y. The external hazard dose rate for Giresun weas calculated to be 0.21 respectively. This result is much lower than the recommended limit of 1.0.Keywords: concentration, radioactivity, Giresun, natural gamma radioactivity
Procedia PDF Downloads 3915540 Oral Antibiotics in Trans-Rectal Prostate Biopsy and Its Efficacy to Reduce Infectious Complications: Systematic Review
Authors: Mohand Yaghi, O. Kehinde
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Background: For the diagnosis of prostate cancer Trans-rectal prostate biopsy (TRPB) is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx) decrease infective events after TRPB, but different regimens are used. Aim: To systematically review different regimens of prophylactic oral antibiotics in TRPB. Design: Medline, Embase, Clinical trials site, and Cochrane library were searched, experts were consulted about relevant studies. Randomized clinical trials (RCT) conducted in the last twenty years, which investigated different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Measurements: Primary outcomes were bacteriuria, urinary tract infection (UTI), fever, bacteremia, sepsis. Secondary outcomes were hospitalization rate, and the prevalence of ABx-resistant bacteria. Results: Nine trials were eligible with 3012 patients. Antibiotics prevented bacteriuria (3.5% vs. 9.88%), UTI (4.46% vs. 9.75%), and hospitalization (0.21% vs. 2.13%) significantly in comparison with placebo or no treatment. No significant difference was found in all outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple dose except in Bacteriuria (6.75% vs. 3.25%), and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%). Quinolones reduced only UTI significantly in comparison with other antibiotics. Lastly, Ciprofloxacin is the best Quinolone to prevent UTI, and hospitalization. Conclusion: it is essential to prescribe prophylactic Antibiotics in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria was identified more often in the single dose cohorts.Keywords: infection, prostate cancer, sepsis, TRPB
Procedia PDF Downloads 3685539 Estimation of Normalized Glandular Doses Using a Three-Layer Mammographic Phantom
Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu
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The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity
Procedia PDF Downloads 1895538 Anxieolytic Activity of Ethyl Acetate Extract of Flowers Nerium indicum
Authors: D. S. Mohale, A. V. Chandewar
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Anxiety is defined as an exaggerated feeling of apprehension, uncertainty and fear. Nerium indicum is a well-known ornamental and medicinal plant belonging to the family Apocynaceae. A wide spectrum of biological activities has been reported with various constituents isolated from different parts of the plant. This study was conducted to investigate antianxiety activity of flower extract. Flowers were collected and dried in shade and coarsely powdered. Powdered mixture was extracted with ethyl acetate by maceration process. Extract of flowers obtained was subsequently dried in oven at 40-50 °C. This extract is then tested for antianxiety activity at low and high dose using Elevated Plus Maze and Light & dark Model. Rats shown increased open arm entries and time spent in open arm in elevated Plus maze with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. In Light & dark Model, light box entries and time spent in light box increased with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. From result it is concluded that Ethyl acetate extract of flower of Nerium indicum possess antianxiety activity at low and high dose.Keywords: anxiety, anxieolytic, social isolation, nerium indicum, kaner
Procedia PDF Downloads 3095537 Rituximab Therapy for Musculoskeletal Involvement in Systemic Sclerosis
Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva
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Objectives. There is very few data on changes of the musculoskeletal manifestations (artritis, arthralgia, muscle weakness, etc.) in systemic sclerosis (SSc) on rituximab (RTX) therapy. The aim of our study was to assess the severity of the musculoskeletal involvement in SSc patients (pts) and its changes during RTX therapy. Methods. Our study included 103 pts with SSc. The mean followup period was 12.6±10.7 months. The mean age was 47±12.9 years, female-87 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had interstitial lung disease (ILD) and were positive for ANA, 67% of them were positive for antitopoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. Arthritis was observed in 22 pts (21%), arthralgias in 47 pts (46%). Muscle weakness was observed in 17 pts (17%). Tendon friction rubs was established in 7 pts (7%). The results at baseline and at the end of the follow up are presented in the form of mean values. Results. There was an improvement of all outcome parameters and musculoskeletal manifestations on RTX therapy. There was a decrease in the number of pts with arthritis from 22 (21%) to 10 (9%), a decrease in the number of pts with arthralgias from 47 (46%) to 31 (30%). The number of pts with muscle weakness decreased from 17 (17%) to 7 (7%). The number of pts with tendon friction rubs decreased from 7 (7%) to 3 (3%). The creatine phosphokinase decreased from 365.5±186 to 70.8±50.4 (p=0.00006). The C-reactive protein (CRP) decreased from 23.2±31.3 to 8.62±7.4 (p=0.001). The dose of prednisolone was reduced from 11.3±4.5 to 9.8±3.5 mg/day (p=0.0004). Conclusion. In our study, musculoskeletal involvement was detected in almost half of the patients with SSc-ILD. There was an improvement of musculoskeletal manifestations despite a small cumulative dose of RTX. We also managed to reduce the dose of glucocorticosteroids. The improvement of musculoskeletal manifestations was accompanied by a decrease in laboratory parameters - creatine phosphokinase and CRP. RTX is effective option for treatment of musculoskeletal manifestations in SSc.Keywords: arthritis, musculoskeletal involvement, systemic sclerosis, rituximab
Procedia PDF Downloads 825536 Genoprotective Effect of Lepidium sativum L. Seed Methanolic Extract on Cyclophosphamide-Induced DNA Damage in Mice and Characterization of Its Flavonoidal Content
Authors: Iman A. A. Kassem, Ayman A. Farghaly, Zeinab M. Hassan, Farouk R. Melek, Neveen S. Ghaly
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Lipidium sativum L, an annual herb that grows to 50 cm, is known as an important member of family Brassicaceae. Besides its nutritional value, the seeds were widely used in folk medicine for treatment of cough, asthma, and headache. It was also reported to possess hypocholesterolemic, anti-inflammatory, antidiarrheal, antimicrobial and anticancer activities. In this study, the genoprotective properties of L. sativum seed methanolic extract (LSME) were evaluated in vivo. Three groups of mice were given LSME for five consecutive days at the three dose levels 25, 50 and 100 mg/kg b.wt. The three groups were then injected intraperitoneally with cyclophosphamide at a dose of 20 mg/kg b.wt. to induce DNA damage. A group received only cyclophosphamide (20 mg/kg b.wt.) served as control. LSME significantly inhibited the DNA aberrations in mice caused by cyclophosphamide in a dose-dependent manner in the two groups that received LSME at 50 and 100 mg/kg b.wt. dose levels. The chromosomal aberrations' inhibitory indices were calculated as 18 and 31 in mice bone marrow cells and 27 and 48 in mice spermatocytes, respectively. Phytochemical examination carried out by us revealed that flavonoids were the main chemical constituents of LSME. The major flavonoids kaempferol, kaempferol-3-O-rhamnoside, kaempferol-3-O-glucoside, quercetin, and quercetin-3-O-glucoside were isolated and characterized. It was concluded that the genoprotective effect of LSME might be attributed to the presence of flavonoids which are well-known for their antioxidant properties.Keywords: cyclophosphamide, flavonoids, genoprotective effect, Lepidium sativum
Procedia PDF Downloads 1555535 Efficacy of Single-Dose Azithromycin Therapy for the Treatment of Chlamydia trachomatis in Patients Evaluated for Child Sexual Abuse in an Urban Health Center 2006-16
Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann
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Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms
Procedia PDF Downloads 294