Search results for: fort portal regional referral hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4030

Search results for: fort portal regional referral hospital

1570 An Assessment of Inferior Dental (IDN) and Lingual Nerve (LN) Injuries Following Third Molar Removal Under LA, IVS, and GA - An Audit and Case-Series

Authors: Aamna Tufail, Catherine Anyanwu

Abstract:

Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.

Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars

Procedia PDF Downloads 84
1569 School Context-Related Factors That Affect Principals’ Instructional Leadership Competence at Primary Schools in Tarcha Town, Ethiopia

Authors: Godaye Gobena Gomiole

Abstract:

The purpose of this study was to investigate school context-related factors that affect principals' instructional leadership competence in primary schools in Tarcha Town, Ethiopia. A qualitative case study research design was used. The data were collected through semi-structured interviews and document analysis. Twelve senior principals were included in the study through purposive sampling. Interviews were used to collect in-depth data. The data was analyzed thematically. The findings of the study indicated that primary school principals face both internal and external challenges. Internally, they face limited knowledge and skills, a lack of courage and commitment, and administrative work overload. Their external challenges included negative attitudes from parents and teachers, a lack of instructional materials, and little support from local education authorities. Consequently, they can't serve effectively as instructional leaders or resource people. Based on the findings, it is recommended that the Ministry of Education, South West Regional Education Bureau, Dawuro Zone Education Department, and Tarcha Town Administration Education Officers and Cluster Supervisors regularly monitor and support school leaders and prepare and provide pertinent teaching materials and training so that the principals can lead in the capacity that is appropriate for the position.

Keywords: instructional leadership, primary school, principals, school context related factors

Procedia PDF Downloads 43
1568 A Study of the Effects of Nurse Innovation on Service Quality and Service Experience

Authors: Rhay-Hung Weng, Ching-Yuan Huang, Wan-Ping Chen

Abstract:

Recently, many hospitals have put much emphasis upon the development of nurse innovation. The present study aimed to clarify how nurse innovation is related to medical service quality and medical service experience. This study adopted questionnaire-survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilized to test the possible impact of nurse innovation on medical service quality and experience. In terms of the dimensions of nurse innovation, “innovation behavior” ranked the highest (3.24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4.35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4.44). All dimensions of nurse innovation have no significant effects on medical service quality and medical service experience. Of these three dimensions of nurse innovation, the level of innovation behavior was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on medical service quality and medical service experience. Managers shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on “patient-centered ” shall be enhanced among hospital nurses. Health care managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses.

Keywords: innovation, employee innovative behavior, service quality, service experience

Procedia PDF Downloads 324
1567 Saliva Cortisol and Yawning as a Predictor of Neurological Disease

Authors: Simon B. N. Thompson

Abstract:

Cortisol is important to our immune system, regulates our stress response, and is a factor in maintaining brain temperature. Saliva cortisol is a practical and useful non-invasive measurement that signifies the presence of the important hormone. Electrical activity in the jaw muscles typically rises when the muscles are moved during yawning and the electrical level is found to be correlated with the cortisol level. In two studies using identical paradigms, a total of 108 healthy subjects were exposed to yawning-provoking stimuli so that their cortisol levels and electrical nerve impulses from their jaw muscles was recorded. Electrical activity is highly correlated with cortisol levels in healthy people. The Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details were collected and exclusion criteria applied for voluntary recruitment: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners as compared with the non-yawners between rest and post-stimuli. Significant evidence supports the Thompson Cortisol Hypothesis that suggests rises in cortisol levels are associated with yawning. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, diagnosis, neurological disease, thompson cortisol hypothesis, yawning

Procedia PDF Downloads 329
1566 Comparison of Early Silicon Oil Removal and Late Silicon Oil Removal in Patients With Rhegmatogenous Retinal Detachment

Authors: Hamidreza Torabi, Mohsen Moghtaderi

Abstract:

Introduction: Currently, deep vitrectomy with silicone oil tamponade is the standard treatment method for patients with Rhegmatogenous Retinal Detachment (RRD). After retinal repair, it is necessary to remove silicone oil from the eye, but the appropriate time to remove the oil and complications related to that time has been less studied. The aim of this study was to compare the results of the early removal of silicone oil with the delayed removal of silicone oil in patients with RRD. Method & material: Patients who were referred to the Ophthalmology Clinic of Baqiyatallah Hospital, Tehran, Iran, due to RRD with detached macula in 2021 & 2022 were evaluated. These patients were treated with deep vitrectomy and silicone oil tamponade. Patients whose retinas were attached after the passage of time were candidates for silicone oil removal (SOR) surgery. For patients in the early SOR group, SOR surgery was performed 3-6 months after the initial vitrectomy surgery, and for the late SOR group, SOR was performed after 6 months after the initial vitrectomy surgery. Results: In this study, 60 patients with RRD were evaluated. 23 (38.3%) patients were in the early group, and 37 (61.7%) patients were in the late group. Based on our findings, it was seen that the mean visual acuity of patients based on the Snellen chart in the early group (0.48 ± 0.23 Decimal) was better than the late group (0.33 ± 0.18 Decimal) (P-value=0.009). Retinal re-detachment has happened only in one patient with early SOR. Conclusion: Early removal of silicone oil (less than 6 months) from the eyes of patients undergoing RRD surgery has been associated with better vision results compared to late removal.

Keywords: retinal detachment, vitrectomy, silicone oil, silicone oil removal, visual acuity

Procedia PDF Downloads 71
1565 Climate Change, Agriculture and Food Security in Sub-Saharan Africa: What Effects and What Answers?

Authors: Abdoulahad Allamine

Abstract:

The objective of this study is to assess the impact of climate variability on agriculture and food security in 43 countries of sub-Saharan Africa. We use for this purpose the data from BADC bases, UNCTAD, and WDI FAOSTAT to estimate a VAR model on panel data. The sample is divided into three (03) agro-climatic zones, more explicitly the equatorial zone, the Sahel region and the semi-arid zone. This allows to highlight the differential impacts sustained by countries and appropriate responses to each group of countries. The results show that the sharp fluctuations in the volume of rainfall negatively affect agriculture and food security of countries in the equatorial zone, with heavy rainfall and high temperatures in the Sahel region. However, countries with low temperatures and low rainfall are the least affected. The hedging policies against the risks of climate variability must be more active in the first two groups of countries. On this basis and in general, we recommend integration of agricultural policies between countries is done to reduce the effects of climate variability on agriculture and food security. It would be logical to encourage regional and international closer collaboration on the development and dissemination of improved varieties, ecological intensification, and management of biotic and abiotic stresses facing these climate variability to sustainably increase food production. Small farmers also need training in agricultural risk hedging techniques related to climate variations; this requires an increase in state budgets allocated to agriculture.

Keywords: agro-climatic zones, climate variability, food security, Sub-Saharan Africa, VAR on panel data

Procedia PDF Downloads 368
1564 Osteitis in the Diabetic Foot and the Risk Factor on the Population

Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic, biopsy, diabetic foot

Procedia PDF Downloads 90
1563 A C/T Polymorphism at the 5’ Untranslated Region of CD40 Gene in Patients Associated with Graves’ Disease in Kumaon Region

Authors: Sanjeev Kumar Shukla, Govind Singh, Prabhat Pant Shahzad Ahmad

Abstract:

Background: Graves’ disease is an autoimmune disorder with a genetic predisposition, and CD40 plays a pathogenic role in various autoimmune diseases. A single nucleotide polymorphism at position –1 of the Kozak sequence of the 5 untranslated regions of the CD40 gene of exon 1 has been reported to be associated with the development of Graves’ Disease. Objective: The aim of the present study was to investigate whether CD40 gene polymorphism confers susceptibility to Graves’ disease in the Kumaon region. CD40 gene polymorphisms were studied in Graves’ Disease patients (n=50) and healthy control subjects without anti-thyroid autoantibodies or a family history of autoimmune disorders (n=50). Material and Method: CD40 gene polymorphisms were studied in fifty Graves’ Disease patients and fifty healthy control subjects. All samples were collected from STG Hospital, Haldwani, Nainital. A C/T polymorphism at position –1 of the CD40 gene was measured using the polymerase chain reaction-restriction fragment length polymorphism. Results: There was no significant difference in allele or genotype frequency of the CD40 SNP between Graves’ Disease and control subjects. There was a significant decrease in the TT genotype frequency in the Graves’ Disease patients who developed Graves’ Disease after 40 years old than those under 40 years of age. These data suggest that the SNP of the CD40 gene is associated with susceptibility to the later onset of Graves’ Disease. Conclusion: The CD40 gene was a different susceptibility gene for Graves’ Disease within certain families because it was both linked and associated with Graves’ Disease.

Keywords: autoimmune diseases, pathogenesis, diagnosis, therapy

Procedia PDF Downloads 41
1562 Application of Nonparametric Geographically Weighted Regression to Evaluate the Unemployment Rate in East Java

Authors: Sifriyani Sifriyani, I Nyoman Budiantara, Sri Haryatmi, Gunardi Gunardi

Abstract:

East Java Province has a first rank as a province that has the most counties and cities in Indonesia and has the largest population. In 2015, the population reached 38.847.561 million, this figure showed a very high population growth. High population growth is feared to lead to increase the levels of unemployment. In this study, the researchers mapped and modeled the unemployment rate with 6 variables that were supposed to influence. Modeling was done by nonparametric geographically weighted regression methods with truncated spline approach. This method was chosen because spline method is a flexible method, these models tend to look for its own estimation. In this modeling, there were point knots, the point that showed the changes of data. The selection of the optimum point knots was done by selecting the most minimun value of Generalized Cross Validation (GCV). Based on the research, 6 variables were declared to affect the level of unemployment in eastern Java. They were the percentage of population that is educated above high school, the rate of economic growth, the population density, the investment ratio of total labor force, the regional minimum wage and the ratio of the number of big industry and medium scale industry from the work force. The nonparametric geographically weighted regression models with truncated spline approach had a coefficient of determination 98.95% and the value of MSE equal to 0.0047.

Keywords: East Java, nonparametric geographically weighted regression, spatial, spline approach, unemployed rate

Procedia PDF Downloads 310
1561 Role of International Organizations towards Good Governance: Recent Trends

Authors: E. Prema Shyam

Abstract:

The role of international organizations has contributed in various ways for the good governance in the world at large. Since the beginning of the 1990s international organizations, particularly those active in the areas of human rights, trade and economic etc., have embraced a 'good governance'. It is also pertinent to mention that the application of the concept of good governance to international organizations themselves and not exclusively to national or regional polities is a more recent phenomenon. Especially since the second half of the 1990s, a number of international organizations have carried out major governance reforms, assuming that their calls for governments to heed higher standards of good governance will be all the more credible provided that they develop a good governance standard for themselves. In addition to this number of organizations such as the United Nations (UN), Organisation for Economic Co-operation and Development (OECD), European Union (EU), International Committee of the Red Cross and World Trade Organization (WTO). OECD has been specifically mobilized to fight corruption. The World Bank was the first international organization to address the issue of good governance when it attributed the African development crisis to a crisis of governance in a 1989 report. International organizations are often denounced for their lack of transparency and democracy. However, in the last few years, a number of them have pushed through impressive reforms aimed at enhancing good governance standards within their own organizations, especially in the light of their long-standing secrecy. This is a remnant of the traditional conception of international organizations, which renders them merely answerable to their Members. International organizations have already gone quite some way in the areas of good management and opening up to the public. However, as far as participatory governance is concerned, lot to be done for the larger interest of society. In this paper, an attempt has been made to focus the issues on international organisations with regard to good governance.

Keywords: good governance, World Trade Organisation, international organisation, governance reforms

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1560 Zoning and Planning Response to Low-Carbon Development Transition in the Chengdu-Chongqing City Clusters, China

Authors: Hanyu Wang, Guangdong Wang

Abstract:

County-level areas serve as vital spatial units for advancing new urbanization and implementing the principles of low-carbon development, representing critical regions where conflicts between the two are pronounced. Using the 142 county-level units in the Chengdu-Chongqing city clusters as a case study, a coupled coordination model is employed to investigate the coupled coordination relationship and its spatiotemporal evolution between county-level new urbanization and low-carbon development levels. Results indicate that (1) from 2005 to 2020, the overall levels of new urbanization and low-carbon development in the Chengdu-Chongqing city clusters showed an upward trend but with significant regional disparities. The new urbanization level exhibited a spatial differentiation pattern of "high in the suburban areas, low in the distant suburbs, and some counties standing out." The temporal change in low-carbon development levels was not pronounced, yet spatial disparities were notable. (2) The overall coupling coordination degree between new urbanization and low-carbon development is transitioning from barely coordinated to moderately coordinated. The lag in new urbanization levels serves as a primary factor constraining the coordinated development of most counties. (3) Based on the temporal evolution of development states, all county units can be categorized into four types: coordinated demonstration areas, synergistic improvement areas, low-carbon transformation areas, and development lag areas. The research findings offer crucial reference points for spatial planning and the formulation of low-carbon development policies.

Keywords: county units, coupling coordination, low-carbon development, new urbanization

Procedia PDF Downloads 76
1559 A Survey of Chronic Pain Patients’ Experiences in the Emergency Department

Authors: G. Fitzpatrick, S. O. Chonghaile, D. Harmon

Abstract:

Objective: Chronic pain patients represent a unique challenge in the Emergency Department. Very little literature has been published regarding this group of patients. Our aim was to determine the attitude of patients with chronic pain to the Emergency Department in order to improve and streamline their future visits. Methods: A two-year survey was carried out on Chronic Pain Patients regarding their Emergency Department Attendances. Patients attending the Pain Clinic in Croom Hospital, Co. Limerick were asked to complete a 20-part questionnaire regarding their experiences of visiting the Emergency Department in the preceding year. 46 questionnaires were completed. Results: Unbearable breakthrough pain was the main reason for visiting the Emergency Department. More than half (54%) of those surveyed were not satisfied with the treatment received. Problems indicated included under-treatment of pain (59%), a sense of being under undue suspicion of drug-seeking behaviour (33%) and a perception that the patient themselves understood their condition better than the treating doctor (76%). Paracetamol, NSAIDs, or time off work comprised 72% of the treatments offered – all of which could have been provided by their General Practitioner. Only 4% were offered a nerve block. 67% felt that the creation of personalised Patient Plans, consisting of an agreed plan between the patient, their pain specialist, and the Emergency Department, would expedite their trip through the Emergency Department. Conclusions: Chronic pain patients generally have a negative experience in the ED. Possible future solutions include increasing our empathy and levels of knowledge, provision of nerve blocks in the ED, and use of personalised “Patient Plans” to streamline the treatment pathway for this group of patients.

Keywords: chronic pain, survey, patients, emergency department

Procedia PDF Downloads 364
1558 Apollo Clinical Excellence Scorecard (ACE@25): An Initiative to Drive Quality Improvement in Hospitals

Authors: Anupam Sibal

Abstract:

Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

Procedia PDF Downloads 287
1557 A Contemplation of Iranian Islamic Architecture in the Age of Globalization

Authors: Maziar Asefi, Safa Salkhi Khasraghi

Abstract:

Despite the great development of Islamic Architecture in its conquered lands, its active performance in a vast geographical area, faded by the advent of industrial age. Now in the Information Age with great advances in technologies and increased interconnection among many societies, every aspect of life is affected by rapid spreading phenomenon called globalization which resulted in the world with less regional and cultural boundaries. So being proudly globalized in the past and becoming inactive in today's globalized world puts Islamic Architecture in a great challenge. Indeed, its important role has changed from transmitting cultural values to the world to importing dominated values even defectively. This study aimed to determine the factors influenced this controversial situation of Islamic Architecture, especially in current age. The paper focuses on performance of Islamic architecture in relation with Globalization as an ancient process. So qualitative method in terms of logic analysis was chosen to evaluate how Islamic architecture of Iran has contributed in Globalization subject in different time periods. Several works were analyzed as case studies in three categories: religious, monumental, commercial utilities and climate element. Theoretical and practical findings indicate that there is a mutual relationship between Islamic Architecture and Globalization which is transformed from the active mode to passive mode gradually in three periods of Globalization: proto, modern and communication Globalization. The proposed solution in the response to this challenge is finding a solution that makes an equilibrium between science, art, and technology, as well as taking the global performance of architecture.

Keywords: Islamic architecture, globalisation, the relationship among art, science and technology, Iranian architecture

Procedia PDF Downloads 294
1556 Tranexamic Acid in Orthopedic Surgery in Children

Authors: K. Amanzoui, A. Erragh, M. Elharit, A. Afif, K. Elfakhr, S. Kalouch, A. Chlilek

Abstract:

Orthopedic surgery is a provider of pre and postoperative bleeding; patients are exposed to several risks, and different measures are proposed to reduce bleeding during surgery, called the transfusion-sparing method, including tranexamic acid, which has shown its effectiveness in numerous studies. A prospective analytical study in 50 children was carried out in the orthopedic traumatology operating room of the EL HAROUCHI hospital of the CHU IBN ROCHD in Casablanca over a period of six months (April to October 2022). Two groups were randomized: one receiving tranexamic acid (Group A) and a non-receiving control group (Group B). The average age was 10.3 years, of which 58.8% were female. The first type of surgery was thoracolumbar scoliosis (52%). The average preoperative hemoglobin was 12.28 g/dl in group A, against 12.67 g/dl in the control group. There was no significant difference between the two groups (p=0.148). Mean intraoperative bleeding was 396.29 ml in group A versus 412 ml in the control group. No significant difference was observed for this parameter (p=0.632). The average hemoglobin level in the immediate postoperative period in our patients is 10.2 g/dl. In group A, it was 10.95 g/dl versus 10.93 g/dl in group B. At H24 postoperative, the mean hemoglobin value was 10.29 g/dl in group A against 9.5 g/dl in group B. For group A, the blood loss recorded during the first 24 hours was 209.43 ml, against 372 ml in group B, with a significant difference between the two groups (p=0.001). There is no statistically significant difference between the 2 groups in terms of the use of fillers, ephedrine or intraoperative transfusion. While for postoperative transfusion, we note the existence of a statistically significant difference between group A and group B. It is suggested that the use of tranexamic acid is an effective, simple, and low-cost way to limit postoperative blood loss and the need for transfusion.

Keywords: tranexamic acid, blood loss, orthopedic surgery, children

Procedia PDF Downloads 60
1555 Evaluating the Impact of Marine Protected Areas on Human-Shark Interactions at a Global Scale

Authors: Delphine Duval, Morgan Mangeas, Charlie Huveneers, Adam Barnett, Laurent Vigliola

Abstract:

The global number of shark bites has increased over the past four decades with, however, high regional variability both in space and time. A systematic review, aligned with the 2020 PRISMA guidelines, explored the peer-reviewed literature published between 1960 and 2023 to identify factors potentially explaining trends in human-shark interactions. Results revealed that variations in the frequency of human-shark interactions could be explained by a plethora of factors, including changes in prey availability, environmental conditions, human and shark population density and behavior, as well as habitat destruction. However, to our best knowledge, only five studies have conducted statistical assessments of the relative contribution of these factors. The increased number in human-shark interactions and the frequent clusters of shark bites within short timeframes offer opportunities to test the causative factors that may explain trends in unprovoked shark bites. it study aims to evaluate the impact of marine protected areas (MPAs) on the number of human-shark interactions, using data from the Global Shark Attack File and the World Database on Protected Areas. Results indicate contrasting effects of MPAs at different spatial scales. Enhancing our understanding of the factors contributing to shark bites is essential for improving risk reduction policies for humans and conservation plans for shark populations.

Keywords: unprovoked shark interactions, marine protected areas, attack risk, human-wildlife interaction

Procedia PDF Downloads 35
1554 Diagnostic Physiopathology of Osteitis in the Diabetic Foot

Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 97
1553 Therapeutic Application of Light and Electromagnetic Fields to Reduce Hyper-Inflammation Triggered by COVID-19

Authors: Blanche Aguida, Marootpong Pooam, Nathalie Jourdan, Margaret Ahmad

Abstract:

COVID-19-related morbidity is associated with exaggerated inflammation and cytokine production in the lungs, leading to acute respiratory failure. The cellular mechanisms underlying these so-called ‘cytokine storms’ are regulated through the Toll-like receptor 4 (TLR4) signaling pathway and by reactive oxygen species (ROS). Both light (photobiomodulation) and magnetic fields (e.g., pulsed electromagnetic field) stimulation are non-invasive therapies known to confer anti-inflammatory effects and regulate ROS signaling pathways. Here we show that daily exposure to two 10-minute intervals of moderate-intensity infra-red light significantly lowered the inflammatory response induced via the TLR4 receptor signaling pathway in human cell cultures. Anti-inflammatory effects were likewise achieved by electromagnetic field exposure of cells to daily 10-minute intervals of either pulsed electromagnetic fields (PEMF) or to low-level static magnetic fields. Because current illumination and electromagnetic field therapies have no known side effects and are already approved for some medical uses, we have here developed protocols for verification in clinical trials of COVID 19 infection. These treatments are affordable, simple to implement, and may help to resolve the acute respiratory distress of COVID 19 patients both in the home and in the hospital.

Keywords: COVID 19, electromagnetic fields therapy, inflammation, photobiomodulation therapy

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1552 Sustainable Transboundary Water Management: Challenges and Good Practices of Cooperation in International River Basin Districts

Authors: Aleksandra Ibragimow, Moritz Albrecht, Eerika Albrecht

Abstract:

Close international cooperation between all countries within a river basin has become one of the key aspects of sustainable cross-border water management. This is due to the fact that water does not stop at administrative or political boundaries. Therefore, the preferred mode to protect and manage transnational water bodies is close cooperation between all countries and stakeholders within the natural hydrological unit of the river basin. However, past practices have demonstrated that combining interests of different countries and stakeholders with differing political systems and management approaches to environmental issues upstream as well as downstream can be challenging. The study focuses on particular problems and challenges of water management in international river basin districts by the example of the International Oder River Basin District. The Oder River is one of the largest cross-border rivers of the Baltic Sea basin passing through Poland, Germany, and the Czech Republic. Attention is directed towards the activities and the actions that were carried out during the Districts' first management cycle of transnational river basin management (2009-2015). The results show that actions of individual countries have been focused on the National Water Management Plans while a common appointment about identified supra-regional water management problems has not been solved, and conducted actions can be considered as preliminary and merely a basis for future management. This present state raises the question whether the achievement of main objectives of Water Framework Directive (2000/60/EC) can be a realistic task.

Keywords: International River Basin Districts, water management, water frameworkdirective, water management plans

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1551 EU Policies in Determining Refugee Status

Authors: Adriano Mortada

Abstract:

Human history is rife with conflict, and the question of refugee status determination and their rehabilitation has been up for debate since. Refugee Status Determination is the administrative or legal process by which UNHCR or governments determine whether a person seeking international protection or asylum can be identified as a refugee under international, regional, or national law. Refugee Status Determination is considered to be a vital process in aiding refugees’ realization of their rights under international law. One of the major reasons why the refugee status determination is considered an “issue”, and is one that is much debated upon annually, is the fact that the national bureaucratic systems are rigid and unbending. This is particularly concerning in the 21st century despite human advancement in policy and diplomacy, working in tandem with the United Nations and their charters and resolutions on human rights and dignity. The paper seeks to criticize the European member states' response to the refugee crisis and their inflexible and prejudiced bureaucratic systems when it comes to refugee status determination. The paper looks at multiple case studies as primary evidence and the alternate case studies where the system helped refugees, like those in Jordan, Pakistan, Turkey, and Lebanon. The main concern of the paper is to highlight the bias in the selected European systems, which do not stem from the Human Rights Charter but rather on the basis of geographical backgrounds, cultural and religious affiliations of those seeking refugee status or asylum in their respective countries. The paper hopes to not only create awareness about this issue but also provide a research background to advocacy programs to bring a change in the systems.

Keywords: refugee status determination, human rights, bureaucracy, United Nations, European Union

Procedia PDF Downloads 90
1550 Study of the Persian Gulf’s and Oman Sea’s Numerical Tidal Currents

Authors: Fatemeh Sadat Sharifi

Abstract:

In this research, a barotropic model was employed to consider the tidal studies in the Persian Gulf and Oman Sea, where the only sufficient force was the tidal force. To do that, a finite-difference, free-surface model called Regional Ocean Modeling System (ROMS), was employed on the data over the Persian Gulf and Oman Sea. To analyze flow patterns of the region, the results of limited size model of The Finite Volume Community Ocean Model (FVCOM) were appropriated. The two points were determined since both are one of the most critical water body in case of the economy, biology, fishery, Shipping, navigation, and petroleum extraction. The OSU Tidal Prediction Software (OTPS) tide and observation data validated the modeled result. Next, tidal elevation and speed, and tidal analysis were interpreted. Preliminary results determine a significant accuracy in the tidal height compared with observation and OTPS data, declaring that tidal currents are highest in Hormuz Strait and the narrow and shallow region between Iranian coasts and Islands. Furthermore, tidal analysis clarifies that the M_2 component has the most significant value. Finally, the Persian Gulf tidal currents are divided into two branches: the first branch converts from south to Qatar and via United Arab Emirate rotates to Hormuz Strait. The secondary branch, in north and west, extends up to the highest point in the Persian Gulf and in the head of Gulf turns counterclockwise.

Keywords: numerical model, barotropic tide, tidal currents, OSU tidal prediction software, OTPS

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1549 International Dispute Settlements According to the Law of the Sea: Coastal States vs. Maritime Conflicts

Authors: Ermal Xhelilaj

Abstract:

International practice has revealed that many maritime conflicts have been initiated as a direct result of coastal states’ disagreements over maritime boundaries and other related maritime issues. These disagreements embrace relevant problematic matters reflecting international conflicts, which in order to prevent further escalation into international crises or even armed conflicts have to be legally resolved. The most challenging cases in international system involve regional or bilateral disputes regarding maritime boundaries delimitations between states, which may result in the activation of respective armed forces, considered crucial elements for the protection of territorial sovereignty. Taken under considerations the legal issues that Law of the Sea Convention (1982) reflects, including the legal provisions over disputes settlements, the importance of analyzing this paramount issue might be considered relevant at present. Therefore, this study will be focused in discussing legal and practical issues that concern the resolution of international maritime disputes seen from international relations point of view, by initially analyzing UN Convention on the Law of the Sea (UNCLOS 1982) relevant legal provisions, further discussing several notable cases over maritime boundaries delimitations as well as concluding with some recommendations related to this issue. The author is of the opinion that although the boundaries delimitation’s legal regime of UNCLOS reflects important standards for dispute settlements, yet considering the complex situation that represents this issue, relevant amendments might be necessary to be undertaken by international maritime organizations in order to further clarify the aforementioned legal matter.

Keywords: Law of the Sea, maritime conflicts, dispute settlements, international relations

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1548 Dem Based Surface Deformation in Jhelum Valley: Insights from River Profile Analysis

Authors: Syed Amer Mahmood, Rao Mansor Ali Khan

Abstract:

This study deals with the remote sensing analysis of tectonic deformation and its implications to understand the regional uplift conditions in the lower Jhelum and eastern Potwar. Identification and mapping of active structures is an important issue in order to assess seismic hazards and to understand the Quaternary deformation of the region. Digital elevation models (DEMs) provide an opportunity to quantify land surface geometry in terms of elevation and its derivatives. Tectonic movement along the faults is often reflected by characteristic geomorphological features such as elevation, stream offsets, slope breaks and the contributing drainage area. The river profile analysis in this region using SRTM digital elevation model gives information about the tectonic influence on the local drainage network. The steepness and concavity indices have been calculated by power law of scaling relations under steady state conditions. An uplift rate map is prepared after carefully analysing the local drainage network showing uplift rates in mm/year. The active faults in the region control local drainages and the deflection of stream channels is a further evidence of the recent fault activity. The results show variable relative uplift conditions along MBT and Riasi and represent a wonderful example of the recency of uplift, as well as the influence of active tectonics on the evolution of young orogens.

Keywords: quaternary deformation, SRTM DEM, geomorphometric indices, active tectonics and MBT

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1547 Technology in the Calculation of People Health Level: Design of a Computational Tool

Authors: Sara Herrero Jaén, José María Santamaría García, María Lourdes Jiménez Rodríguez, Jorge Luis Gómez González, Adriana Cercas Duque, Alexandra González Aguna

Abstract:

Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.

Keywords: calculator, care, eHealth, health

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1546 The Usefulness and Limitations of Manual Aspiration Immediately after Pneumothorax Complicating Percutaneous CT Guided Lung Biopsies: A Retrospective 9-Year Review from a Large Tertiary Centre

Authors: Niall Fennessy, Charlotte Yin, Vineet Gorolay, Michael Chan, Ilias Drivas

Abstract:

Background: The aim of this study was to evaluate the effect of manual aspiration of air from the pleural cavity in mitigating the need for chest drain placement after a CT-guided lung biopsy. Method: This is a single institution retrospective review of CT-guided lung biopsies performed on 799 patients between September 2013 and May 2021 in a major tertiary hospital. Percutaneous manual aspiration of air was performed in 104/306 patients (34%) with pneumothoraxes as a preventative measure. Simple and multivariate analysis was performed to identify independent risk factors (modifiable and nonmodifiable) for the success of manual aspiration in mitigating the need for chest drain insertion. Results: The overall incidence of pneumothorax was 37% (295/799). Chest drains were inserted for 81/295 (27%) of the pneumothoraxes, representing 81/799 (10%) of all CT-guided lung biopsies. Of patients with pneumothoraces, 104 (36%) underwent percutaneous aspiration via either the coaxial guide needle or an 18 or 20G intravenous catheter attached to a three-way stopcock and syringe. Amongst this group, 13 patients (13%) subsequently required chest drain insertion. The success of percutaneous aspiration in avoiding subsequent pleural drain insertion decreased with aspiration volume >500mL, radial pneumothorax depth >3cm, increased subpleural depth of the lesion, and the presence of background emphysema.

Keywords: computed tomography, lung biopsy, pneumothorax, manual aspiration, chest drainage

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1545 Power-Sharing Politics: A Panacea to Conflict Resolution and Stability in Africa

Authors: Emmanuel Dangana Monday

Abstract:

Africa as a continent has been ravaged and bedeviled by series of political conflicts associated with politics and power-sharing maneuvering. As a result it has become the most unstable continent in the world in terms of power distribution and stable political culture. This paper examines the efficacy of conscious and deliberate power-sharing strategies to settle or resolve political conflicts in Africa in the arrangements of creation of states, revenue and resources allocation, and office distribution systems. The study is concerned with the spatial impact of conflicts generated in some renowned African countries in which power-sharing would have been a solution. Ethno-regional elite groups are identified as the major actors in the struggles for the distribution of territorial, economic and political powers in Africa. The struggle for power has become so intense that it has degenerated to conflicts and wars of inter and intra-political classes and parties respectively. Secondary data and deductive techniques were used in data collection and analysis. It is discovered that power-sharing has become an indispensable tool to curb the incessant political and power crisis in Africa. It is one of the finest tolerable modality of mediating elite’ competition, since it reflects the interests of both the dominant and the perceived marginalized groups. The study recommends that countries and regions of political, ethnic and religious differences in Africa should employed power-sharing strategy in order to avoid unnecessary political tension and resultant crisis. Interest groups should always come to the negotiation table to reach a realistic, durable and expected compromise to secure a peacefully resolute Africa.

Keywords: Africa, power-sharing, conflicts, politics and political stability

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1544 Gulfnet: The Advent of Computer Networking in Saudi Arabia and Its Social Impact

Authors: Abdullah Almowanes

Abstract:

The speed of adoption of new information and communication technologies is often seen as an indicator of the growth of knowledge- and technological innovation-based regional economies. Indeed, technological progress and scientific inquiry in any society have undergone a particularly profound transformation with the introduction of computer networks. In the spring of 1981, the Bitnet network was launched to link thousands of nodes all over the world. In 1985 and as one of the first adopters of Bitnet, Saudi Arabia launched a Bitnet-based network named Gulfnet that linked computer centers, universities, and libraries of Saudi Arabia and other Gulf countries through high speed communication lines. In this paper, the origins and the deployment of Gulfnet are discussed as well as social, economical, political, and cultural ramifications of the new information reality created by the network. Despite its significance, the social and cultural aspects of Gulfnet have not been investigated in history of science and technology literature to a satisfactory degree before. The presented research is based on an extensive archival research aimed at seeking out and analyzing of primary evidence from archival sources and records. During its decade and a half-long existence, Gulfnet demonstrated that the scope and functionality of public computer networks in Saudi Arabia have to be fine-tuned for compliance with Islamic culture and political system of the country. It also helped lay the groundwork for the subsequent introduction of the Internet. Since 1980s, in just few decades, the proliferation of computer networks has transformed communications world-wide.

Keywords: Bitnet, computer networks, computing and culture, Gulfnet, Saudi Arabia

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1543 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis

Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik

Abstract:

Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.

Keywords: diagnosis, serology, seroprevalence, toxoplasmosis

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1542 Satellite Derived Snow Cover Status and Trends in the Indus Basin Reservoir

Authors: Muhammad Tayyab Afzal, Muhammad Arslan, Mirza Muhammad Waqar

Abstract:

Snow constitutes an important component of the cryosphere, characterized by high temporal and spatial variability. Because of the contribution of snow melt to water availability, snow is an important focus for research on climate change and adaptation. MODIS satellite data have been used to identify spatial-temporal trends in snow cover in the upper Indus basin. For this research MODIS satellite 8 day composite data of medium resolution (250m) have been analysed from 2001-2005.Pixel based supervised classification have been performed and extent of snow have been calculated of all the images. Results show large variation in snow cover between years while an increasing trend from west to east is observed. Temperature data for the Upper Indus Basin (UIB) have been analysed for seasonal and annual trends over the period 2001-2005 and calibrated with the results acquired by the research. From the analysis it is concluded that there are indications that regional warming is one of the factor that is affecting the hydrology of the upper Indus basin due to accelerated glacial melting during the simulation period, stream flow in the upper Indus basin can be predicted with a high degree of accuracy. This conclusion is also supported by the research of ICIMOD in which there is an observation that the average annual precipitation over a five year period is less than the observed stream flow and supported by positive temperature trends in all seasons.

Keywords: indus basin, MODIS, remote sensing, snow cover

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1541 Incidence of Iron Deficiency Anemia Among the Children with Febrile Seizures

Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

Abstract:

Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

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