Search results for: regional hospital
1332 Computational Fluid Dynamics Model of Various Types of Rocket Engine Nozzles
Authors: Konrad Pietrykowski, Michal Bialy, Pawel Karpinski, Radoslaw Maczka
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The nozzle is an element of the rocket engine in which the conversion of the potential energy of gases generated during combustion into the kinetic energy of the gas stream takes place. The design parameters of the nozzle have a decisive influence on the ballistic characteristics of the engine. Designing a nozzle assembly is, therefore, one of the most responsible stages in developing a rocket engine design. The paper presents the results of the simulation of three types of rocket propulsion nozzles. Calculations were made using CFD (Computational Fluid Dynamics) in ANSYS Fluent software. The next types of nozzles differ in shape. The analysis was made of a conical nozzle, a bell type nozzle with a conical supersonic part and a bell type nozzle. Calculation results are presented in the form of pressure, velocity and kinetic energy distributions of turbulence in the longitudinal section. The courses of these values along the nozzles are also presented. The results show that the cone nozzle generates strong turbulence in the critical section. Which negatively affect the flow of the working medium. In the case of a bell nozzle, the transformation of the wall caused the elimination of flow disturbances in the critical section. This reduces the probability of waves forming before or after the trailing edge. The most sophisticated construction is the bell type nozzle. It allows you to maximize performance without adding extra weight. The bell type nozzle can be used as a starter and auxiliary engine nozzle due to its advantages. The project/research was financed in the framework of the project Lublin University of Technology-Regional Excellence Initiative, funded by the Polish Ministry of Science and Higher Education (contract no. 030/RID/2018/19).Keywords: computational fluid dynamics, nozzle, rocket engine, supersonic flow
Procedia PDF Downloads 1591331 The Judiciary as Pacemaker? Considering the Role of Courts in an Expansion of Protection for War Refugees and People Fleeing Natural Disasters
Authors: Charlotte Lülf
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Migration flows, resulting from war, climate change or economic crisis cannot be tackled by single states but need to be addressed as a transnational and international responsibility. The traditional architecture surrounding the work of the UNHCR and the 1951 Convention, however, is not equipped to deal with these challenges. Widely excluded from legal protection are people not individually persecuted for the statutory criteria, people that flee from the indiscriminate effects of an armed conflict as well as people fleeing natural disasters. With the lack of explicit legal protection and the political reluctance of nation states worldwide to extend their commitment in new asylum laws, the judiciary must be put in focus: it plays a unique role in interpreting and potentially expanding the application of existing regulations. This paper as part of an ongoing Ph.D. Project deals with the current and partly contradicting approaches to the protection of war- and climate refugees. Changing jurisprudential practice of national and regional courts will be assessed, as will be their dialogue to interpret the international obligations of human rights law, migration laws, and asylum laws in an interacting world. In recent judgments refoulment to an armed conflict as well as countries without adequate disaster relief or health care was argued as violating fundamental human and asylum law rights and therefore prohibited – even for applicants without refugee status: The first step towards access to subsidiary protection could herewith be established. Can one observe similar developments in other parts of the world? This paper will evaluate the role of the judiciary to define, redefine and potentially expand protection for people seeking refuge from armed conflicts and natural disasters.Keywords: human rights law, asylum-seekers, displacement, migration
Procedia PDF Downloads 2761330 Emergency Management of Poisoning Tracery Care Hospital in India
Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav
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The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care
Procedia PDF Downloads 1021329 Multiple Etiologies and Incidences of Co-Infections in Childhood Diarrhea in a Hospital Based Screening Study in Odisha, India
Authors: Arpit K. Shrivastava, Nirmal K. Mohakud, Subrat Kumar, Priyadarshi S. Sahu
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Acute diarrhea is one of the major causes of morbidity and mortality among children less than five years of age. Multiple etiologies have been implicated for infectious gastroenteritis causing acute diarrhea. In our study fecal samples (n=165) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies such as Rotavirus, Adenovirus, Diarrhoeagenic Escherichia coli (EPEC, EHEC, STEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. The overall results from our study showed that 57% of children below 5 years of age with acute diarrhea were positive for at least one infectious etiology. Diarrhoeagenic Escherichia coli was detected to be the major etiological agent (29.09%) followed by Rotavirus (24.24%), Shigella (21.21%), Adenovirus (5.45%), Cryptosporidium (2.42%), and Giardia (0.60%). Among the different DEC strains, EPEC was detected significantly higher in <2 years children in comparison to >2 years age group (p =0.001). Concurrent infections with two or more pathogens were observed in 47 of 160 (28.48%) cases with a predominant incidence particularly in <2-year-old children (66.66%) compared to children of 2 to 5 years age group. Co-infection of Rotavirus with Shigella was the most frequent combination, which was detected in 17.94% cases, followed by Rotavirus with EPEC (15.38%) and Shigella with STEC (12.82%). Detection of multiple infectious etiologies and diagnosis of the right causative agent(s) can immensely help in better management of acute childhood diarrhea. In future more studies focusing on the detection of cases with concurrent infections must be carried out, as we believe that the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea.Keywords: children, co-infection, infectious diarrhea, Odisha
Procedia PDF Downloads 3361328 The Effects of L-Arginine Supplementation on Clinical Symptoms, Quality of Life, and Anal Internal Sphincter Pressure in Patients with Chronic Anal Fissure
Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat
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Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life
Procedia PDF Downloads 721327 Illness Perception and Health-Related Quality of Life among Young Females Living with Polycystic Ovary Syndrome
Authors: Vibha Kriti
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Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder generally found in reproductive women. It is associated with significant reproductive, metabolic, cosmetic, and psychological consequences. Objective: There is a high prevalence of PCOS found among reproductive-age women, therefore, the major objective of the present study is to identify the illness perception of PCOS women and to explore the relationship between illness perception and health-related quality of life (HRQoL). Material and Method: A cross-sectional study was conducted in a university tertiary-care center, Sir Sunder Lal Hospital, Banaras Hindu University (B.H.U). Tools used for data collection were self-structured, which included socio-demographic status, illness perception questionnaire (revised version), and short-form 36 for assessing illness perception and health-related quality of life, respectively. Statistical analysis was done by SPSS version ‘24’. Results: The results of correlation analyses indicated that there is a strong relationship between strong illness perception and HRQoL. Stepwise regression indicated that illness identity, long illness duration, and severe consequences were associated with the worse outcome on emotional functioning and on social functioning. A high score on the controllability of the disease and seeking social support was significantly related to better functioning. Conclusion: Illness perception is an important factor in self-care behaviors in PCOS females and has a strong association with health-related quality of life and has a profound effect on it.Keywords: polycystic ovary syndrome, illness perception, quality of life, young females, mental health
Procedia PDF Downloads 941326 Assessment of the Electrical, Mechanical, and Thermal Nociceptive Thresholds for Stimulation and Pain Measurements at the Bovine Hind Limb
Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage
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Background: Three nociceptive thresholds of thermal, electrical, and mechanical thresholds commonly use to evaluate the local anesthesia in many species, for instance, cow, horse, cat, dog, rabbit, and so on. Due to the lack of investigations to evaluate and/or validate such those nociceptive thresholds, our plan was the comparison of two-foot local anesthesia methods of Intravenous Regional Anesthesia (IVRA) and our modified four-point Nerve Block Anesthesia (NBA). Materials and Methods: Eight healthy nonpregnant nondairy Holstein Frisian cows in a cross-over study design were selected for this study. All cows divided into two different groups to receive two local anesthesia techniques of IVRA and our modified four-point NBA. Three thermal, electrical, and mechanical force and pinpricks were applied to evaluate the quality of local anesthesia methods before and after local anesthesia application. Results: The statistical evaluation demonstrated that our four-point NBA has a qualification to select as a standard foot local anesthesia. However, the recorded results of our study revealed no significant difference between two groups of local anesthesia techniques of IVRA and modified four-point NBA related to quality and duration of anesthesia stimulated by electrical, mechanical and thermal nociceptive stimuli. Conclusion and discussion: All three nociceptive threshold stimuli of electrical, mechanical and heat nociceptive thresholds can be applied to measure and evaluate the efficacy of foot local anesthesia of dairy cows. However, our study revealed no superiority of those three nociceptive methods to evaluate the duration and quality of bovine foot local anesthesia methods. Veterinarians to investigate the duration and quality of their selected anesthesia method can use any of those heat, mechanical, and electrical methods.Keywords: mechanical, thermal, electrical threshold, IVRA, NBA, hind limb, dairy cow
Procedia PDF Downloads 2461325 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh
Authors: Mannan Mridha, Mohammad S. Islam
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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.Keywords: intensive care units, medical errors, medical devices, patient care and safety
Procedia PDF Downloads 1491324 The Use of Metformin in Treatment of Polycystic Ovary Syndrome (PCOS) and Glucose Control in Pregnant Women with Gestational Diabetes Mellitus (GDM) at Tripoli Medical Center
Authors: Ebtisam A. Benomran, Abdurrauf M. Gusbi, Malak S. Elazarg, M. Sultan, Layla M. Kafu, Arwa M. Matoug, Esra E. Benamara
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Normal pregnancy is associated with metabolic changes leading to decreased insulin sensitivity and reduced glucose tolerance, however, 3-5% of pregnant women proceed to develop gestational diabetes mellitus (GDM). Researcher studied the use of metformin in many fields and the benefit to risk balance of using metformin during pregnancy and the risk of fetotoxic. In this study we examined the use of Metformin to control Glucose in pregnant Women with gestational diabetes mellitus (GDM) and evaluate its safety use during the first trimester of pregnancy.A group of pregnant patients with gestational diabetes mellitus from the first trimester of pregnancy, non smoking with no family history of congenital malformation disease, aged between (20-45 years) and have no liver diseases and who had indicating good compliance at more than one visit over several month until delivery put on Metformin were participated in this trial. Our study shown that all the studied group of pregnant women using metformin 500 mg daily delivered a healthy babies. Meta-analysis by mother risk program showed no increase in incidence of malformations by use Metformin during the first trimester of pregnancy. A hundred outpatients were participated in the survey on the general knowledge and awareness of diabetic patients to their illness and medication used their aged between 20-40 years old. In this survey we realize that 90% of the doctors are not giving the patient full information about their illness and the use of metformin during pregnancy, also about 65% of the patients did not know about the nutritionist in the hospital and the right control diet for diabetes. Courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.Keywords: gestational diabetes, malformations, metformin, pregnancy
Procedia PDF Downloads 4921323 A Perspective on Education to Support Industry 4.0: An Exploratory Study in the UK
Authors: Sin Ying Tan, Mohammed Alloghani, A. J. Aljaaf, Abir Hussain, Jamila Mustafina
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Industry 4.0 is a term frequently used to describe the new upcoming industry era. Higher education institutions aim to prepare students to fulfil the future industry needs. Advancement of digital technology has paved the way for the evolution of education and technology. Evolution of education has proven its conservative nature and a high level of resistance to changes and transformation. The gap between the industry's needs and competencies offered generally by education is revealing the increasing need to find new educational models to face the future. The aim of this study was to identify the main issues faced by both universities and students in preparing the future workforce. From December 2018 to April 2019, a regional qualitative study was undertaken in Liverpool, United Kingdom (UK). Interviews were conducted with employers, faculty members and undergraduate students, and the results were analyzed using the open coding method. Four main issues had been identified, which are the characteristics of the future workforce, student's readiness to work, expectations on different roles played at the tertiary education level and awareness of the latest trends. The finding of this paper concluded that the employers and academic practitioners agree that their expectations on each other’s roles are different and in order to face the rapidly changing technology era, students should not only have the right skills, but they should also have the right attitude in learning. Therefore, the authors address this issue by proposing a learning framework known as 'ASK SUMA' framework as a guideline to support the students, academicians and employers in meeting the needs of 'Industry 4.0'. Furthermore, this technology era requires the employers, academic practitioners and students to work together in order to face the upcoming challenges and fast-changing technologies. It is also suggested that an interactive system should be provided as a platform to support the three different parties to play their roles.Keywords: attitude, expectations, industry needs, knowledge, skills
Procedia PDF Downloads 1251322 Effect of Ethanol and Betadine on the Preformed Biofilm of Staphylococcus Aureus Isolated from Urinary Catheter
Authors: Kara Terki Ibtissem, Hassaine Hafida, Bellifa Samia
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Introduction: Staphylococcus aureus is one of the species that are most frequently isolated from urinary catheters. The ability to produce a biofilm is an important step in the pathogenesis of these staphylococci; biofilm formation is strongly dependent on the environmental conditions it also depends on the different parameters these biofilms are subjected to. Antiseptics, including ethanol and betadine, are used in clinical practice for disinfection and infection prevention. Recent studies, however, demonstrate that disinfectants may enhance biofilm production in Staphylococci. Methods: In this study, 48 staphylococcus aureus isolated from urinary catheters at the University Hospital Center of Sidi Bel Abbes (in Northwestern Algeria) were analyzed to detect the formation of biofilm by culture on Red Congo Agar (RCA), the Tube Method (TM) and tissue Culture Plate (TCP) techniques, this last was also used to investigate the effect of ethanol and Betadine on the preformed biofilm In a second time to know which environment is most favorable to the formation of the biofilm we perform a statistical test based on the student test by the software R. Results: It has been found that 23 strains produced a bacterial slime on the Congo red medium, 5 strains produced a biofilm by the tube method, 2 of which are highly productive. In addition, 7 strains produced a biofilm on polystyrene micro-plates; this number was higher in the presence of ethanol 70% and ethanol 90% with 19 and 11 biofilm-producing strains, respectively. On the other hand, no biofilm was formed in the presence of Betadine. Conclusion: It is important to examine the response of biofilms following an imposed external constraint, such as disinfectants, in order to develop new strategies to combat bacterial biofilms but also to better control their formation.Keywords: staphylococcus aureus, biofilm, urinary catheter, ethanol
Procedia PDF Downloads 641321 The Analysis of Changes in Urban Hierarchy of Isfahan Province in the Fifty-Year Period (1956-2006)
Authors: Hamidreza Joudaki, Yousefali Ziari
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The appearance of city and urbanism is one of the important processes which have affected social communities. Being industrialized urbanism developed along with each other in the history. In addition, they have had simple relationship for more than six thousand years, that is, from the appearance of the first cities. In 18th century by coming out of industrial capitalism, progressive development took place in urbanism in the world. In Iran, the city of each region made its decision by itself and the capital of region (downtown) was the only central part and also the regional city without any hierarchy, controlled its realm. However, this method of ruling during these three decays, because of changing in political, social and economic issues that have caused changes in rural and urban relationship. Moreover, it has changed the variety of performance of cities and systematic urban network in Iran. Today, urban system has very vast imbalanced apace and performance. In Isfahan, the trend of urbanism is like the other part of Iran and systematic urban hierarchy is not suitable and normal. This article is a quantitative and analytical. The statistical communities are Isfahan Province cities and the changes in urban network and its hierarchy during the period of fifty years (1956 -2006) has been surveyed. In addition, those data have been analyzed by model of Rank and size and Entropy index. In this article Iran cities and also the factor of entropy of primate city and urban hierarchy of Isfahan Province have been introduced. Urban residents of this Province have been reached from 55 percent to 83% (2006). As we see the analytical data reflects that there is mismatching and imbalance between cities. Because the entropy index was.91 in 1956.And it decreased to.63 in 2006. Isfahan city is the primate city in the whole of these periods. Moreover, the second and the third cities have population gap with regard to the other cities and finally, they do not follow the system of rank-size.Keywords: urban network, urban hierarchy, primate city, Isfahan province, urbanism, first cities
Procedia PDF Downloads 2591320 The Effects of Evidence-Based Nursing Training and Consultation Program on Self-Efficacy and Outcome Expectancy of Evidence-Based Practice among Nurses
Authors: Yea-Pyng Lin
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Evidence-based nursing (EBN) can improve quality of patient care and reduce medical expenses. Development of training and consultation program according to nurses’ needs and difficulties is essential to promote their competence and self-efficacy in EBN. However, limited research evaluated the effects of EBN program on EBN self-efficacy among nurses. This study aimed to evaluate the effects of an EBN consultation program on self-efficacy and outcome expectancy of evidence-based practice (EBP) among nurses. A two-group pretest-posttest quasi-experimental design was used. A purposive sample of full-time nurses was recruited from a hospital. Experimental group (n=28) received the EBN consultation program including 18-hour EBN training courses, hand-on practices and group discussion by faculty mentors. Control group (n=33) received regular in-service education with no EBN program. All participants received baseline and post-test assessment using Chinese version of Self-Efficacy in EBP scale (SE-EBP) and Outcome Expectancy for EBP scale (OE-EBP). After receiving EBN consultation program, experimental group’s posttest scores of SE-EBP (t=-4.98, p<0.001) and OE-SEP (t=-3.65, p=0.001) were significantly higher than those of the pretests. By controlling the age and years of nursing work experience, the experimental group‘s SE-EBP(F=10.47, p=0.002) and OE-SEP(F=9.53, p=0.003) scores were significantly improved compared to those of the control group. EBN program focus on hand-on practice and group discussion by faculty mentors in addition to EBN training courses can improve EBP self-efficacy and outcome expectancy among nurses. EBN program focus on English literature reading, database searching, and appraisal practice according to nurses’ needs and difficulties can promote implementation of EBN.Keywords: evidence-based nursing, evidence-based practice, consultation program, self-efficacy, outcome expectancy
Procedia PDF Downloads 5011319 Development the Potential of Parking Tax and Parking Retribution Revenues: Case Study in Bekasi City
Authors: Ivan Yudianto
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The research objectives are to analyze the factors that impede the Parking Tax and Parking Retribution collection in Bekasi City Government, analyzing the factors that can increase local own revenue from the tax sector of parking tax and parking retribution, analyze monitoring the parking retribution collection by the Bekasi City Government, analyze strategies Bekasi City Government through the preparation of a roadmap and action plan to increase parking tax and parking retribution revenues. The approach used in this research is a qualitative approach. Qualitative research is used because the problem is not yet clear and the object to be studied will be holistic, complex, and dynamic, and the relationship will be interactive symptoms. Methods of data collection and technical analysis of the data was in-depth interviews, participant observation, documentary materials, literature, and triangulation, as well as new methods such as the methods of visual materials and internet browsing. The results showed that there are several factors that become an obstacle such as the parking taxpayer does not disclose the actual parking revenue, the parking taxpayer are late or do not pay Parking Tax, many parking locations controlled by illegal organizations, shortage of human resources in charge levy and supervise the parking tax and parking retribution collection in the Bekasi City Government, surveillance parking tax and parking retribution are not scheduled on a regular basis. Several strategic priorities in order to develop the potential of the Parking Tax and Parking Retribution in the Bekasi City Government, namely through increased controling and monitoring of the Parking Taxpayer, forming a team of auditors to audit the Parking Taxpayer, seek law enforcement persuasive and educative to reduce Parking Taxpayer wayward, providing strict sanctions against the Parking Taxpayer disobedient, revised regulations mayors about locations of parking in Bekasi City, rationalize revenues target of Parking Retribution, conducting takeover attempts parking location on the roadside of the individual or specific group, and drafting regional regulations on parking subscribe.Keywords: local own revenue, parking retribution, parking tax, parking taxpayer
Procedia PDF Downloads 3261318 Effect of Inoculation with Consortia of Plant-Growth Promoting Bacteria on Biomass Production of the Halophyte Salicornia ramosissima
Authors: Maria João Ferreira, Natalia Sierra-Garcia, Javier Cremades, Carla António, Ana M. Rodrigues, Helena Silva, Ângela Cunha
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Salicornia ramosissima, a halophyte that grows naturally in coastal areas of the northern hemisphere, is often considered the most promising halophyte candidate for extensive crop cultivation and saline agriculture practices. The expanding interest in this plant surpasses its use as gourmet food and includes their potential application as a source of bioactive compounds for the pharmaceutical industry. Despite growing well in saline soils, sustainable and ecologically friendly techniques to enhance crop production and the nutritional value of this plant are still needed. The root microbiome of S. ramosissima proved to be a source of taxonomically diverse plant growth-promoting bacteria (PGPB). Halotolerant strains of Bacillus, Salinicola, Pseudomonas, and Brevibacterium, among other genera, exhibit a broad spectrum of plant-growth promotion traits [e.g., 3-indole acetic acid (IAA), 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase, siderophores, phosphate solubilization, Nitrogen fixation] and express a wide range of extracellular enzyme activities. In this work, three plant growth-promoting bacteria strains (Brevibacterium casei EB3, Pseudomonas oryzihabitans RL18, and Bacillus aryabhattai SP20) isolated from the rhizosphere and the endosphere of S. ramosissima roots from different saltmarshes along the Portuguese coast were inoculated in S. ramosissima seeds. Plants germinated from inoculated seeds were grown for three months in pots filled with a mixture of perlite and estuarine sediment (1:1) in greenhouse conditions and later transferred to a growth chamber, where they were maintained two months with controlled photoperiod, temperature, and humidity. Pots were placed on trays containing the irrigation solution (Hoagland’s solution 20% added with 10‰ marine salt). Before reaching the flowering stage, plants were collected, and the fresh and dry weight of aerial parts was determined. Non-inoculated seeds were used as a negative control. Selected dried stems from the most promising treatments were later analyzed by GC-TOF-MS for primary metabolite composition. The efficiency of inoculation and persistence of the inoculum was assessed by Next Generation Sequencing. Inoculations with single strain EB3 and co-inoculations with EB3+RL18 and EB3+RL18+SP20 (All treatment) resulted in significantly higher biomass production (fresh and dry weight) compared to non-inoculated plants. Considering fresh weight alone, inoculation with isolates SP20 and RL18 also caused a significant positive effect. Combined inoculation with the consortia SP20+EB3 or SP20+RL18 did not significantly improve biomass production. The analysis of the profile of primary metabolites will provide clues on the mechanisms by which the growth-enhancement effect of the inoculants operates in the plants. These results sustain promising prospects for the use of rhizospheric and endophytic PGPB as biofertilizers, reducing environmental impacts and operational costs of agrochemicals and contributing to the sustainability and cost-effectiveness of saline agriculture. Acknowledgments: This work was supported by project Rhizomis PTDC/BIA-MIC/29736/2017 financed by Fundação para a Ciência e Tecnologia (FCT) through the Regional Operational Program of the Center (02/SAICT/2017) with FEDER funds (European Regional Development Fund, FNR, and OE) and by FCT through CESAM (UIDP/50017/2020 + UIDB/50017/2020), LAQV-REQUIMTE (UIDB/50006/2020). We also acknowledge FCT/FSE for the financial support to Maria João Ferreira through a PhD grant (PD/BD/150363/2019). We are grateful to Horta dos Peixinhos for their help and support during sampling and seed collection. We also thank Glória Pinto for her collaboration providing us the use of the growth chambers during the final months of the experiment and Enrique Mateos-Naranjo and Jennifer Mesa-Marín of the Departamento de Biología Vegetal y Ecología, the University of Sevilla for their advice regarding the growth of salicornia plants in greenhouse conditions.Keywords: halophytes, PGPB, rhizosphere engineering, biofertilizers, primary metabolite profiling, plant inoculation, Salicornia ramosissima
Procedia PDF Downloads 1601317 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis
Authors: Maatouk Mohamed, Nouira Mariem
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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review
Procedia PDF Downloads 821316 Pediatrics HIV and Asymptomatic Malaria Parasitemia (AMP) Co-Infection
Authors: David Segun Adeniyi, Tongvwam P. J., Wekpe S., Owolagba F. E., Ofuche E., Samuels J. O., Okonkwo P.
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Background: Pediatrics HIV viral suppression remains a major challenge across Africa. In this study, we sought to establish the relationship between AMP and sustained plasma HIV viremia among a population of pediatric clients on Antiretroviral Therapy (ART). We also seek to determine the prevalence of AMP among the study population. Methods: 180 pediatrics clients on ART at four (4) Comprehensive Hospitals in Jos, Nigeria, participated in this study between the months of October to December 2022. The mean age of the study participants was 13 years. Venous blood was drawn from the participants after consent was sought, and ethical approval was obtained from the Plateau State Specialist Hospital (PSSH) Research and Ethics Committee. All samples were screened for AMP using the CareStart® HRP2 Malaria kit. The Absolute and % CD4 values of the clients were obtained using the BD Presto® CD4 Analyzer. The separated plasma samples were assayed for HIV viral load using the Roche Cobas C4800® system. Obtained data were analyzed using simple descriptive statistics. Results: From the 180 participants in this study, 12.8% (23) have AMP. 90.6% (163) were virally suppressed (<1000 copies/ml), while 9.4% (17) were virally unsuppressed (>1000 copies/ml). 11.7% (19/163) of the virally suppressed population have AMP, with mean absolute and % CD4 values of 648 and 31%, respectively. The virally suppressed population without AMP has mean absolute and % CD4 values of 719 and 32%, respectively. 24% (4/17) of the virally unsuppressed population have AMP, with mean absolute and % CD4 values of 514 and 26%, respectively. The virally unsuppressed population without AMP has mean absolute and % CD4 values of 292 and 16%, respectively. Conclusion: Our study shows that there is a high prevalence of AMP among the study populations (11.7% and 24%, respectively). The high prevalence of AMP among the virally unsuppressed with mean absolute and % CD4 values of 514 and 26% alludes to the fact that malaria co-infection with HIV fosters a dysregulated immune complex response which favors an increased HIV plasma viremia. We thus recommend the routine use of Malaria IPT in pediatric HIV clients.Keywords: pediatrics, HIV, Malaria, viral suppression
Procedia PDF Downloads 831315 Criminal Laws Associated with Cyber-Medicine and Telemedicine in Current Law Systems in the World
Authors: Shahryar Eslamitabar
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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving
Procedia PDF Downloads 6611314 Precambrian/Neoproterozoic Sediments of the Sirt Basin, Libya: New Palynological Evidence
Authors: Ali D. El-mehdawi, Ibrahim E. Elkanouni
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Thick pre-Upper Cretaceous sandstones, sandstones intercalated with red/black shale or quarzitic sandstones, traditionally known to range in age from Cambrian to Early Cretaceous, mostly overlie the subsurface basement rocks of the Sirt Basin of Libya. These sediments known as Nubian, Sarir, Amal or Cambro-Ordovician sandstones. They are usually barren of any age datable palynomorphs and microfossils and represent the main hydrocarbon reservoirs in the basin. As a part of an ongoing regional project concerned with revision and updating of the stratigraphic nomenclature of the Sirt Basin and adjacent areas, sixteen core and ditch cutting samples from four wells penetrating the known Cambro-Ordovician sediments in the central and eastern parts of the basin were examined palynologicaly to investigate its age and the depositional paleoenvironment. The samples proved to be barren or yielded rare palynomorph assemblage, which dominated by dark grey to black small and large-sized sphaeromorph acritarchs assemblage of leiosphaerid types. The dominated species are Kildinosphaera chagrinata, K. cf. chagrinata, Kildinella ripheica, Kilinella timanica, Leiosphaeridia asperata and Leiosphaeridia spp. These leiosphaerides assemblage are comparable to those have been reported from the Late Precambrian, late Riphean age in Cyrenaica Platform, NE Libya, and would indicated shallow marine depositional environment. The age assignment suggests that this interval most probably equates to Mourizide, Bir Bayai and Wadi alHayt formations known in the Murzuq, Kufrah and Cyrenaica areas, respectively. This study proves the presence of Precambrian sediments in Jaghbub high and Amal Platform in the eastern part of Sirt Basin and probably in Maradah Trough and Aj Jahamah/Zoltun Platform northwestern part of the Sirt Basin.Keywords: palynology, leiosphaerides, precambrian, sirt basin, libya
Procedia PDF Downloads 841313 The Potential of Southern Malang as Geotourism Site: The Distribution of Geodiversity and Geotrek in Southern Malang, Indonesia
Authors: Arda Bagus M, Yehezkiel Festian P, Budianto Santoso
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The Tourism Area of Southern Malang is administratively located in the Regency of Malang, East Java Province, Indonesia and geographically is in a position between 112o17' - 112o57' E dan 7o44' - 8o26' S. Southern Malang consists of several sub-districts that directly borders with the Indian Ocean, such as Donomulyo, Bantur, Gedangan, Sumbermanjing, Tirto Yudo, and Ampel Gading. This area has a high geotourism potential because of the existence of geodiversity such as beaches, waterfalls, caves, and karst area. However, to the best of the authors’ knowledge, there is still no systematic data that informs the geotourism potentials to the public. The aim of this research is to complete the lack of data and then arrange it systematically so it can be used for both tourism and research purposes. Research methods such as field observation, literature study, and depth interview to local people have been implemented. Aspects reviewed by visiting the field are accommodation, transportation, and the feasibility of a place to be geotourism object. The primary data was taken in Sumbermanjing, Gedangan, Bantur, and Donomulyo sub-district. A literature study is needed to determine the regional geology of Southern Malang and as a comparison to new data obtained in the field. The results of the literature study show that southern Malang consists of three formations: Wonosari Formation, Mandalaka Formation, and River-swamps Sediment Formation with the age range of Oligocene to Quaternary. Depth interviews have been conducted by involving local people with the aim of knowing cultural-history in the research area. From this research, the geotourism object distribution map has been made. The map also includes Geotrek and basic geological information of each object. The results of this research can support the development of geotourism in Southern Malang.Keywords: geodiversity, geology, geotourism, geotrek, southern Malang
Procedia PDF Downloads 1761312 Comparative Analysis of Glycated Hemoglobin (hba1c) Between HPLC and Immunoturbidimetry Method in Type II Diabetes Mellitus Patient
Authors: Intanri Kurniati, Raja Iqbal Mulya Harahap, Agustyas Tjiptaningrum, Reni Zuraida
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Background: Diabetes mellitus is still increasing and has become a health and social burden in the world. It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Some of these glycated proteins are suggested to be involved in the development and progression of chronic diabetic complications. Among these glycated proteins, glycated hemoglobin (HbA1C) is commonly used as the gold standard index of glycemic control in the clinical setting. HbA1C testing has some methods, and the most commonly used is immunoturbidimetry. This research aimed to compare the HbA1c level between immunoturbidimetry and HbA1C level in T2DM patients. Methods: This research involves 77 patients from Abd Muluk Hospital Bandar Lampung; the patient was asked for consent in this research, then underwent phlebotomy to be tested for HbA1C; the sample was then examined for HbA1C with Turbidimetric Inhibition Immunoassay (TINIA) and High-Performance Liquid Chromatography (HPLC) method. Result: Mean± SD of the samples with the TINIA method was 9.2±1,2; meanwhile, the level HbA1C with the HPLC method is 9.6±1,2. The t-test showed no significant difference between the group subjects. (p<0.05). It was proposed that the two methods have high suitability in testing, and both are eligibly used for the patient. Discussion: There was no significant difference among research subjects, indicating that the high conformity of the two methods is suitable to be used for monitoring patients clinically. Conclusion: There is increasing in HbA1C level in a patient with T2DM measured with HPLC and or Turbidimetric Inhibition Immunoassay (TINIA) method, and there were no significant differences among those methods.Keywords: diabetes mellitus, glycated albumin, HbA1C, HPLC, immunoturbidimetry
Procedia PDF Downloads 1011311 Neural Networks Based Prediction of Long Term Rainfall: Nine Pilot Study Zones over the Mediterranean Basin
Authors: Racha El Kadiri, Mohamed Sultan, Henrique Momm, Zachary Blair, Rachel Schultz, Tamer Al-Bayoumi
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The Mediterranean Basin is a very diverse region of nationalities and climate zones, with a strong dependence on agricultural activities. Predicting long term (with a lead of 1 to 12 months) rainfall, and future droughts could contribute in a sustainable management of water resources and economical activities. In this study, an integrated approach was adopted to construct predictive tools with lead times of 0 to 12 months to forecast rainfall amounts over nine subzones of the Mediterranean Basin region. The following steps were conducted: (1) acquire, assess and intercorrelate temporal remote sensing-based rainfall products (e.g. The CPC Merged Analysis of Precipitation [CMAP]) throughout the investigation period (1979 to 2016), (2) acquire and assess monthly values for all of the climatic indices influencing the regional and global climatic patterns (e.g., Northern Atlantic Oscillation [NOI], Southern Oscillation Index [SOI], and Tropical North Atlantic Index [TNA]); (3) delineate homogenous climatic regions and select nine pilot study zones, (4) apply data mining methods (e.g. neural networks, principal component analyses) to extract relationships between the observed rainfall and the controlling factors (i.e. climatic indices with multiple lead-time periods) and (5) use the constructed predictive tools to forecast monthly rainfall and dry and wet periods. Preliminary results indicate that rainfall and dry/wet periods were successfully predicted with lead zones of 0 to 12 months using the adopted methodology, and that the approach is more accurately applicable in the southern Mediterranean region.Keywords: rainfall, neural networks, climatic indices, Mediterranean
Procedia PDF Downloads 3131310 Response of Diaphragmatic Excursion to Inspiratory Muscle Trainer Post Thoracotomy
Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen
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Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy
Procedia PDF Downloads 3191309 The Effect of Diapirs on the Geometry and Evolution of the Ait Ourir Basin, High Atlas Mountains of Marrakesh, Morocco
Authors: Hadach Fatiha, Algouti Ahmed, Algouti Abdellah, Jdaba Naji, Es-Sarrar Othman, Mourabit Zahra
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This paper investigates the structure and evolution of diapirism in the Ait Ourir basin, located in the High Atlas of Marrakesh, using structural and sedimentological fieldwork integrated with field mapping. A tectonic-sedimentological study of the Mesozoic cover of the Ait Ourir basin area revealed that these units were subjected to important saccadic halokinetic activity, reflected by anticline structures associated with regional faults that created several synclinal mini-basins. However, the lack of seismic coverage in the study area makes the proposed interpretation based on extrapolations of information observed on the surface. In this work, we suggest that faults and salt activity led to the formation of different structures within the studied area. The growth of the Triassic evaporites at different stages during the Mesozoic is reflected by progressive and local unconformities, recorded as having different ages. These structures created high diapiric zones with reduced sedimentation, showing abrupt lateral thickness variations in several places where this activity was occurring; this is clearly defined within the Wanina and Jbel Sour’s mini-basins, where the Senonian was observed to rest at an angular unconformity over the entire sedimentary cover encompassing the time period from the Liassic to the Turonian. The diapirism associated with the major faults, especially encountered between the basins, is often accompanied by late Triassic volcanic material. This diapir-fault relationship resulted in shallow and often depocentric zones in a pull-apart system within a distensive context.Keywords: diapir, evaporites, faults, pull-apart, Mesozoic cover, Ait Ourir, western High Atlas, Morocco
Procedia PDF Downloads 711308 Emotional, Behavioral and Social Problems in Children with Fecal Incontinence by Child Behavior Checklist (CBCL): A Cross-sectional Study
Authors: Roshanak Farjad, Amirhossein Hosseini
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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria
Procedia PDF Downloads 761307 Sustainable Intensification of Agriculture in Victoria’s Food Bowl: Optimizing Productivity with the use of Decision-Support Tools
Authors: M. Johnson, R. Faggian, V. Sposito
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A participatory and engaged approach is key in connecting agricultural managers to sustainable agricultural systems to support and optimize production in Victoria’s food bowl. A sustainable intensification (SI) approach is well documented globally, but participation rates amongst Victorian farmers is fragmentary, and key outcomes and implementation strategies are poorly understood. Improvement in decision-support management tools and a greater understanding of the productivity gains available upon implementation of SI is necessary. This paper reviews the current understanding and uptake of SI practices amongst farmers in one of Victoria’s premier food producing regions, the Goulburn Broken; and it spatially analyses the potential for this region to adapt to climate change and optimize food production. A Geographical Information Systems (GIS) approach is taken to develop an interactive decision-support tool that can be accessible to on-ground agricultural managers. The tool encompasses multiple criteria analysis (MCA) that identifies factors during the construction phase of the tool, using expert witnesses and regional knowledge, framed within an Analytical Hierarchy Process. Given the complexities of the interrelations between each of the key outcomes, this participatory approach, in which local realities and factors inform the key outcomes and help to strategies for a particular region, results in a robust strategy for sustainably intensifying production in key food producing regions. The creation of an interactive, locally embedded, decision-support management and education tool can help to close the gap between farmer knowledge and production, increase on-farm adoption of sustainable farming strategies and techniques, and optimize farm productivity.Keywords: agriculture, decision-support management tool, Geographic Information System, GIS, sustainable intensification
Procedia PDF Downloads 1661306 Annual Audit for the Year 2021 for Patients with Hyperparathyroidism: Not as Rare an Entity as We Believe
Authors: Antarip Bhattacharya, Dhritiman Maitra
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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH
Procedia PDF Downloads 1251305 Irritable Bowel Syndrome Prevalence and Associated Risk Factors Among Medical Students And Intern Doctors in Sudan
Authors: Zainab Alghali Elsaid Muhammed
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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students
Procedia PDF Downloads 1021304 External Vacuum Dressing: Optimising Non-Operative Management of Flail Sternum Post CPR
Authors: Nicholas Bayfield, Mark Newman
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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing
Procedia PDF Downloads 1551303 People Living with HIV/AIDS: In the Face of Social Stigma and the Role of Therapeutic Communication
Authors: Semiu Bello
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Since the discovery of HIV/AIDS in 1981, it has been a major global challenge and its ravaging consequences have had negative imprints on both the affected and infected people. The challenge of HIV/AIDS does not only affect the developing countries of the world, the developed nations have had their share of the experiences. The disease has, therefore, attracted the attentions of national governments and international donor agencies with huge financial investments toward the eradication of the virus and its global menace. Socially, however, people living with HIV/AIDS have had to battle with an array of social challenges in regards to the infection; the social stigmas, which seem to be more prevalent in underdeveloped and developing societies. The social stigmas with which people living with HIV/AIDS have suffered from include, but not limited, to social isolation, group avoidance, loss of jobs, public ridicule and non-appointment to official and government positions. Given this background, this study examines the roles of therapeutic communication otherwise called patient-provider communication within a clinical environment, focusing on Olabisi Onabanjo University Teaching Hospital (OOUTH) Sagamu, Nigeria as a case study. In other words, this study will investigate the level of interpersonal communication, interactions, and relationships that often take place between people living with HIV/AIDS and health care providers including doctors, nurses and social workers. This study will methodologically adopt the in-depth interview to interview six members of people living with HIV/AIDS at OOUTH. The dimensions of the data will determine the policy prescriptions of this study, which as envisage, may contribute to the improved use of therapeutic communication by health care providers and may thereof improve the psychology of people living with HIV/AIDS in the face of any social stigma.Keywords: health care providers, people living with HIV/AIDS, social stigma, therapeutic communication
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