Search results for: disease control honeybees
13383 Identification and Application of Biocontrol Agents against Cotton Leaf Curl Virus Disease in Gossypium hirsutum under Green House Conditions
Authors: Memoona Ramzan, Bushra Tabassum, Anwar Khan, Muhammad Tariq, Mudassar Fareed Awan, Idrees Ahmad Nasir, Zahida Qamar, Naila Shahid, Tayyab Husnain
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Biological control is a novel approach being used in crop protection nowadays. Bacteria like Bacillus and Pseudomonas are reported for this purpose and few of their products are commercially available too. Rhizosphere and phyllosphere of healthy cotton plants were used as a source to isolate bacteria capable of exhibiting properties worthy for selection as biocontrol agent. For this purpose all isolated strains were screened for the activities like phosphate solubilization, Indole acetic acid (IAA) production and biocontrol against fungi. Two strains S1HL3 and S1HL4 showed phosphate solubilization and IAA production simultaneously while two other JS2HR4 and JS3HR2 were good inhibitors of fungal pathogens. Through biochemical and molecular characterization these bacteria were identified as P. aeruginosa, Burkholderia and Bacillus respectively. In green house trials of these isolates against Cotton leaf curl virus (CLCuV), seven treatments including individual bacterial isolate and consortia were included. Treated plants were healthy as compared to control plants in which upto 74% CLCuV symptomatic plants exist. Maximum inhibition of CLCuV was observed in T7 treated plants where viral load was only 0.4% as compared to control where viral load was upto 74%. This treatment consortium included Bacillus and Pseudomonas isolates; S1HL3, S1HL4, JS2HR4 and JS3HR2. Principal Component Biplot depicted highly significant correlation between percentage viral load and the disease incidence.Keywords: cotton leaf curl virus, biological control, bacillus, pseudomonas
Procedia PDF Downloads 38313382 Central Vascular Function and Relaxibility in Beta-thalassemia Major Patients vs. Sickle Cell Anemia Patients by Abdominal Aorta and Aortic Root Speckle Tracking Echocardiography
Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri
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Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TMKeywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH
Procedia PDF Downloads 17013381 The Social Ecology of Serratia entomophila: Pathogen of Costelytra giveni
Authors: C. Watson, T. Glare, M. O'Callaghan, M. Hurst
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The endemic New Zealand grass grub (Costelytra giveni, Coleoptera: Scarabaeidae) is an economically significant grassland pest in New Zealand. Due to their impacts on production within the agricultural sector, one of New Zealand's primary industries, several methods are being used to either control or prevent the establishment of new grass grub populations in the pasture. One such method involves the use of a biopesticide based on the bacterium Serratia entomophila. This species is one of the causative agents of amber disease, a chronic disease of the larvae which results in death via septicaemia after approximately 2 to 3 months. The ability of S. entomophila to cause amber disease is dependant upon the presence of the amber disease associated plasmid (pADAP), which encodes for the key virulence determinants required for the establishment and maintenance of the disease. Following the collapse of grass grub populations within the soil, resulting from either natural population build-up or application of the bacteria, non-pathogenic plasmid-free Serratia strains begin to predominate within the soil. Whilst the interactions between S. entomophila and grass grub larvae are well studied, less information is known on the interactions between plasmid-bearing and plasmid-free strains, particularly the potential impact of these interactions upon the efficacy of an applied biopesticide. Using a range of constructed strains with antibiotic tags, in vitro (broth culture) and in vivo (soil and larvae) experiments were conducted using inoculants comprised of differing ratios of isogenic pathogenic and non-pathogenic Serratia strains, enabling the relative growth of pADAP+ and pADAP- strains under competition conditions to be assessed. In nutrient-rich, the non-pathogenic pADAP- strain outgrew the pathogenic pADAP+ strain by day 3 when inoculated in equal quantities, and by day 5 when applied as the minority inoculant, however, there was an overall gradual decline in the number of viable bacteria for both strains over a 7-day period. Similar results were obtained in additional experiments using the same strains and continuous broth cultures re-inoculated at 24-hour intervals, although in these cultures, the viable cell count did not diminish over the 7-day period. When the same ratios were assessed in soil microcosms with limited available nutrients, the strains remained relatively stable over a 2-month period. Additionally, in vivo grass grub co-infections assays using the same ratios of tagged Serratia strains revealed similar results to those observed in the soil, but there was also evidence of horizontal transfer of pADAP from the pathogenic to the non-pathogenic strain within the larval gut after a period of 4 days. Whilst the influence of competition is more apparent in broth cultures than within the soil or larvae, further testing is required to determine whether this competition between pathogenic and non-pathogenic Serratia strains has any influence on efficacy and disease progression, and how this may impact on the ability of S. entomophila to cause amber disease within grass grub larvae when applied as a biopesticide.Keywords: biological control, entomopathogen, microbial ecology, New Zealand
Procedia PDF Downloads 15613380 Prevalence of Enterocytozoon hepatopenaei in Shrimp Cultured in Inland Saline Water
Authors: Naveen Kumar B. T., Anuj Tyagi, Prabjeet Singh, Shanthanagouda A. H., Sumeet Rai
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Inland saline water resources are gaining the importance in expanding the aquaculture activities to mitigate the nutritional and food security issues of the world. For profitable and sustainable aquaculture practices, scientific farming, biosecurity measure, and best fish health management should be the integral part of developmental activities. Keeping in line with global awareness and trends, the Indian government has taken an innovative step to conduct disease surveillance and awareness programme for aquatic disease through network project. This ‘National Surveillance Programme for Aquatic Animal Diseases (NSPAAD)’ is being implemented in collaboration of national institutes and state agriculture universities with funding support from National Fisheries Development Board (NFDB), Govt. of India. Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, an NSPAAD collaborator, has been actively engaged in disease surveillance in the Indian state of Punjab. Shrimp farming in inland saline areas of Punjab is expanding at a tremendous pace under the guidance of GADVASU along with the support of State Fisheries Department. Under this national disease surveillance programme, we reported Enterocytozoon hepatopenaei (EHP) infection in the Litopenaeus vannamei cultured in the inland saline waters. Polymerase chain reaction (PCR) based diagnosis was carried out using the OIE (World Organisation for Animal Health) protocol. It was observed that out of 20 shrimp farms, two farms were 1st step PCR positive and two more farms were nested PCR positive. All the EHP positive ponds had shown the white faeces along with mortalities at very low rate. Therefore, implementation of biosecurity and continuous surveillance and monitoring program for finfish and shellfish aquaculture are in need of the hour to prevent and control the large-scale disease outbreaks and subsequent economic losses.Keywords: disease, EHP, inland saline water, shrimp culture
Procedia PDF Downloads 26213379 The Association Between COL4A3 Variant RS55703767 With the Susceptibility to Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus: Results from the Cohort Study
Authors: Zi-Han Li, Zi-Jun Sun, Dong-Yuan Chang, Li Zhu, Min Chen, Ming-Hui Zhao
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Aims: A genome-wide association study (GWAS) reported that patients with the rs55703767 minor allele in collagen type IV α3 chain encoding gene COL4A3 showed protection against diabetic kidney disease (DKD) in type 1 diabetes mellitus (T1DM). However, the role of rs55703767 in type 2 DKD has not been elucidated. The aim of the current study was to investigate the association between COL4A3 variant rs55703767 and DKD risk in Chinese patients with type 2 diabetes mellitus (T2DM). Methods: This nested case-control study was performed on 1311 patients who had T2DM for at least 10 years, including 580 with DKD and 731 without DKD. We detected the genotypes of all patients by TaqMan SNP Genotyping Assay and analyzed the association between COL4A3 variant rs55703767 and DKD risk. Results: Genetic analysis revealed that there was no significant difference between T2DM patients with DKD and those without DKD regarding allele or genotype frequencies of rs55703767, and the effect of this variant was not hyperglycemia specific. Conclusion: Our findings suggested that there was no detectable association between the COL4A3 variant rs55703767 and the susceptibility to DKD in the Chinese T2DM population.Keywords: collagen type IV α3 chain, gene polymorphism, type 2 diabetes, diabetic kidney disease
Procedia PDF Downloads 11013378 The Effectiveness of a Self-Efficacy Psychoeducational Programme to Enhance Outcomes of Patients with End-Stage Renal Disease
Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He
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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy
Procedia PDF Downloads 31913377 A Multi-Site Knowledge Attitude and Practice Survey of Ebola Virus Disease (EVD) in Nigeria
Authors: Ilyasu G., Ogoina D., Otu AA, Muhammed FD, Ebenso B., Otokpa D., Rotifa S., Tuduo-Wisdom O., Habib AG
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Background: The 2014 Ebola Virus Disease (EVD) outbreak was characterized by fear, misconceptions and irrational behaviors. We conducted a knowledge attitude and practice survey of EVD in Nigeria to inform the institution of effective control measures. Methods: Between July 30th and September 30th 2014, a cross-sectional study on knowledge, attitude and practice (KAP) of Ebola Virus Disease (EVD) was undertaken among adults of the general population and healthcare workers (HCW) in three states of Nigeria, including Kano, Cross River and Bayelsa states. Demographic information and data on KAP were obtained using a self-administered standardized questionnaire. The percentage KAP scores were categorized as good and poor. Independent predictors of good knowledge of EVD were ascertained using a binary logistic regression model. Results: Out of 1035 study participants with a median age of 32 years, 648 (62.6%) were males, 846 (81.7%) had tertiary education and 441 (42.6%) were HCW. There were 218, 239 and 578 respondents from Bayelsa, Cross Rivers, and Kano states, respectively. The overall median percentage KAP scores and interquartile ranges (IQR) were 79.46% (15.07%), 95.0% (33.33%), and 49.95% (37.50%), respectively. Out of the 1035 respondents, 470 (45.4%), 544(52.56%), and 252 (24.35%) had good KAP of EVD defined using 80%, 90%, and 70% score cut-offs, respectively. Independent predictors of good knowledge of EVD were a HCW (Odds Ratio-OR-2.89, 95% Confidence interval-CI of 1.41-5.90), reporting ‘moderate to high fear of EVD’ (OR-2.15, 95% CI-1.47-3.13) and ‘willingness to modify habit’ (OR-1.68, 95% CI-1.23-2.30). Conclusion: Our results reveal suboptimal EVD-related knowledge, attitude and practice among adults in Nigeria. To effectively control future outbreaks of EVD in Nigeria, there is a need to institute public sensitization programs that improve understanding of EVD and address EVD-related myths and misconceptions, especially among the general population.Keywords: Ebola, health care worker, knowledge, attitude
Procedia PDF Downloads 28413376 A Neuropsychological Investigation of the Relationship between Anxiety Levels and Loss of Inhibitory Cognitive Control in Ageing and Dementia
Authors: Nasreen Basoudan, Andrea Tales, Frederic Boy
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Non-clinical anxiety may be comprised of state anxiety - temporarily experienced anxiety related to a specific situation, and trait anxiety - a longer lasting response or a general disposition to anxiety. While temporary and occasional anxiety whether as a mood state or personality dimension is normal, nonclinical anxiety may influence many more components of information processing than previously recognized. In ageing and dementia-related research, disease characterization now involves attempts to understand a much wider range of brain function such as loss of inhibitory control, as against the more common focus on memory and cognition. However, in many studies, the tendency has been to include individuals with clinical anxiety disorders while excluding persons with lower levels of state or trait anxiety. Loss of inhibitory cognitive control can lead to behaviors such as aggression, reduced sensitivity to others, sociopathic thoughts and actions. Anxiety has also been linked to inhibitory control, with research suggesting that people with anxiety are less capable of inhibiting their emotions than the average person. This study investigates the relationship between anxiety and loss of inhibitory control in younger and older adults, using a variety of questionnaires and computers-based tests. Based on the premise that irrespective of classification, anxiety is associated with a wide range of physical, affective, and cognitive responses, this study explores evidence indicative of the potential influence anxiety per se on loss of inhibitory control, in order to contribute to discussion and appropriate consideration of anxiety-related factors in methodological practice.Keywords: anxiety, ageing, dementia, inhibitory control
Procedia PDF Downloads 24013375 Health Behaviors Related to Preventing Disease of Hand Foot and Mouth Disease of Child Caregivers in Child Development Center Ubon Ratchathani Province, Thailand
Authors: Comsun Thongchai, Vorapoj Promasatayaprot
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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand
Procedia PDF Downloads 19613374 Effective Validation Model and Use of Mobile-Health Apps for Elderly People
Authors: Leonardo Ramirez Lopez, Edward Guillen Pinto, Carlos Ramos Linares
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The controversy brought about by the increasing use of mHealth apps and their effectiveness for disease prevention and diagnosis calls for immediate control. Although a critical topic in research areas such as medicine, engineering, economics, among others, this issue lacks reliable implementation models. However, projects such as Open Web Application Security Project (OWASP) and various studies have helped to create useful and reliable apps. This research is conducted under a quality model to optimize two mHealth apps for older adults. Results analysis on the use of two physical activity monitoring apps - AcTiv (physical activity) and SMCa (energy expenditure) - is positive and ideal. Through a theoretical and practical analysis, precision calculations and personal information control of older adults for disease prevention and diagnosis were performed. Finally, apps are validated by a physician and, as a result, they may be used as health monitoring tools in physical performance centers or any other physical activity. The results obtained provide an effective validation model for this type of mobile apps, which, in turn, may be applied by other software developers that along with medical staff would offer digital healthcare tools for elderly people.Keywords: model, validation, effective, healthcare, elderly people, mobile app
Procedia PDF Downloads 21813373 Searching for Health-Related Information on the Internet: A Case Study on Young Adults
Authors: Dana Weimann Saks
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This study aimed to examine the use of the internet as a source of health-related information (HRI), as well as the change in attitudes following the online search for HRI. The current study sample included 88 participants, randomly divided into two experimental groups. One was given the name of an unfamiliar disease and told to search for information about it using various search engines, and the second was given a text about the disease from a credible scientific source. The study findings show a large percentage of participants used the internet as a source of HRI. Likewise, no differences were found in the extent to which the internet was used as a source of HRI when demographics were compared. Those who searched for the HRI on the internet had more negative opinions and believed symptoms of the disease were worse than the average opinion among those who obtained the information about the disease from a credible scientific source. The Internet clearly influences the participants’ beliefs, regardless of demographic differences.Keywords: health-related information, internet, young adults, HRI
Procedia PDF Downloads 12613372 Study on the Knowledge, Attitude and Practice (KAP) of Patients with Hypertension in Aseer Hospital, Asir Region, Saudi Arabia
Authors: Ayesha Siddiqua
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Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.Keywords: Attitude, hypertension, Knowledge, practices
Procedia PDF Downloads 35013371 Role of Interlukin-18 in Primary Knee Osteoarthritis: Clinical, Laboratory and Radiological Study
Authors: Ibrahim Khalil Ibrahim, Enas Mohamed Shahine, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Ghada Salah Attia Hussein
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Osteoarthritis (OA) is a multifactorial disease characterized by a progressive degradation of articular cartilage and is the leading cause of disability in elderly persons. IL-18 contributes to the destruction of cartilage and bone in the disease process of arthritis. The aim of the study was to investigate the role of IL-18 in primary knee OA patients. Serum level of IL-18 was assessed by enzyme-linked immunosorbent assay in 30 primary knee OA patients and compared to 20 age and gender-matched healthy volunteers as a control group. Radiographic severity of OA was assessed by Kellgren and Lawrence (KL) global scale. Pain, stiffness and functional assessment were done using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). OA patients had significantly higher serum IL-18 level than in control group (420.93 ± 345.4 versus 151.03 ± 144.16 pg/ml, P=0.001). Serum level of IL-18 was positively correlated with KL global scale (P=0.001). There were no statistically significant correlations between serum level of IL-18 and pain, stiffness, function subscales and total WOMAC index scores among the studied patients. In conclusions, IL-18 has a role in the pathogenesis of OA and it is positively correlated with the radiographic damage of OA.Keywords: Interlukin-18, knee osteoarthritis, primary osteoarthritis, WOMAC scale
Procedia PDF Downloads 38413370 Understanding and Addressing the Tuberculosis Notification Gap in Nepal
Authors: Lok Raj Joshi, Naveen Prakash Shah, Sharad Kumar Sharma, I. Ratna Bhattarai, Rajendra Basnet, Deepak Dahal, Bahagwan Maharjan, Seraphine Kaminsa
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Context: Tuberculosis (TB) is a significant health issue in Nepal, a country with a high burden of the disease. Despite efforts to control TB, there is still a gap in the notification of TB cases, which hinders effective control and treatment. This paper aims to address this notification gap and proposes strategies to improve TB control in Nepal. Research Aim: The aim of this research is to understand and address the tuberculosis notification gap in Nepal. The focus is on enhancing the healthcare system, involving the private sector and communities, raising awareness, and addressing social determinants to achieve sustainable TB control. Methodology: The research methodology involved a review of existing epidemiological data and research studies related to TB in Nepal. Additionally, consultation with an expert group from the TB control program in Nepal provided insights into the current state of TB control and challenges in addressing the notification gap. Findings: The findings reveal that only 55% of TB cases were reported in 2022, indicating a significant notification gap. Of the reported cases, only 32% and 19% were referred by the private sector and community, respectively. Furthermore, 20% of diagnosed cases were not treated in the initial phase. The estimated number of cases of multidrug-resistant TB (MDR TB) was 2,800, suggesting a low diagnosis rate. Among the diagnosed MDR TB cases, only 60% were receiving treatment. Additionally, it was observed that 20% of diagnosed MDR TB cases were from India and not enrolling in TB treatment in Nepal, indicating a high rate of defaulters. Theoretical Importance: The study highlights the importance of adopting a holistic strategy to address the notification gap in TB cases in Nepal. It emphasizes the need to enhance healthcare infrastructure, raise awareness, involve the private sector and local communities, establish effective methods to trace initial defaulters, implement TB interventions in border regions, and mitigate the social stigma associated with the disease. Data Collection and Analysis Procedures: Data for this study was collected through a review of existing epidemiological data and research studies. The data were then analyzed to identify patterns, trends, and gaps in TB case notification in Nepal.Keywords: TB, tuberculosis, private sector, community, migrants, nepal
Procedia PDF Downloads 10013369 The Non-Motor Symptoms of Filipino Patients with Parkinson’s Disease
Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul
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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression
Procedia PDF Downloads 44813368 Association of Selected Biochemical Markers and Body Mass Index in Women with Endocrine Disorders
Authors: M. Mydlárová Blaščáková, J. Bernasovská, J. Poráčová, I. Boroňová
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Obesity is frequent attendant phenomenon of patients with endocrinological disease. Between BMI and endocrinological diseases is close correlation. In thesis we focused on the allocation of hormone concentration – PTH and TSH, CHOL a mineral element Ca in a blood serum. The examined group was formed by 100 respondents (women) aged 36 – 83 years, who were divided into two groups – control group (CG), group with diagnosed endocrine disease (DED). The concentration of PTH and TSH, Ca and CHOL was measured through the medium of analyzers Cobas e411 (Japan); Cobas Integra 400 (Switzerland). At individuals was measured body weight as well as stature and thereupon from those data we enumerated BMI. On the basis of Student T-test in biochemical parameter of PTH and Ca we found out significantly meaningful difference (p<0,05) between CG and DED. In CG we made a founding the association between BMI and PTH by means of correlation analysis.Keywords: biochemical markers, hormones, obesity, women
Procedia PDF Downloads 41913367 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease
Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale
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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.Keywords: COPD, pulmonary hypertension, chronic lung disease, India
Procedia PDF Downloads 35713366 Unpleasant Symptom Clusters Influencing Quality of Life among Patients with Chronic Kidney Disease
Authors: Anucha Taiwong, Nirobol Kanogsunthornrat
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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis
Procedia PDF Downloads 31813365 Laboratory Diagnostic Testing of Peste des Petits Ruminants in Georgia
Authors: Nino G. Vepkhvadze, Tea Enukidze
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Every year the number of countries around the world face the risk of the spread of infectious diseases that bring significant ecological and social-economic damage. Hence, the importance of food product safety is emphasized that is the issue of interest for many countries. To solve them, it’s necessary to conduct preventive measures against the diseases, have accurate diagnostic results, leadership, and management. The Peste des petits ruminants (PPR) disease is caused by a morbillivirus closely related to the rinderpest virus. PPR is a transboundary disease as it emerges and evolves, considered as one of the top most damaging animal diseases. The disease imposed a serious threat to sheep-breeding when the farms of sheep, goats are significantly growing within the country. In January 2016, PPR was detected in Georgia. Up to present the origin of the virus, the age relationship of affected ruminants and the distribution of PPRV in Georgia remains unclear. Due to the nature of PPR, and breeding practices in the country, reemerging of the disease in Georgia is highly likely. The purpose of the studies is to provide laboratories with efficient tools allowing the early detection of PPR emergence and re-emergences. This study is being accomplished under the Biological Threat Reduction Program project with the support of the Defense Threat Reduction Agency (DTRA). The purpose of the studies is to investigate the samples and identify areas at high risk of the disease. Georgia has a high density of small ruminant herds bred as free-ranging, close to international borders. Kakheti region, Eastern Georgia, will be considered as area of high priority for PPR surveillance. For this reason, in 2019, in Kakheti region investigated n=484 sheep and goat serum and blood samples from the same animals, utilized serology and molecular biology methods. All samples were negative by RT-PCR, and n=6 sheep samples were seropositive by ELISA-Ab. Future efforts will be concentrated in areas where the risk of PPR might be high such as international bordering regions of Georgia. For diagnostics, it is important to integrate the PPRV knowledge with epidemiological data. Based on these diagnostics, the relevant agencies will be able to control the disease surveillance.Keywords: animal disease, especially dangerous pathogen, laboratory diagnostics, virus
Procedia PDF Downloads 11513364 Multilevel Modeling of the Progression of HIV/AIDS Disease among Patients under HAART Treatment
Authors: Awol Seid Ebrie
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HIV results as an incurable disease, AIDS. After a person is infected with virus, the virus gradually destroys all the infection fighting cells called CD4 cells and makes the individual susceptible to opportunistic infections which cause severe or fatal health problems. Several studies show that the CD4 cells count is the most determinant indicator of the effectiveness of the treatment or progression of the disease. The objective of this paper is to investigate the progression of the disease over time among patient under HAART treatment. Two main approaches of the generalized multilevel ordinal models; namely the proportional odds model and the nonproportional odds model have been applied to the HAART data. Also, the multilevel part of both models includes random intercepts and random coefficients. In general, four models are explored in the analysis and then the models are compared using the deviance information criteria. Of these models, the random coefficients nonproportional odds model is selected as the best model for the HAART data used as it has the smallest DIC value. The selected model shows that the progression of the disease increases as the time under the treatment increases. In addition, it reveals that gender, baseline clinical stage and functional status of the patient have a significant association with the progression of the disease.Keywords: nonproportional odds model, proportional odds model, random coefficients model, random intercepts model
Procedia PDF Downloads 42113363 Comparison of Deep Brain Stimulation Targets in Parkinson's Disease: A Systematic Review
Authors: Hushyar Azari
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Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus
Procedia PDF Downloads 17913362 Exact and Approximate Controllability of Nuclear Dynamics Using Bilinear Controls
Authors: Ramdas Sonawane, Mahaveer Gadiya
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The control problem associated with nuclear dynamics is represented by nonlinear integro-differential equation with additive controls. To control chain reaction, certain amount of neutrons is added into (or withdrawn out of) chamber as and when required. It is not realistic. So, we can think of controlling the reactor dynamics by bilinear control, which enters the system as coefficient of state. In this paper, we study the approximate and exact controllability of parabolic integro-differential equation controlled by bilinear control with non-homogeneous boundary conditions in bounded domain. We prove the existence of control and propose an explicit control strategy.Keywords: approximate control, exact control, bilinear control, nuclear dynamics, integro-differential equations
Procedia PDF Downloads 44413361 UML Model for Double-Loop Control Self-Adaptive Braking System
Authors: Heung Sun Yoon, Jong Tae Kim
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In this paper, we present an activity diagram model for double-loop control self-adaptive braking system. Since activity diagram helps to improve visibility of self-adaption, we can easily find where improvement is needed on double-loop control. Double-loop control is adopted since the design conditions and actual conditions can be different. The system is reconfigured in runtime by using double-loop control. We simulated to verify and validate our model by using MATLAB. We compared single-loop control model with double-loop control model. Simulation results show that double-loop control provides more consistent brake power control than single-loop control.Keywords: activity diagram, automotive, braking system, double-loop, self-adaptive, UML, vehicle
Procedia PDF Downloads 41613360 Disease Trajectories in Relation to Poor Sleep Health in the UK Biobank
Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao
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Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank
Procedia PDF Downloads 9213359 The Effectiveness of Cognitive-Behavioral Group Therapy on Stress, Illness Anxiety and Obsessions-Compulsion Caused by the Coronavirus Crisis in Adolescent (14-18 Year olds) in Tehran, Iran
Authors: Maryam Mousavi Nik, Sara Pasandian
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The aim of the current research was to determine the effectiveness of Cognitive-Behavioral Group Therapy (G-CBT) on stress, illness anxiety and obsessions-compulsion caused by the coronavirus crisis in adolescents (14-18-Year-olds) in Tehran, Iran. This research was carried out in the form of a semi-experimental study with a control group and in the framework of a pre-test and post-test design for both experimental and control groups. The statistical population of this research consisted of all high schools in Tehran in 2022. The sample size includes 32 Adolescents (14-18-Year-olds) who were selected using a cluster sampling method, and then they were randomly replaced in two experimental (n=16) and control (n=16) groups. In this research, an adolescent stress questionnaire (ASQ-N) with an emphasis on the impact of Coronavirus, Coronavirus disease anxiety (CDAS) and The Children's Yale-Brown Obsessive Compulsive Symptom Scale (CY-BOCS) emphasis on the Coronavirus were used, and group therapy intervention with The cognitive-behavioral approach was conducted for 8 sessions of 90 minutes in the experimental group. The research data were analyzed by Multivariate analysis of covariance (MANCOVA) and covariance (ANCVA) tests. The results of multivariate covariance analysis showed that group therapy intervention with a cognitive-behavioral approach had a significant effect on at least one of the variables of stress, illness anxiety and obsession-compulsion at the level (P<0.01, F=94.772) in the post-test stage. Also, the results of covariance analysis of one variable showed that group therapy intervention with a cognitive-behavioral approach in the level of (P<0.01, F=106.377) stress, in the level of (P<0.01, F=48.147) disease anxiety and in the level (P>0.01, F=17.033) of obsession-compulsion had a significant effect in the post-test stage. The results showed that The treatment with GCBT can be effective in decreasing stress, illness anxiety and obsessions and compulsion caused by the coronavirus crisis in Adolescents (15-20-Year-olds) and may be considered as an alternative to either individual cognitive-behavioral therapy or medication.Keywords: stress, disease anxiety, obsession-compulsion, coronavirus (Covid-19) crisis, and cognitive-behavioral therapy
Procedia PDF Downloads 6413358 Comparative Study between Direct Torque Control and Sliding Mode Control of Sensorless Induction Machine
Authors: Fouad Berrabah, Saad Salah, Zaamouche Fares
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In this paper, the Direct Torque Control (DTC) Control and the Sliding Mode Control for induction motor are presented and compared. The performance of the two control schemes is evaluated in terms of torque and current ripple, and transient response to variations of the torque , speed and robustness, trajectory tracking. In order to identify the more suitable solution for any application, both techniques are analyzed mathematically and simulation results are compared which advantages and drawbacks are discussed.Keywords: induction motor, DTC- MRAS control, sliding mode control, robustness, trajectory tracking
Procedia PDF Downloads 59713357 Saving the Decolonized Subject from Neglected Tropical Diseases: Public Health Campaign and Household-Centred Sanitation in Colonial West Africa, 1900-1960
Authors: Adebisi David Alade
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In pre-colonial West Africa, the deadliness of the climate vis-a- vis malaria and other tropical diseases to Europeans turned the region into the “white man’s grave.” Thus, immediately after the partition of Africa in 1885, civilisatrice and mise en valeur not only became a pretext for the establishment of colonial rule; from a medical point of view, the control and possible eradication of disease in the continent emerged as one of the first concerns of the European colonizers. Though geared toward making Africa exploitable, historical evidence suggests that some colonial Water, Sanitation and Hygiene (WASH) policies and projects reduced certain tropical diseases in some West African communities. Exploring some of these disease control interventions by way of historical revisionism, this paper challenges the orthodox interpretation of colonial sanitation and public health measures in West Africa. This paper critiques the deployment of race and class as analytical tools for the study of colonial WASH projects, an exercise which often reduces the complexity and ambiguity of colonialism to the binary of colonizer and the colonized. Since West Africa presently ranks high among regions with Neglected Tropical Diseases (NTDs), it is imperative to decentre colonial racism and economic exploitation in African history in order to give room for Africans to see themselves in other ways. Far from resolving the problem of NTDs by fiat in the region, this study seeks to highlight important blind spots in African colonial history in an attempt to prevent post-colonial African leaders from throwing away the baby with the bath water. As scholars researching colonial sanitation and public health in the continent rarely examine its complex meaning and content, this paper submits that the outright demonization of colonial rule across space and time continues to build ideological wall between the present and the past which not only inhibit fruitful borrowing from colonial administration of West Africa, but also prevents a wide understanding of the challenges of WASH policies and projects in most West African states.Keywords: colonial rule, disease control, neglected tropical diseases, WASH
Procedia PDF Downloads 18713356 How Participatory Climate Information Services Assist Farmers to Uptake Rice Disease Forecasts and Manage Diseases in Advance: Evidence from Coastal Bangladesh
Authors: Moriom Akter Mousumi, Spyridon Paparrizos, Fulco Ludwig
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Rice yield reduction due to climate change-induced disease occurrence is becoming a great concern for coastal farmers of Bangladesh. The development of participatory climate information services (CIS) based on farmers’ needs could implicitly facilitate farmers to get disease forecasts and make better decisions to manage diseases. Therefore, this study aimed to investigate how participatory climate information services assist coastal rice farmers to take up rice disease forecasts and better manage rice diseases by improving their informed decision-making. Through participatory approaches, we developed a tailor-made agrometeorological service through the DROP app to forecast rice diseases and manage them in advance. During farmers field schools (FFS) we communicated 7-day disease forecasts during face-to-face weekly meetings using printed paper and, messenger app derived from DROP app. Results show that the majority of the farmers understand disease forecasts through visualization, symbols, and text. The majority of them use disease forecast information directly from the DROP app followed by face-to-face meetings, messenger app, and printed paper. Farmers participation and engagement during capacity building training at FFS also assist them in making more informed decisions and improved management of diseases using both preventive measures and chemical measures throughout the rice cultivation period. We conclude that the development of participatory CIS and the associated capacity-building and training of farmers has increased farmers' understanding and uptake of disease forecasts to better manage of rice diseases. Participatory services such as the DROP app offer great potential as an adaptation option for climate-smart rice production under changing climatic conditions.Keywords: participatory climate service, disease forecast, disease management, informed decision making, coastal Bangladesg
Procedia PDF Downloads 4613355 Spatial Cluster Analysis of Human Cases of Crimean Congo Hemorrhagic Fever Reported in Pakistan
Authors: Tariq Abbas, Younus Muhammad, Sayyad Aun Muhammad
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Background : Crimean Congo hemorrhagic fever (CCHF) is a tick born viral zoonotic disease that has been notified from almost all regions of Pakistan. The aim of this study was to investigate spatial distribution of CCHF cases reported to National Institue of Health , Islamabad during year 2013. Methods : Spatial statistics tools were applied to detect extent spatial auto-correlation and clusters of the disease based on adjusted cumulative incidence per million population for each district. Results : The data analyses revealed a large multi-district cluster of high values in the uplands of Balochistan province near Afghanistan border. Conclusion : The cluster included following districts: Pishin; Qilla Abdullah; Qilla Saifullah; Quetta, Sibi; Zhob; and Ziarat. These districts may be given priority in CCHF surveillance, control programs, and further epidemiological research . The location of the cluster close to border of Afghanistan and Iran highlight importance of the findings for organizations dealing with disease at national, regional and global levels.Keywords: Crimean Congo hemorrhagic fever, Pakistan, spatial autocorrelation, clusters , adjusted cumulative incidence
Procedia PDF Downloads 41213354 Role of Toll Like Receptor-2 in Female Genital Tuberculosis Disease Infection and Its Severity
Authors: Swati Gautam, Salman Akhtar, S. P. Jaiswar, Amita Jain
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Background: FGTB is now a major global health problem mostly in developing countries including India. In humans, Mycobacterium Tuberculosis (M.tb) is a causating agent of infection. High index of suspicion is required for early diagnosis due to asymptomatic presentation of FGTB disease. In macrophages Toll Like Receptor-2 (TLR-2) is one which mediated host’s immune response to M.tb. The expression of TLR-2 on macrophages is important to determine the fate of innate immune responses to M.tb. TLR-2 have two work. First its high expression on macrophages worsen the outer of infection and another side, it maintains M.tb to its dormant stage avoids activation of M.tb from latent phase. Single Nucleotide Polymorphism (SNP) of TLR-2 gene plays an important role in susceptibility to TB among different populations and subsequently, in the development of infertility. Methodology: This Case-Control study was done in the Department of Obs and Gynae and Department of Microbiology at King George’s Medical University, U.P, Lucknow, India. Total 300 subjects (150 Cases and 150 Controls) were enrolled in the study. All subjects were enrolled only after fulfilling the given inclusion and exclusion criteria. Inclusion criteria: Age 20-35 years, menstrual-irregularities, positive on Acid-Fast Bacilli (AFB), TB-PCR, (LJ/MGIT) culture in Endometrial Aspiration (EA). Exclusion criteria: Koch’s active, on ATT, PCOS, and Endometriosis fibroid women, positive on Gonococal and Chlamydia. Blood samples were collected in EDTA tubes from cases and healthy control women (HCW) and genomic DNA extraction was carried out by salting-out method. Genotyping of TLR2 genetic variants (Arg753Gln and Arg677Trp) were performed by using single amplification refractory mutation system (ARMS) PCR technique. PCR products were analyzed by electrophoresis on 1.2% agarose gel and visualized by gel-doc. Statistical analysis of the data was performed using the SPSS 16.3 software and computing odds ratio (OR) with 95% CI. Linkage Disequiliribium (LD) analysis was done by SNP stats online software. Results: In TLR-2 (Arg753Gln) polymorphism significant risk of FGTB observed with GG homozygous mutant genotype (OR=13, CI=0.71-237.7, p=0.05), AG heterozygous mutant genotype (OR=13.7, CI=0.76-248.06, p=0.03) however, G allele (OR=1.09, CI=0.78-1.52, p=0.67) individually was not associated with FGTB. In TLR-2 (Arg677Trp) polymorphism a significant risk of FGTB observed with TT homozygous mutant genotype (OR= 0.020, CI=0.001-0.341, p < 0.001), CT heterozygous mutant genotype (OR=0.53, CI=0.33-0.86, p=0.014) and T allele (OR=0.463, CI=0.32-0.66, p < 0.001). TT mutant genotype was only found in FGTB cases and frequency of CT heterozygous more in control group as compared to FGTB group. So, CT genotype worked as protective mutation for FGTB susceptibility group. In haplotype analysis of TLR-2 genetic variants, four possible combinations, i.e. (G-T, A-C, G-C, and A-T) were obtained. The frequency of haplotype A-C was significantly higher in FGTB cases (0.32). Control group did not show A-C haplotype and only found in FGTB cases. Conclusion: In conclusion, study showed a significant association with both genetic variants of TLR-2 of FGTB disease. Moreover, the presence of specific associated genotype/alleles suggest the possibility of disease severity and clinical approach aimed to prevent extensive damage by disease and also helpful for early detection of disease.Keywords: ARMS, EDTA, FGTB, TLR
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