Search results for: medication administration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1740

Search results for: medication administration

1500 Unravelling the Procedural Obligations of the Administration in the Case Law of the European Court of Human Rights

Authors: Agne Andrijauskaite

Abstract:

The observance of procedural rights by administrative authorities is essential for the effective implementation of subjective rights and is part and parcel of the notion of good governance. Whilst a lot of legal scholarship addresses the scope and content of such rights under the European Union legal framework, a very limited attention is given to their application in the case law of European Court of Human Rights (ECtHR) despite its growing engagement with the subject. This paper written as a part of a wider project on the development of pan-European principles of good administration by the Council of Europe aims to fill this lacuna. This will be done by delimiting the scope and extent of individual procedural safeguards through an analysis of the practice of the ECtHR. The right to be heard, the right to access the files and the right to a decision in reasonable time by administrative authorities will be selected as loci classici for the purpose of this article. The results presented in the paper should contribute to the awareness of growing body of ECtHR’s case-law revolving around administrative procedural law and the growing debate on the notion of good governance found therein within academic community.

Keywords: European Court of Human Rights, good governance, procedural rights, procedural Law

Procedia PDF Downloads 258
1499 Hepatoprotective Assessment of L-Ascorbate 1-(2-Hydroxyethyl)-4,6-Dimethyl-1, 2-Dihydropyrimidine-2-on in Toxic Liver Damage Test

Authors: Vladimir Zobov, Nail Nazarov, Alexandra Vyshtakalyuk, Vyacheslav Semenov, Irina Galyametdinova, Vladimir Reznik

Abstract:

The aim of this study was to investigate hepatoprotective properties of the Xymedon derivative L-ascorbate 1- (2-hydroxyethyl)-4,6-dimethyl-1,2-dihydropyrimidine-2-one (XD), which exhibits high efficiency as actoprotector. The study was carried out on 68 male albino rats weighing 250-400 g using preventive exposure to the test preparation. Effectiveness of XD win comparison with effectiveness of Xymedon (original substance) after administration of the compounds in identical doses. Maximum dose was 20 mg/kg. The animals orally received Xymedon or its derivative in doses of 10 and 20 mg/kg over 4 days. In 1-1.5 h after drug administration, CCl4 in vegetable oil (1:1) in a dose of 2 ml/kg. Controls received CCl4 but without hepatoprotectors. Intact control group consisted of rats, not receiving CCl4 or other compounds. The next day after the last administration of CCl4 and compounds under study animals were dehematized under ether anesthesia, blood and liver samples were taken for biochemical and histological analysis. Xymedon and XD administered according to the preventice scheme, exerted hepatoprotective effects: Xymedon — in the dose of 20 mg/kg, XD — in doses of 10 and 20 mg/kg. The drugs under study had different effects on liver condition, affected by induction with CCl4. Xymedon had a more pronounced effect both on the ALT level, which can be elevated not only due to destructive changes in hepatocytes, but also as a cholestasis manifestation, and on the serum total protein level, which reflects protein synthesis in liver. XD had a more pronounced effect on AST level, which is one of the markers of hepatocyte damage. Lower effective dose of XD — 10 mg/kg, compared to Xymedon effective according to, and its pronounced effect on AST, the hepatocyte cytolysis marker, is indicative of its higher preventive effectiveness, compared to Xymedon. This work was performed with the financial support of Russian Science Foundation (grant No: 14-50-00014).

Keywords: hepatoprotectors, pyrimidine derivatives, toxic liver damage, xymedon

Procedia PDF Downloads 277
1498 Nurse-Led Codes: Practical Application in the Emergency Department during a Global Pandemic

Authors: F. DelGaudio, H. Gill

Abstract:

Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

Procedia PDF Downloads 126
1497 Flood Management Plans in Different Flooding Zones of Gujranwala and Rawalpindi Divisions, Punjab, Pakistan

Authors: Muhammad Naveed

Abstract:

In this paper, flood issues in Gujranwala and Rawalpindi divisions are discussed as a primary importance as these zones are affected continuously from flooding in recent years, provincial variability of the issue, introduce status of the continuous administration measures, their adequacy and future needs in flood administration are secured. Flood issues in these zones are exhibited by Chenab River Basin, Jhelum Rivers Basin. Some unique problems, related to floods in these divisions is lack of major dams on Chenab and Jhelum rivers and also mismanagement of rivers and canal water like dam break stream, and water signing in Tal zones, are additionally mentioned. There are major Nalaas in these regions like Nalaa Lai of Rawalpindi and Nalaa Daik, Nalaa Palkhu, Nalaa Aik of Gujranwala are major cause of floods in these regions other than rivers. Proper management of these Nalaas and moving of nearby population well in time could reduce impacts from flood in these regions. Progress of different flood administration measures, both auxiliary and non-basic, are discussed. Likewise, future needs to accomplish proficient and fruitful flood management measures in Pakistan are additionally brought up. In this paper, we describe different hard and soft engineering techniques to overcome flood situations in these zones as these zones are more vulnerable due to lack of management in canal and river water. Effective management and use of hard and soft techniques are need of time in coming future for controlling greater flooding in flood risk zones to overcome or minimize people’s death as well as agricultural and financial resources as flood and other natural disasters are a major drawback in the economic prosperity of the country.

Keywords: flood management, rivers, major dams, agricultural and financial loss, future management and control

Procedia PDF Downloads 176
1496 Prospects and Challenges of Enforcing Accountability and Transperancy for Good Governance: An Analysis of Nigeria’s Situation

Authors: Mahmoud Datti Yola

Abstract:

There is wider agreement among the scholars of political science and public administration that transparency and accountability constituted one of the most crucial ingredients of good governance. In addition democratic government is expected to be accountable and responsive to the wishes and aspirations of the people. In Nigeria, after more than fifteen years to the handover of power to the civilian administration, the leaders has not been at their best, as people’ expectations for nation building, socio-economic progress and better opportunities has been dashed by high level corruption, rising insecurity, absence of the rule of law and lack of transparency and accountability. The objective of this paper is to examine the prospects and challenges of transparency and accountability in Nigeria’s democratic governance. The study utilizes secondary data for this purpose. The study is of the view that the enormous task of dealing with the issue of corruption, insecurity and promotion of ethics and accountability in Nigeria lies not only in effective oversight of the executive by the legislative bodies, respect for the rule of law and an independent judiciary, but also in the ability of the citizens, civil society organizations and other associations to hold elected and appointed officials accountable.

Keywords: good governance, transperancy, accountability, Nigeria

Procedia PDF Downloads 572
1495 Exploring the Impact of Mobility-Related Treatments (Drug and Non-Pharmacological) on Independence and Wellbeing in Parkinson’s Disease - A Qualitative Synthesis

Authors: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

Abstract:

Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

Procedia PDF Downloads 45
1494 Glycemic Control on Self-Efficacy and Self-Care Behaviors among Omani Adults with Type 2 Diabetes

Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

Abstract:

Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

Procedia PDF Downloads 382
1493 Pharmacokinetic Modeling of Valsartan in Dog following a Single Oral Administration

Authors: In-Hwan Baek

Abstract:

Valsartan is a potent and highly selective antagonist of the angiotensin II type 1 receptor, and is widely used for the treatment of hypertension. The aim of this study was to investigate the pharmacokinetic properties of the valsartan in dogs following oral administration of a single dose using quantitative modeling approaches. Forty beagle dogs were randomly divided into two group. Group A (n=20) was administered a single oral dose of valsartan 80 mg (Diovan® 80 mg), and group B (n=20) was administered a single oral dose of valsartan 160 mg (Diovan® 160 mg) in the morning after an overnight fast. Blood samples were collected into heparinized tubes before and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24 h following oral administration. The plasma concentrations of the valsartan were determined using LC-MS/MS. Non-compartmental pharmacokinetic analyses were performed using WinNonlin Standard Edition software, and modeling approaches were performed using maximum-likelihood estimation via the expectation maximization (MLEM) algorithm with sampling using ADAPT 5 software. After a single dose of valsartan 80 mg, the mean value of maximum concentration (Cmax) was 2.68 ± 1.17 μg/mL at 1.83 ± 1.27 h. The area under the plasma concentration-versus-time curve from time zero to the last measurable concentration (AUC24h) value was 13.21 ± 6.88 μg·h/mL. After dosing with valsartan 160 mg, the mean Cmax was 4.13 ± 1.49 μg/mL at 1.80 ± 1.53 h, the AUC24h was 26.02 ± 12.07 μg·h/mL. The Cmax and AUC values increased in proportion to the increment in valsartan dose, while the pharmacokinetic parameters of elimination rate constant, half-life, apparent of total clearance, and apparent of volume of distribution were not significantly different between the doses. Valsartan pharmacokinetic analysis fits a one-compartment model with first-order absorption and elimination following a single dose of valsartan 80 mg and 160 mg. In addition, high inter-individual variability was identified in the absorption rate constant. In conclusion, valsartan displays the dose-dependent pharmacokinetics in dogs, and Subsequent quantitative modeling approaches provided detailed pharmacokinetic information of valsartan. The current findings provide useful information in dogs that will aid future development of improved formulations or fixed-dose combinations.

Keywords: dose-dependent, modeling, pharmacokinetics, valsartan

Procedia PDF Downloads 276
1492 Investigate the Side Effects of Patients With Severe COVID-19 and Choose the Appropriate Medication Regimens to Deal With Them

Authors: Rasha Ahmadi

Abstract:

In December 2019, a coronavirus, currently identified as SARS-CoV-2, produced a series of acute atypical respiratory illnesses in Wuhan, Hubei Province, China. The sickness induced by this virus was named COVID-19. The virus is transmittable between humans and has caused pandemics worldwide. The number of death tolls continues to climb and a huge number of countries have been obliged to perform social isolation and lockdown. Lack of focused therapy continues to be a problem. Epidemiological research showed that senior patients were more susceptible to severe diseases, whereas children tend to have milder symptoms. In this study, we focus on other possible side effects of COVID-19 and more detailed treatment strategies. Using bioinformatics analysis, we first isolated the gene expression profile of patients with severe COVID-19 from the GEO database. Patients' blood samples were used in the GSE183071 dataset. We then categorized the genes with high and low expression. In the next step, we uploaded the genes separately to the Enrichr database and evaluated our data for signs and symptoms as well as related medication regimens. The results showed that 138 genes with high expression and 108 genes with low expression were observed differentially in the severe COVID-19 VS control group. Symptoms and diseases such as embolism and thrombosis of the abdominal aorta, ankylosing spondylitis, suicidal ideation or attempt, regional enteritis were observed in genes with high expression and in genes with low expression of acute and subacute forms of ischemic heart, CNS infection and poliomyelitis, synovitis and tenosynovitis. Following the detection of diseases and possible signs and symptoms, Carmustine, Bithionol, Leflunomide were evaluated more significantly for high-expression genes and Chlorambucil, Ifosfamide, Hydroxyurea, Bisphenol for low-expression genes. In general, examining the different and invisible aspects of COVID-19 and identifying possible treatments can help us significantly in the emergency and hospitalization of patients.

Keywords: phenotypes, drug regimens, gene expression profiles, bioinformatics analysis, severe COVID-19

Procedia PDF Downloads 116
1491 E-Government, China Internet Plus, and the One Belt One Road Initiative: The Africa Connection

Authors: Isaac Kofi Mensah, Mi Jianing

Abstract:

The lack of Information and Communication Technologies (ICT) infrastructure in African countries is hampering the successful adoption, development and implementation of e-government in Africa. Electronic government is the use of ICTs to modernize government public administration processes and to provide government services to citizens with a purpose to enhance efficiency, accountability, and transparency in government’s interaction with the citizenry. ICT application in public administration has the potential to modernize and create smarter government and improvement in public service delivery. China’s Internet Plus policy and One Belt One Road strategy present a golden opportunity for countries in Africa to attract the huge financial investment through Chinese IT companies to develop and close Africa’s ICT infrastructure gap. This study recommends the establishment of One Belt One Road ICT Infrastructure Fund for Africa (OBOR ICT Fund for Africa) to enable countries in Africa to source solely for the purpose of ICT infrastructure development in the public sector/government machinery which would in turn promote the adoption and development of e-government in the public sectors of respective countries in Africa.

Keywords: e-government, public service delivery, internet plus, one belt one road initiative, China, Africa

Procedia PDF Downloads 648
1490 The Influence of Theories and Approaches to Educational Policy and Planning in Ghana’s Current Educational Developments

Authors: Ruth Donkoh, Wing On Lee, Solomon A. Boateng, Portia Oware Twerefoo, Josephine Donkor

Abstract:

In this paper we defend the value of theories and approaches to educational policy and planning in enhancing the educational developments in Ghana. This mission is achieved by enumerating the recent educational developments in Ghana and juxtaposing it with some educational theories, approaches to policy making, and policy planning to see if the educational developments conform with the theory principles as well as policy making and planning processes. Data collection for the research was made through textual analysis of policy documents as well as review of relevant literatures. The findings reveled that educational developments in Ghana are unable to attain its objectives due to the policies not conforming with the policy formation and planning principles. In addition, was that education planning in Ghana does not follow the policy-administration dichotomy theory principles and likewise the distribution of educational needs goes contrary to the equity theory. We recommend that educational policies in Ghana should be in conformity with the principles of theories as well as the approaches to educational policy making and planning to help meet the needs of learners, attain educational quality, and to help in the accomplishment of educational development objectives.

Keywords: Ghana education, equity theories, politics- administration dichotomy theory, educational policies, educational planning

Procedia PDF Downloads 123
1489 Association of Daily Physical Activity with Diabetes Control in Patients with Type II Diabetes

Authors: Chia-Hsun Chang

Abstract:

Background: Combination of drug treatment, dietary management, and regular exercise can effectively control type II diabetes mellitus (T2DM). Performing daily physical activities other than structured exercise is much easier and whether daily physical activities including work, walking, housework, gardening, leisure exercise, or transportation have a similar effect on diabetes control is not well studied.Aims and Objectives: This study aims to determine whether daily physical activity undertaken by patients with T2DM is associated with their diabetes control. Design: A correlation study with prospective design. Methods: Purposive sampling of 206 patients with T2DM was recruited from a medical center in Central Taiwan. The International Physical Activity Questionnaire was used to assess daily levels of physical activities, and the Diabetes Compliance Questionnaire was used to assess medication and dietary compliance. Data of diabetes control (hemoglobin A1c, HbA1c)were followed up every three months for one year after recruitment. Results: In this study, the average age of the participants was 62.5 years (±10.4 years), and the average duration of diabetes since diagnosis was 13.2 years (±7.8), 112 of the participants were women (54.4%) and 94 of the participants were men (45.6%). The mean HbA1c level was 7.8% (±1.4), and 78.2% of the participants presented with unsatisfactory diabetes control. Because the participants were distributed across a wide age range, and their physical health, activity levels, and comorbidities might have varied with age, the participants were divided into two groups: 121 participants who were younger than 65 years (58.7%) and 85 participants who were older than 65 years (41.3%). Both younger (< 65 years) and older (> 65 years) patients with diabetes engaged in more moderate and low levels of physical activity (89.3% and 87%, respectively). Results showed that the levels of daily physical activity were not significantly associated with diabetes control after adjustment for medication and dietary compliance in both groups. Conclusion: Performing daily physical activity is not significantly correlated with diabetes control. Daily physical activity cannot completely replace exercise. Relevance to Clinical Practice: Health personnel must encourage patients to engage in exercise that is planned, structured, and repetitive for improving diabetes control.

Keywords: daily physical activity, diabetes control, international physical activity questionnaire (IPAQ), type II diabetes mellitus (T2DM)

Procedia PDF Downloads 150
1488 Model Development of Health Tourism at Ban Nam Chieo Community, Laem Ngop, Trat Province

Authors: Pradapet Krutchangthong, Jirawat Sudsawart

Abstract:

This research aims to study the health tourism administration and factors related to health tourism promotion at Ban Nam Chieo Community, Laem Ngop, Trat Province. The sample in this research is 361 tourists who use the service and Ban Nam Chieo Community residents who provide the service. Sampling was done from a population size of 3,780 using Taro Yamane’s formula. The tools used in the study were questionnaires and interviews. The statistics used in this research are percentage, mean and standard deviation. The result of Model Development of Health Tourism at Ban Nam Chieo Community, Laem Ngop , Trat Province shows that most of them are female with bachelor degree. They are government officers with an average income between 16,001-20,000 Baht. Suggested health system activities for health tourism development are: 1) health massage, 2) herbal compress, 3) exercise in the water by walking on shell. Meanwhile, factors related to health tourism promotion at Ban Nam Chieo Community, Laem Ngop, Trat Province are: 1) understanding the context of the community and service providers, 2) cooperation from related government and private sectors.

Keywords: health tourism, health system activities, promotion, administration

Procedia PDF Downloads 363
1487 On the Road towards Effective Administrative Justice in Macedonia, Albania and Kosovo: Common Challenges and Problems

Authors: Arlinda Memetaj

Abstract:

A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of both effective public administration and administrative justice system has been for a long period of time among the most ‘important and urgent’ final strategic objectives of almost any country in the Balkans region, including Macedonia, Albania and Kosovo. Closely related to this is their common strategic goal to enter the membership in the European Union, which requires fulfilling of many criteria and standards as incorporated in EU acquis communautaire. The latter is presently done with the framework of the Stabilization and Association Agreement which each of these countries has concluded with the EU accordingly. To above aims, each of the three countries has so far adopted a huge series of legislative and strategic documents related to any aspects of their individual administrative justice system. ‘Changes and reforms’ in this field have been thus the most frequent terms being used in any of these countries. The three countries have already established their own national administrative judiciary, while permanently amending their laws on the general administrative procedure introducing thereby considerable innovations concerned. National administrative courts are expected to have crucial important role within the broader judiciary systems-related reforms of these countries; they are designed to check the legality of decisions of the state administration with the aim to guarantee an effective protection of human rights and legitimate interests of private persons through a regular, conform, fast and reasonable judicial administrative process. Further improvements in this field are presently an integral crucial part of all the relevant national strategic documents including the ones on judiciary reform and public administration reform, as adopted by each of the three countries; those strategic documents are designed among others to provide effective protection of their citizens` rights` of administrative justice. On the basis of the later, the paper finally is aimed at highlighting selective common challenges and problems of the three countries on their European road, while claiming (among others) that the current status quo situation in each of them may be overcome only if there is a proper implementation of the administrative courts decisions and a far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main methods used in this paper include the analytical and comparative ones due to the very character of the paper itself.

Keywords: administrative courts , administrative justice, administrative procedure, benefit, effective administrative justice, human rights, implementation, monitoring, reform

Procedia PDF Downloads 128
1486 Mobile Application for Construction Sites Management

Authors: A. Khelifi, M. Al Kaabi, B. Al Rawashdeh

Abstract:

The infrastructure is one of the most important pillars of the UAE, where it spends millions of dollars for investments in the construction sectors. The research done by Kuwait Finance House (KFH) Research showed clearly that the UAE investments in the construction sectors have exceeded 30 billion dollars in 2013. There are many construction companies in the UAE and each one of them is taking the responsibilities to build different infrastructures. The large scale construction projects consist of multi human activities which can affect the efficiency and productivity of the running projects. The Construction Administration System is developed to increase the efficiency and productivity at the construction sites. It runs on two platforms: web server and mobile phone and supports two main users: mobile user and institution employee. With Construction Administration Mobile Application the user can manage and control several projects, create several reports and send these reports in Portable Document Format (PDF) formats through emails, view the physical location of each project, capturing and save photos. An institution employee can use the system to view all existing workers and projects, send emails and view the progress of each project.

Keywords: construction sites, management, mobile application, Portable Document Format (PDF)

Procedia PDF Downloads 353
1485 Challenge of the Credibility of Witnesses in the International Criminal Court and the Precondition to Establish the Truth

Authors: Romina Beqiri

Abstract:

In the context of the prosecution of those responsible for the commission of the most hideous crimes and the fight against impunity, a fundamental role is played by witnesses of the crimes who contribute to ascertaining the ‘procedural truth’. This article examines recent decisions and legislation of the Hague-based International Criminal Court in terms of the endangerment of the integrity of the criminal proceedings in consequence of witness tampering. The analysis focuses on the new developments in the courtroom and the academia, in particular, on the first-ever sentence confirming the charges of corruptly influencing witnesses, interpretation of presenting false evidence and giving false testimony when under an obligation to tell the truth. Confronted with recent tampering with witnesses and their credibility at stake in the ongoing cases, the research explores different Court’s decisions and scholars’ legal disputes concerning the deterrence approach to punish the authors of offences against the administration of justice when committed intentionally. Therefore, the analysis concludes that the Court cannot tolerate any witness false testimony and should enhance consistency and severity of sanctions for the sake of fair trial and end impunity.

Keywords: International Criminal Court, administration of justice, credibility of witness, fair trial, false testimony, witness tampering

Procedia PDF Downloads 151
1484 Attitudes of Grade School and Kindergarten Teachers towards the Implementation of Mother-Tongue Based Language in Education

Authors: Irene Guatno Toribio

Abstract:

This study purported to determine and describe the attitudes of grade school and kindergarten teachers in District I, Division of City Schools in Parañaque towards the implementation of mother tongue-based multilingual education instruction. Employing a descriptive method of research, this study specifically looked into the attitudes of the participants towards the implementation of mother tongue-based language in terms of curricular content, teaching methods, instructional materials used, and administrative support. A total of nineteen teachers, eight (8) of which were kindergarten teachers and eleven (11) were grade one teachers. A self-made survey questionnaire was developed by the researcher and validated by the experts. This constituted the main instrument in gathering the needed data and information relative to the major concern of the study, which were analyzed and interpreted through the use of descriptive statistics. The findings of this study revealed that grade one and kindergarten teachers have a positive attitude towards the integration and inclusion of mother-tongue based language in the curriculum. In terms of suggested teaching methods, the kindergarten teacher’s attitude towards the use of storytelling and interactive activities is highly positive, while two groups of teachers both recommend the use of big books and painting kit as an instructional materials. While the kindergarten teachers would tend to cling on the use of big books, this was not the case for grade school teachers who would rather go for the use of painting kit which was not favored by the kindergarten teachers. Finally, in terms of administrative support, the grade one teacher is very satisfied when it comes to the support of their school administrator. While the kindergarten teachers has developed the feeling that the school administration has failed to give them enough materials in their activities, the grade school teachers, on the other hand, have developed the feeling that the same school administration might have failed to strictly evaluate the kindergarten teachers. Based on the findings of this study, it is recommended that the school administration must provide seminars to teachers to better equip them with the needed knowledge and competencies in implementing the Mother-Tongue Based, Multilingual Education (MTB-MLE).

Keywords: attitude, grade school, kindergarten teachers, mother-tongue

Procedia PDF Downloads 293
1483 Study Case of Spacecraft Instruments in Structural Modelling with Nastran-Patran

Authors: Francisco Borja de Lara, Ali Ravanbakhsh, Robert F. Wimmer-Schweingruber, Lars Seimetz, Fermín Navarro

Abstract:

The intense structural loads during the launch of a spacecraft represent a challenge for the space structure designers because enough resistance has to be achieved while maintaining at the same time the mass and volume within the allowable margins of the mission requirements and inside the limits of the budget project. In this conference, we present the structural analysis of the Lunar Lander Neutron Dosimetry (LND) experiment on the Chang'E4 mission, the first probe to land on the moon’s far side included in the Chinese’ Moon Exploration Program by the Chinese National Space Administration. To this target, the software Nastran/Patran has been used: a structural model in Patran and a structural analysis through Nastran have been realized. Next, the results obtained are used both for the optimization process of the spacecraft structure, and as input parameters for the model structural test campaign. In this way, the feasibility of the lunar instrument structure is demonstrated in terms of the modal modes, stresses, and random vibration and a better understanding of the structural tests design is provided by our results.

Keywords: Chang’E4, Chinese national space administration, lunar lander neutron dosimetry, nastran-patran, structural analysis

Procedia PDF Downloads 496
1482 Opinions of Individuals from Different Age and Income Brackets on the Duterte Administration's Overall Performance

Authors: Jose Carlos Montemayor, Kendrick Thomas Angelo Santos

Abstract:

Filipinos have been divided on President Rodrigo Duterte’s leadership ever since his election in 2016. This study aimed to gain a thorough, in-depth understanding of the opinions of Filipinos from different age and income brackets on these issues in order to address the lack of studies analysing the current Philippine political landscape. An interview tackling relevant national issues were conducted with twelve respondents from the intersections of four age groups and three income brackets. The government’s handling of some issues received mixed opinions, some had neutral viewpoints, while others had more unfavorable ones. The responses differed on three levels: (1) the general stance on an issue; (2) the strength of a stance; and (3) the factoring in of an issue in forming an overall perception on the administration’s performance. Contrary to previous studies on political thought, opinions varied greatly such that no unique set of viewpoints could be attributed to any of the defined age or income groups. These results will be most useful to political science researchers, political analysts, and candidates shaping their platforms for the upcoming elections. Future studies are recommended to tackle more national issues and to consider other factors that may affect political opinions and behavior.

Keywords: age groups, opinion formation, socioeconomic brackets, Philippine politics, Rodrigo Duterte

Procedia PDF Downloads 105
1481 The Constitution of Kenya, 2010, and the Feminist Legal Theory

Authors: Tecla Rita Karendi, Andy Cons Matata

Abstract:

Although before and at the advent of colonial administration, several women such as Mekatilili wa Menza and Muthoni Nyanjiru took up leadership positions in resisting the colonial administration. Kenya is generally considered a patriarchal society. Many women who tried to take up positions of leadership in postcolonial Kenya, such as the Nobel Prize winner Wangari Maathai, were branded as prostitutes or generally immoral women. However, the Constitution of Kenya, 2010, has since made a huge impact not only in the area of affirmative action but also in various aspects of the feminist legal theory such as the constitutional requirement that no more than two-thirds of the members of the elective or appointive bodies should be of the same gender. This favours women who are often sidelined in elective posts such as parliament or county assemblies and state-appointed posts in the parastatals and commissions. The constitution also recognizes the right to abortion, which was outrightly outlawed in the independence constitution. Certain practices adverse to women’s health, such as wife inheritance, female genital mutilation, and property rights, are either outlawed or framed to recognized women’s rights. The education of the girl-child is also now considered a priority, unlike in the past. Despite these developments, a lot remains to be done.

Keywords: feminist legal theory, constitution of Kenya, 2010, affirmative action, leadership

Procedia PDF Downloads 185
1480 Ethnobotanical Survey on the Use of Herbal Medicine at Children in Algeria

Authors: Metahri Leyla

Abstract:

Herbal medicine is one of the oldest medicines in the world. It constitutes an interesting alternative to treat and cure without creating new diseases. Despite the progress of medicine, the increase in the number of doctors, the creation of social security, many parents have resorted to herbal medicine for their children; they are increasingly asking for "natural remedies", "without risk" for their children. Herbal tea is a very accessible way to enjoy the benefits of herbal medicine. Accordingly; the objective of our study is to obtain detailed information on the composition and mode of administration of these herbal teas and to identify the different plants used; their beneficial effects, as well as their possible toxicity. The current research work represents an ethnobotanical survey spread over one month (from January 6, 2021, to February 19, 2021) carried out by means of an electronic questionnaire concerning 753 respondents involving single or multiparous mothers. The obtained results reveal that a total of 684 mothers used herbal teas for their infants, which revealed the use of 55 herbal remedies for several indications, the most sought after are the carminative effect and relief of colic, and which 9% of users noticed undesirable effects linked to the administration of herbal teas to their infants. As a conclusion, it has been asserted that the use of herbal teas as a natural remedy by Algerian mothers is a widely accepted practice, however, the "natural" nature of the plants does not mean that they are harmless.

Keywords: herbal medicine, herbal teas, children, mothers, medicinal plants

Procedia PDF Downloads 112
1479 Prophylactic and Curative Effect of Selenium on Infertility Induced by Formaldehyde Using Male Albino Mice

Authors: Suhera M. Aburawi, Habiba A. El Jaafari, Soad A. Treesh, Abdulssalam M. Abu-Aisha, Faisal S. Alwaer, Reda A. Eltubuly, Medeha Elghedamsi

Abstract:

Introduction: Infertility is a source of psychological, and sometimes social, stress on parents who desire to have children. Formaldehyde is used chiefly as disinfectant, preservative and in the chemical synthesis. The medical uses of formaldehyde are limited, but focused especially on laboratory use. Selenium is an essential trace mineral element for human; it is essential for sperm function and male fertility. Selenium deficiency has been linked to reproductive problems in animals. Objectives: To investigate the prophylactic and curative effect of selenium on male infertility induced by formaldehyde using male albino mice. Method: Forty male albino mice were used, weight 25-30 gm. Five groups of male mice (n=8) were used. Group 1 was daily administered water for injection (5ml/kg) for five days, group 2 was daily administered selenium (100 μg/kg) for five days, group 3 was daily administered formaldehyde (30mg/kg) for five days, group 4 (prophylaxis) was daily administered a combination of formaldehyde and selenium for five days, while group 5 (curative) was daily administered formaldehyde for five days followed by daily administration of selenium for the next five days. Intraperitoneal administration was adopted. At the end of the administration, seminal fluid was collected from vas deferens. Sperm count, morphology and motility were scored; histopathological screening of genital system was carried out. SPSS was applied for comparing groups. Results and conclusion: It was found that formaldehyde toxicity did not change the sperm count and percentage of motile sperm; unhealthy sperm was increased, while healthy sperm was decreased. Formaldehyde produces degeneration/damage to the male mice genital system. Selenium alone produce an increase in sperm count, volume of seminal fluid and the percentage of motile sperm. Selenium has prophylactic and curative effects against formaldehyde-induce genital system toxicity. Future work is recommended to find out if selenium protective effect is through antioxidant or other mechanisms.

Keywords: infertility, formaldehyde, selenium, male mice

Procedia PDF Downloads 404
1478 Medical Workforce Knowledge of Adrenaline (Epinephrine) Administration in Anaphylaxis in Adults Considerably Improved with Training in an UK Hospital from 2010 to 2017

Authors: Jan C. Droste, Justine Burns, Nithin Narayan

Abstract:

Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

Procedia PDF Downloads 108
1477 The Influence of Gender on Itraconazole Pharmacokinetic Parameters in Healthy Adults

Authors: Milijana N. Miljkovic, Viktorija M. Dragojevic-Simic, Nemanja K. Rancic, Vesna M. Jacevic, Snezana B. Djordjevic, Momir M. Mikov, Aleksandra M. Kovacevic

Abstract:

Itraconazole (ITZ) is a weak base and extremely lipophilic compound, with water solubility as a rate-limiting step in its absorption from the gastrointestinal tract. Its absolute bioavailability, about 55%, is maximal when its oral formulation, capsules, are taken immediately after a full meal. Peak plasma concentrations (Cmax) are reached within 2 to 5 hrs after their administration. ITZ undergoes extensive hepatic metabolism by human CYP3A4 isoenzyme and more than 30 different metabolites have been identified. One of the main ones is hydroxyitraconazole (HITZ), in which plasma concentrations are almost twice higher than those of ITZ. Gender differences in drug PK (Pharmacokinetics) have already been recognized, but variations in metabolism are believed to be their major cause. The aim of the study was to investigate the influence of gender on ITZ PK parameters after administration of oral capsule formulation, following 100 mg single dosing in healthy adult volunteers under fed conditions. The single-center, open-label PK study was performed. PK analyses included PK parameters obtained after a single 100 mg dose administration of itraconazole capsules to 48 females and 66 males. Blood samples were collected at pre-dose and up to 72.0 h after administration (1.0, 2.0, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 7.0, 9.0, 12.0, 24.0, 36.0 and 72.0 hrs). The calculated pharmacokinetic parameters, based on the plasma concentrations of itraconazole and hydroxyitraconazole, were Cmax, AUClast, and AUCtot. Plasma concentrations of ITZ and HITZ were determined using a validated liquid chromatographic method with mass spectrometric detection, while pharmacokinetic parameters were estimated using non-compartmental methods. The pharmacokinetic analyses were performed using Kinetica software version 5.0. The mean value of ITZ Cmaxmen was 74.79 ng/ml, and Cmaxwomen was 51.291 ng/ml (independent samples test; p = 0.005). Hydroxyitraconazole had a mean value of Cmaxmen 106.37 ng/ml, and the mean value Cmaxwomen was 70.05 ng/ml. Women had, on average, lower AUClast and Cmax than men. AUClastmen for ITZ was 736.02 ng/mL*h and AUClastwomen was 566.62 ng/mL*h, while AUClastmen for HITZ was 1154.80 was ng/mL*h and AUClastwomen for HITZ was 708.12 ng/mL*h (independent samples test; p = 0.033). The mean values of ITZ AUCtotmen were 884.73 ng/mL*h and AUCtotwomen was 685.10 ng/mL*h. AUCtotmen for HITZ was 1290.41 ng/mL*h, while AUCtotwomen for HIZT was 788.60 ng/mL*h (p < 0.001). The results could point out to lower oral bioavailability of ITZ in women, since values of Cmax, AUClast, and AUCtot of both ITZ and HITZ were significantly lower in women than in men, respectively. The reason may be higher expression and activity of CYP3A4 in women than in men, but there also may be differences in other PK parameters. High variability of both ITZ and HITZ concentrations in both genders confirmed that ITZ is a highly variable drug. Further examinations of its PK are needed to justify strategies for therapeutic drug monitoring in patients treated by this antifungal agent.

Keywords: itraconazole, gender, hydroxyitraconazole, pharmacokinetics

Procedia PDF Downloads 115
1476 Concomitant Exposure of Bacoside A and Bromelain Relieves Dichlorvos Toxicity in Mice Serum

Authors: Sonam Agarwal, Renu Bist

Abstract:

Current study emphasizes the toxic effects of dichlorvos on serum in terms of oxidative stress. Meanwhile, a protective action of bacoside A and bromelain was investigated against the biochemical alterations in serum. The experimental design included six groups of mice: saline was given as a vehicle to the control mice (group I). Mice belonging to groups II, III and IV, were administered with dichlorvos (40 mg/kg b.w.), bromelain and bacoside A, respectively. The fifth group received a combination of bromelain and bacoside A. In group VI, Bacoside A, and bromelain were administered 20 minutes prior to exposure of dichlorvos. Thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCC), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and reduced glutathione (GSH) level were used as biochemical test of toxic action for dichlorvos intoxication. Significantly increased TBARS and PCC level in second group suggests that dichlorvos enhances the production of free radicals in serum of mice (p< 0.05). Antioxidants treatment significantly decreased the levels of TBARS and PCC (p< 0.05). Dichlorvos administration causes a significant reduction in the level of CAT, SOD, GPx and GSH (p< 0.05) which was restored significantly by co-administration of bromelain and Bacoside A in dichlorvos exposed mice (p< 0.05). Treatment of bromelain and Bacoside A in combination served as better scavengers of toxicity induced by dichlorvos.

Keywords: bacoside A, bromelain, dichlorvos, serum

Procedia PDF Downloads 317
1475 Determining Face-Validity for a Set of Preventable Drug-Related Morbidity Indicators Developed for Primary Healthcare in South Africa

Authors: D. Velayadum, P. Sthandiwe , N. Maharaj, T. Munien, S. Ndamase, G. Zulu, S. Xulu, F. Oosthuizen

Abstract:

Introduction and aims of the study: It is the responsibility of the pharmacist to manage drug-related problems in order to ensure the greatest benefit to the patient. In order to prevent drug-related morbidity, pharmacists should be aware of medicines that may contribute to certain drug-related problems due to their pharmacological action. In an attempt to assist healthcare practitioners to prevent drug-related morbidity (PDRM), indicators for prevention have been designed. There are currently no indicators available for primary health care in developing countries like South Africa, where the majority of the population access primary health care. There is, therefore, a need to develop such indicators, specifically with the aim of assisting healthcare practitioners in primary health care. Methods: A literature study was conducted to compile a comprehensive list of PDRM indicators as developed internationally using the search engines Google Scholar and PubMed. MESH term used to retrieve suitable articles was 'preventable drug-related morbidity indicators'. The comprehensive list of PDRM indicators obtained from the literature study was further evaluated for face validity. Face validity was done in duplicate by 2 sets of independent researchers to ensure 1) no duplication of indicators when compiling a single list, 2) inclusion of only medication available in primary healthcare, and 3) inclusion of medication currently available in South Africa. Results: The list of indicators, compiled from PDRM indicators in the USA, UK, Portugal, Australia, India, and Canada contained 324 PDRM. 184 of these indicators were found to be duplicates, and the duplications were omitted, leaving a final list of 140. The 140 PDRM indicators were evaluated for face-validity, and 97 were accepted as relevant to primary health care in South Africa. 43 indicators did not comply with the criteria and were omitted from the final list. Conclusion: This study is a first step in compiling a list of PDRM indicators for South Africa. It is important to take cognizance to the fact the health systems differ vastly internationally, and it is, therefore, important to develop country-specific indicators.

Keywords: drug-related morbidity, primary healthcare, South Africa, developing countries

Procedia PDF Downloads 128
1474 The Comparison of the Effects of Adipose-Derived Mesenchymal Stem Cells Delivery by Systemic and Intra-Tracheal Injection on Elastase-Induced Emphysema Model

Authors: Maryam Radan, Fereshteh Nejad Dehbashi, Vahid Bayati, Mahin Dianat, Seyyed Ali Mard, Zahra Mansouri

Abstract:

Pulmonary emphysema is a pathological respiratory condition identified by alveolar destruction which leads to limitation of airflow and diminished lung function. A substantial body of evidence suggests that mesenchymal stem cells (MSCs) have the ability to induce tissue repair primarily through a paracrine effect. In this study, we aimed to determine the efficacy of Intratracheal adipose-derived mesenchymal stem cells (ADSCs) therapy in comparison to this approach with that of Intravenous (Systemic) therapy. Fifty adult male Sprague–Dawley rats weighing between 180 and 200 g were used in this experiment. The animals were randomized to Control groups (Intratracheal or Intravenous vehicle), Elastase group (intratracheal administration of porcine pancreatic elastase; 25 U/kg on day 0 and day 10th), Elastase+Intratracheal ADSCs therapy (1x107 Cells, on day 28) and Elastase+Systemic ADSCs therapy (1x107 Cells, on day 28). The rats which not subjected to any treatment, considered as the control. All rats were sacrificed 3 weeks later. Morphometric findings in lung tissues (Mean linear intercept) confirmed the establishment of the emphysema model via alveolar disruption. Contrarily, ADSCs administration partially restored alveolar architecture. These results were associated with improving arterial oxygenation, reducing lung edema, and decreasing lung inflammation with higher significant effects in the Intratracheal therapy route. These results documented that the efficacy of intratracheal ADSCs was comparable with intravenous ADSCs therapy. Accordingly, the obtained data suggested that intratracheal delivery of ADSCs would enhance lung repair in pulmonary emphysema. Moreover, this method provides benefits over a systemic administration, such as the reduction of cell number and the low risk to engraft other organs.

Keywords: mesenchymal stem cell, emphysema, Intratracheal, systemic

Procedia PDF Downloads 190
1473 The Safe Introduction of Tocilizumab for the Treatment of SARS-CoV-2 Pneumonia at an East London District General Hospital

Authors: Andrew Read, Alice Parry, Kate Woods

Abstract:

Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

Procedia PDF Downloads 153
1472 Subacute Toxicity Study of Total Alkaloids of Seeds of Peganum harmala in Female Rat

Authors: Mahdeb Nadia, Ghadjati Nadhra, Bettihi Sara, Daamouche Z. El Youm, Bouzidi Abdelouahab

Abstract:

The effects of subacute administration of total alkaloids of seeds Peganum harmala were studied in female Albino-Wistar rats. After intraperitoneal administration of dose 50 mg/kg for 10 days and 40 mg/kg for 7 days of total alkaloids to the seeds of Peganum harmala (animal treatment lasted 17 days), there were remarkable changes in general appearance and deaths occurred in experimental group. After 17 days a significant reduction was observed in the surviving animals treated with total alkaloid seeds.The Red Blood Cells (RBC), Hematocrit (HCT), Hemoglobin (HGB) and White blood cells (WBCs), show significant reduction in the treated groups. There were no statistical differences in Glutamic-Oxaloacetic Transaminase (GOT), Glutamic-pyruvic Transaminase (GPT) and Alkaline Phosphatase (ALP), total protein, glucose and creatinine observed between groups. However the urea was significantly higher in the treated female rats than the control group. Histological examination of liver showed no histopathological changes. Alkaloids of Peganum harmala showed significant toxicity in female rats.

Keywords: Peganum harmala, rat, liver, kidney, alkaloids, toxicity

Procedia PDF Downloads 408
1471 Cardioprotective Effect of Oleanolic Acid and Urosolic Acid against Doxorubicin-Induced Cardiotoxicity in Rats

Authors: Sameer N. Goyal, Chandragauda R. Patil

Abstract:

Oleanolic acid (3/3-hydroxy-olea-12-en-28-oic acid) and its isomer, Ursolic acid (38-hydroxy-urs-12-en-28-oic acid) are triterpenoids compounds which exist widely in plant kingdom in the free acid form or as glycosidic triterpenoids saponins. The aim of the study is to evaluate intravenously administered oleanolic acid and ursolic acid in doxorubicin induced cardiotoxicity. Cardiotoxicity was induced in albino wistar rat with single intravenous injection of doxorubicin at dose of 67.75mg/kg i.v for 48 hrs at 12 hrs interval following doxorubicin administration in the same model cardioprotective effect of amifostine (90 mg/kg i.v, single dose prior 30 min before doxorubicin administration) was evaluated as standard treatment. Induction of cardiotoxicity was confirmed by rise in cardiac markers in serum such as CK–MB, LDH and also by electrocardiographically. The doxorubicin treated group significantly increased in QT interval, serum CK-MB, serum LDH, SGOT, SGPT and antioxidant parameter. Both the treatment group showed significant protective effect on Hemodynamic, electrocardiographic, biochemical, and antioxidant parameters. The oleanolic acid showed slight protective effect in histological lesions in doxorubicin induced cardiotoxicity. Hence, the results indicate that Oleanolic acid has more cardioprotective potential than ursolic acid against doxorubicin induced cardiotoxicity in rats.

Keywords: cardioprotection, doxorubicin, oleanolic acid, ursolic acid

Procedia PDF Downloads 499