Search results for: wastewater treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8538

Search results for: wastewater treatment

5598 Impact of Microbial Pathogen on Aquatic Environment

Authors: Muhammad Younis Laghari

Abstract:

Global climate change has had many effects on the aquatic environment, and the major issue is pollution. Along with the other pollutants, there are a significant number of human microbial pathogens that pollute the water bodies. Another concern about the water quality is that the major aquatic resources bring water-borne pathogens and other related diseases. These resources include industrial effluent, untreated domestic sewage, acid mine drainage, etc. However, these water discharges through various routes may have treatment to eliminate the pathogenic microbes. Therefore, it is essential to control the leakage from sewer systems, residential discharge, and agricultural run-off. These pathogenic microbes have been implicated in the lives of water health (fishes), which is harmful and causes diseases. Mostly, the mortality of aquatic species results because of catastrophic floods due to poor water waste treatment and sanitation that introduce pathogenic bacteria into rivers. Pathogens survive in rivers and remain poorly known but essential to control water-borne diseases. The presence of bacteria in watercourses is diverse and constitutes a complicated subject. Many species are autochthonous and play an important role in aquatic ecosystems, while many others arise from untreated or poorly treated waste from industrial and domestic sources. Further, more investigation is required to know the induction of water-borne pathogens in various water resources and the potential impacts of water resource development on pathogen contamination.

Keywords: microbial pathogens, contamination, water resources, river water body

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5597 Fabrication and Characterisation of Additive Manufactured Ti-6Al-4V Parts by Laser Powder Bed Fusion Technique

Authors: Norica Godja, Andreas Schindel, Luka Payrits, Zsolt Pasztor, Bálint Hegedüs, Petr Homola, Jan Horňas, Jiří Běhal, Roman Ruzek, Martin Holzleitner, Sascha Senck

Abstract:

In order to reduce fuel consumption and CO₂ emissions in the aviation sector, innovative solutions are being sought to reduce the weight of aircraft, including additive manufacturing (AM). Of particular importance are the excellent mechanical properties that are required for aircraft structures. Ti6Al4V alloys, with their high mechanical properties in relation to weight, can reduce the weight of aircraft structures compared to structures made of steel and aluminium. Currently, conventional processes such as casting and CNC machining are used to obtain the desired structures, resulting in high raw material removal, which in turn leads to higher costs and impacts the environment. Additive manufacturing (AM) offers advantages in terms of weight, lead time, design, and functionality and enables the realisation of alternative geometric shapes with high mechanical properties. However, there are currently technological shortcomings that have led to AM not being approved for structural components with high safety requirements. An assessment of damage tolerance for AM parts is required, and quality control needs to be improved. Pores and other defects cannot be completely avoided at present, but they should be kept to a minimum during manufacture. The mechanical properties of the manufactured parts can be further improved by various treatments. The influence of different treatment methods (heat treatment, CNC milling, electropolishing, chemical polishing) and operating parameters were investigated by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX), X-ray diffraction (XRD), electron backscatter diffraction (EBSD) and measurements with a focused ion beam (FIB), taking into account surface roughness, possible anomalies in the chemical composition of the surface and possible cracks. The results of the characterisation of the constructed and treated samples are discussed and presented in this paper. These results were generated within the framework of the 3TANIUM project, which is financed by EU with the contract number 101007830.

Keywords: Ti6Al4V alloys, laser powder bed fusion, damage tolerance, heat treatment, electropolishing, potential cracking

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5596 Multi-Criteria Decision-Making in Ranking Drinking Water Supply Options (Case Study: Tehran City)

Authors: Mohsen Akhlaghi, Tahereh Ebrahimi

Abstract:

Considering the increasing demand for water and limited resources, there is a possibility of a water crisis in the not-so-distant future. Therefore, to prevent this crisis, other options for drinking water supply should be examined. In this regard, the application of multi-criteria decision-making methods in various aspects of water resource management and planning has always been of great interest to researchers. In this report, six options for supplying drinking water to Tehran City were considered. Then, experts' opinions were collected through matrices and questionnaires, and using the TOPSIS method, which is one of the types of multi-criteria decision-making methods, they were calculated and analyzed. In the TOPSIS method, the options were ranked by calculating their proximity to the ideal (Ci). The closer the numerical value of Ci is to one, the more desirable the option is. Based on this, the option with the optimization pattern of water consumption, with Ci = 0.9787, is the best option among the proposed options for supplying drinking water to Tehran City. The other options, in order of priority, are rainwater harvesting, wastewater reuse, increasing current water supply sources, desalination and its transfer, and transferring water from freshwater sources between basins. In conclusion, the findings of this study highlight the importance of exploring alternative drinking water supply options and utilizing multi-criteria decision-making approaches to address the potential water crisis.

Keywords: multi-criteria decision, sustainable development, topsis, water supply

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5595 Effect of Two Transactional Instructional Strategies on Primary School Pupils’ Achievement in English Language Vocabulary and Reading Comprehension in Ibadan Metropolis, Nigeria

Authors: Eniola Akande

Abstract:

Introduction: English vocabulary and reading comprehension are core to academic achievement in many school subjects. Deficiency in both accounts for dismal performance in internal and external examinations among primary school pupils in Ibadan Metropolis, Nigeria. Previous studies largely focused on factors influencing pupils’ achievement in English vocabulary and reading comprehension. In spite of what literature has shown, the problem still persists, implying the need for other kinds of intervention. This study was therefore carried out to determine the effect of two transactional strategies Picture Walk (PW) and Know-Want to Learn-Learnt (KWL) on primary four pupils’ achievement in English vocabulary and reading comprehension in Ibadan Metropolis. The moderating effects of gender and learning style were also examined. Methodology: The study was anchored on Rosenblatt’s Transactional Reading and Piaget’s Cognitive Development theories; pretest-posttest control group quasi-experimental design with 3x2x3 factorial matrix was adopted. Six public primary schools were purposively selected based on the availability of qualified English language teachers in Primary Education Studies. Six intact classes (one per school) with a total of 101 primary four pupils (48 males and 53 females) participated. The intact classes were randomly assigned to PW (27), KWL (44) and conventional (30) groups. Instruments used were English Vocabulary (r=0.83), Reading Comprehension (r=0.84) achievement tests, Pupils’ Learning Style Preference Scale (r=0.93) and instructional guides. Treatment lasted six weeks. Data were analysed using the Descriptive statistics, Analysis of Covariance and Bonferroni post-hoc test at 0.05 level of significance. The mean age was 8.86±0.84 years. Result: Treatment had a significant main effect on pupils’ reading comprehension (F(2,82)=3.17), but not on English vocabulary. Participants in KWL obtained the highest post achievement means score in reading comprehension (8.93), followed by PW (8.06) and control (7.21) groups. Pupils’ learning style had a significant main effect on pupils’ achievement in reading comprehension (F(2,82)=4.41), but not on English vocabulary. Pupils with preference for tactile learning style had the highest post achievement mean score in reading comprehension (9.40), followed by the auditory (7.43) and the visual learning style (7.37) groups. Gender had no significant main effect on English vocabulary and reading comprehension. There was no significant two-way interaction effect of treatment and gender on pupils’ achievement in English vocabulary and reading comprehension. The two-way interaction effect of treatment and learning style on pupils’ achievement in reading comprehension was significant (F(4,82)=3.37), in favour of pupils with tactile learning style in PW group. There was no significant two-way interaction effect of gender and learning style on pupils’ achievement in English vocabulary and reading comprehension. The three-way interaction effects were not significant on English vocabulary and reading comprehension. Conclusion: Picture Walk and Know-Want to learn-Learnt instructional strategies were effective in enhancing pupils’ achievement in reading comprehension but not on English vocabulary. Learning style contributed considerably to achievement in reading comprehension but not to English vocabulary. Primary school, English language teachers, should put into consideration pupils’ learning style when adopting both strategies in teaching reading comprehension for improved achievement in the subject.

Keywords: comprehension-based intervention, know-want to learn-learnt, learning style, picture walk, primary school pupils

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5594 The Role of Autophagy Modulation in Angiotensin-II Induced Hypertrophy

Authors: Kitti Szoke, Laszlo Szoke, Attila Czompa, Arpad Tosaki, Istvan Lekli

Abstract:

Autophagy plays an important role in cardiac hypertrophy, which is one of the most common causes of heart failure in the world. This self-degradative catabolic process, responsible for protein quality control, balancing sources of energy at critical times, and elimination of damaged organelles. The autophagic activity can be triggered by starvation, oxidative stress, or pharmacological agents, like rapamycin. This induced autophagy can promote cell survival during starvation or pathological stress. In this study, it is investigated the effect of the induced autophagic process on angiotensin induced hypertrophic H9c2 cells. In our study, it is used H9c2 cells as an in vitro model. To induce hypertrophy, cells were treated with 10000 nM angiotensin-II, and to activate autophagy, 100 nM rapamycin treatment was used. The following groups were formed: 1: control, 2: 10000 nM AT-II, 3: 100 nM rapamycin, 4: 100 nM rapamycin pretreatment then 10000 nM AT-II. The cell viability was examined via MTT (cell proliferation assay) assay. The cells were stained with rhodamine-conjugated phalloidin and DAPI to visualize F-actin filaments and cell nuclei then the cell size alteration was examined in a fluorescence microscope. Furthermore, the expression levels of autophagic and apoptotic proteins such as Beclin-1, p62, LC3B-II, Cleaved Caspase-3 were evaluated by Western blot. MTT assay result suggests that the used pharmaceutical agents in the tested concentrations did not have a toxic effect; however, at group 3, a slight decrement was detected in cell viability. In response to AT-II treatment, a significant increase was detected in the cell size; cells became hypertrophic. However, rapamycin pretreatment slightly reduced the cell size compared to group 2. Western blot results showed that AT-II treatment-induced autophagy, because the increased expression of Beclin-1, p62, LC3B-II were observed. However, due to the incomplete autophagy, the apoptotic Cleaved Caspase-3 expression also increased. Rapamycin pretreatment up-regulated Beclin-1 and LC3B-II, down-regulated p62 and Cleaved Caspase-3, indicating that rapamycin-induced autophagy can restore the normal autophagic flux. Taken together, our results suggest that rapamycin activated autophagy reduces angiotensin-II induced hypertrophy.

Keywords: angiotensin-II, autophagy, H9c2 cell line, hypertrophy, rapamycin

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5593 Hepatitis B, Hepatitis C and HIV Infections and Associated Risk Factors among Substance Abusers in Mekelle Substance Users Treatment and Rehabilitation Centers, Tigrai, Northern Ethiopia

Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

Abstract:

Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

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5592 Quality Evaluation of Treated Ballast Seawater for Potential Reuse

Authors: Siti Nur Muhamad, Mohamad Abu Ubaidah Amir, Adenen Shuhada Abdul Aziz, Siti Sarah Mohd Isnan, Ainul Husna Abdul Rahman, Nur Afiqah Rosly, Roshamida Abd Jamil

Abstract:

The International Convention for the Control and Management of Ships’ Ballast Water and Sediments (BWM Convention) will commencing on 8 September 2017 after ratified by 51 States in September 2016. However, there is no value recovered for the treated ballast water as it simply discharged during de-ballasting. In order to evaluate value creation of treated ballast water, three seawater applications which are seawater toilet flushing, cooling tower and desalination was studied and compared with treated ballast seawater. An exploratory study was conducted in Singapore as a case study as this country is facing water scarcity issues and a busy port in the world which received more than 28 billion m3 of ballast water in 2015. Surprisingly the treatment technology between seawater toilet flushing and ballast water management has similarity as both applications use screening and disinfection process and quality standard and analysis between treated ballast water with seawater applications found that seawater toilet flushing have the same quality parameter with treated ballast water. Thus, the treated ballast water can replace the raw seawater for seawater desalination. As such, with reduction of cost for screen unit, desalination water can exceed water production by NEWater in Singapore as the cost can recover the energy needed for desalination. It can conclude that treated ballast water has high recovery value and can be reused in seawater application.

Keywords: ballast water treatment, desalination, BWM convention, ballast water management

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5591 Antiangiogenic Potential of Phellodendron amurense Bark Extract Observed on Chorioallantoic Membrane

Authors: Ľudmila Ballová, Slavomír Kurhajec, Eva Petrovová, Jarmila Eftimová

Abstract:

Angiogenesis, a formation of new blood vessels from a pre-existing vasculature, plays an important role in pathologic processes such as the growth and metastasis of tumours. Tumours cannot grow beyond a few millimetres without blood supply from the newly formed blood vessels from the host tissue, a process called tumour-induced angiogenesis. The successful research of antiangiogenic treatment of cancer has focused on nutraceuticals with angiogenesis-modulating properties. Berberine, as a major active component of the bark of Phellodendron amurense Rupr., has shown antitumour activity by intervening into different steps of carcinogenesis. The influence of ethanolic extract of Phellodendron amurese bark on the angiogenesis was tested in vivo on chick chorioallantoic membrane (CAM). The irritancy of the CAM after the application of the crude bark extract dissolved in normal saline (10 mg/mL) was investigated on embryonic day 7. No significant signs of the irritancy, such as vasoconstriction, hyperaemia, haemorrhage or coagulation were observed which indicates the harmless character of the extract. A significant reduction in vessel sprouting and higher percentage of avascular zone was observed in the case of CAM treated with the extract in comparison with non-treated CAM (control), which is a proof of the antiangiogenic potential of the extract. These results could contribute to the development of novel drugs for the treatment of cancer or other diseases, in which angiogenesis plays a significant role.

Keywords: angiogenesis, berberine, chorioallantoic membrane, irritancy, phellodendron amurense

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5590 Anxieolytic Activity of Ethyl Acetate Extract of Flowers Nerium indicum

Authors: D. S. Mohale, A. V. Chandewar

Abstract:

Anxiety is defined as an exaggerated feeling of apprehension, uncertainty and fear. Nerium indicum is a well-known ornamental and medicinal plant belonging to the family Apocynaceae. A wide spectrum of biological activities has been reported with various constituents isolated from different parts of the plant. This study was conducted to investigate antianxiety activity of flower extract. Flowers were collected and dried in shade and coarsely powdered. Powdered mixture was extracted with ethyl acetate by maceration process. Extract of flowers obtained was subsequently dried in oven at 40-50 °C. This extract is then tested for antianxiety activity at low and high dose using Elevated Plus Maze and Light & dark Model. Rats shown increased open arm entries and time spent in open arm in elevated Plus maze with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. In Light & dark Model, light box entries and time spent in light box increased with treatment low and high dose of extract of Nerium indicum flower as compared to their respective control groups. From result it is concluded that Ethyl acetate extract of flower of Nerium indicum possess antianxiety activity at low and high dose.

Keywords: anxiety, anxieolytic, social isolation, nerium indicum, kaner

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5589 Developing Alternative Recovery Technology of Waste Heat in Automobile Factory

Authors: Kun-Ping Cheng, Dong-Shang Chang, Rou-Wen Wang

Abstract:

Pre-treatment of automobile paint-shop procedures are the preparation of warm water rinsing tank, hot water rinsing tank, degreasing tank, phosphate tank. The conventional boiler steam fuel is natural gas, producing steam to supply the heat exchange of each tank sink. In this study, the high-frequency soldering economizer is developed for recovering waste heat in the automotive paint-shop (RTO, Regenerative Thermal Oxidation). The heat recovery rate of the new economizer is 20% to 30% higher than the conventional embedded heat pipe. The adaptive control system responded to both RTO furnace exhaust gas and heat demands. In order to maintain the temperature range of the tanks, pre-treatment tanks are directly heated by waste heat recovery device (gas-to-water heat exchanger) through the hot water cycle of heat transfer. The performance of developed waste heat recovery system shows the annual recovery achieved to 1,226,411,483 Kcal of heat (137.8 thousand cubic meters of natural gas). Boiler can reduce fuel consumption by 20 to 30 percent compared to without waste heat recovery. In order to alleviate environmental impacts, the temperature at the end of the flue is further reduced from 160 to 110°C. The innovative waste heat recovery is helpful to energy savings and sustainable environment.

Keywords: waste heat recovery system, sustainability, RTO (Regenerative Thermal Oxidation), economizer, automotive industry

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5588 Approximation of PE-MOCVD to ALD for TiN Concerning Resistivity and Chemical Composition

Authors: D. Geringswald, B. Hintze

Abstract:

The miniaturization of circuits is advancing. During chip manufacturing, structures are filled for example by metal organic chemical vapor deposition (MOCVD). Since this process reaches its limits in case of very high aspect ratios, the use of alternatives such as the atomic layer deposition (ALD) is possible, requiring the extension of existing coating systems. However, it is an unsolved question to what extent MOCVD can achieve results similar as an ALD process. In this context, this work addresses the characterization of a metal organic vapor deposition of titanium nitride. Based on the current state of the art, the film properties coating thickness, sheet resistance, resistivity, stress and chemical composition are considered. The used setting parameters are temperature, plasma gas ratio, plasma power, plasma treatment time, deposition time, deposition pressure, number of cycles and TDMAT flow. The derived process instructions for unstructured wafers and inside a structure with high aspect ratio include lowering the process temperature and increasing the number of cycles, the deposition and the plasma treatment time as well as the plasma gas ratio of hydrogen to nitrogen (H2:N2). In contrast to the current process configuration, the deposited titanium nitride (TiN) layer is more uniform inside the entire test structure. Consequently, this paper provides approaches to employ the MOCVD for structures with increasing aspect ratios.

Keywords: ALD, high aspect ratio, PE-MOCVD, TiN

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5587 Microalgae Hydrothermal Liquefaction Process Optimization and Comprehension to Produce High Quality Biofuel

Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

Abstract:

Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

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5586 Influence of Farnesol on Growth and Development of Dysdercus koenigii

Authors: Shailendra Kumar, Kamal Kumar Gupta

Abstract:

Dysdercus koenigii is an economically important pest of cotton worldwide. The pest damages the crop by sucking sap, staining lint, reducing the oil content of the seeds and deteriorating the quality of cotton. Plant possesses a plethora of secondary metabolites which are used as defense mechanism against herbivores. One of the important categories of such chemicals is insect growth regulators and the intermediates in their biosynthesis. Farnesol belongs to sesquiterpenoid. It is an intermediate in Juvenile hormone biosynthetic pathway in insects has been widely reported in the variety of plants. This chemical can disrupt the normal metabolic function and therefore, affects various life processes of the insects. Present study tested the efficacy of farnesol against Dysdercus koenigii. 2μl of 5% (100µg) and 10% (200µg) of the farnesol was applied topically on the dorsum of thoracic region of the newly emerged fifth instar nymphs of Dysdercus. The treated insects were observed daily for their survival, weight gain, and developmental anomalies for a period of ten days. The results indicated that treatment with 200µg farnesol decreased survival of the insects to 70% after 24h of exposure. At lower doses, no significant decrease in the survival was observed. However, the surviving nymphs showed alteration in growth, development, and metamorphosis. The weight gain in the treated nymphs showed deviation from control. The treated nymphs showed an increase in mortality during subsequent days and increase in the nymphal duration. The number of nymphs undergoing metamorphosis decreased to 46% and 88% in the treatments with the dose of 200µg and 100µg respectively. Severe developmental anomalies were also observed in the treated nymphs. The treated nymphs moulted into supernumerary nymphs, adultoids, adults with exuviae attached and adults with wing deformities. On treatment with 200µg; 26% adultoid, 4% adults with exuviae attached and 12% adults with wing deformed were produced. Treatment with 100µg resulted in production of 34% adultoid, 26% adults with deformed wing and 4% adults with exuviae attached. Many of the treated nymphs did not metamorphose into adults, remained in nymphal stage and died. Our results indicated potential application plant-derived secondary metabolites like farnesol in the management of Dysdercus population.

Keywords: development, Dysdercus koenigii, farnesol, survival

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5585 Salter Pelvic Osteotomy for the Treatment of Developmental Dysplasia of the Hip: Assessment of Postoperative Results and Risk Factors

Authors: Suvorov Vasyl, Filipchuk Viktor

Abstract:

Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).

Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy

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5584 Study of the Quality of Surface Water in the Upper Cheliff Basin

Authors: Touhari Fadhila, Mehaiguene Madjid, Meddi Mohamed

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This work aims to assess the quality of water dams based on the monitoring of physical-chemical parameters by the National Agency of Water Resources (ANRH) for a period of 10 years (1999-2008). Quality sheets of surface water for the four dams in the region of upper Cheliff (Ghrib, Deurdeur, Harreza, and Ouled Mellouk) show a degradation of the quality (organic pollution expressed in COD and OM) over time. Indeed, the registered amount of COD often exceeds 50 mg/ l, and the OM exceeds 15 mg/l. This pollution is caused by discharges of wastewater and eutrophication. The waters of dams show a very high salinity (TDS = 2574 mg/l in 2008 for the waters of the dam Ghrib, standard = 1500 mg/l). The concentration of nitrogenous substances (NH4+, NO2-) in water is high in 2008 at Ouled Melloukdam. This pollution is caused by the oxidation of nitrogenous organic matter. On the other hand, we studied the relationship between the evolution of quality parameters and filling dams. We observed a decrease in the salinity and COD following an improvement of the filling state of dams, this resides in the dilution water through the contribution of rainwater. While increased levels of nitrates and phosphorus in the waters of four dams studied during the rainy season is compared to the dry period, this increase may be due to leaching from fertilizers used in agricultural soils situated in watersheds.

Keywords: surface water quality, pollution, physical-chemical parameters, upper Cheliff basin.

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5583 Suggestion of Two-Step Traction Therapy for Safer and More Effective Conservative Treatment for Low Back Pain

Authors: Won Man Park, Dae Kyung Choi, Kyungsoo Kim, Yoon Hyuk Kim

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Traction therapy has been used in the treatment of spinal pain for decades. However, a case study reported the occurrence of large disc protrusion during motorized traction therapy. In this study, we hypothesized that additional local decompression with a global axial traction could be helpful for risk reduction of intervertebral disc damage. A validated three dimensional finite element model of the lumbar spine was used. Two-step traction therapy using the axial global traction (the first step) with 1/3 body weight and the additional local decompression (the second step) with 7 mm translation of L4 spinal bone was determined for the traction therapy. During two-step traction therapy, the sacrum was constrained in all translational directions. Reduced lordosis angle by the global axial traction recovered with the additional local decompression. Stress on fibers of the annulus fibrosus by the axial global traction decreased with the local decompression by 17%~96% in the posterior region of intervertebral disc. Stresses on ligaments except anterior longitudinal ligaments in all motion segments decreased till 4.9 mm~5.6 mm translation of L4 spinal bone. The results of this study showed that the additional local decompression is very useful for reducing risk of damage in the intervertebral disc and ligaments caused by the global axial traction force. Moreover, the local decompression could be used to enhance reduction of intradiscal pressure.

Keywords: lumbar spine, traction-therapy, biomechanics, finite element analysis

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5582 Prospective Study of the Evaluation of Autologous Blood Injection in the Treatment of Lateral Epicondylitis

Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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5581 Care and Support for Infants and Toddlers with Special Needs

Authors: Florence A. Undiyaundeye, Aniashie Akpanke

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Early identification of developmental disorders in infants and toddlers is critical for the well being of children. It is also an integral function of the primary care medical provider and the early care given in the home or crèche. This paper is focused at providing information on special need infants and toddlers and strategies to support them in developmental concern to cope with the challenges in and out of the classroom and to interact with their peers without stigmatization and inferiority complex. The target children are from birth through three years of age. There is a strong recommendation for developmental surveillance to be incorporated at every well child preventive care program in training and practical stage of formal school settings. The paper posits that any concerns raised during surveillance should be promptly addressed with standardized developmental screening by appropriate health service providers. In addition screening tests should be administered regularly at age 9+, 19+ and 30 months of these infants. The paper also establishes that the early identification of these developmental challenges of the infants and toddlers should lead to further developmental and medical evaluation, diagnosis and treatment, including early developmental school intervention, control and teaching and learning integration and inclusion for proper career build up. Children diagnosed with developmental disorders should be identified as children with special needs so that management is initiated and its underlying etiology may also drive a range of treatment of the child, to parents. Conselling and school integration as applicable to the child’s specific need and care for sustenance in societal functioning.

Keywords: care, special need, support, infants and toddlers, management and developmental disorders

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5580 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

Abstract:

The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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5579 Therapeutic Evaluation of Bacopa Monnieri Extract on Liver Fibrosis in Rats

Authors: Yu Wen Wang, Shyh Ming Kuo, Hsia Ying Cheng, Yu Chiuan Wu

Abstract:

Liver fibrosis is caused by the activation of hepatic stellate cells in the liver to secrete excessive and deposition of extracellular matrix. In recent years, many treatment strategies have been developed to reduce the activation of hepatic stellate cells and therefore to increase the decomposition of extracellular matrix. Bacopa monnieri, an herbaceous plant of the scrophulariaceae, containing saponins and glycosides, which with antioxidant, anti-inflammation, pain relief and free radical scavenging characteristics. This study was to evaluate the inhibition of hepatic stellate cell activity by Bacopa monnieri extract and its therapeutic potential in treating thioacetamide-induced liver fibrosis in rats. The results showed that the IC50 of Bacopa monnieri extract was 0.39 mg/mL. Bacopa monnieri extract could effectively reduce H2O2-induced hepatic stellate cells inflammation. In the TAA-induced liver fibrosis animal studies, albumin secretion recovered to normal level after treated with Bacopa monnieri extract for 2-w, and fibrosis related proteins, α-SMA and TGF-1levels decreased indicating the extract exerted therapeutic effect on the liver fibrosis. However, inflammatory factors TNF- obviously decreased after 4-w treatment. In summary, we could successfully extract the main component-Bacopaside I from the plant and acquired a potential therapy using this component in treating TAA-induced liver fibrosis in rat.

Keywords: anti-inflammatory, Bacopa monnieri, fibrosis, hepatic stellate cells, water extract

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5578 Mitigating Acid Mine Drainage Pollution: A Case Study In the Witwatersrand Area of South Africa

Authors: Elkington Sibusiso Mnguni

Abstract:

In South Africa, mining has been a key economic sector since the discovery of gold in 1886 in the Witwatersrand region, where the city of Johannesburg is located. However, some mines have since been decommissioned, and the continuous pumping of acid mine drainage (AMD) also stopped causing the AMD to rise towards the ground surface. This posed a serious environmental risk to the groundwater resources and river systems in the region. This paper documents the development and extent of the environmental damage as well as the measures implemented by the government to alleviate such damage. The study will add to the body of knowledge on the subject of AMD treatment to prevent environmental degradation. The method used to gather and collate relevant data and information was the desktop study. The key findings include the social and environmental impact of the AMD, which include the pollution of water sources for domestic use leading to skin and other health problems and the loss of biodiversity in some areas. It was also found that the technical intervention of constructing a plant to pump and treat the AMD using the high-density sludge technology was the most effective short-term solution available while a long-term solution was being explored. Some successes and challenges experienced during the implementation of the project are also highlighted. The study will be a useful record of the current status of the AMD treatment interventions in the region.

Keywords: acid mine drainage, groundwater resources, pollution, river systems, technical intervention, high density sludge

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5577 Comparative Antihyperglycemic Activity of Serpentina (Andrographis paniculata) and Papait (Mollugo oppositifolia linn) Aqueous Extracts in Alloxan-Induced Diabetic Mice

Authors: Karina Marie G. Nicolas, Kimberly M. Visaya, Emmanuel R. Cauinian

Abstract:

A comparative study on the antihyperglycemic activity of aqueous extracts of Serpentina (Andrographis paniculata) and Papait (Mollugo oppositifolia linn) administered at 400mg/kg body weight per orem twice daily for 14 days was investigated using 24 alloxan-induced diabetic male, 6-8 weeks old ICR mice and Metformin as standard control. The blood glucose levels of all the animals in the treatment groups were not reduced to < 200mg/dl so as to consider them as non-diabetic but Papait showed a consistent blood glucose lowering effect from day 0 to 14 causing 36.07% reduction as compared to Serpentina which was observed to cause a fluctuating effect on blood glucose levels and a reduction of only 22.53% while the Metformin treated animals exhibited the highest reduction at 45.29%. The blood glucose levels at day 14 of animals treated with Papait (322.93 mg/dl) had comparable blood glucose levels (p<0.05) with the Metformin treated groups (284.50 mg/dl). Also, all the animals in the three treatment groups were still hypercholesterolemic with an observed consistent weight loss and a decrease in feed intake except for Serpentina which recorded a slight increase. Results of the study showed a superior antihyperglycemic activity of Papait compared with Serpentina.

Keywords: antihyperglycemic, diabetes, hypercholesterolemic, papait, serpentina

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5576 Habituation on Children Mental Retardation through Practice of Behaviour Therapy in Great Aceh, Aceh Province

Authors: Marini Kristina Situmeang, Siti Hazar Sitorus, Mukhammad Fatkhullah, Arfan Fadli

Abstract:

This study aims to identify and explain how forms of treatment and community action include parents who have children with mental retardation while undergoing behavioral therapy that leads to habituation processes. Based on observations made there is inappropriate treatment such as labeling that child mental retardation is considered ‘crazy’ by some people in Aceh Besar region. Reflecting on the phenomenon of discriminatory treatment, the existence of children with mental retardation should be realized in concrete actions that can encourage the development of cognitive abilities, language, motor, and social, one of them through behavioral. The purpose of this research is to find out and explain how the social practices of children with mental retardation when undergoing behavioral therapy that leads to habituation process. This study focuses on families or parents who have children with mental retardation and do therapy of behavioral therapy at home or at physiotherapy clinics in Aceh Besar. The research method is qualitative with case study approach. Data collection techniques are conducted with in-depth interviews and Focus Group Discussion (FGD). The results showed that habituation process which is conducted by parents at home and in fisotherapy clinic have a positive effect on the development of children behavior of mental retardation, especially when dealing with the environment of the community around the residence. Habituation processes conducted through behavioral therapy practices are influenced by Habitus (Gestational and childcare at therapy) and Reinforcement (in this case family and social support). Habituation process is done in the form of habituation, the creation of the situation, and strengthening the character. For example, when a child's mental retardation commits a wrong act (disgraceful or inappropriate behavior) then the child gets punishment in accordance with the form of punishment in a normal child generally, and when he performs a good deed, then he is given a prize such as praise or a thing he likes. Through some of these actions, the child with mental retardation can behave in accordance with the character formed and expected by the community. The process of habituation done by parents accompanied by continuous support of physiotherapy can be one of the alternative booster of cognitive and social development of children mental retardation to then out of the ‘crazy’ label that has been given.

Keywords: behaviour therapy, habituation, habitus, mental retardation

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5575 Social Economy Effects on Wetlands Change in China during Three Decades Rapid Growth Period

Authors: Ying Ge

Abstract:

Wetlands are one of the essential types of ecosystems in the world. They are of great value to human society thanks to their special ecosystem functions and services, such as protecting biodiversity, adjusting hydrology and climate, providing essential habitats and, products and tourism resources. However, wetlands worldwide are degrading severely due to climate change, accelerated urbanization, and rapid economic development. Both nature and human factors drive wetland change, and the influences are variable from wetland types. Thus, the objectives of this study were to (1) to compare the changes in China’s wetland area during the three decades rapid growth period (1978-2008); (2) to analyze the effects of social economy and environmental factors on wetlands change (area loss and change of wetland types) in China during the high-speed economic development. The socio-economic influencing factors include population, income, education, development of agriculture, industry, infrastructure, wastewater amount, etc. Several statistical methods (canonical correlation analysis, principal component analysis, and regression analysis) were employed to analyze the relationship between socio-economic indicators and wetland area change. This study will determine the relevant driving socio-economic factors on wetland changes, which is of great significance for wetland protection and management.

Keywords: socioeconomic effects, China, wetland change, wetland type

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5574 Silver Nanoparticles Loaded Cellulose Nanofibers (Cnf)/mesoporous Bioactive Glass Hydrogels For Periodontitis Treatment

Authors: Anika Pallapothu

Abstract:

Periodontitis, a severe gum disease, poses a significant threat to the integrity of bone and soft tissues supporting teeth, primarily initiated by bacterial accumulation around the gum line. Conventional treatments like scaling/root planning and plaque removal are widely employed, but integrating modern technologies such as nanotechnology holds promise for innovative therapeutic approaches. This study explores the utilization of silver nanoparticles encapsulated within cellulose nanofiber (CNF) and mesoporous bioactive glass hydrogel matrices for periodontitis management. Silver nanoparticles exhibit potent antimicrobial properties by disrupting microbial cell membranes, inducing reactive oxygen species (ROS) generation, and interfering with vital cellular processes like ATP production and nucleic acid synthesis. Mesoporous bioactive glass, renowned for its high surface area, osteoconductive, and bioactivity, presents a favorable platform for pharmaceutical applications. Incorporating CNF enhances the properties of the hydrogel due to its biocompatibility, biodegradability, and water absorption capacity. The proposed composite material is anticipated to exert beneficial effects in periodontitis treatment by demonstrating antibacterial and anti-inflammatory activities, offering a promising avenue for future therapeutic interventions.

Keywords: periodontitis, cellulose nanofibers, silver nanoparticles, mesoporous bioactive glass, antibacterial activity, anti-inflammatory activity

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5573 Recycling Waste Product for Metal Removal from Water

Authors: Saidur R. Chowdhury, Mamme K. Addai, Ernest K. Yanful

Abstract:

The research was performed to assess the potential of nickel smelter slag, an industrial waste, as an adsorbent in the removal of metals from aqueous solution. An investigation was carried out for Arsenic (As), Copper (Cu), lead (Pb) and Cadmium (Cd) adsorption from aqueous solution. Smelter slag was obtain from Ni ore at the Vale Inco Ni smelter in Sudbury, Ontario, Canada. The batch experimental studies were conducted to evaluate the removal efficiencies of smelter slag. The slag was characterized by surface analytical techniques. The slag contained different iron oxides and iron silicate bearing compounds. In this study, the effect of pH, contact time, particle size, competition by other ions, slag dose and distribution coefficient were evaluated to measure the optimum adsorption conditions of the slag as an adsorbent for As, Cu, Pb and Cd. The results showed 95-99% removal of As, Cu, Pb, and almost 50-60% removal of Cd, while batch experimental studies were conducted at 5-10 mg/L of initial concentration of metals, 10 g/L of slag doses, 10 hours of contact time and 170 rpm of shaking speed and 25oC condition. The maximum removal of Arsenic (As), Copper (Cu), lead (Pb) was achieved at pH 5 while the maximum removal of Cd was found after pH 7. The column experiment was also conducted to evaluate adsorption depth and service time for metal removal. This study also determined adsorption capacity, adsorption rate and mass transfer rate. The maximum adsorption capacity was found to be 3.84 mg/g for As, 4 mg/g for Pb, and 3.86 mg/g for Cu. The adsorption capacity of nickel slag for the four test metals were in decreasing order of Pb > Cu > As > Cd. Modelling of experimental data with Visual MINTEQ revealed that saturation indices of < 0 were recorded in all cases suggesting that the metals at this pH were under- saturated and thus in their aqueous forms. This confirms the absence of precipitation in the removal of these metals at the pHs. The experimental results also showed that Fe and Ni leaching from the slag during the adsorption process was found to be very minimal, ranging from 0.01 to 0.022 mg/L indicating the potential adsorbent in the treatment industry. The study also revealed that waste product (Ni smelter slag) can be used about five times more before disposal in a landfill or as a stabilization material. It also highlighted the recycled slags as a potential reactive adsorbent in the field of remediation engineering. It also explored the benefits of using renewable waste products for the water treatment industry.

Keywords: adsorption, industrial waste, recycling, slag, treatment

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5572 Investigation of Rifampicin and Isoniazid Resistance Mutated Genes in Mycobacterium Tuberculosis Isolated From Patients

Authors: Seyyed Mohammad Amin Mousavi Sagharchi, Alireza Mahmoudi Nasab, Tim Bakker

Abstract:

Introduction: Mycobacterium tuberculosis (MTB) is the most intelligent bacterium that existed in the world to our best knowledge. This bacterium can cause tuberculosis (TB) which is responsible for its spread speed and murder of millions of people around the world. MTB has the practical function to escape from anti-tuberculosis drugs (AT), for this purpose, it handles some mutations in the main genes and creates new patterns for inhibited genes. Method and materials: Researchers have their best tries to safely isolate MTB from the sputum specimens of 35 patients in some hospitals in the Tehran province and detect MTB by culture on Löwenstein-Jensen (LJ) medium and microscopic examination. DNA was extracted from the established bacterial colony by enzymatic extraction method. It was amplified by the polymerase chain reaction (PCR) method, reverse hybridization, and evaluation for detection of resistance genes; generally, researchers apply GenoType MTBDRplus assay. Results: Investigations of results declare us that 21 of the isolated specimens (about 60%) have mutation in rpoB gene, which resisted to rifampicin (most prevalence), and 8 of them (about 22.8%) have mutation in katG or inhA genes which resisted to isoniazid. Also, 4 of them (about 11.4%) don't have any mutation, and 2 of them (about 5.7%) have mutation in every three genes, which makes them resistant to the two drugs mentioned above. Conclusion: Rifampicin and isoniazid are two essential AT that using in the first line of treatment. Resistance in rpoB, and katG, and inhA genes related to mentioned drugs lead to ineffective treatment.

Keywords: mycobacterium tuberculosis, tuberculosis, drug resistance, isoniazid, rifampicin

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5571 Synergistic Effect of Platelet-Rich Plasma with Hyaluronic Acid Injection Following Arthrocentesis to Reduce Pain and Improve Function in Temporomandibular joint (TMJ) Osteoarthritis

Authors: Ayman Hegab

Abstract:

Increasing evidence supports the use of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) for the treatment of knee osteoarthritis, which effectively promotes cartilage repair. This study aimed to determine whether injection of PRP+HA following arthrocentesis reduces pain and improves maximum incisal opening. This was a single-blind, prospective, randomized control study. The patients were selected based on the Hegab classification: Group I: patients treated with arthrocentesis followed by a single PRP injection; Group II (Control): patients treated with arthrocentesis followed by a single HA injection; and Group III: patients treated with arthrocentesis followed by a single PRP+HA combination injection. The primary predictor variable was the medication used for injection. The primary outcome variables were the maximum voluntary mouth opening and pain index scores. The secondary outcome variable was joint sounds. All outcome variables were assessed and compared among the three groups at baseline and at 1-, 3-, 6-, and 12-month intervals. Other variables, including patients’ age and sex, were evaluated in relation to the patient outcomes. Injecting PRP+HA showed statistically significant improvement in the primary and secondary treatment outcomes over PRP or HA injection throughout the study period (P<0.005). Injection of PRP+HA following arthrocentesis had significant long-term clinical efficacy regarding pain relief that was considered the main concern of both the patient and clinician.

Keywords: TMJ, HA, PRP, osteoarthritis

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5570 Microstructure and Properties of Cu-Bearing Hypereutectic High Chromium Cast Iron

Authors: Liqiang Gong, Hanguang Fu

Abstract:

In order to further improve the wear resistance of Hypereutectic High Chromium Cast iron (HHCCI), the effects of different Cu contents on the microstructure and properties of HHCCI were systematically studied. It was found that with the increase of Cu content, the carbide size was refined, and the increase of Cu content led to the increase of austenite and the decrease of hardness in as-cast HHCCI. After heat treatment at 1050 °C, the hardness of HHCCI increased significantly compared with as-cast. And with the increase of Cu content, the hardness of HHCCI increased first and then decreased, and the hardness was the highest when 0.5 wt.% Cu was added. The increase of copper content promotes the precipitation of secondary carbides and makes the interface between α-Fe and M23C6-type secondary carbides a semi-coherent boundary. With the increase of Cu content, the wear loss of HHCCI decreased after heat treatment at 1050 °C, and the wear resistance improved. When the Cu content increased to 1.0 wt.%, the wear resistance of HHCCI was the best, which was 2.6 times that of copper-free HHCCI. The continued increase of copper content has no obvious effect on the wear resistance of HHCCI. In addition, a small amount of Cu tends to adsorb on the (0001) preferential growth surface of M₇C₃-type carbides, thereby refining the carbides. From the First-principles calculations, the solid solution strengthening effect of Cu on the matrix and the adsorption and refinement of carbides were revealed, and the influence mechanism on the wear resistance of HHCCI was characterized.

Keywords: hypereutectic high chromium cast iron, cu alloying, carbides, wear resistance, first-principles calculations

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5569 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

Abstract:

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

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