Search results for: Kabir Omar
Commenced in January 2007
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Edition: International
Paper Count: 356

Search results for: Kabir Omar

86 A Study of Career Suitability Among Medical Students

Authors: Nurul Azmawati Mohamed, Zarini Ismail, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, K. Omar

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Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Keywords: career suitability, career interest, medical students, personality trait

Procedia PDF Downloads 279
85 Examining Statistical Monitoring Approach against Traditional Monitoring Techniques in Detecting Data Anomalies during Conduct of Clinical Trials

Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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84 Nutrigenetic and Bioinformatic Analysis of Rice Bran Bioactives for the Treatment of Lifestyle Related Disease Diabetes and Hypertension

Authors: Md. Alauddin, Md. Ruhul Amin, Md. Omar Faruque, Muhammad Ali Siddiquee, Zakir Hossain Howlader, Mohammad Asaduzzaman

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Diabetes and hypertension are the major lifestyle related diseases. The α-amylase and angiotensin converting enzymes (ACE) are the key enzymes that regulate diabetes and hypertension. The aim was to develop a drug for the treatment of diabetes and hypertension. The Rice Bran (RB) sample (Oryza sativa; BRRI-Dhan-84) was collected from the Bangladesh Rice Research Institute (BRRI), and rice bran proteins were isolated and hydrolyzed by hydrolyzing enzyme alcalase and trypsin. In vivo experiment suggested that rice bran bioactives has an effect on regulating the expression of several key gluconeogenesis and lipogenesis-regulating genes, such as glucose-6-phosphatase, phosphoenolpyruvate carboxykinase, and fatty acid synthase. The above genes have a connection of regulating the glucose level, lipids profile as well as act as an anti-inflammatory agent. A molecular docking, bioinformatics and in vitro experiments were performed. We found rice bran protein hydrolysates significantly (<0.05) influence the peptide concentration in the case of trypsin, alcalase, and (trypsin + alcalase) digestion. The in vitro analysis found that protein hydrolysate significantly (<0.05) reduced diabetic and hypertension as well as oxidative stress. A molecular docking study showed that the YY and IP peptide have a significantly strong binding affinity to the active site of the ACE enzyme and α-amylase with -7.8Kcal/mol and -6.2Kcal/mol, respectively. The Molecular dynamics (MD) simulation and Swiss ADME data analysis showed that less toxicity risk, good physicochemical properties, pharmacokinetics, and drug-likeness with drug scores 0.45 and 0.55 of YY and IP peptides, respectively. Thus, rice bran bioactive could be a good candidate for the treatment of diabetes and hypertension.

Keywords: anti-hypertensive and anti-hyperglycemic, anti-oxidative, bioinformatics, in vitro study, rice bran proteins and peptides

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83 Isolation and Characterization of the First Known Inhibitor Cystine Knot Peptide in Sea Anemone: Inhibitory Activity on Acid-Sensing Ion Channels

Authors: Armando A. Rodríguez, Emilio Salceda, Anoland Garateix, André J. Zaharenko, Steve Peigneur, Omar López, Tirso Pons, Michael Richardson, Maylín Díaz, Yasnay Hernández, Ludger Ständker, Jan Tytgat, Enrique Soto

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Acid-sensing ion channels are cation (Na+) channels activated by a pH drop. These proteins belong to the ENaC/degenerin superfamily of sodium channels. ASICs are involved in sensory perception, synaptic plasticity, learning, memory formation, cell migration and proliferation, nociception, and neurodegenerative disorders, among other processes; therefore those molecules that specifically target these channels are of growing pharmacological and biomedical interest. Sea anemones produce a large variety of ion channels peptide toxins; however, those acting on ligand-gated ion channels, such as Glu-gated, Ach-gated ion channels, and acid-sensing ion channels (ASICs), remain barely explored. The peptide PhcrTx1 is the first compound characterized from the sea anemone Phymanthus crucifer, and it constitutes a novel ASIC inhibitor. This peptide was purified by chromatographic techniques and pharmacologically characterized on acid-sensing ion channels of mammalian neurons using patch-clamp techniques. PhcrTx1 inhibited ASIC currents with an IC50 of 100 nM. Edman degradation yielded a sequence of 32 amino acids residues, with a molecular mass of 3477 Da by MALDI-TOF. No similarity to known sea anemone peptides was found in protein databases. The computational analysis of Cys-pattern and secondary structure arrangement suggested that this is a structurally ICK (Inhibitor Cystine Knot)-type peptide, a scaffold that had not been found in sea anemones but in other venomous organisms. These results show that PhcrTx1 represents the first member of a new structural group of sea anemones toxins acting on ASICs. Also, this peptide constitutes a novel template for the development of drugs against pathologies related to ASICs function.

Keywords: animal toxin, inhibitor cystine knot, ion channel, sea anemone

Procedia PDF Downloads 261
82 The Effect of Different Exercise Intensities on Plasma Endostatin in Healthy Volunteers

Authors: Inayat Shah, Muhammad Omar Malik, Ghareeb Alshuwaier, Ronald H. Baxendale

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Background: The balance between angiogenesis and angiostasis is important in growth and developmental processes in the body. Angiogenic and angiostatic mediators control this balance. Endostatin is one of the prominent angiostatic mediators. The marked angiostatic effect of endostatin includes inhibiting endothelial cell migration, proliferation and apoptosis. Physical activity decreases the risk and development of many angiogenesis related health problems including atherosclerosis and numerous cancers. Physiological influences of different physical activities on plasma endostatin concentration are controversial and not completely clear. Moreover, correlation of physical characteristics and metabolic predictors during physical activity on circulating endostatin is indistinct and poorly speculated. The study aimed to determine the effects of mild, moderate and vigorous exercise on the concentration of endostatin in plasma. Methodology: 22 participants, 16 males (age = 30.6 ± 7.8 years) and 6 females (age = 26.5 ± 5 years) were recruited. Weekly session of different intensities exercise based on the predicted maximum heart of the participants [60%(low), 70% (moderate) and 80% (vigorous)] were carried out. The duration and work rate for each participant was determined through sub-maximal exercise. Standardization of the session was done on total energy expenditure of the participants per session. One pre exercise and two post exercise samples were taken at intervals of 10 and 60 minutes. Results: Pre-exercise mean endostatin was 101 ± 20 ng/dl. Low intensity exercise insignificantly decreased the endostatin concentration in plasma at 10 and 60 minutes 97 ± 20 ng/dl (p= 0.5), 98 ± 23 ng/dl (p= 0.8)). However, moderate (p= 0.022, 0.004) and vigorous intensities (p ≤ 0.001, 0.02) increased the endostatin concentrations significantly at both 10 and 60 minutes intervals respectively. The effects were not significantly influenced by gender, exercise mode (walking vs. running), components of exercise (HR, Speed, Gradients, distance, duration) or metabolism during exercise (VO₂ max, VCO₂, RER, energy expenditure, rate of carbohydrate or fats oxidation). Conclusion: Low intensity exercises did not influence endostatin concentration. However, moderate to high intensity exercises significantly increase endostatin concentration and may have potential benefits.

Keywords: angiogenesis, exercise, endostatin, physical activity

Procedia PDF Downloads 191
81 Infusing Social Business Skills into the Curriculum of Higher Learning Institutions with Special Reference to Albukhari International University

Authors: Abdi Omar Shuriye

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A social business is a business designed to address socio-economic problems to enhance the welfare of the communities involved. Lately, social business, with its focus on innovative ideas, is capturing the interest of educational institutions, governments, and non-governmental organizations. Social business uses a business model to achieve a social goal, and in the last few decades, the idea of imbuing social business into the education system of higher learning institutions has spurred much excitement. This is due to the belief that it will lead to job creation and increased social resilience. One of the higher learning institutions which have invested immensely in the idea is Albukhari International University; it is a private education institution, on a state-of-the-art campus, providing an advantageous learning ecosystem. The niche area of this institution is social business, and it graduates job creators, not job seekers; this Malaysian institution is unique and one of its kind. The objective of this paper is to develop a work plan, direction, and milestone as well as the focus area for the infusion of social business into higher learning institutions with special reference to Al-Bukhari International University. The purpose is to develop a prototype and model full-scale to enable higher learning education institutions to construct the desired curriculum fermented with social business. With this model, major predicaments faced by these institutions could be overcome. The paper sets forth an educational plan and will spell out the basic tenets of social business, focusing on the nature and implementational aspects of the curriculum. It will also evaluate the mechanisms applied by these educational institutions. Currently, since research in this area remains scarce, institutions adopt the process of experimenting with various methods to find the best way to reach the desired result on the matter. The author is of the opinion that social business in education is the main tool to educate holistic future leaders; hence educational institutions should inspire students in the classroom to start up their own businesses by adopting creative and proactive teaching methods. This proposed model is a contribution in that direction.

Keywords: social business, curriculum, skills, university

Procedia PDF Downloads 55
80 Developing the Principal Change Leadership Non-Technical Competencies Scale: An Exploratory Factor Analysis

Authors: Tai Mei Kin, Omar Abdull Kareem

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In light of globalization, educational reform has become a top priority for many countries. However, the task of leading change effectively requires a multidimensional set of competencies. Over the past two decades, technical competencies of principal change leadership have been extensively analysed and discussed. Comparatively, little research has been conducted in Malaysian education context on non-technical competencies or popularly known as emotional intelligence, which is equally crucial for the success of change. This article provides a validation of the Principal Change Leadership Non-Technical Competencies (PCLnTC) Scale, a tool that practitioners can easily use to assess school principals’ level of change leadership non-technical competencies that facilitate change and maximize change effectiveness. The overall coherence of the PCLnTC model was constructed by incorporating three theories: a)the change leadership theory whereby leading change is the fundamental role of a leader; b)competency theory in which leadership can be taught and learned; and c)the concept of emotional intelligence whereby it can be developed, fostered and taught. An exploratory factor analysis (EFA) was used to determine the underlying factor structure of PCLnTC model. Before conducting EFA, five important pilot test approaches were conducted to ensure the validity and reliability of the instrument: a)reviewed by academic colleagues; b)verification and comments from panel; c)evaluation on questionnaire format, syntax, design, and completion time; d)evaluation of item clarity; and e)assessment of internal consistency reliability. A total of 335 teachers from 12 High Performing Secondary School in Malaysia completed the survey. The PCLnTCS with six points Liker-type scale were subjected to Principal Components Analysis. The analysis yielded a three-factor solution namely, a)Interpersonal Sensitivity; b)Flexibility; and c)Motivation, explaining a total 74.326 per cent of the variance. Based on the results, implications for instrument revisions are discussed and specifications for future confirmatory factor analysis are delineated.

Keywords: exploratory factor analysis, principal change leadership non-technical competencies (PCLnTC), interpersonal sensitivity, flexibility, motivation

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79 Simulation of Scaled Model of Tall Multistory Structure: Raft Foundation for Experimental and Numerical Dynamic Studies

Authors: Omar Qaftan

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Earthquakes can cause tremendous loss of human life and can result in severe damage to a several of civil engineering structures especially the tall buildings. The response of a multistory structure subjected to earthquake loading is a complex task, and it requires to be studied by physical and numerical modelling. For many circumstances, the scale models on shaking table may be a more economical option than the similar full-scale tests. A shaking table apparatus is a powerful tool that offers a possibility of understanding the actual behaviour of structural systems under earthquake loading. It is required to use a set of scaling relations to predict the behaviour of the full-scale structure. Selecting the scale factors is the most important steps in the simulation of the prototype into the scaled model. In this paper, the principles of scaling modelling procedure are explained in details, and the simulation of scaled multi-storey concrete structure for dynamic studies is investigated. A procedure for a complete dynamic simulation analysis is investigated experimentally and numerically with a scale factor of 1/50. The frequency domain accounting and lateral displacement for both numerical and experimental scaled models are determined. The procedure allows accounting for the actual dynamic behave of actual size porotype structure and scaled model. The procedure is adapted to determine the effects of the tall multi-storey structure on a raft foundation. Four generated accelerograms were used as inputs for the time history motions which are in complying with EC8. The output results of experimental works expressed regarding displacements and accelerations are compared with those obtained from a conventional fixed-base numerical model. Four-time history was applied in both experimental and numerical models, and they concluded that the experimental has an acceptable output accuracy in compare with the numerical model output. Therefore this modelling methodology is valid and qualified for different shaking table experiments tests.

Keywords: structure, raft, soil, interaction

Procedia PDF Downloads 101
78 Antioxidant Activity and Total Phenolic Content within the Aerial Parts of Artemisia absinthium

Authors: Hallal Nouria, Kharoubi Omar

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Wormwood (Artemisia absinthium L.) is a medicinal and aromatic bitter herb, which has been used as a medicine from ancient times. It has traditionally been used as anthelmintic, choleretic, antiseptic, balsamic, depurative, digestive, diuretic, emmenagogue and in treating leukemia and sclerosis. The species was cited to be used externally as cataplasm of crushed leaves for snake and scorpion bites or decoction for wounds and sores applied locally as antiseptic and antifungal. Wormwood extract have high contents of total phenolic compounds and total flavonoids indicating that these compounds contribute to antiradical and antioxidative activity. Most of the degenerative diseases are caused by free radicals. Antioxidants are the agents responsible for scavenging free radicals. The aim of present study was to evaluate the phytochemical and in vitro antioxidant properties of Wormwood extract. DPPH assay and reducing power assay were the method adopted to study antioxidant potentials of extracts. Standard methods were used to screen preliminary phytochemistry and quantitative analysis of tannin, phenolics and flavanoids. Aqueous and alcoholic extracts were showed good antioxidant effect with IC50 ranges from 62 μg/ml for aqueous and 116μg/ml for alcoholic extracts. Phenolic compounds, tannins and flavonoids were the major phytochemicals present in both the extracts. Percentage of inhibition increased with the increased concentration of extracts. The aqueous and alcoholic extract yielded 20, 15& 3, 59 mg/g gallic acid equivalent phenolic content 2, 78 & 1,83 mg/g quercetin equivalent flavonoid and 2, 34 & 6, 40 g tannic acid equivalent tannins respectively. The aqueous and methanol extracts of the aerial parts showed a positive correlation between the total phenolic content and the antioxidant activity measured in the plant samples. The present study provides evidence that both extracts of Artemisia absinthium is a potential source of natural antioxidant.

Keywords: pharmaceutical industries, medicinal and aromatic plant, antioxidants, phenolic compounds, Artemisia absinthium

Procedia PDF Downloads 396
77 Reasons for Choosing Medicine and the Personality Traits of Pre-Clinical Medical Students

Authors: Zarini Ismail, Nurul Azmawati Mohamed, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, Khairani Omar

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Choosing a career is one of the most important decisions that people have to make in life. While choosing a suitable career, a person cannot ignore their intrinsic traits such as the type of personality, interests, values, and aptitude. The objective of this study is to ascertain the personality of the pre-clinical medical students and their reasons or intentions for choosing medicine as a career. This study is a cross-sectional study involving Year 3 pre-clinical medical students at Universiti Sains Islam Malaysia. Participants were given a set of validated questionnaires on demographic data and open-ended questions for reasons of choosing medicine. Thematic analysis were used to analyse the open-ended question. The Participants were also required to answer a Career Interest Questionnaire (based on Holland’s Theory). A total of 81 Year 3 medical students were involved in this study. About two third (69%) of them were female and their age ranged from 20 to 21 years old. The majority of them were from middle-income families. From the thematic analysis, there were several reasons given for choosing medicine by the students. The majority of the students stated that it was their passion and interest in the medical field (45.7%). Approximately 24.7% decided to take the medical course because of parents/family influenced and 19.8% mentioned that they wanted to help the society. Other themes emerged were jobs opportunity in future (1.2%) and influenced by friends (3.7%). Based on Holland’s theory, ideally to become a good medical doctor one should score high in investigative and social personality trait. However, 26.3% of the students had low scores in these personality traits. We then looked into the reasons given by these students for choosing medicine. Approximately 28% were due to parents/family decision while 52% admitted that it was due to their interest. When compared with the group of students with high personality scores (investigative and social), there was not much difference in the reasons given for choosing medicine. The main reasons given by the students for choosing medicine were own interest, family’s influence and to help others. However, a proportion of them had low scores in the personality traits which are relevant for medicine. Although some of these students admitted that they choose medicine based on their interest, their strength might not be suitable for their chosen carrier.

Keywords: career, medical students, medicine, personality

Procedia PDF Downloads 315
76 Pattern Recognition Approach Based on Metabolite Profiling Using In vitro Cancer Cell Line

Authors: Amanina Iymia Jeffree, Reena Thriumani, Mohammad Iqbal Omar, Ammar Zakaria, Yumi Zuhanis Has-Yun Hashim, Ali Yeon Md Shakaff

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Metabolite profiling is a strategy to be approached in the pattern recognition method focused on three types of cancer cell line that driving the most to death specifically lung, breast, and colon cancer. The purpose of this study was to discriminate the VOCs pattern among cancerous and control group based on metabolite profiling. The sampling was executed utilizing the cell culture technique. All culture flasks were incubated till 72 hours and data collection started after 24 hours. Every running sample took 24 minutes to be completed accordingly. The comparative metabolite patterns were identified by the implementation of headspace-solid phase micro-extraction (HS-SPME) sampling coupled with gas chromatography-mass spectrometry (GCMS). The optimizations of the main experimental variables such as oven temperature and time were evaluated by response surface methodology (RSM) to get the optimal condition. Volatiles were acknowledged through the National Institute of Standards and Technology (NIST) mass spectral database and retention time libraries. To improve the reliability of significance, it is of crucial importance to eliminate background noise which data from 3rd minutes to 17th minutes were selected for statistical analysis. Targeted metabolites, of which were annotated as known compounds with the peak area greater than 0.5 percent were highlighted and subsequently treated statistically. Volatiles produced contain hundreds to thousands of compounds; therefore, it will be optimized by chemometric analysis, such as principal component analysis (PCA) as a preliminary analysis before subjected to a pattern classifier for identification of VOC samples. The volatile organic compound profiling has shown to be significantly distinguished among cancerous and control group based on metabolite profiling.

Keywords: in vitro cancer cell line, metabolite profiling, pattern recognition, volatile organic compounds

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75 The Correlation between Clostridium Difficile Infection and Bronchial Lung Cancer Occurrence

Authors: Molnar Catalina, Lexi Frankel, Amalia Ardeljan, Enoch Kim, Marissa Dallara, Omar Rashid

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Introduction: Clostridium difficile (C. diff) is a toxin-producing bacteria that can cause diarrhea and colitis. U.S. Center for Disease Control and Prevention revealed that C. difficile infection (CDI) has increased from 31 cases per 100,000 persons per year in 1996 to 61 per 100,000 in 2003. Approximately 500,000 cases per year occur in the United States. After exposure, the bacteria colonize the colon, where it adheres to the intestinal epithelium where it produces two toxins: TcdA and TcdB. TcdA affects the intestinal epithelium, causing fluid secretion, inflammation, and tissue necrosis, while TcdB acts as a cytotoxin purpose of this study was to evaluate the association between C diff infection and bronchial lung cancer development. Methods: Using ICD- 9 and ICD-10 codes, the data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to assess the patients infected with C diff as opposed to the non-infected patients. The Holy Cross Health, Fort Lauderdale, granted access to the database for the purpose of academic research. Patients were matched for age and Charlson Comorbidity Index (CCI). Standard statistical methods were used. Results: Bronchial lung cancer occurrence in the population not infected with C diff infection was 4741, as opposed to the population infected with C. diff, where 2039 cases of lung cancer were observed. The difference was statistically significant (p-value < 2.2x10^e-16), which reveals that C diff might be protective against bronchial lung cancer. The data was then matched by treatment to create to minimize the effect of treatment bias. Bronchial cancer incidence was 422 and 861 in infected vs. non-infected (p-value of < 2.2x10^e-16), which once more indicates that C diff infection could be beneficial in diminishing bronchial cancer development. Conclusion: This retrospective study conveys a statistical correlation between C diff infection and decreased incidence of lung bronchial cancer. Further studies are needed to comprehend the protective mechanisms of C. Diff infection on lung cancer.

Keywords: C. diff, lung cancer, protective, microbiology

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74 An Empirical Examination of Ethnic Differences in the Use and Experience of Child Healthcare Services in New Zealand

Authors: Terryann Clark, Kabir Dasgupta, Sonia Lewycka, Gail Pacheco, Alexander Plum

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This paper focused on two main research aims using data from the Growing Up in New Zealand (GUINZ) birth cohort: 1. To examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood years (namely immunisation, dental checks and use of General Practitioners (GPs)) 2. To quantify the contribution of relevant explanatory factors to ethnic differences. Current policy in New Zealand indicates there should be, in terms of associated direct costs, equitable access by ethnicity for healthcare services. However, empirical evidence points to persistent ethnic gaps in several domains. For example, the data highlighted that Māori have the lowest immunisation rates, across a number of time points in early childhood – despite having a higher antenatal intention to immunise relative to NZ European. Further to that, NZ European are much more likely to have their first-choice lead maternity caregiver (LMC) and use child dental services compared to all ethnicities. Method: This research explored the underlying mechanisms behind ethnic differences in the use and experience of child healthcare services. First, a multivariate regression analysis was used to adjust raw ethnic gaps in child health care utilisation by relevant covariates. This included a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Second, a decomposition analysis was used to assess the proportion of each ethnic gap that can be explained, as well as the main drivers behind the explained component. The analysis for both econometric approaches was repeated for each data time point available, which included antenatal, 9 months, 2 years and 4 years post-birth. Results: The following findings emerged: There is consistent evidence that Asian and Pacific peoples have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at all time points except one. Pacific peoples had a lower rate relative to NZ European for receiving all first-year immunisations on time. For a number of potential individual and household predictors of healthcare service utilisation, the association is time-variant across early childhood. For example, socio-economic status appears highly relevant for timely immunisations in a child’s first year, but is then insignificant for the 15 month immunisations and those at age 4. Social factors play a key role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence. Perceived ethnically motivated discrimination by a health professional was significant with respect to both reducing the likelihood of achieving first choice LMC, and also satisfaction levels with child’s GP. Some ethnic gaps were largely unexplained, despite the wealth of factors employed as independent variables in our analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared to NZ Europeans; and also the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.

Keywords: child health, cohort analysis, ethnic disparities, primary healthcare

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73 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh

Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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72 Improvement of Compressive and Tensile Strengths of Concrete Using Polypropylene Fibers

Authors: Omar Asad Ahmad, Mohammed Awwad

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Concrete is one of the essential elements that used in different types of construction these days, but it has many problems when interacts with environmental elements such as water, air, temperature, dust, and humidity. Also concrete made with Portland cement has certain characteristics: it is relatively strong in compression but weak in tension and tends to be brittle. These disadvantages make concrete limited to use in certain conditions. The most common problems appears on concrete are manifested by tearing, cracking, corrosion and spalling, which will lead to do some defect in concrete then in the whole construction, The fundamental objective of this research was to provide information about the hardened properties of concrete achieved by using easily available local raw materials in Jordan to support the practical work with partners in assessing the practicability of the mixes with polypropylene, and to facilitate the introduction of polypropylene fiber concrete (PFC) technology into general construction practice. Investigate the effect of the polypropylene fibers in PCC mixtures and on materials properties such as compressive strength, and tensile strength. Also to investigate the use of polypropylene fibers in plain cubes and cylindrical concrete to improve its compressive and tensile strengths to reduce early cracking and inhibit later crack growth. Increasing the hardness of concrete in this research is the main purpose to measure the deference of compressive strength and tensile strength between plain concrete and concrete mixture with polypropylene fibers different additions and to investigate its effect on reducing the early and later cracking problem. To achieve the goals of research 225 concrete test sample were prepared to measure it’s compressive strength and tensile strength, the concrete test sample were three classes (A,B,C), sub-classified to standard , and polypropylene fibers added by the volume of concrete (5%, 10%, 15%, and 20%). The investigation of polypropylene fibers mixture with concrete shows that the strengths of the cement are increased and the cracking decreased. The results show that for class A the recommended addition were 5% of polypropylene fibers additions for compressive strength and 10 % for tensile strength revels the best compressive strength that reach 26.67 Mpa and tensile strength that reach 2.548 Mpa records. Achieved results show that for classes B and C the recommend additions were 10 % polypropylene fibers revels the best compressive strength records where they reach 21.11 and 33.78 Mpa, records reach for tensile strength 2.707 and 2.65 Mpa respectively.

Keywords: polypropylene, effects, compressive, tensile, strengths, concrete, construction

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71 Combined Effect of Gender Differences and Fatiguing Task on Unipedal Postural Balance and Functional Mobility in Adults with Multiple Sclerosis

Authors: Sonda Jallouli, Omar Hammouda, Imen Ben Dhia, Salma Sakka, Chokri Mhiri, Mohamed Habib Elleuch, Abedlmoneem Yahia, Sameh Ghroubi

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Multiple sclerosis (MS) is characterized by gender differences with affecting women two to four times more than men, but the disease progression is faster and more severe in men. Fatigue represents one of the most frequent and disabling symptoms related to MS. Results of previous studies regarding gender differences in fatigue perception in MS persons are contradictory. Besides, fatigue has been shown to affect negatively postural balance and functional mobility in MS persons. However, no study has taken into account gender differences in the response of these physical parameters to a fatiguing protocol in MS persons. Given the reduction of autonomy due to the alteration of these parameters induced by fatigue and the importance of gender differences in postural balance training programs in fatigued men and women with MS, the aim of this study was to investigate the effect of gender difference on unipedal postural balance and functional mobility after performing a fatiguing task in MS adults. Methods: Eleven women (30.29 ± 7.99 years) and seven men (30.91 ± 8.19 years) with relapsing-remitting MS performed a fatiguing protocol: three sets of the 5×sit to stand test (5-STST), six-minute walk test (6MWT) followed by three sets of the 5-STST. Unipedal balance, functional mobility, and fatigue perception were measured prefatigue (T0) and post fatigue (T3) using a clinical unipedal balance test, timed up and go test (TUGT), and analogic visual scale of fatigue (VASF), respectively. Heart rate (HR) and rate of perceived exertion (RPE) were recorded before, during and after the fatiguing task. Results: Compared to women, men showed an impairment of unipedal balance on the dominant leg (p<0.001, d=0.52) and mobility (p<0.001, d=3) via reducing unipedal stance time and increasing duration of TUGT execution, respectively. No gender differences were observed in 6MWT, 5-STST, HR, RPE and VASF scores. Conclusion: Fatiguing protocol negatively affected unipedal postural balance and mobility only in men. These gender differences were inconclusive but can be taken into account in postural balance rehabilitation programs for persons with MS.

Keywords: functional mobility, fatiguing exercises, multiple sclerosis, sex differences, unipedal balance

Procedia PDF Downloads 94
70 Risk Factors Affecting Construction Project Cost in Oman

Authors: Omar Amoudi, Latifa Al Brashdi

Abstract:

Construction projects are always subject to risks and uncertainties due to its unique and dynamic nature, outdoor work environment, the wide range of skills employed, various parties involved in addition to situation of construction business environment at large. Altogether, these risks and uncertainties affect projects objectives and lead to cost overruns, delay, and poor quality. Construction projects in Oman often experience cost overruns and delay. Managing these risks and reducing their impacts on construction cost requires firstly identifying these risks, and then analyzing their severity on project cost to obtain deep understanding about these risks. This in turn will assist construction managers in managing and tacking these risks. This paper aims to investigate the main risk factors that affect construction projects cost in the Sultanate of Oman. In order to achieve the main aim, literature review was carried out to identify the main risk factors affecting construction cost. Thirty-three risk factors were identified from the literature. Then, a questionnaire survey was designed and distributed among construction professionals (i.e., client, contractor and consultant) to obtain their opinion toward the probability of occurrence for each risk factor and its possible impact on construction project cost. The collected data was analyzed based on qualitative aspects and in several ways. The severity of each risk factor was obtained by multiplying the probability occurrence of a risk factor with its impact. The findings of this study reveal that the most significant risk factors that have high severity impact on construction project cost are: Change of Oil Price, Delay of Materials and Equipment Delivery, Changes in Laws and Regulations, Improper Budgeting, and Contingencies, Lack of Skilled Workforce and Personnel, Delays Caused by Contractor, Delays of Owner Payments, Delays Caused by Client, and Funding Risk. The results can be used as a basis for construction managers to make informed decisions and produce risk response procedures and strategies to tackle these risks and reduce their negative impacts on construction project cost.

Keywords: construction cost, construction projects, Oman, risk factors, risk management

Procedia PDF Downloads 300
69 Compositional Assessment of Fermented Rice Bran and Rice Bran Oil and Their Effect on High Fat Diet Induced Animal Model

Authors: Muhammad Ali Siddiquee, Md. Alauddin, Md. Omar Faruque, Zakir Hossain Howlader, Mohammad Asaduzzaman

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Rice bran (RB) and rice bran oil (RBO) are explored as prominent food components worldwide. In this study, fermented rice bran (FRB) was produced by employing edible gram-positive bacteria (Lactobacillus acidophilus, Lactobacillus bulgaricus, and Bifidobacterium bifidum) at 125 x 10⁵ spore g⁻¹ of rice bran, and investigated to evaluate nutritional quality. The crude rice bran oil (CRBO) was extracted from RB, and its quality was also investigated compared to market-available rice bran oil (MRBO) in Bangladesh. We found that fermentation of rice bran with lactic acid bacteria increased total proteins (29.52%), fat (5.38%), ash (48.47%), crude fiber (38.96%), and moisture (61.04%) and reduced the carbohydrate content (36.61%). We also found that essential amino acids (methionine, tryptophan, threonine, valine, leucine, lysine, histidine, and phenylalanine) and non-essential amino acids (alanine, aspartate, glycine, glutamine, proline, serine, and tyrosine) were increased in FRB except methionine and proline. Moreover, total phenolic content, tannin content, flavonoid content, and antioxidant activity were increased in FRB. The RBO analysis showed that γ-oryzanol content (10.00mg/g) was found in CRBO compared to MRBO (ranging from 7.40 to 12.70 mg/g) and Vitamin-E content 0.20% was found higher in CRBO compared to MRBO (ranging 0.097 to 0.12%). The total saturated (25.16%) and total unsaturated fatty acids (74.44%) were found in CRBO, whereas MRBO contained total saturated (22.08 to 24.13%) and total unsaturated fatty acids (71.91 to 83.29%), respectively. The physiochemical parameters were found satisfactory in all samples except acid value and peroxide value higher in CRBO. Finally, animal experiments showed that FRB and CRBO reduce the body weight, glucose, and lipid profile in high-fat diet-induced animal models. Thus, FRB and RBO could be value-added food supplements for human health.

Keywords: fermented rice bran, crude rice bran oil, amino acids, proximate composition, gamma-oryzanol, fatty acids, heavy metals, physiochemical parameters

Procedia PDF Downloads 28
68 Assessment of Knowledge and Attitude towards End of Life Care among Nurses Working in Tertiary Hospital

Authors: Emni Omar Daw Hussin, Pathmawathi Subramanian, Wong Li Ping

Abstract:

Background: To provide quality care at the end of life, nurses should possess knowledge and skills to provide effective end-of-life care, as well as develop the attitudes and interpersonal competence to provide compassionate care. Aim: This study aimed to assess nurses’ knowledge and attitude towards end of life care and caring for terminal ill patients and to examine relationships among demographic variables and nurse’s knowledge and attitudes toward end of life care and caring for terminal ill patients. Method: a cross-sectional study was conducted at 1 tertiary hospital located in Kuala Lumpur, Malaysia. Self-administrative questionnaire was used to collect data from 553 nurses from over all departments except emergency department, operation theater and outpatient clinic. Two tools were used in this study, the Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale to assess the nurses’ attitude and End of Life Knowledge Assessment to assess the nurses’ knowledge. Result: the result of this study yielded that, the majority of participants (54.8%) and (54.4%) have less positive attitude and knowledge towards end of life care and caring for terminal ill patients respectively. As well as there is no significant relationship were found between nurses’ ethnicity, religion, and the total score of FATCOD scale; End of Life Knowledge Assessment score. On other hand there is significant relationship among nurses’ age, working experience, level of education, attending any post basic courses and the total score of both FATCOD scale and End of Life Knowledge Assessment. Conclusion: A lack of education and experience and post basic course about end of life care and palliative care may contribute to the negative attitudes and poor knowledge regarding end of life care. Providing sufficient courses about end of life care could enhance the nurses’ knowledge towards end of life care, as well as providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implication for Practice: This study elaborates the need for further research to develop an effective educational programs to enhance nurses’ knowledge and to promote positive attitude towards death and dying, as well as enhance communication skills, and coping strategies.

Keywords: knowledge, attitude, nurse, end of life care

Procedia PDF Downloads 414
67 Exercise Training for Management Hypertensive Patients: A Systematic Review and Meta-Analysis

Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail

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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.

Keywords: blood Pressure, exercise, hypertension, peak VO2

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66 Incidence of Lymphoma and Gonorrhea Infection: A Retrospective Study

Authors: Diya Kohli, Amalia Ardeljan, Lexi Frankel, Jose Garcia, Lokesh Manjani, Omar Rashid

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Gonorrhea is the second most common sexually transmitted disease (STDs) in the United States of America. Gonorrhea affects the urethra, rectum, or throat and the cervix in females. Lymphoma is a cancer of the immune network called the lymphatic system that includes the lymph nodes/glands, spleen, thymus gland, and bone marrow. Lymphoma can affect many organs in the body. When a lymphocyte develops a genetic mutation, it signals other cells into rapid proliferation that causes many mutated lymphocytes. Multiple studies have explored the incidence of cancer in people infected with STDs such as Gonorrhea. For instance, the studies conducted by Wang Y-C and Co., as well as Caini, S and Co. established a direct co-relationship between Gonorrhea infection and incidence of prostate cancer. We hypothesize that Gonorrhea infection also increases the incidence of Lymphoma in patients. This research study aimed to evaluate the correlation between Gonorrhea infection and the incidence of Lymphoma. The data for the research was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. This database was utilized to evaluate patients infected with Gonorrhea versus the ones who were not infected to establish a correlation with the prevalence of Lymphoma using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for academic research. Standard statistical methods were applied throughout. Between January 2010 and December 2019, the query was analyzed and resulted in 254 and 808 patients in both the infected and control group, respectively. The two groups were matched by Age Range and CCI score. The incidence of Lymphoma was 0.998% (254 patients out of 25455) in the Gonorrhea group (patients infected with Gonorrhea that was Lymphoma Positive) compared to 3.174% and 808 patients in the control group (Patients negative for Gonorrhea but with Lymphoma). This was statistically significant by a p-value < 2.210-16 with an OR= 0.431 (95% CI 0.381-0.487). The patients were then matched by antibiotic treatment to avoid treatment bias. The incidence of Lymphoma was 1.215% (82 patients out of 6,748) in the Gonorrhea group compared to 2.949% (199 patients out of 6748) in the control group. This was statistically significant by a p-value <5.410-10 with an OR= 0.468 (95% CI 0.367-0.596). The study shows a statistically significant correlation between Gonorrhea and a reduced incidence of Lymphoma. Further evaluation is recommended to assess the potential of Gonorrhea in reducing Lymphoma.

Keywords: gonorrhea, lymphoma, STDs, cancer, ICD

Procedia PDF Downloads 166
65 Perception of Pre-Clinical Students towards Doctors Lifestyle

Authors: Shalinawati Ramli, Khairani Omar, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

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Medical doctors’ work to prevent, diagnose, treat diseases, disorders, and injuries as well as prescribing medication. Many people are attracted to this profession because it gives them the opportunity to help others. Doctors’ improve quality of life by providing advice, healing physical ailments and performing complex surgeries. Medicine is a profession in which dedication to the wellbeing of others is of paramount importance. Balancing the requirements of work and personal life can be a struggle as the demand of work as a doctors’ is great. Perception and expectation of medical students regarding the lifestyle of doctors’ is important to ensure that they had made the right career choice. Thus, the aim of this study is to assess the perception of pre-clinical students regarding doctors’ lifestyle. This study is a cross-sectional study involving all third-year pre-clinical medical students at University Sains Islam Malaysia. A total of 81 students participated in this study. Participants were given a set of questionnaire consisting of demographic data, open-ended questions on their perception on doctors’ lifestyle of working environment, salary expectation and family life. Thematic analysis were used to analyse the data. The participants comprised 69% female and their age range was between 20-21 years old. Majority of them were from middle-income families. Majority of the students perceived that the doctors’ lifestyle would be busy (72%). Approximately 30% of them expected that the time schedule will be unpredictable, 21% mentioned that sacrifice is required and 16% perceived it as a tiring job. Other themes emerged were ‘requiring high commitment’ (6%), challenging (7%) and risky (4%). With regards to salary expectation, 48% expected reasonable salary, 33% high salary and 12% described it as 'not worth compared to the workload'. Majority of them perceived that their family life will be restricted (62%) and time management is important (33%). Only 15% mentioned that family members have to sacrifice and spousal understanding is important (7%). About 10% of them perceived that their family will not be affected by their profession. Majority of the medical students perceived a busy doctors’ lifestyle, reasonable salary and restricted family life. However, there was a significant proportion of them who required counselling for better preparation of their future lifestyle.

Keywords: doctors lifestyle, pre-clinical students, perception, understanding

Procedia PDF Downloads 273
64 Design, Construction and Evaluation of a Mechanical Vapor Compression Distillation System for Wastewater Treatment in a Poultry Company

Authors: Juan S. Vera, Miguel A. Gomez, Omar Gelvez

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Water is Earth's most valuable resource, and the lack of it is currently a critical problem in today’s society. Non-treated wastewaters contribute to this situation, especially those coming from industrial activities, as they reduce the quality of the water bodies, annihilating all kind of life and bringing disease to people in contact with them. An effective solution for this problem is distillation, which removes most contaminants. However, this approach must also be energetically efficient in order to appeal to the industry. In this endeavour, most water distillation treatments fail, with the exception of the Mechanical Vapor Compression (MVC) distillation system, which has a great efficiency due to energy input by a compressor and the latent heat exchange. This paper presents the process of design, construction, and evaluation of a Mechanical Vapor Compression (MVC) distillation system for the main Colombian poultry company Avidesa Macpollo SA. The system will be located in the principal slaughterhouse in the state of Santander, and it will work along with the Gas Energy Mixing system (GEM) to treat the wastewaters from the plant. The main goal of the MVC distiller, rarely used in this type of application, is to reduce the chlorides, Chemical Oxygen Demand (COD) and Biological Oxygen Demand (BOD) levels according to the state regulations since the GEM cannot decrease them enough. The MVC distillation system works with three components, the evaporator/condenser heat exchanger where the distillation takes place, a low-pressure compressor which gives the energy to create the temperature differential between the evaporator and condenser cavities and a preheater to save the remaining energy in the distillate. The model equations used to describe how the compressor power consumption, heat exchange area and distilled water are related is based on a thermodynamic balance and heat transfer analysis, with correlations taken from the literature. Finally, the design calculations and the measurements of the installation are compared, showing accordance with the predictions in distillate production and power consumption, changing the temperature difference of the evaporator/condenser.

Keywords: mechanical vapor compression, distillation, wastewater, design, construction, evaluation

Procedia PDF Downloads 129
63 Rasagiline Improves Metabolic Function and Reduces Tissue Injury in the Substantia Nigra in Parkinson's Disease: A Longitudinal In-Vivo Advanced MRI Study

Authors: Omar Khan, Shana Krstevska, Edwin George, Veronica Gorden, Fen Bao, Christina Caon, NP-C, Carla Santiago, Imad Zak, Navid Seraji-Bozorgzad

Abstract:

Objective: To quantify cellular injury in the substantia nigra (SN) in patients with Parkinson's disease (PD) and to examine the effect of rasagiline of tissue injury in the SN in patients with PD. Background: N-acetylaspartate (NAA) quantified with MRS is a reliable marker of neuronal metabolic function. Fractional anisotropy (FA) and mean diffusivity (MD) obtained with DTI, characterize tissue alignment and integrity. Rasagline, has been shown to exert anti-apototic effect. We applied these advanced MRI techniques to examine: (i) the effect of rasagiline on cellular injury and metabolism in patients with early PD, and (ii) longitudinal changes seen over time in PD. Methods: We conducted a prospective longitudinal study in patients with mild PD, naive to dopaminergic treatment. The imaging protocol included multi-voxel proton-MRS and DTI of the SN, acquired on a 3T scanner. Scans were performed at baseline and month 3, during which the patient was on no treatment. At that point, rasagiline 1 mg orally daily was initiated and MRI scans are were obtained at 6 and 12 months after starting rasagiline. The primary objective was to compare changes during the 3-month period of “no treatment” to the changes observed “on treatment” with rasagiline at month 12. Age-matched healthy controls were also imaged. Image analysis was performed blinded to treatment allocation and period. Results: 25 patients were enrolled in this study. Compared to the period of “no treatment”, there was significant increase in the NAA “on treatment” period (-3.04 % vs +10.95 %, p= 0.0006). Compared to the period of “no treatment”, there was significant increase in following 12 month in the FA “on treatment” (-4.8% vs +15.3%, p<0.0001). The MD increased during “no treatment” and decreased in “on treatment” (+2.8% vs -7.5%, p=0.0056). Further analysis and clinical correlation are ongoing. Conclusions: Advanced MRI techniques quantifying cellular injury in the SN in PD is a feasible approach to investigate dopaminergic neuronal injury and could be developed as an outcome in exploratory studies. Rasagiline appears to have a stabilizing effect on dopaminergic cell loss and metabolism in the SN in PD, that warrants further investigation in long-term studies.

Keywords: substantia nigra, Parkinson's disease, MRI, neuronal loss, biomarker

Procedia PDF Downloads 286
62 Evaluation of Percutaneous Tube Thoracostomy Performed by Trainee in Both Trauma and Non-Trauma Patients

Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

Abstract:

Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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61 Neuro-Preservation Potential of Resveratrol Against High Fat High Fructose-Induced Metabolic Syndrome

Authors: Rania F. Ahmed, Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O. Saleh, Omar A. H. Ahmed-Farid

Abstract:

The metabolic syndrome is an important public health concern often related to obesity, improper diet, and sedentary lifestyles and can predispose individuals to the development of many dangerous health conditions, disability and early death. This research aimed to investigate the efficacy of resveratrol (RSV) to reverse the neuro-complications associated with metabolic syndrome experimentally-induced in rats using an eight weeks high fat, high fructose diet (HFHF) model. The corresponding drug treatments were administered orally during the last 10 days of the diet. Behavioural tests namely the open field test (OFT) and the forced swimming test (FST) were conducted. Brain levels of monoamines viz. serotonin, norepinephrine and dopamine as well as their metabolites were assessed. 8-hydroxyguanosine (8-OHDG) as an indicative of DNA-fragmentation, nitric oxide (NOx) and tumor necrosis factor-α (TNF- α) were estimated. Finally, brain antioxidant parameters namely malondialdehyde (MDA), reduced and oxidized glutathione (GSH, GSSG) were evaluated. HFHF-induced metabolic syndrome resulted in decreased activity in the OFT and increased immobility duration in the FST. Furthermore, HFHF-induced metabolic syndrome lead to a significant increase in brain monoamines turn over as well as elevation in 8-OHDG, NOx, TNF- α, MDA and GSSG; and reduction in GSH. Ten days daily treatment with RSV (20 and 40 mg/kg p.o) dose dependently increased activity in the OFT and decreased immobility duration in the FST. Moreover, RSV normalized brain monoamines contents, reduced 8-OHDG, NOx, TNF- α, MDA and GSSG; and elevated GSH. In conclusion, we can say that RSV showed neuro-protective properties against HFHF-induced metabolic syndrome represented by monoamines preservation, prevention of neurodegeneration, anti-inflammatory and antioxidant potentials and could be recommended as a beneficial daily dietary supplement to treat the neuronal side effects associated with HFHF-induced metabolic syndrome.

Keywords: antioxidants, DNA-fragmentation, forced swimming test, HFHF-induced metabolic syndrome, monoamines, nitric oxide (NOx), open field, resveratrol, tumor necrosis factor-α (TNF- α), 8-hydroxyguanosine (8-OHDG)

Procedia PDF Downloads 246
60 Effect of Locally Produced Sweetened Pediatric Antibiotics on Streptococcus mutans Isolated from the Oral Cavity of Pediatric Patients in Syria - in Vitro Study

Authors: Omar Nasani, Chaza Kouchaji, Muznah Alkhani, Maisaa Abd-alkareem

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Objective: To evaluate the influence of sweetening agents used in pediatric medications on the growth of Streptococcus mutans colonies and its effect on the cariogenic activity in the oral cavity. No previous studies are registered yet in Syrian children. Methods: Specimens were isolated from the oral cavity of pediatric patients, then in-vitro study is applied on locally manufactured liquid pediatric antibiotic drugs, containing natural or synthetic sweeteners. The selected antibiotics are Ampicillin (sucrose), Amoxicillin (sucrose), Amoxicillin + Flucloxacillin (sorbitol), Amoxicillin+Clavulanic acid (Sorbitol or sucrose). These antibiotics have a known inhibitory effect on gram positive aerobic/anaerobic bacteria especially Streptococcus mutans strains in children’s oral biofilm. Five colonies are studied with each antibiotic. Saturated antibiotics were spread on a 6mm diameter filter disc. Incubated culture media were compared with each other and with the control antibiotic discs. Results were evaluated by measuring the diameter of the inhibition zones. The control group of antibiotic discs was resourced from Abtek Biologicals Ltd. Results: The diameter of inhibition zones around discs of antibiotics sweetened with sorbitol was larger than those sweetened with sucrose. The effect was most important when comparing Amoxicillin + Clavulanic Acid (sucrose 25mm; versus sorbitol 27mm). The highest inhibitory effect was observed with the usage of Amoxicillin + Flucloxacillin sweetened with sorbitol (38mm). Whereas the lowest inhibitory effect was observed with Amoxicillin and Ampicillin sweetened with sucrose (22mm and 21mm). Conclusion: The results of this study indicate that although all selected antibiotic produced an inhibitory effect on S. mutans, sucrose weakened the inhibitory action of the antibiotic to varying degrees, meanwhile antibiotic formulations containing sorbitol simulated the effects of the control antibiotic. This study calls attention to effects of sweeteners included in pediatric drugs on the oral hygiene and tooth decay.

Keywords: pediatric, dentistry, antibiotics, streptococcus mutans, biofilm, sucrose, sugar free

Procedia PDF Downloads 31
59 Cellulose Nanocrystals from Melon Plant Residues: A Sustainable and Renewable Source

Authors: Asiya Rezzouq, Mehdi El Bouchti, Omar Cherkaoui, Sanaa Majid, Souad Zyade

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In recent years, there has been a steady increase in the exploration of new renewable and non-conventional sources for the production of biodegradable nanomaterials. Nature harbours valuable cellulose-rich materials that have so far been under-exploited and can be used to create cellulose derivatives such as cellulose microfibres (CMFs) and cellulose nanocrystals (CNCs). These unconventional sources have considerable potential as alternatives to conventional sources such as wood and cotton. By using agricultural waste to produce these cellulose derivatives, we are responding to the global call for sustainable solutions to environmental and economic challenges. Responsible management of agricultural waste is increasingly crucial to reducing the environmental consequences of its disposal, including soil and water pollution, while making efficient use of these untapped resources. In this study, the main objective was to extract cellulose nanocrystals (CNC) from melon plant residues using methods that are both efficient and sustainable. To achieve this high-quality extraction, we followed a well-defined protocol involving several key steps: pre-treatment of the residues by grinding, filtration and chemical purification to obtain high-quality (CMF) with a yield of 52% relative to the initial mass of the melon plant residue. Acid hydrolysis was then carried out using phosphoric acid and sulphuric acid to convert (CMF) into cellulose nanocrystals. The extracted cellulose nanocrystals were subjected to in-depth characterization using advanced techniques such as transmission electron microscopy (TEM), thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction. The resulting cellulose nanocrystals have exceptional properties, including a large specific surface area, high thermal stability and high mechanical strength, making them suitable for a variety of applications, including as reinforcements for composite materials. In summary, the study highlights the potential for recovering agricultural melon waste to produce high-quality cellulose nanocrystals with promising applications in industry, nanotechnology, and biotechnology, thereby contributing to environmental and economic sustainability.

Keywords: cellulose, melon plant residues, cellulose nanocrystals, properties, applications, composite materials

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58 Synthesis, Characterization and Photocatalytic Applications of Ag-Doped-SnO₂ Nanoparticles by Sol-Gel Method

Authors: M. S. Abd El-Sadek, M. A. Omar, Gharib M. Taha

Abstract:

In recent years, photocatalytic degradation of various kinds of organic and inorganic pollutants using semiconductor powders as photocatalysts has been extensively studied. Owing to its relatively high photocatalytic activity, biological and chemical stability, low cost, nonpoisonous and long stable life, Tin oxide materials have been widely used as catalysts in chemical reactions, including synthesis of vinyl ketone, oxidation of methanol and so on. Tin oxide (SnO₂), with a rutile-type crystalline structure, is an n-type wide band gap (3.6 eV) semiconductor that presents a proper combination of chemical, electronic and optical properties that make it advantageous in several applications. In the present work, SnO₂ nanoparticles were synthesized at room temperature by the sol-gel process and thermohydrolysis of SnCl₂ in isopropanol by controlling the crystallite size through calculations. The synthesized nanoparticles were identified by using XRD analysis, TEM, FT-IR, and Uv-Visible spectroscopic techniques. The crystalline structure and grain size of the synthesized samples were analyzed by X-Ray diffraction analysis (XRD) and the XRD patterns confirmed the presence of tetragonal phase SnO₂. In this study, Methylene blue degradation was tested by using SnO₂ nanoparticles (at different calculations temperatures) as a photocatalyst under sunlight as a source of irradiation. The results showed that the highest percentage of degradation of Methylene blue dye was obtained by using SnO₂ photocatalyst at calculations temperature 800 ᵒC. The operational parameters were investigated to be optimized to the best conditions which result in complete removal of organic pollutants from aqueous solution. It was found that the degradation of dyes depends on several parameters such as irradiation time, initial dye concentration, the dose of the catalyst and the presence of metals such as silver as a dopant and its concentration. Percent degradation was increased with irradiation time. The degradation efficiency decreased as the initial concentration of the dye increased. The degradation efficiency increased as the dose of the catalyst increased to a certain level and by further increasing the SnO₂ photocatalyst dose, the degradation efficiency is decreased. The best degradation efficiency on which obtained from pure SnO₂ compared with SnO₂ which doped by different percentage of Ag.

Keywords: SnO₂ nanoparticles, a sol-gel method, photocatalytic applications, methylene blue, degradation efficiency

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57 Exhaled Breath Condensate in Lung Cancer: A Non-Invasive Sample for Easier Mutations Detection by Next Generation Sequencing

Authors: Omar Youssef, Aija Knuuttila, Paivi Piirilä, Virinder Sarhadi, Sakari Knuutila

Abstract:

Exhaled breath condensate (EBC) is a unique sample that allows studying different genetic changes in lung carcinoma through a non-invasive way. With the aid of next generation sequencing (NGS) technology, analysis of genetic mutations has been more efficient with increased sensitivity for detection of genetic variants. In order to investigate the possibility of applying this method for cancer diagnostics, mutations in EBC DNA from lung cancer patients and healthy individuals were studied by using NGS. The key aim is to assess the feasibility of using this approach to detect clinically important mutations in EBC. EBC was collected from 20 healthy individuals and 9 lung cancer patients (four lung adenocarcinomas, four 8 squamous cell carcinoma, and one case of mesothelioma). Mutations in hotpot regions of 22 genes were studied by using Ampliseq Colon and Lung cancer panel and sequenced on Ion PGM. Results demonstrated that all nine patients showed a total of 19 cosmic mutations in APC, BRAF, EGFR, ERBB4, FBXW7, FGFR1, KRAS, MAP2K1, NRAS, PIK3CA, PTEN, RET, SMAD4, and TP53. In controls, 15 individuals showed 35 cosmic mutations in BRAF, CTNNB1, DDR2, EGFR, ERBB2, FBXW7, FGFR3, KRAS, MET, NOTCH1, NRAS, PIK3CA, PTEN, SMAD4, and TP53. Additionally, 45 novel mutations not reported previously were also seen in patients’ samples, and 106 novel mutations were seen in controls’ specimens. KRAS exon 2 mutations G12D was identified in one control specimen with mutant allele fraction of 6.8%, while KRAS G13D mutation seen in one patient sample showed mutant allele fraction of 17%. These findings illustrate that hotspot mutations are present in DNA from EBC of both cancer patients and healthy controls. As some of the cosmic mutations were seen in controls too, no firm conclusion can be drawn on the clinical importance of cosmic mutations in patients. Mutations reported in controls could represent early neoplastic changes or normal homeostatic process of apoptosis occurring in lung tissue to get rid of mutant cells. At the same time, mutations detected in patients might represent a non-invasive easily accessible way for early cancer detection. Follow up of individuals with important cancer mutations is necessary to clarify the significance of these mutations in both healthy individuals and cancer patients.

Keywords: exhaled breath condensate, lung cancer, mutations, next generation sequencing

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