Search results for: Saeed Anwar
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 412

Search results for: Saeed Anwar

142 A Cross-Sectional Study on Board Certified Pharmacists in Arab Countries 2018 Update

Authors: Mohamed Anwar Hammad, Khaled Mohamed Al Akhali, Yasmin Elsobky

Abstract:

Board certification is a voluntary process that confirms a pharmacist's capability, competency, education, skills, and proficiency beyond what is essential for licensure. This analysis was intended to investigate the prevalence of board-certified pharmacists in the Arab countries and compare the Board of Pharmacy Specialties (BPS) between Egypt, Saudi Arabia, and Canada. A cross-sectional study was conducted. The data were mined from the BPS website. Data were managed by IBM SPSS Statistics 23.0 and presented as descriptive statistics. Of 36918 Board certified pharmacists (BCPs) until February 2018, only 4038 (10.9%) were from the outside United States of America. From 4038 BCPs, about 1782 (44.1%) were from Arab nations. Egypt has the top prevalence of the BPS among the Arab countries 937 (52.6%) BCPs. However, the Kingdom of Saudi Arabia comes in the second position 442 (24.8%). Pharmacotherapy (BCPS), nutrition support pharmacy (BCNSP), critical care pharmacy (BCCCP) and oncology pharmacy (BCOP) are the highest specialties by 1474 (82.7%), 114 (6.4%), 61 (3.42%) and 60 (3.37%) respectively, while, infectious diseases pharmacy (AQID), cardiology pharmacy (AQCD) and nuclear pharmacy (BCNP) are the lowest prevalence of specialties by 7 (0.4%), 6 (0.3%) and 1 (0.06%) respectively. Added qualifications were canceled and became a new specialty in BPS as the rest of the specialties. Both infectious diseases and cardiology specialties exams are not conducted yet all over the world from the beginning of 2018. Egypt has the second prevalence 937 (2.54%), before Canada 920 (2.49%) and after United States of America 32880 (89.06%) in the worldwide in terms of BCPs. In conclusion the BCPS is the uppermost specialty; however, there is still a need for all the other specialties. In a short period, BCCCP jumped to the third position. Cardiology and infectious disease will be new specialties. Egyptian pharmacists are in the top of Arab countries, and 2nd in worldwide BCPs.

Keywords: AQCD, AQID, Arab countries, BCACP, BCCCP, BCGP, BCNP, BCNSP, BCOP, BCPPS, BCPS, BCPP, Board of Pharmacy Specialties (BPS), Canada, Egypt, Saudi Arabia, USA

Procedia PDF Downloads 180
141 Effect of Exercise Training and Dietary Silymarin on Levels of Leptin, Adiponectin, Paraoxonase and Body Composition

Authors: Alireza Barari, Saeed Shirali

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The etiology of obesity is heterogeneous with several factors, and the pathophysiology of obesity has recently related to leptin, oxidative damage, and inflammation. Silybum marianum have a health-promoting perspective and has shown that bioactive molecules of silymarin have the antioxidant and antitumor properties and can affect secretion of hormones and enzyme activity in animal. This study aimed to evaluate the antioxidant effects and changes in hormonal levels and body composition after silymarin consumption. Forty-five healthy untrained colleges male take part in the 4-week investigation. The subjects were assigned to 5 groups: endurance training, Silymarin with endurance training, strength training with placebo, Silymarin with strength training or placebo. Body fat percentage and Blood sample analysis were measured before and after the intervention to assay leptin, adiponectin and paraoxonase in the sample of subject's serum. There was a considerable decrease in body fat percent and a significant increase in VO2 max in 'Strength training' and 'Strength training with Silymarin' groups. But, no significant changes in levels of leptin, adiponectinin, and paraoxanase (PON) that were observed between exercise and exercise with Silymarin in these groups. We observed reduction in body fat% and increase in adiponectin induced by exercise for 4 weeks in untrained healthy men. Silybin, could not effectively improve all parameters and don’t prevent the progression of cell damage by antioxidant activity of PON.

Keywords: anti-inflammatory activity, antioxidant activity, silymarin, body composition, paraoxonase (PON)

Procedia PDF Downloads 192
140 Traumatic Spinal Cord Injury in King Fahd Medical City: An Epidemiological Study

Authors: Saeed Alshahri

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Introduction: Our study aims to estimate the characteristics & causes of TSCI at King Fahad Medical City (KFMC) in Riyadh city in order to hypothesize strategy for primary prevention of traumatic spinal cord injury. Method: Cross-sectional, retrospective study was conducted on all TSCI patients who aged 14 and above and who were admitted to rehabilitation center of King Fahad Medical City from January 2012 to December 2015. Furthermore, a descriptive analysis was conducted while considering factors including age, gender, marital status, educational level and causes of injury and characteristics of injury. Results: Total of 216 patients were admitted during this period, mean age was 28.94, majority of patients were male (86.5%), 71.7% of total patients were high school level of education or less, 68% were single, RTA was the main cause with 90.7% and the main result of TSCI was complete paraplegia 37%. Furthermore, statistically, we found that males are at a low risk of having incomplete paraplegia compared to female (p = 0.035, RRR=0.35). Conclusion: The rate of TSCI related to RTA has increased in Saudi Arabia in previous years despite the government’s efforts to decrease RTA. It’s clear that we need TSCI registry data developed on the basis of international data standards to have a clear idea about the exact etiology of TSCI in Saudi Arabia. This will assist in planning for primary prevention.

Keywords: traumatic spinal cord injury, road traffic accident, Saudi Arabia, spinal cord injury

Procedia PDF Downloads 317
139 Co-Immobilization of Palladium Nanoparticles and Polyoxometalate into the Cavities of the Mesocellular Foams: A Biomimetic Cooperative Catalytic System for Aerobic Oxidation of Alcohols under Green Conditions

Authors: Saeed Chehri, Sirvan Moradi, Amin Rostami

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Cooperative catalyst systems have been developed as highly promising sustainable alternatives to traditional catalysts. In these catalysts, two or more catalytic centers cooperate to reduce the energy of chemical transformations. In nature, such systems are abundantly seen in metalloenzymes that use metal and an organic cofactor. We have designed a reusable cooperative catalyst oxidation system consisting of palladium nanoparticles and polyoxometalate. This biomimetic cooperative catalytic system was synthesized by the stepwise immobilization of palladium nanoparticlesandpolyoxometalateinto the same cavity of siliceous mesocellularfoams (Pd-POM@MCF)and wascharacterizedby SEM, EDX, FT-IR, TGAand ICP techniques. POM-Pd@MCF/HQexhibits high activity toward aerobic oxidation of alcohols to the corresponding carbonyl compoundsin water solvent at room temperature. The major novelties and advantages of this oxidation method are as follows: (i) this is the first report of the co-immobilization of polyoxometalateand palladium for use as a robust and highlyefficient heterogeneouscooperative oxidative nanocatalyst system for aerobic oxidation of alcohols, (ii) oxidation of alcoholswere performed using an ideal oxidant with good to high yields in a green solvent at ambient temperature and (iii) the immobilization of the oxygen-activating catalyst(polyoxometalate) and oxidizing catalyst (Pd) onto MCF provide practical cooperative catalyst the system that can be reused several times without a significant loss of activity (vi) the methodsconform to several of the guiding principles of green chemistry.

Keywords: palladium nanoparticles, polyoxometalate, reusable cooperative catalytic system, biomimetic oxidation reaction

Procedia PDF Downloads 88
138 A Conundrum of Teachability and Learnability of Deaf Adult English as Second Language Learners in Pakistani Mainstream Classrooms: Integration or Elimination

Authors: Amnah Moghees, Saima Abbas Dar, Muniba Saeed

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Teaching a second language to deaf learners has always been a challenge in Pakistan. Different approaches and strategies have been followed, but they have been resulted into partial or complete failure. The study aims to investigate the language problems faced by adult deaf learners of English as second language in mainstream classrooms. Moreover, the study also determines the factors which are very much involved in language teaching and learning in mainstream classes. To investigate the language problems, data will be collected through writing samples of ten deaf adult learners and ten normal ESL learners of the same class; whereas, observation in inclusive language teaching classrooms and interviews from five ESL teachers in inclusive classes will be conducted to know the factors which are directly or indirectly involved in inclusive language education. Keeping in view this study, qualitative research paradigm will be applied to analyse the corpus. The study figures out that deaf ESL learners face severe language issues such as; odd sentence structures, subject and verb agreement violation, misappropriation of verb forms and tenses as compared to normal ESL learners. The study also predicts that in mainstream classrooms there are multiple factors which are affecting the smoothness of teaching and learning procedure; role of mediator, level of deaf learners, empathy of normal learners towards deaf learners and language teacher’s training.

Keywords: deaf English language learner, empathy, mainstream classrooms, previous language knowledge of learners, role of mediator, language teachers' training

Procedia PDF Downloads 141
137 Thermo-Mechanical Properties of PBI Fiber Reinforced HDPE Composites: Effect of Fiber Length and Composition

Authors: Shan Faiz, Arfat Anis, Saeed M. Al-Zarani

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High density polyethylene (HDPE) and poly benzimidazole fiber (PBI) composites were prepared by melt blending in a twin screw extruder (TSE). The thermo-mechanical properties of PBI fiber reinforced HDPE composite samples (1%, 4% and 8% fiber content) of fiber lengths 3 mm and 6 mm were investigated using differential scanning calorimeter (DSC), universal testing machine (UTM), rheometer and scanning electron microscopy (SEM). The effect of fiber content and fiber lengths on the thermo-mechanical properties of the HDPE-PBI composites was studied. The DSC analysis showed decrease in crystallinity of HDPE-PBI composites with the increase of fiber loading. Maximum decrease observed was 12% at 8% fiber length. The thermal stability was found to increase with the addition of fiber. T50% was notably increased to 40oC for both grades of HDPE using 8% of fiber content. The mechanical properties were not much affected by the increase in fiber content. The optimum value of tensile strength was achieved using 4% fiber content and slight increase of 9% in tensile strength was observed. No noticeable change was observed in flexural strength. In rheology study, the complex viscosities of HDPE-PBI composites were higher than the HDPE matrix and substantially increased with even minimum increase of PBI fiber loading i.e. 1%. We found that the addition of the PBI fiber resulted in a modest improvement in the thermal stability and mechanical properties of the prepared composites.

Keywords: PBI fiber, high density polyethylene, composites, melt blending

Procedia PDF Downloads 330
136 Evaluation of Drought Tolerant Sunflower Hybrids Indicated Their Broad Adaptability Under Stress Environment

Authors: Saeed Rauf

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Purpose: Drought stress is a major production constraint in sunflowers and causes yield losses under tropical and subtropical environments having high evapo-tranpirational losses. Given the consequences, three trials were designed to evaluate drought-resistant sunflower hybrids. Research Methods: Field trials were conducted under a split-plot arrangement with 17 hybrids and two contrasting regimes at Sargodha, Pakistan and 7 hybrids at Karj, Iran. Water stress condition was simulated by holding water in a stress regime. Hybrids were also screened against five levels of osmotic-ally induced stress, i.e. 0-15%, under a completely randomized design with 3 replications. Findings: Hybrids H1 (C.112.× RH.344) and H3 (C.112.× RSIN.82) showed the highest seed yield ha-1 and early flowering at Karj Iran. Commercial hybrid had the highest CTD (18.2°C) followed by C112 × RH.344 (17.29 °C). Hybrid C.250 × R.SIN.82 had the highest seed yield (m-2), followed by C.112 × RH.365 and C.124 × RSIN.82 under both stress and non-stress regimes at Sargodha, Pakistan. Seedling trial results showed that 6 hybrids only germinated in 5 and 7.5% PEG-induced osmotic stress, respectively. H1 (C.112 × RH.344) and H2 (C.112 × RH.347) had the highest germination% at 5% and 7.5% osmotic stress (OS). Seedling vigor index (SVI) was the highest in H1 (C.112 × RH.344) hybrids at 5% OS, H2 had the highest SVI under 7.5% OS, followed by H3 (C112 × RH344) and H4 (C116 × RH344). Originality/Value: In view of above results, it was concluded that hybrid combination H1 had the highest seed yield under stress conditions in both environments. High seed yield may be due to its better germination and vigor index under stress conditions.

Keywords: climate change, CTD, genetic variability, osmotic stress

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135 Design and Optimization of Sustainable Buildings by Combined Cooling, Heating and Power System (CCHP) Based on Exergy Analysis

Authors: Saeed Karimi, Ali Behbahaninia

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In this study, the design and optimization of combined cooling, heating, and power system (CCHP) for a sustainable building are dealt with. Sustainable buildings are environmentally responsible and help us to save energy also reducing waste, pollution and environmental degradation. CCHP systems are widely used to save energy sources. In these systems, electricity, cooling, and heating are generating using just one primary energy source. The selection of the size of components based on the maximum demand of users will lead to an increase in the total cost of energy and equipment for the building complex. For this purpose, a system was designed in which the prime mover (gas turbine), heat recovery boiler, and absorption chiller are lower than the needed maximum. The difference in months with peak consumption is supplied with the help of electrical absorption chiller and auxiliary boiler (and the national electricity network). In this study, the optimum capacities of each of the equipment are determined based on Thermo economic method, in a way that the annual capital cost and energy consumption will be the lowest. The design was done for a gas turbine prime mover, and finally, the optimum designs were investigated using exergy analysis and were compared with a traditional energy supply system.

Keywords: sustainable building, CCHP, energy optimization, gas turbine, exergy, thermo-economic

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134 Sub-Lethal Effects of Thiamethoxam and Pirimicarb on Life-Table Parameters of Diaeretiella rapae (Hymenoptera: Braconidae), Parasitoid of Lipaphis erysimi (Hemiptera: Aphididae)

Authors: Nastaran Rezaei, Mohammad Saeed Mossadegh, Farhan Kocheyli, Khalil Talebi Jahromi, Aurang Kavousi

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Integrated Pest Management (IPM) aims to combine biological and chemical strategies and measures, hence highlighting the study of acute toxicity and sub-lethal effects of pesticides comprehensively. The present research focused on the side effects of thiamethoxam and pirimicarb sub-lethal concentrations on demographic parameters of Diaeretiella rapae (McIntosh Laboratory) (Hymenoptera: Braconidae). Adult parasitoids were exposed to LC25 of insecticides as well as distilled water as the control. The results showed that thiamethoxam adversely affected population parameters (r, λ, R0, T), adults' longevity, females' oviposition period and mean fecundity, and a similar trend was obtained for pirimicarb with the exception of generation time (T), the latter did not significantly change compared to the control. The intrinsic rate of increase (r) in the control and those treated with pirimicarb and thiamethoxam were 0.2801, 0.2064, 0.1525 days-1, respectively, and the sex ratio was biased toward females in all treatments. Furthermore, none of the insecticides influenced total pre-oviposition period (TPOP) and offspring emergence rate. In general, these results indicated that both insecticides potentially distort the demographic parameters of the parasitoid even at sub-lethal concentrations, and then they should not be considered for IPM program in the presence of D. rapae.

Keywords: Diaeretiella rapae, Lipaphis erysimi, life-table study, pirimicarb, thiamethoxam

Procedia PDF Downloads 157
133 An Impairment of Spatiotemporal Gait Adaptation in Huntington's Disease when Navigating around Obstacles

Authors: Naznine Anwar, Kim Cornish, Izelle Labuschagne, Nellie Georgiou-Karistianis

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Falls and subsequent injuries are common features in symptomatic Huntington’s disease (symp-HD) individuals. As part of daily walking, navigating around obstacles may incur a greater risk of falls in symp-HD. We designed obstacle-crossing experiment to examine adaptive gait dynamics and to identify underlying spatiotemporal gait characteristics that could increase the risk of falling in symp-HD. This experiment involved navigating around one or two ground-based obstacles under two conditions (walking while navigating around one obstacle, and walking while navigating around two obstacles). A total of 32 participants were included, 16 symp-HD and 16 healthy controls with age and sex matched. We used a GAITRite electronic walkway to examine the spatiotemporal gait characteristics and inter-trail gait variability when participants walked at their preferable speed. A minimum of six trials were completed which were performed for baseline free walk and also for each and every condition during navigating around the obstacles. For analysis, we separated all walking steps into three phases as approach steps, navigating steps and recovery steps. The mean and inter-trail variability (within participant standard deviation) for each step gait variable was calculated across the six trails. We found symp-HD individuals significantly decreased their gait velocity and step length and increased step duration variability during the navigating steps and recovery steps compared with approach steps. In contrast, HC individuals showed less difference in gait velocity, step time and step length variability from baseline in both respective conditions as well as all three approaches. These findings indicate that increasing spatiotemporal gait variability may be a possible compensatory strategy that is adopted by symp-HD individuals to effectively navigate obstacles during walking. Such findings may offer benefit to clinicians in the development of strategies for HD individuals to improve functional outcomes in the home and hospital based rehabilitation program.

Keywords: Huntington’s disease, gait variables, navigating around obstacle, basal ganglia dysfunction

Procedia PDF Downloads 418
132 The Effectiveness of Solution-Focused Group Therapy on Improving Depressed Mothers of Child Abuser Families

Authors: Roya Maqami, Kaveh Qaderi Bagajan, Mohammad Mahdi Yousefi, Saeed Moradi

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The purpose of this study is to investigate the efficacy of solution-focused group therapy on improving the depressed mothers of child abuser families. This study was carried out in the form of a semi-pilot, pre-test and post-test on two groups (experimental and control). Subjects include all mothers and their children that are the members of Shush and Naser Khosro child home. Beck Depression Inventory and Child Trauma Questionnaire were used to collect data. First, child abuse questionnaire was completed by children, Then Beck Depression Inventory was completed by their mothers that 22 of them were recognized as depressed and randomly divided in two groups of experimental and control. After applying pre-test for both of these groups, the intervention of solution- focused group therapy was performed in five sessions on experimental group. Finally, post-test was applied on both groups and subsequently in a month, follow-up test was performed. T-test, multivariate variance, and repeated measurement analysis of variance were used to analyze the data. According to the findings, it can be concluded that this therapy leads to the improvement of depressed mother's mood. As a result, the intervention of solution-focused group therapy is useful in order to improve the depressing mood of mothers of child abuser families.

Keywords: child abuse, depressed mothers, child abuser families, solution focused group therapy

Procedia PDF Downloads 339
131 Peripheral Nerves Cross-Sectional Area for the Diagnosis of Diabetic Polyneuropathy: A Meta-Analysis of Ultrasonographic Measurements

Authors: Saeed Pourhassan, Nastaran Maghbouli

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1) Background It has been hypothesized that, in individuals with diabetes mellitus, the peripheral nerve is swollen due to sorbitol over-accumulation. Additionally growing evidence supported electro diagnostic study of diabetes induced neuropathy as a method having some challenges. 2) Objective To examine the performance of sonographic cross-sectional area (CSA) measurements in the diagnosis of diabetic polyneuropathy (DPN). 3) Data Sources Electronic databases, comprising PubMed and EMBASE and Google scholar, were searched for the appropriate studies before Jan 1, 2020. 4) Study Selection Eleven trials comparing different peripheral nerve CSA measurements between participants with and without DPN were included. 5) Data Extraction Study design, participants' demographic characteristics, diagnostic reference of DPN, and evaluated peripheral nerves and methods of CSA measurement. 6) Data Synthesis Among different peripheral nerves, Tibial nerve diagnostic odds ratios pooled from five studies (713 participants) were 4.46 (95% CI, 0.35–8.57) and the largest one with P<0.0001, I²:64%. Median nerve CSA at wrist and mid-arm took second and third place with ORs= 2.82 (1.50-4.15), 2.02(0.26-3.77) respectively. The sensitivities and specificities pooled from two studies for Sural nerve were 0.78 (95% CI, 0.68–0.89), and 0.68 (95% CI, 0.53–0.74). Included studies for other nerves were limited to one study. The largest sensitivity was for Sural nerve and the largest specificity was for Tibial nerve. 7) Conclusions The peripheral nerves CSA measured by ultrasound imaging is useful for the diagnosis of DPN and is most significantly different between patients and participants without DPN at the Tibial nerve. Because the Tibial nerve CSA in healthy participants, at various locations, rarely exceeds 24 mm2, this value can be considered as a cutoff point for diagnosing DPN.

Keywords: diabetes, diagnosis, polyneuropathy, ultrasound

Procedia PDF Downloads 104
130 Cheiloscopy and Dactylography in Relation to ABO Blood Groups: Egyptian vs. Malay Populations

Authors: Manal Hassan Abdel Aziz, Fatma Mohamed Magdy Badr El Dine, Nourhan Mohamed Mohamed Saeed

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Establishing association between lip print patterns and those of fingerprints as well as blood groups is of fundamental importance in the forensic identification domain. The first aim of the current study was to determine the prevalent types of ABO blood groups, lip prints and fingerprints patterns in both studied populations. Secondly, to analyze any relation found between the different print patterns and the blood groups, which would be valuable in identification purposes. The present study was conducted on 60 healthy volunteers, (30 males and 30 females) from each of the studied population. Lip prints and fingerprints were obtained and classified according to Tsuchihashi's classification and Michael Kuchen’s classification, respectively. The results show that the ulnar loop was the most frequent among both populations. Blood group A was the most frequent among Egyptians, while blood groups O and B were the predominant among Malaysians. Significant relations were observed between lip print patterns and fingerprint (in the second quadrant for Egyptian males and the first one for Malaysian). For Malaysian females, a statistically significant association was proved in the fourth quadrant. Regarding the blood groups, 89.5% of ulnar loops were significantly related to blood group A among Egyptian males. The results proved an association between the fingerprint pattern and the lip prints, as well as between the ABO blood group and the pattern of fingerprints. However, further researches with larger sample sizes need to be directed to approve the current results.

Keywords: ABO, cheiloscopy, dactylography, Egyptians, Malaysians

Procedia PDF Downloads 194
129 Factors Associated with Injuries and Trauma Among the Survivors of Gender-Based Violence in Afghanistan

Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan

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Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.

Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan

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128 Measurement of Echocardiographic Ejection Fraction Reference Values and Evaluation between Body Weight and Ejection Fraction in Domestic Rabbits (Oryctolagus cuniculus)

Authors: Reza Behmanesh, Mohammad Nasrolahzadeh-Masouleh, Ehsan Khaksar, Saeed Bokaie

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Domestic rabbits (Oryctolagus cuniculus) are an excellent model for cardiovascular research because the size of these animals is more suitable for study and experimentation than smaller animals. One of the most important diagnostic imaging methods is echocardiography, which is used today to evaluate the anatomical and functional cardiovascular system and is one of the most accurate and sensitive non-invasive methods for examining heart disease. Ventricular function indices can be assessed with cardiac imaging techniques. One of these important cardiac parameters is the ejection fraction (EF), which has a valuable place along with other involved parameters. EF is a measure of the percentage of blood that comes out of the heart with each contraction. For this study, 100 adult and young standard domestic rabbits, six months to one year old and of both sexes (50 female and 50 male rabbits) without anesthesia and sedation were used. In this study, the mean EF in domestic rabbits studied in males was 58.753 ± 6.889 and in females, 61.397 ± 6.530, which are comparable to the items mentioned in the valid books and the average size of EF measured in this study; there is no significant difference between this research and other research. There was no significant difference in the percentage of EF between most weight groups, but there was a significant difference (p < 0.05) in weight groups (2161–2320 g and 2481–2640 g). Echocardiographic EF reference values for domestic rabbits (Oryctolagus cuniculus) non-anesthetized are presented, providing reference values for future studies.

Keywords: echocardiography, ejection fraction, rabbit, heart

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127 Behavior and Obesity: The Perception of Healthcare Professionals Concerning the Role of Behavior on Obesity

Authors: Saeed Wahass

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Objective: Obesity is epidemic, affecting all societies and cultures. Most serious medical illnesses are attributed to obesity. For this reason, all healthcare systems worldwide have focused on obesity for both intervention and prevention. However, there is scientific evidence supporting that obesity is treatable through implementing different modalities of interventions. They include biological interventions like medications and bariatric surgeries and behavioral interventions. It seems healthcare professionals may suggest the quick and the easiest interventions for obesity like surgery, ignoring other modesties that might require efforts from their sides and patients as well. Searching on the onset, progression and prevention, behavior plays a major role. As a result, psychological interventions have become increasingly core for intervention and prevention of obesity. They are effective and cost effective in dealing with obesity. Methods: A questionnaire describing the role of behavior on obesity and the way it can be prevented and treated was distributed to a group of health professionals who are dealing with obesity e.g. bariatric surgeons, bariatric physicians, psychologists, health educators, nurses and social workers. Results: 88% of healthcare professionals believed that behavior plays a major role on the onset and progression of obesity, 95% of them recognized that obesity can be prevented with consideration for behavior factors. A major proportion (87%) of the respondents see that psychological interventions are effective and cost effective in treating obesity. Conclusions: It optimistically appears that the majority of healthcare professionals believe that behavior is a key component in understanding, preventing and treating obesity. This outcome may help in developing specific training courses for healthcare professionals, who are dealing with obesity concerning the way they can treat patients behaviorally and, moreover, educating the community.

Keywords: behavior, obesity, healthcare provider, psychological interventions

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126 Association between Copper Uptake and Decrease of Copper (hypocupremia) in Burn Patients-Infected Pseudomonas aeruginosa

Authors: Khaled Khleifat, Muayyad Abboud, Amjad Khleifat, Humodi Saeed

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In this study, Pseudomonas aeruginosa was isolated from infected burn patients and characterized by standard biochemical tests. The in vitro copper uptake was compared between this isolated pathogenic strain and two non-pathogenic control strains of Gram positive bacteria Bacillusthuringiensis strain Israelisas well as Gram negative bacteria Enterobacter aerogenes. Maximum copper uptake of 470 ppm/g biomass was obtained by P. aeruginosa strain, while the control strains B. thuringiensis andEnterobacter aerogenes had copper uptake of 350 and 383 ppm/g biomass, respectively. However, the lowest copper uptake (60 ppm/g biomass) was observed with another control the saprophytic strain Pseudomonas (Shewanella) putrefaciens. A further investigation regarding the effect of copper toxicity on bacterial growth, gave an MIC score of 600 ppm for P. aeruginosa strain compared to 460 and 300 ppm for the two Gram positive and Gram negative control strains, respectively. In tandem with these in vitro findings, blood analysis on burn patients infected with P. aeruginosa has indicated a selective decrease of copper (hypocupremia) and ceruloplasmin plasma levels. The iron metabolism was also affected by this copper deprivation leading to a similar decrease in plasma levels of PCV, iron, total iron binding capacity, and transferrin. All these hematological changes were significantly different (P < 0.05) from the matched group of non-infected burn patients. The observed hypocupremia in infected burn patients was attributed to demanding scavenger ability by P. aeruginosa strain for the copper of plasma.

Keywords: pseudomonas, Cu uptake, burn patients, biosorption

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125 Psychology Behind Aesthetic Rhinoplasty–Introducing the Term Sifon

Authors: Komal Saeed

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Introduction: Rhinoplasty is considered one of the challenging aesthetic procedures. Psychosocial concerns motivate the urge for aesthetic procedures especially rhinoplasty. Males who fall in this category are designated as single, immature, male, over expectant and narcissistic (SIMON) in literature. As of yet, there is no term that depicts females showing similar characteristics. The purpose of this study is to evaluate the incidence of body dysmorphic disorder (BDD) in females seeking rhinoplasty and to introduce a term for such individuals. Materials and Methods: A prospective, questionnaire based, qualitative study was conducted in the Department Of Plastic Surgery between March 2018 and March 2020. 110 female candidates seeking aesthetic rhinoplasty were included in the study. BDD was evaluated using the Dysmorphic Concerns Questionnaire, DCQ. Data were analyzed using SPSS version 25 software and correlation between the groups was evaluated. Results: Out of 110 female subjects, 77.3% (n=85) were single, 16.4% (n=18) were married and 6.4% (n=7) were divorced. BDD was found in 41.8% (n=46) of the candidates, majority being single (n=41, 89.1%) and having educational status above diploma (n=39, 84.8%). There was a statistically higher percentage of young adults between 24 and 28 years (n=33, 71.7%) having BDD (p= 0.0001). Conclusion: Considering the high frequency of BDD among females seeking rhinoplasty, a standardized term ‘SIFON’ is introduced to describe such individuals who are S; single, I; immature, F; female, O; over expectant, N; narcissistic as apposed to SIMON in males. These individuals perceive aesthetic procedures as a solution to their body dissatisfaction. Therefore, preoperative counseling seems necessary to avoid unsatisfactory outcomes secondary to mental health.

Keywords: aesthetic rhinoplasty, body dismorphic disorder, single, immature, obsessive

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124 Pattern of External Injuries Sustained during Bomb Blast Attacks in Karachi, Pakistan from 2000 to 2007

Authors: Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akbar Shoukat Ali, Zeeshan-Ul-Hassan Usmani, Joseph Varon, Salim Surani

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Objective: Terrorism and suicidal bomb blast attacks are commonplace in Karachi, Pakistan. During the years 2000 to 2007, there were over 60 bomb explosions resulting in more than 1500 casualties. These explosions produce a wide variety of external injuries. We undertook this study to evaluate pattern of external injury produced after bomb blast attacks and to compare injury profile resulting from explosions in open versus semi-confined blast environments. Method: A retrospective, cross-sectional, study was conducted to review injuries sustained after bomb blast attacks in Karachi, Pakistan, from January 2000 to October 2007. Emergency medical records and medico legal certificates of patients presented to three major public sector hospitals of Karachi were evaluated using self-design proforma. Results: Data of 481 victims meet inclusion criteria and were incorporated for final analysis. Of these, 63.6% were injured in open spaces and 36.4% were injured in semi-confined blast environments. Lacerations were commonly encountered as external injury (47.7%) followed by penetrating wounds (15.3%). Lower and upper extremities were most commonly affected (38.6% and 19% respectively). Open and semi-confined blast environments produced a specific injury pattern and profile (p=<0.001). Conclusions: Bomb blast attacks in Karachi produce an external injury pattern consistent with other studies, with exception of an increased frequency in penetrating wounds. Semi-confined blast environments were associated with severe injuries. Further studies are required to better classify injuries and their severity based on standardized scoring systems. Effective emergency response systems must be designed to cope with mass causalities following bomb explosions.

Keywords: bomb blast attacks, injury pattern, external injury, open space, semi-confined space, blast environment

Procedia PDF Downloads 375
123 Subway Stray Current Effects on Gas Pipelines in the City of Tehran

Authors: Mohammad Derakhshani, Saeed Reza Allahkarama, Michael Isakhani-Zakaria, Masoud Samadian, Hojjat Sharifi Rasaey

Abstract:

In order to investigate the effects of stray current from DC traction systems (subway) on cathodically protected gas pipelines, the subway and the gas network maps in the city of Tehran were superimposed and a comprehensive map was prepared. 213 intersections and about 100150 meters of parallel sections of gas pipelines were found with respect to the railway right of way which was specified for field measurements. The potential measurements data were logged for one hour in each test point. 24-hour potential monitoring was carried out in selected test points as well. Results showed that dynamic stray current from subway on pipeline potential appears as fluctuations in its static potential that is visible in the diagrams during night periods. These fluctuations can cause the pipeline potential to exit the safe zone and lead to corrosion or overprotection. In this study, a maximum potential shift of 100 mv in the pipe-to-soil potential was considered as a criterion for dynamic stray current effective presence. Results showed that a potential fluctuation range between 100 mV to 3 V exists in measured points on pipelines which exceeds the proposed criterion and needs to be investigated. Corrosion rates influenced by stray currents were calculated using coupons. Results showed that coupon linked to the pipeline in one of the locations at region 1 of the city of Tehran has a corrosion rate of 4.2 mpy (with cathodic protection and under influence of stray currents) which is about 1.5 times more than free corrosion rate of 2.6 mpy.

Keywords: stray current, DC traction, subway, buried Pipelines, cathodic protection list

Procedia PDF Downloads 793
122 Effect of Satureja khuzestanica Jamzad Supplementation on Inflammatory and Antioxidant Indicators in Type 2 Diabetes Patients: A Randomized Controlled Clinical Trial Study

Authors: Maryam Bordbar, Yaser Mokhayeri, Sajjad Roosta, Fatemeh Ghasemi, Saeed Choobkar, Hamidreza Nikbakht, Ebrahim Falahi

Abstract:

Objective: Diabetes mellitus type 2 is the most common metabolic disorder that is growing exponentially worldwide. Satureja Khuzestanica Jamzad is a native plant of Iran that grows widely in the south of Iran. Its antimicrobial, antioxidant, anti-inflammatory and pain-relieving effects have been documented in animal studies. The purpose of this study is to investigate the effect of consumption daily S. khuzestanica on inflammatory and antioxidant indicators in type 2 diabetic patients. Methods and Materials: In a double-blind, placebo-controlled clinical trial, 67 patients with type 2 diabetes were included and divided into two groups. One group received S. khuzestanica (capsule containing 500 mg) and the other group received placebo (500 mg talcum powder) once a day for 12 weeks. After the intervention, the inflammatory and antioxidant indicators of the two groups were compared. Results: In comparison to placebo groups, there was a significant difference in levels of total antioxidant capacity, superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase; these antioxidant indicators were higher in the intervention group (P<0.05). Moreover, a considerable decrease in weight, CRP and IL-6 levels were observed in patients in the S.Khuzestanica group. Conclusion: Our findings may provide novel complementary treatments without adverse effects for diabetes complications.

Keywords: Satureja khuzestanica Jamzad, diabetes mellitus, antioxidant indicators, IL-6, C-reactive protein

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121 Assessment of E-Readiness in Libraries of Public Sector Universities Khyber Pakhtunkhwa-Pakistan

Authors: Saeed Ullah Jan

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This study has examined the e-readiness in libraries of public sector universities in Khyber Pakhtunkhwa. Efforts were made to evaluate the availability of human resources, electronic infrastructure, and network services and programs in the public sector university libraries. The population of the study was the twenty-seven public sector university libraries of Khyber Pakhtunkhwa. A quantitative approach was adopted, and a questionnaire-based survey was conducted to collect data from the librarian/in charge of public sector university libraries. The collected data were analyzed using Statistical Package for Social Sciences version 22 (SPSS). The mean score of the knowledge component interpreted magnitudes below three which indicates that the respondents are poorly or moderately satisfied regards knowledge of libraries. The satisfaction level of the respondents about the other components, such as electronic infrastructure, network services and programs, and enhancers of the networked world, was rated as average or below. The study suggested that major aspects of existing public-sector university libraries require significant transformation. For this purpose, the government should provide all the required resources and facilities to meet the population's informational and recreational demands. The Information Communication Technology (ICT) infrastructure of public university libraries needs improvement in terms of the availability of computer equipment, databases, network servers, multimedia projectors, digital cameras, uninterruptible power supply, scanners, and backup devices such as hard discs and Digital Video Disc/Compact Disc.

Keywords: ICT-libraries, e-readiness-libraries, e-readiness-university libraries, e-readiness-Pakistan

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120 Multiscale Entropy Analysis of Electroencephalogram (EEG) of Alcoholic and Control Subjects

Authors: Lal Hussain, Wajid Aziz, Imtiaz Ahmed Awan, Sharjeel Saeed

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Multiscale entropy analysis (MSE) is a useful technique recently developed to quantify the dynamics of physiological signals at different time scales. This study is aimed at investigating the electroencephalogram (EEG) signals to analyze the background activity of alcoholic and control subjects by inspecting various coarse-grained sequences formed at different time scales. EEG recordings of alcoholic and control subjects were taken from the publically available machine learning repository of University of California (UCI) acquired using 64 electrodes. The MSE analysis was performed on the EEG data acquired from all the electrodes of alcoholic and control subjects. Mann-Whitney rank test was used to find significant differences between the groups and result were considered statistically significant for p-values<0.05. The area under receiver operator curve was computed to find the degree separation between the groups. The mean ranks of MSE values at all the times scales for all electrodes were higher control subject as compared to alcoholic subjects. Higher mean ranks represent higher complexity and vice versa. The finding indicated that EEG signals acquired through electrodes C3, C4, F3, F7, F8, O1, O2, P3, T7 showed significant differences between alcoholic and control subjects at time scales 1 to 5. Moreover, all electrodes exhibit significance level at different time scales. Likewise, the highest accuracy and separation was obtained at the central region (C3 and C4), front polar regions (P3, O1, F3, F7, F8 and T8) while other electrodes such asFp1, Fp2, P4 and F4 shows no significant results.

Keywords: electroencephalogram (EEG), multiscale sample entropy (MSE), Mann-Whitney test (MMT), Receiver Operator Curve (ROC), complexity analysis

Procedia PDF Downloads 352
119 Prevalence and Evaluation of Antimicrobial Activity of Dodonaea viscosa Extract and Antibacterial Agents against Salmonella spp. Isolated from Poultry

Authors: Shayma Munqith Al-Baker, Fadhl Ahmed Saeed Al-Gasha’a, Samira Hamid Hanash, Ahmed Ali Al-Hazmi

Abstract:

A total of 200 samples (180 fecal materials and 20 organ samples) were collected from (5 different poultry farms, 10 local poultry shops, 5 houses poultry, 5 Eggs stores shops and 5 hand slaughters centers) in Ibb city, Yemen, 2014. According to morphological, cultural, as well as biochemical characterization and serological tests, 59 29.5% isolates were identified as Salmonella spp. and all Salmonella isolates were categorized by serotype, which comprised of, 37 62.71% Salmonella Typhimurium serovar, 21 35.59%. Salmonella Enteritidis serovar and 11.69% Salmonella Heidelberg serovar. Antibiotic sensitivity test was done for bacterial isolates and the results showed there were clear differences in antibiotic resistant. Antimicrobial susceptibility of the isolates varies as follows: Ofloxacin 79.66%, Ciprofloxacin 67.80%, Colistin 59.32% and Gentamycin 52.54%. All of isolates were resistant to Erythromycin, Penicillin and Lincomycin. Antibacterial activity was done for both aqueous and ethanol extracts of Dodonaea viscosa plant by using well and disc diffusion assay. The results indicated that well diffusion assay had best results than disc diffusion assay, the highest inhibition zone was 22 mm for well diffusion and 15 mm for disc diffusion assay, the results observed that ethanol extract had best antibacterial effect than aqueous extract which the percentage of bacterial isolates affected with ethanol extract was 71.19% comparing with aqueous extract 28.81% by using disc diffusion assay, while the percentage of bacterial isolates affected with ethanol extract was 88.13% comparing with aqueous extract 52.54% by using will diffusion assay.

Keywords: Salmonella spp, Dodonaea viscosa, antimicrobial and salmonellosis

Procedia PDF Downloads 442
118 Assessment of Osteocalcin and Homocysteine Levels in Saudi Female Patients with Type II Diabetes Mellitus

Authors: Walaa Mohammed Saeed

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Studies suggest a crosstalk between bone and metabolism through Osteocalcin (OC), a bone-derived protein that plays an important role in regulating glucose and fat metabolism. Studies relate type II Diabetes Mellitus (DMII) with Homocysteine (Hcy) and cardiovascular diseases (CVD). This study investigates the relationship between levels of OC, Hcy, and DMII in 85 subjects of which 50 were diabetic female patients (29–65 years) and 35 healthy controls. OC and Hcy levels were measured in fasting blood samples using immunoassay analyzer. Fasting serum glucose, glycated hemoglobin, lipid profile, were estimated by automated Siemens Dimension XP auto-analyzer. A significant increase in the frequency of low OC levels (p < 0.001) and high Hcy levels (p < 0.001) was detected in diabetic patients compared to controls (chi-squared test). Using ANOVA test, patients were divided into tertiles based on plasma OC and Hcy levels; fasting serum glucose varied inversely with OC but directly with Hcy tertiles (p=0.049, p=0.033 respectively). Atherogenic Index of Plasma (AIP=Log TG/HDL) predicts that diabetic patients with 36% high and 15% intermediate cardiovascular risk had increased frequency of low OC levels compared to low-risk patients (p=0.047). Another group of diabetic patients with 39% high and 11% intermediate CVD risk had increased frequency of high Hcy levels (p=0.033). A significant negative correlation existed between OC and glucose (r = -0.318; p = 0.035) while correlation between glucose level and Hcy (r = 0.851 p=0.022) was positive. Hence, low serum OC levels and high Hcy levels were associated with impaired glucose metabolism that may increase cardiovascular risk in DMII.

Keywords: osteocalcin, homocysteine, type 2 diabetes, cardiovascular

Procedia PDF Downloads 122
117 Determination of ILSS of Composite Materials Using Micromechanical FEA Analysis

Authors: K. Rana, H.A.Saeed, S. Zahir

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Inter Laminar Shear Stress (ILSS) is a main key parameter which quantify the properties of composite materials. These properties can ascertain the use of material for a specific purpose like aerospace, automotive etc. A modelling approach for determination of ILSS is presented in this paper. Geometric modelling of composite material is performed in TEXGEN software where reinforcement, cured matrix and their interfaces are modelled separately as per actual geometry. Mechanical properties of matrix and reinforcements are modelled separately which incorporated anisotropy in the real world composite material. ASTM D2344 is modelled in ANSYS for ILSS. In macroscopic analysis model approximates the anisotropy of the material and uses orthotropic properties by applying homogenization techniques. Shear Stress analysis in that case does not show the actual real world scenario and rather approximates it. In this paper actual geometry and properties of reinforcement and matrix are modelled to capture the actual stress state during the testing of samples as per ASTM standards. Testing of samples is also performed in order to validate the results. Fibre volume fraction of yarn is determined by image analysis of manufactured samples. Fibre volume fraction data is incorporated into the numerical model for correction of transversely isotropic properties of yarn. A comparison between experimental and simulated results is presented.

Keywords: ILSS, FEA, micromechanical, fibre volume fraction, image analysis

Procedia PDF Downloads 342
116 Correlation between the Ratios of House Dust Mite-Specific IgE/Total IgE and Asthma Control Test Score as a Biomarker of Immunotherapy Response Effectiveness in Pediatric Allergic Asthma Patients

Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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115 A Dataset of Program Educational Objectives Mapped to ABET Outcomes: Data Cleansing, Exploratory Data Analysis and Modeling

Authors: Addin Osman, Anwar Ali Yahya, Mohammed Basit Kamal

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Datasets or collections are becoming important assets by themselves and now they can be accepted as a primary intellectual output of a research. The quality and usage of the datasets depend mainly on the context under which they have been collected, processed, analyzed, validated, and interpreted. This paper aims to present a collection of program educational objectives mapped to student’s outcomes collected from self-study reports prepared by 32 engineering programs accredited by ABET. The manual mapping (classification) of this data is a notoriously tedious, time consuming process. In addition, it requires experts in the area, which are mostly not available. It has been shown the operational settings under which the collection has been produced. The collection has been cleansed, preprocessed, some features have been selected and preliminary exploratory data analysis has been performed so as to illustrate the properties and usefulness of the collection. At the end, the collection has been benchmarked using nine of the most widely used supervised multiclass classification techniques (Binary Relevance, Label Powerset, Classifier Chains, Pruned Sets, Random k-label sets, Ensemble of Classifier Chains, Ensemble of Pruned Sets, Multi-Label k-Nearest Neighbors and Back-Propagation Multi-Label Learning). The techniques have been compared to each other using five well-known measurements (Accuracy, Hamming Loss, Micro-F, Macro-F, and Macro-F). The Ensemble of Classifier Chains and Ensemble of Pruned Sets have achieved encouraging performance compared to other experimented multi-label classification methods. The Classifier Chains method has shown the worst performance. To recap, the benchmark has achieved promising results by utilizing preliminary exploratory data analysis performed on the collection, proposing new trends for research and providing a baseline for future studies.

Keywords: ABET, accreditation, benchmark collection, machine learning, program educational objectives, student outcomes, supervised multi-class classification, text mining

Procedia PDF Downloads 142
114 The Effect of Zeolite on Sandy-Silt Soil Mechanical Properties

Authors: Shahryar Aftabi, Saeed Fathi, Mohammad H. Aminfar

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It is well known that cemented sand is one of the best approaches for soil stabilization. In some cases, a blend of sand, cement and other pozzolan materials such as zeolite, nano-particles and fiber can be widely (commercially) available and be effectively used in soil stabilization, especially in road construction. In this research, we investigate the effects of CaO which is based on the geotechnical characteristics of zeolite composition with sandy silt soil. Zeolites have low amount of CaO in their structures, that is, varying from 3% to 10%, and by removing the cement paste, we want to investigate the effect of zeolite pozzolan without any activator on soil samples strength. In this research, experiments are concentrated on various weight percentages of zeolite in the soil to examine the effect of the zeolite on drainage shear strength and California Bearing Ratio (CBR) both with and without curing. The study also investigates their liquid limit and plastic limit behavior and makes a comparative result by using Feng's and Wroth-Wood's methods in fall cone (cone penetrometer) device; in the final the SEM images have been presented. The results show that by increasing the percentage of zeolite in without-curing samples, the fine zeolite particles increase some soil's strength, but in the curing-state we can see a relatively higher strength toward without-curing state, since the zeolites have no plastic behavior, the pozzolanic property of zeolites plays a much higher role than cementing properties. Indeed, it is better to combine zeolite particle with activator material such as cement or lime to gain better results.

Keywords: California bearing ratio, CBR, direct shear, fall-cone, sandy silt, SEM, zeolite

Procedia PDF Downloads 108
113 Experience of Continuous Ambulatory Peritoneal Dialysis in Remote Area of Southeast Bangladesh

Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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