Search results for: Syed Azhar Syed Sulaiman
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 385

Search results for: Syed Azhar Syed Sulaiman

145 Hansen Solubility Parameters, Quality by Design Tool for Developing Green Nanoemulsion to Eliminate Sulfamethoxazole from Contaminated Water

Authors: Afzal Hussain, Mohammad A. Altamimi, Syed Sarim Imam, Mudassar Shahid, Osamah Abdulrahman Alnemer

Abstract:

Exhaustive application of sulfamethoxazole (SUX) became as a global threat for human health due to water contamination through diverse sources. The addressed combined application of Hansen solubility (HSPiP software) parameters and Quality by Design tool for developing various green nanoemulsions. HSPiP program assisted to screen suitable excipients based on Hansen solubility parameters and experimental solubility data. Various green nanoemulsions were prepared and characterized for globular size, size distribution, zeta potential, and removal efficiency. Design Expert (DoE) software further helped to identify critical factors responsible to have direct impact on percent removal efficiency, size, and viscosity. Morphological investigation was visualized under transmission electron microscopy (TEM). Finally, the treated was studied to negate the presence of the tested drug employing ICP-OES (inductively coupled plasma optical emission microscopy) technique and HPLC (high performance liquid chromatography). Results showed that HSPiP predicted biocompatible lipid, safe surfactant (lecithin), and propylene glycol (PG). Experimental solubility of the drug in the predicted excipients were quite convincing and vindicated. Various green nanoemulsions were fabricated, and these were evaluated for in vitro findings. Globular size (100-300 nm), PDI (0.1-0.5), zeta potential (~ 25 mV), and removal efficiency (%RE = 70-98%) were found to be in acceptable range for deciding input factors with level in DoE. Experimental design tool assisted to identify the most critical variables controlling %RE and optimized content of nanoemulsion under set constraints. Dispersion time was varied from 5-30 min. Finally, ICP-OES and HPLC techniques corroborated the absence of SUX in the treated water. Thus, the strategy is simple, economic, selective, and efficient.

Keywords: quality by design, sulfamethoxazole, green nanoemulsion, water treatment, icp-oes, hansen program (hspip software

Procedia PDF Downloads 51
144 Efficacy and Safety Profile of Biosimilar PEG-Asparaginase (Asviia) in Patients with Acute Leukaemia: A Retrospective Study from Kashmir

Authors: Faisal Guru Rashid, Syed Nisar, Mohammad Hussain Mir, Ulfat Ara, Richa Tripathi

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Background: Biosimilar pegylated L-asparaginase is a potential alternative to the innovator version for treating acute lymphoblastic leukaemia (ALL) in Indian children, addressing issues of availability and cost. Biosimilar offers a viable solution, ensuring wider access to essential treatment in resource-limited settings like India. With this in mind, we conducted a study to assess the efficacy and toxicity of Biosimilar Pegaspargase (Asviia) in patients with Acute Leukaemia at our centre. Materials and methods: A retrospective study was conducted to assess the efficacy and safety of biosimilar PEG-asparaginase (Asviia) in newly diagnosed paediatric acute lymphoblastic leukaemia patients at the Paediatric Oncology unit of Department of Medical Oncology at Sher-I-Kashmir Institute of Medical Sciences, SKIMS Srinagar. The study included patients of ALL treated at our centre between January 2021- and December 2023. Each patient received 2 induction doses of pegaspargenase. Results: 45 patients (16 females and 29 males) were included in the study who received biosimilar PEG-asparaginase (Asviia) as a part of the treatment protocol. The age range of patients was between 1 and 16 years with a median age was 7.5 years. Median PEG Asparaginase dose received was 1175 IU (1125-3750 IU). The majority of patients were Pre-B ALL. There was considerable improvement in the haematological parameters, like haemoglobin levels rising by 1.39 and platelet counts rising by 30,402 after the patients received the first dose of Peg-ASP. Biosimilar Pegaspargase in Acute Leukaemia patients showed a tolerable safety profile with no life-threatening events. 13% of patients exhibited allergic reactions, and 17% had sepsis. Two patients (4.4%) had pancreatitis and Transaminitis events. At the end of induction, out of 45 patients, 40 (88.89%) patients had complete remission with Minimal Residual Disease (MRD) negativity, while 5 patients were MRD positive. Conclusion: Biosimilar PEG-Asparaginase (Asviia) demonstrated a tolerable safety profile and good efficacy, with nearly 90% of patients having complete Remission with MRD negativity.

Keywords: acute lymphoblastic leukaemia, biosimilar, PEG-asparaginase, minimal residual disease, remission

Procedia PDF Downloads 15
143 Honey Dressing versus Silver Sulfadiazine Dressing for Wound Healing in Second Degree Thermal Burn Patients

Authors: Syed Faizan Hassan Shah

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Introduction: Burn injuries are among the most devastating of all injuries. Burns is the fourth most common type of trauma worldwide. Ap?proximately 90 percent of burns occur in low to middle-income countries. Nearly half a million Americans each year, with approximately 40,000 hospitalizations and 3,400 deaths annually, suffer burns. The survival rate for admitted burn patients has improved consistently over the past four decades, largely attributed to national decreases in burn size, improvements in burn critical care, and advancements in burn wound care. Objectives: The present study was conducted to compare the efficacy of Honey dressing versus Silver Sulfadiazine dressing for complete wound healing in the 2nd-degree thermal burn. Study Design: A Randomized controlled trial was carried out in the Department of General Surgery/burn unit of Ayub Teaching Hospital Abbottabad from July to December 2018. The study population included thermal burn patients presenting with ASA-I, ASA-II, and body surface area less than 50% of the age group above 12 to 60 years of either gender. All the patients were randomly divided into two equal groups of patients by blocked randomization using permuted block g 6. In group ‘A,’ patients underwent dressing by honey method, and patients in group ‘B’ had silver sulfadiazine dressing. The dressing was changed every 48 hours by a senior sur?geon, and the condition of the wound was observed. Time duration till complete wound healing was noted in the Proforma. Results: A total of 100 patients were selected and divided into two groups of 50 patients in each two groups. The mean age of the patients was 27.66±13.388 ran?ging from 12 to 60 years of age, and the mean duration of complete healing of wound in days was 20.20±6.251, ranging from 2 to 30 days. Mean comparison of age with both groups, age of the patients was 21.24±3.761 (n=50) in group ‘A,’ i.e., honey dressing, and 19.16±7.911 (n=50) was in group ‘B,’ i.e., silver sulfadiazine dressing. Efficacy in the honey dressing group was found effective in 48(75.0%) and ineffect? ive in 2(5.6%) out of 50 patients. Efficacy in silver sulfadiazine dressing group 16(25.0%) was three found effective and in 34(94.4%) was inef?fective out of 50 patients. There was a statistically significant difference between both groups. (P=0.000) . Conclusion: honey dressing is more effective as compared to silver sulfadiazine dressing in terms of complete wound healing in second-degree thermal burn patients; our study also concluded the same.

Keywords: efficacy, honey dressing, silver sulfadiazine dressing, wound healing

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142 Factors Associated with Seroconversion of Oral Polio Vaccine among the Children under 5 Year in District Mirpurkhas, Pakistan 2015

Authors: Muhammad Asif Syed, Mirza Amir Baig

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Background: Pakistan is one of the two remaining polio-endemic countries, posing a significant public health challenge for global polio eradication due to failure to interrupt polio transmission. Country specific seroprevalence studies help in the evaluation of immunization program performance, the susceptibility of population against polio virus and identification of existing level of immunity with factors that affect seroconversion of the oral polio vaccine (OPV). The objective of the study was to find out factors associated with seroconversion of the OPV among children 6-59 months in Pakistan. Methods: A Hospital based cross-sectional serosurvey was undertaken in May-June 2015 at District Mirpurkhas, Sindh-Pakistan. Total 180 children aged 6–59 months were selected by using systematic random sampling from Muhammad Medical College Hospital, Mirpurkhas. Demographic, vaccination history and risk factors information were collected from the parents/guardian. Blood sample was collected and tested for the detection of poliovirus IgG antibodies by using ELISA Kit. The IgG titer <10 IU/ml, 50 to <150 IU/ml and >150 IU/ml was defined as negative, weak positive and positive immunity respectively. Pearson Chi-square test was used to determine the difference in seroprevalence in univariate analysis. Results: A total of 180 subjects were enrolled mean age was 23 months (7 -59 months). Off these 160 (89%) children were well and 18 (10%) partially protected against polio virus. Two (1.1%) children had no protection against polio virus as they had <10 IU/ml poliovirus IgG antibodies titer. Both negative cases belong from the female gender, age group 12-23 months, urban area and BMI <50 percentile. There was a difference between normal and the wasting children; it did attain statistical significance (χ2= 35.5, p=0.00). The difference in seroconversion was also observed in relation to the gender (χ2=6.23, p=0.04), duration of breast feeding (χ2=18.6, p=0.04), history of diarrheal disease before polio vaccine administration (χ2=7.7, p=0.02), and stunting (χ2= 114, p=0.00). Conclusion: This study demonstrated that near 90% children achieve seroconversion of OPV and well protected against polio virus. There is an urgent need to focus on factors like duration of breast feeding, diarrheal diseases and malnutrition (acute and chronic) among the children as an immunization strategy.

Keywords: seroconversion, oral polio vaccine, Polio, Pakistan

Procedia PDF Downloads 272
141 Organic Geochemistry and Oil-Source Correlation of Cretaceous Sediments in the Kohat Basin, Pakistan

Authors: Syed Mamoon Siyar, Fayaz Ali, Sajjad Ahmad, Samina Jahandad, George Kontakiotis, Hammad T. Janjuhah, Assimina Antonarakou, Waqas Naseem

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The Cretaceous Chichali Formation in the Chanda-01, Chanda-02, Chanda-03 and Mela-05 wells and the oil samples from Chanda-01 and Chanda-01 wells located in the Kohat Basin, Pakistan, were analyzed with the objectives of evaluating the hydrocarbon generation potential, source, thermal maturity and depositional of organic matter, and oil-source correlation by employing geochemical screening techniques and biomarker studies. The total organic carbon (TOC) values in Chanda-02, Chanda-03 and Mela-05 indicate, in general, poor to fair, fair and fair to good source rock potential with low genetic potential, respectively. The nature of organic matter has been determined by standard cross plots of Rock Eval pyrolysis parameters, indicating that studied cuttings from the Chichali Formation dominantly contain type III kerogen at present and show maturity for oil generation in the studied wells. The organic petrographic study also confirmed the vitrinite (type III) as a major maceral in the investigated Chichali Shales and its reflectance values show maturity for oil. The different ratios of non-biomarkers and biomarkers i.e., steranes, terpenes and aromatics parameters, indicate the marine source of organic matter deposited in the anoxic environment for the Chichali Formation in Chanda-01 and Chanda-02 wells and mixed source input of organic matter deposited in suboxic conditions for oil in the same wells. The CPI, and different biomarkers parameters such as C29 S/S+R, ββ/αα+ββ), M29/H30, Ts/Ts+Tm, H31 (S/S+R) and aromatic compounds methyl phenanthrene index (MPI) and organic petrographic analysis (vitrinite reflectance) suggest mature stage of oil generation for Chichali Shales and oil samples in the study area with little high thermal maturity in case of oils. Based on source and thermal maturity biomarkers and non-biomarkers parameters, the produced oils have no correlation with the Cretaceous Chichali Formation in the studied Chanda-01 and Chanda-02 wells in Kohat Basin, Pakistan, but it has been suggested that these oils have been generated by the strata containing high terrestrial organic input compare to Chichali Shales.

Keywords: Organic geochemistry, Chichali Shales and crude oils, Kohat Basin, Pakistan

Procedia PDF Downloads 49
140 Cascade Multilevel Inverter-Based Grid-Tie Single-Phase and Three-Phase-Photovoltaic Power System Controlling and Modeling

Authors: Syed Masood Hussain

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An effective control method, including system-level control and pulse width modulation for quasi-Z-source cascade multilevel inverter (qZS-CMI) based grid-tie photovoltaic (PV) power system is proposed. The system-level control achieves the grid-tie current injection, independent maximum power point tracking (MPPT) for separate PV panels, and dc-link voltage balance for all quasi-Z-source H-bridge inverter (qZS-HBI) modules. A recent upsurge in the study of photovoltaic (PV) power generation emerges, since they directly convert the solar radiation into electric power without hampering the environment. However, the stochastic fluctuation of solar power is inconsistent with the desired stable power injected to the grid, owing to variations of solar irradiation and temperature. To fully exploit the solar energy, extracting the PV panels’ maximum power and feeding them into grids at unity power factor become the most important. The contributions have been made by the cascade multilevel inverter (CMI). Nevertheless, the H-bridge inverter (HBI) module lacks boost function so that the inverter KVA rating requirement has to be increased twice with a PV voltage range of 1:2; and the different PV panel output voltages result in imbalanced dc-link voltages. However, each HBI module is a two-stage inverter, and many extra dc–dc converters not only increase the complexity of the power circuit and control and the system cost, but also decrease the efficiency. Recently, the Z-source/quasi-Z-source cascade multilevel inverter (ZS/qZS-CMI)-based PV systems were proposed. They possess the advantages of both traditional CMI and Z-source topologies. In order to properly operate the ZS/qZS-CMI, the power injection, independent control of dc-link voltages, and the pulse width modulation (PWM) are necessary. The main contributions of this paper include: 1) a novel multilevel space vector modulation (SVM) technique for the single phase qZS-CMI is proposed, which is implemented without additional resources; 2) a grid-connected control for the qZS-CMI based PV system is proposed, where the all PV panel voltage references from their independent MPPTs are used to control the grid-tie current; the dual-loop dc-link peak voltage control.

Keywords: Quzi-Z source inverter, Photo voltaic power system, space vector modulation, cascade multilevel inverter

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139 Effect of Motor Imagery of Truncal Exercises on Trunk Function and Balance in Early Stroke: A Randomized Controlled Trial

Authors: Elsa Reethu, S. Karthik Babu, N. Syed

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Background: Studies in the past focused on the additional benefits of action observation in improving upper and lower limb functions and improving activities of daily living when administered along with conventional therapy. Nevertheless, there is a paucity of literature proving the effects of motor imagery of truncal exercise in improving trunk control in patients with stroke. Aims/purpose: To study the effect of motor imagery of truncal exercises on trunk function and balance in early stroke. Methods: A total of 24 patients were included in the study. 12 were included in the experimental group and 12 were included in control group Trunk function was measured using Trunk Control Test (TCT), Trunk Impairment Scale Verheyden (TIS Verheyden) and Trunk Impairment Scale Fujiwara (TIS Fujiwara). The balance was assessed using Brunel Balance Assessment (BBA) and Tinetti POMA. For the experimental group, each session was for 30 minutes of physical exercises and 15 minutes of motor imagery, once a day, six times a week for 3 weeks and prior to the exercise session, patients viewed a video tape of all the trunk exercises to be performed for 15minutes. The control group practiced the trunk exercises alone for the same duration. Measurements were taken before, after and 4 weeks after intervention. Results: The effect of treatment in motor imagery group showed better improvement when compared with control group when measured after 3 weeks on values of static sitting balance, dynamic balance, total TIS (Verheyden) score, BBA, Tinetti balance and gait with a large effect size of 0.86, 1.99, 1.69, 1.06, 1.63 and 0.97 respectively. The moderate effect size was seen in values of TIS Fujiwara (0.58) and small effect size was seen on TCT (0.12) and TIS coordination component (0.13).at the end of 4 weeks after intervention, the large effect size was identified on values of dynamic balance (2.06), total TIS score (1.59) and Tinetti balance (1.24). The moderate effect size was observed on BBA (0.62) and Tinetti gait (0.72). Conclusion: Trunk motor imagery is effective in improving trunk function and balance in patients with stroke and has a carryover effect in the aspects of mobility. The therapy gain that was observed during the time of discharge was seen to be maintained at the follow-up levels.

Keywords: stroke, trunk rehabilitation, trunk function, balance, motor imagery

Procedia PDF Downloads 281
138 Total Arterial Coronary Revascularization with Aorto-Bifemoral Bipopliteal Bypass: A Case Report

Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

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The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

Procedia PDF Downloads 439
137 Characterization of Fish Bone Catalyst for Biodiesel Production

Authors: Sarina Sulaiman, N.Khairudin , P.Jamal, M.Z. Alam, Zaki Zainudin, S. Azmi

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In this study, fish bone waste was used as a new catalyst for biodiesel production. Instead of discarding the fish bone waste, it will be utilized as a source for catalyst that can provide significant benefit to the environment. Also, it can be substitute as a calcium oxide source instead of using eggshell, crab shell and snail shell. The XRD and SEM analysis proved that calcined fish bone contains calcium oxide, calcium phosphate and hydroxyapatite. The catalyst was characterized using Scanning Electron Microscope (SEM) and X-ray Diffraction (XRD).

Keywords: calcinations, fish bone, transesterification, waste catalyst

Procedia PDF Downloads 263
136 A Lightweight Blockchain: Enhancing Internet of Things Driven Smart Buildings Scalability and Access Control Using Intelligent Direct Acyclic Graph Architecture and Smart Contracts

Authors: Syed Irfan Raza Naqvi, Zheng Jiangbin, Ahmad Moshin, Pervez Akhter

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Currently, the IoT system depends on a centralized client-servant architecture that causes various scalability and privacy vulnerabilities. Distributed ledger technology (DLT) introduces a set of opportunities for the IoT, which leads to practical ideas for existing components at all levels of existing architectures. Blockchain Technology (BCT) appears to be one approach to solving several IoT problems, like Bitcoin (BTC) and Ethereum, which offer multiple possibilities. Besides, IoTs are resource-constrained devices with insufficient capacity and computational overhead to process blockchain consensus mechanisms; the traditional BCT existing challenge for IoTs is poor scalability, energy efficiency, and transaction fees. IOTA is a distributed ledger based on Direct Acyclic Graph (DAG) that ensures M2M micro-transactions are free of charge. IOTA has the potential to address existing IoT-related difficulties such as infrastructure scalability, privacy and access control mechanisms. We proposed an architecture, SLDBI: A Scalable, lightweight DAG-based Blockchain Design for Intelligent IoT Systems, which adapts the DAG base Tangle and implements a lightweight message data model to address the IoT limitations. It enables the smooth integration of new IoT devices into a variety of apps. SLDBI enables comprehensive access control, energy efficiency, and scalability in IoT ecosystems by utilizing the Masked Authentication Message (MAM) protocol and the IOTA Smart Contract Protocol (ISCP). Furthermore, we suggest proof-of-work (PoW) computation on the full node in an energy-efficient way. Experiments have been carried out to show the capability of a tangle to achieve better scalability while maintaining energy efficiency. The findings show user access control management at granularity levels and ensure scale up to massive networks with thousands of IoT nodes, such as Smart Connected Buildings (SCBDs).

Keywords: blockchain, IOT, direct acyclic graphy, scalability, access control, architecture, smart contract, smart connected buildings

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135 The Influence of Crude Oil on Growth of Freshwater Algae

Authors: Al-Saboonchi Azhar

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The effects of Iraqi crude oil on growth of three freshwater algae (Chlorella vulgaris Beij., Scenedesmus acuminatus (Lag.) Chodat. and Oscillatoria princeps Vauch.) were investigated, basing on it's biomass expressed as Chl.a. Growth rate and doubling time of the cell were calculated. Results showed that growth rate and species survival varied with concentrations of crude oil and species type. Chlorella vulgaris and Scenedesmus acuminatus were more sensitive in culture containing crude oil as compared with Oscillatoria princeps cultures. The growth of green algae were significantly inhibited in culture containing (5 mg/l) crude oil, while the growth of Oscillatoria princeps reduced in culture containing (10 mg/l) crude oil.

Keywords: algae, crude oil, green algae, Cyanobacteria

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134 Students’ Perception of Their M-Learning Readiness

Authors: Sulaiman Almutairy, Trevor Davies, Yota Dimitriadi

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This paper presents study investigating how to understand better the psychological readiness for mobile learning (m-learning) among Saudi students, while also evaluating m-learning in Saudi Arabia-a topic that has not yet received adequate attention from researchers. Data was acquired through a questionnaire administered to 131 Saudi students at UK universities, in July 2013. The study confirmed that students are confident using mobile devices in their daily lives and that they would welcome more opportunities for mobile learning. The findings indicated that Saudi higher education students are highly familiar with, and are psychologically ready for, m-learning.

Keywords: m-learning, mobile technologies, psychological readiness, higher education

Procedia PDF Downloads 485
133 Opto-Thermal Frequency Modulation of Phase Change Micro-Electro-Mechanical Systems

Authors: Syed A. Bukhari, Ankur Goswmai, Dale Hume, Thomas Thundat

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Here we demonstrate mechanical detection of photo-induced Insulator to metal transition (MIT) in ultra-thin vanadium dioxide (VO₂) micro strings by using < 100 µW of optical power. Highly focused laser beam heated the string locally resulting in through plane and along axial heat diffusion. Localized temperature increase can cause temperature rise > 60 ºC. The heated region of VO₂ can transform from insulating (monoclinic) to conducting (rutile) phase leading to lattice compressions and stiffness increase in the resonator. The mechanical frequency of the resonator can be tuned by changing optical power and wavelength. The first mode resonance frequency was tuned in three different ways. A decrease in frequency below a critical optical power, a large increase between 50-120 µW followed by a large decrease in frequency for optical powers greater than 120 µW. The dynamic mechanical response was studied as a function of incident optical power and gas pressure. The resonance frequency and amplitude of vibration were found to be decreased with increasing laser power from 25-38 µW and increased by1-2 % when the laser power was further increased to 52 µW. The transition in films was induced and detected by a single pump and probe source and by employing external optical sources of different wavelengths. This trend in dynamic parameters of the strings can be co-related with reversible Insulator to metal transition in VO₂ films which creates change in density of the material and hence the overall stiffness of the strings leading to changes in string dynamics. The increase in frequency at a particular optical power manifests a transition to a more ordered metallic phase which tensile stress onto the string. The decrease in frequency at higher optical powers can be correlated with poor phonon thermal conductivity of VO₂ in conducting phase. Poor thermal conductivity of VO₂ can force in-plane penetration of heat causing the underneath SiN supporting VO₂ which can result as a decrease in resonance frequency. This noninvasive, non-contact laser-based excitation and detection of Insulator to metal transition using micro strings resonators at room temperature and with laser power in few µWs is important for low power electronics, and optical switching applications.

Keywords: thermal conductivity, vanadium dioxide, MEMS, frequency tuning

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132 Assessing the Informed Consent Practices during Normal Vaginal Delivery Process and Immediate Postpartum Care in Tertiary Level Hospitals of Bangladesh

Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

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Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

Procedia PDF Downloads 131
131 Influence of Freeze-Thaw Cycles on Protein Integrity and Quality of Chicken Meat

Authors: Nafees Ahmed, Nur Izyani Kamaruzman, Saralla Nathan, Mohd Ezharul Hoque Chowdhury, Anuar Zaini Md Zain, Iekhsan Othman, Sharifah Binti Syed Hassan

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Meat quality is always subject to consumer scrutiny when purchasing from retail markets on mislabeling as fresh meat. Various physiological and biochemical changes influence the quality of meat. As a major component of muscle tissue, proteins play a major role in muscle foods. In meat industry, freezing is the most common form of storage of meat products. Repeated cycles of freezing and thawing are common in restaurants, kitchen, and retail outlets and can also occur during transportation or storage. Temperature fluctuation is responsible for physical, chemical, and biochemical changes. Repeated cycles of ‘freeze-thaw’ degrade the quality of meat by stimulating the lipid oxidation and surface discoloration. The shelf life of meat is usually determined by its appearance, texture, color, flavor, microbial activity, and nutritive value and is influenced by frozen storage and subsequent thawing. The main deterioration of frozen meat during storage is due to protein. Due to the large price differences between fresh and frozen–thawed meat, it is of great interest to consumer to know whether a meat product is truly fresh or not. Researchers have mainly focused on the reduction of moisture loss due to freezing and thawing cycles of meat. The water holding capacity (WHC) of muscle proteins and reduced water content are key quality parameters of meat that ultimately changes color and texture. However, there has been limited progress towards understanding the actual mechanisms behind the meat quality changes under the freeze–thaw cycles. Furthermore, effect of freeze-thaw process on integrity of proteins is ignored. In this paper, we have studied the effect of ‘freeze-thawing’ on physicochemical changes of chicken meat protein. We have assessed the quality of meat by pH, spectroscopic measurements, Western Blot. Our results showed that increase in freeze-thaw cycles causes changes in pH. Measurements of absorbance (UV-visible and IR) indicated the degradation of proteins. The expression of various proteins (CREB, AKT, MAPK, GAPDH, and phosphorylated forms) were performed using Western Blot. These results indicated the repeated cycles of freeze-thaw is responsible for deterioration of protein, thus causing decrease in nutritious value of meat. It damges the use of these products in Islamic Sharia.

Keywords: chicken meat, freeze-thaw, halal, protein, western blot

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130 Computational Approach to Identify Novel Chemotherapeutic Agents against Multiple Sclerosis

Authors: Syed Asif Hassan, Tabrej Khan

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Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder, of the central nervous system (CNS). In the present scenario, the current therapies either do not halt the progression of the disease or have side effects which limit the usage of current Disease Modifying Therapies (DMTs) for a longer period of time. Therefore, keeping the current treatment failure schema, we are focusing on screening novel analogues of the available DMTs that specifically bind and inhibit the Sphingosine1-phosphate receptor1 (S1PR1) thereby hindering the lymphocyte propagation toward CNS. The novel drug-like analogs molecule will decrease the frequency of relapses (recurrence of the symptoms associated with MS) with higher efficacy and lower toxicity to human system. In this study, an integrated approach involving ligand-based virtual screening protocol (Ultrafast Shape Recognition with CREDO Atom Types (USRCAT)) to identify the non-toxic drug like analogs of the approved DMTs were employed. The potency of the drug-like analog molecules to cross the Blood Brain Barrier (BBB) was estimated. Besides, molecular docking and simulation using Auto Dock Vina 1.1.2 and GOLD 3.01 were performed using the X-ray crystal structure of Mtb LprG protein to calculate the affinity and specificity of the analogs with the given LprG protein. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has a higher hypothetical affinity, also has greater negative value. Further, the non-specific ligands were screened out using the structural filter proposed by Baell and Holloway. Based on the USRCAT, Lipinski’s values, toxicity and BBB analysis, the drug-like analogs of fingolimod and BG-12 showed that RTL and CHEMBL1771640, respectively are non-toxic and permeable to BBB. The successful docking and DSX analysis showed that RTL and CHEMBL1771640 could bind to the binding pocket of S1PR1 receptor protein of human with greater affinity than as compared to their parent compound (Fingolimod). In this study, we also found that all the drug-like analogs of the standard MS drugs passed the Bell and Holloway filter.

Keywords: antagonist, binding affinity, chemotherapeutics, drug-like, multiple sclerosis, S1PR1 receptor protein

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129 Improving the Dielectric Strength of Transformer Oil for High Health Index: An FEM Based Approach Using Nanofluids

Authors: Fatima Khurshid, Noor Ul Ain, Syed Abdul Rehman Kashif, Zainab Riaz, Abdullah Usman Khan, Muhammad Imran

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As the world is moving towards extra-high voltage (EHV) and ultra-high voltage (UHV) power systems, the performance requirements of power transformers are becoming crucial to the system reliability and security. With the transformers being an essential component of a power system, low health index of transformers poses greater risks for safe and reliable operation. Therefore, to meet the rising demands of the power system and transformer performance, researchers are being prompted to provide solutions for enhanced thermal and electrical properties of transformers. This paper proposes an approach to improve the health index of a transformer by using nano-technology in conjunction with bio-degradable oils. Vegetable oils can serve as potential dielectric fluid alternatives to the conventional mineral oils, owing to their numerous inherent benefits; namely, higher fire and flashpoints, and being environment-friendly in nature. Moreover, the addition of nanoparticles in the dielectric fluid further serves to improve the dielectric strength of the insulation medium. In this research, using the finite element method (FEM) in COMSOL Multiphysics environment, and a 2D space dimension, three different oil samples have been modelled, and the electric field distribution is computed for each sample at various electric potentials, i.e., 90 kV, 100 kV, 150 kV, and 200 kV. Furthermore, each sample has been modified with the addition of nanoparticles of different radii (50 nm and 100 nm) and at different interparticle distance (5 mm and 10 mm), considering an instant of time. The nanoparticles used are non-conductive and have been modelled as alumina (Al₂O₃). The geometry has been modelled according to IEC standard 60897, with a standard electrode gap distance of 25 mm. For an input supply voltage of 100 kV, the maximum electric field stresses obtained for the samples of synthetic vegetable oil, olive oil, and mineral oil are 5.08 ×10⁶ V/m, 5.11×10⁶ V/m and 5.62×10⁶ V/m, respectively. It is observed that for the unmodified samples, vegetable oils have a greater dielectric strength as compared to the conventionally used mineral oils because of their higher flash points and higher values of relative permittivity. Also, for the modified samples, the addition of nanoparticles inhibits the streamer propagation inside the dielectric medium and hence, serves to improve the dielectric properties of the medium.

Keywords: dielectric strength, finite element method, health index, nanotechnology, streamer propagation

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128 Valuation on MEMS Pressure Sensors and Device Applications

Authors: Nurul Amziah Md Yunus, Izhal Abdul Halin, Nasri Sulaiman, Noor Faezah Ismail, Ong Kai Sheng

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The MEMS pressure sensor has been introduced and presented in this paper. The types of pressure sensor and its theory of operation are also included. The latest MEMS technology, the fabrication processes of pressure sensor are explored and discussed. Besides, various device applications of pressure sensor such as tire pressure monitoring system, diesel particulate filter and others are explained. Due to further miniaturization of the device nowadays, the pressure sensor with nanotechnology (NEMS) is also reviewed. The NEMS pressure sensor is expected to have better performance as well as lower in its cost. It has gained an excellent popularity in many applications.

Keywords: pressure sensor, diaphragm, MEMS, automotive application, biomedical application, NEMS

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127 Prevailing Clinical Evidence on Medicinal Hemp (Cannabis Sativa L.)

Authors: Siti Hajar Muhamad Rosli, Xin Yi Lim, Terence Yew Chin Tan, Muhammad nor Farhan Sa’At, Syazwani Sirdar Ali, Ami Fazlin Syed Mohamed

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A growing interest on therapeutic benefits of hemp (Cannabis sativa subsp. sativa) is evident in the pharmaceutical market, attributed to its lower levels of psychoactive constituent delta-9-tetrahydronannabidiol (THC). Deemed as a legal and safer alternative to its counterpart marijuana, the use of medicinal hemp is highly debatable as current scientific evidence on the efficacy for clinical use is yet to be established This study was aimed to provide an overview of the current landscape of hemp research, through recent clinical findings specific to the pharmacological properties of the hemp plant and its derived compounds. A systematic search was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis-ScR (PRISMA) checklist on electronic databases (MEDLINE, OVID, Cochrane Library Central, and Clinicaltrials.gov) for articles published from 2009 to 2019. With predetermined inclusion criteria, all human trials with hemp intervention were included. A total of 18 human trials were identified, investigating therapeutic effects on the neuronal, gastrointestinal, musculoskeletal and immune system, with sample sizes ranging from one to 194 subjects. Three randomised controlled trials showed hempseed pills (in Traditional Chinese Medicine formulation MaZiRenWan) consumption significantly improved spontaneous bowel movement in functional constipation. The use of commercial cannabidiol (CBD) sourced from hemp suggested benefits in cannabis dependence, epilepsy, and anxiety disorders. However, there was insufficient evidence to suggest analgesic or anxiolytics effects of hemp being equivalent to marijuana. All clinical trials reviewed varied in terms of test item formulation and standardisation, which made it challenging to confirm overall efficacy for a specific disease or condition. Published efficacy data on hemp are still at a preliminary level, with limited high quality clinical evidence for any specific therapeutic indication. With multiple variants of this plant having different phytochemical and bioactive compounds, future empirical research should focus on uniformity in experimental designs to further strengthen the notion of using medicinal hemp.

Keywords: cannabis, complementary medicine, hemp, herbal medicine.

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126 Engineering Escherichia coli for Production of Short Chain Fatty Acid by Exploiting Fatty Acid Metabolic Pathway

Authors: Kamran Jawed, Anu Jose Mattam, Zia Fatma, Saima Wajid, Malik Z. Abdin, Syed Shams Yazdani

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Worldwide demand of natural and sustainable fuels and chemicals have encouraged researchers to develop microbial platform for synthesis of short chain fatty acids as they are useful precursors to replace petroleum-based fuels and chemicals. In this study, we evaluated the role of fatty acid synthesis and β-oxidation cycle of Escherichia coli to produce butyric acid, a 4-carbon short chain fatty acid, with the help of three thioesterases, i.e., TesAT from Anaerococcus tetradius, TesBF from Bryantella formatexigens and TesBT from Bacteroides thetaiotaomicron. We found that E. coli strain transformed with gene for TesBT and grown in presence of 8 g/L glucose produced maximum butyric acid titer at 1.46 g/L, followed by that of TesBF at 0.85 g/L and TesAT at 0.12 g/L, indicating that these thioesterases were efficiently converting short chain fatty acyl-ACP intermediate of fatty acid synthesis pathway into the corresponding acid. The titer of butyric acid varied significantly depending upon the plasmid copy number and strain genotype. Deletion of genes for fatty acyl-CoA synthetase and acyl-CoA dehydrogenase, which are involved in initiating the fatty acid degradation cycle, and overexpression of FadR, which is a dual transcriptional regulator and exerts negative control over fatty acid degradation pathway, reduced up to 30% of butyric acid titer. This observation suggested that β-oxidation pathway is working synergistically with fatty acid synthesis pathway in production of butyric acid. Moreover, accelerating the fatty acid elongation cycle by overexpressing acetyl-CoA carboxyltransferase (Acc) and 3-hydroxy-acyl-ACP dehydratase (FabZ) or by deleting FabR, the transcription suppressor of elongation, did not improve the butyric acid titer, rather favored the long chain fatty acid production. Finally, a balance between cell growth and butyric acid production was achieved with the use of phosphorous limited growth medium and 14.3 g/L butyric acid, and 17.5 g/L total free fatty acids (FFAs) titer was achieved during fed-batch cultivation. We have engineered an E. coli strain which utilizes the intermediate of both fatty acid synthesis and degradation pathway, i.e. butyryl-ACP and -CoA, to produce butyric acid from glucose. The strategy used in this study resulted in highest reported titers of butyric acid and FFAs in engineered E. coli.

Keywords: butenoic acid, butyric acid, Escherichia coli, fed-batch fermentation, short chain fatty acids, thioesterase

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125 Evaluation of the Impact of Pavement Roughness on Vehicle Emissions by HDM-4

Authors: Muhammad Azhar, Arshad Hussain

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Vehicular emissions have increased in recent years due to rapid growth in world traffic resulting in an increase in associated problems such as air pollution and climate change, therefore it’s necessary to control vehicle emissions. This study looks at the effect of road maintenance on vehicle emissions. The Highway Development and Management Tool (HDM-4) was used to find the effect of road maintenance on vehicle emissions. Key data collected were traffic volume and composition, vehicle characteristics, pavement characteristics and climate data of the study area. Two options were analysed using the HDM-4 software; the base case or do nothing while the second is overlay maintenance. The study also showed a strong correlation between average roughness and yearly emission levels in both the alternatives. Finally, the study showed that proper maintenance reduces the roughness and emissions.

Keywords: vehicle emissions, road roughness, IRI, maintenance, HDM-4, CO2

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124 A Review on Light Shafts Rendering for Indoor Scenes

Authors: Hatam H. Ali, Mohd Shahrizal Sunar, Hoshang Kolivand, Mohd Azhar Bin M. Arsad

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Rendering light shafts is one of the important topics in computer gaming and interactive applications. The methods and models that are used to generate light shafts play crucial role to make a scene more realistic in computer graphics. This article discusses the image-based shadows and geometric-based shadows that contribute in generating volumetric shadows and light shafts, depending on ray tracing, radiosity, and ray marching technique. The main aim of this study is to provide researchers with background on a progress of light scattering methods so as to make it available for them to determine the technique best suited to their goals. It is also hoped that our classification helps researchers find solutions to the shortcomings of each method.

Keywords: shaft of lights, realistic images, image-based, and geometric-based

Procedia PDF Downloads 248
123 A Comparative Study of Virus Detection Techniques

Authors: Sulaiman Al amro, Ali Alkhalifah

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The growing number of computer viruses and the detection of zero day malware have been the concern for security researchers for a large period of time. Existing antivirus products (AVs) rely on detecting virus signatures which do not provide a full solution to the problems associated with these viruses. The use of logic formulae to model the behaviour of viruses is one of the most encouraging recent developments in virus research, which provides alternatives to classic virus detection methods. In this paper, we proposed a comparative study about different virus detection techniques. This paper provides the advantages and drawbacks of different detection techniques. Different techniques will be used in this paper to provide a discussion about what technique is more effective to detect computer viruses.

Keywords: computer viruses, virus detection, signature-based, behaviour-based, heuristic-based

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122 Packaging Improvement for Unit Cell Vanadium Redox Flow Battery (V-RFB)

Authors: A. C. Khor, M. R. Mohamed, M. H. Sulaiman, M. R. Daud

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Packaging for vanadium redox flow battery is one of the key elements for successful implementation of flow battery in the electrical energy storage system. Usually the bulky battery size and low energy densities make this technology not available for mobility application. Therefore RFB with improved packaging size and energy capacity are highly desirable. This paper focuses on the study of packaging improvement for unit cell V-RFB to the application on Series Hybrid Electric Vehicle. Two different designs of 25 cm2 and 100 cm2 unit cell V-RFB at same current density are used for the sample in this investigation. Further suggestions on packaging improvement are highlighted.

Keywords: electric vehicle, redox flow battery, packaging, vanadium

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121 Capacity of Cold-Formed Steel Warping-Restrained Members Subjected to Combined Axial Compressive Load and Bending

Authors: Maryam Hasanali, Syed Mohammad Mojtabaei, Iman Hajirasouliha, G. Charles Clifton, James B. P. Lim

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Cold-formed steel (CFS) elements are increasingly being used as main load-bearing components in the modern construction industry, including low- to mid-rise buildings. In typical multi-storey buildings, CFS structural members act as beam-column elements since they are exposed to combined axial compression and bending actions, both in moment-resisting frames and stud wall systems. Current design specifications, including the American Iron and Steel Institute (AISI S100) and the Australian/New Zealand Standard (AS/NZS 4600), neglect the beneficial effects of warping-restrained boundary conditions in the design of beam-column elements. Furthermore, while a non-linear relationship governs the interaction of axial compression and bending, the combined effect of these actions is taken into account through a simplified linear expression combining pure axial and flexural strengths. This paper aims to evaluate the reliability of the well-known Direct Strength Method (DSM) as well as design proposals found in the literature to provide a better understanding of the efficiency of the code-prescribed linear interaction equation in the strength predictions of CFS beam columns and the effects of warping-restrained boundary conditions on their behavior. To this end, the experimentally validated finite element (FE) models of CFS elements under compression and bending were developed in ABAQUS software, which accounts for both non-linear material properties and geometric imperfections. The validated models were then used for a comprehensive parametric study containing 270 FE models, covering a wide range of key design parameters, such as length (i.e., 0.5, 1.5, and 3 m), thickness (i.e., 1, 2, and 4 mm) and cross-sectional dimensions under ten different load eccentricity levels. The results of this parametric study demonstrated that using the DSM led to the most conservative strength predictions for beam-column members by up to 55%, depending on the element’s length and thickness. This can be sourced by the errors associated with (i) the absence of warping-restrained boundary condition effects, (ii) equations for the calculations of buckling loads, and (iii) the linear interaction equation. While the influence of warping restraint is generally less than 6%, the code suggested interaction equation led to an average error of 4% to 22%, based on the element lengths. This paper highlights the need to provide more reliable design solutions for CFS beam-column elements for practical design purposes.

Keywords: beam-columns, cold-formed steel, finite element model, interaction equation, warping-restrained boundary conditions

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120 Real-world Characterization of Treatment Intensified (Add-on to Metformin) Adults with Type 2 Diabetes in Pakistan: A Multi-center Retrospective Study (Converge)

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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119 Chitin Degradation in Pseudomonas fluorescens

Authors: Azhar Alhasawi, Vasu D. Appanna

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Chitin, the second most abundant bio-polymer in nature after cellulose, composed of β (1→4) linked N-acetylglucosamine (GlcNAc), is a major structural component in the cell walls of fungi and the shells of crustaceans. Chitin and its derivatives are gaining importance of economic value due to its biological activity and its industrial and biomedical applications. There are several methods to hydrolyze chitin to NAG, but they are typically expensive and environmentally unfriendly. Chitinase which catalyzes the breakdown of chitin to NAG has received much attention owing to its various applications in biotechnology. The presented research examines the ability of the versatile soil microbe, Pseudomonas fluorescens grown in chitin medium to produce chitinase and a variety of value-added products under abiotic stress. We have found that with high pH, Pseudomonas fluorescens enable to metabolize chitin more than with neutral pH and the overexpression of chitinase was also increased. P-dimethylaminobenzaldehyde (DMAB) assay for NAG production will be monitored and a combination of sodium dodecyl polyacrylamide gels will be used to monitor the proteomic and metabolomic changes as a result of the abiotic stress. The bioreactor of chitinase will also be utilized.

Keywords: Pseudomonas fluorescens, chitin, DMAB, chitinase

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118 A Compilation of Nanotechnology in Thin Film Solar Cell Devices

Authors: Nurul Amziah Md Yunus, Izhal Abdul Halin, Nasri Sulaiman, Noor Faezah Ismail, Nik Hasniza Nik Aman

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Nanotechnology has become the world attention in various applications including the solar cells devices due to the uniqueness and benefits of achieving low cost and better performances of devices. Recently, thin film solar cells such as cadmium telluride (CdTe), copper-indium-gallium-diSelenide (CIGS), copper-zinc-tin-sulphide (CZTS), and dye-sensitized solar cells (DSSC) enhanced by nanotechnology have attracted much attention. Thus, a compilation of nanotechnology devices giving the progress in the solar cells has been presented. It is much related to nanoparticles or nanocrystallines, carbon nanotubes, and nanowires or nanorods structures.

Keywords: nanotechnology, nanocrystalline, nanowires, carbon nanotubes, nanorods, thin film solar cells

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117 Study on Co-Relation of Prostate Specific Antigen with Metastatic Bone Disease in Prostate Cancer on Skeletal Scintigraphy

Authors: Muhammad Waleed Asfandyar, Akhtar Ahmed, Syed Adib-ul-Hasan Rizvi

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Objective: To evaluate the ability of serum concentration of prostate specific antigen between two cutting points considering it as a predictor of skeletal metastasis on bone scintigraphy in men with prostate cancer. Settings: This study was carried out in department of Nuclear Medicine at Sindh Institute of Urology and Transplantation (SIUT) Karachi, Pakistan. Materials and Method: From August 2013 to November 2013, forty two (42) consecutive patients with prostate cancer who underwent technetium-99m methylene diphosphonate (Tc-99mMDP) whole body bone scintigraphy were prospectively analyzed. The information was collected from the scintigraphic database at a Nuclear medicine department Sindh institute of urology and transplantation Karachi Pakistan. Patients who did not have a serum PSA concentration available within 1 month before or after the time of performing the Tc-99m MDP whole body bone scintigraphy were excluded from this study. A whole body bone scintigraphy scan (from the toes to top of the head) was performed using a whole-body Moving gamma camera technique (anterior and posterior) 2–4 hours after intravenous injection of 20 mCi of Tc-99m MDP. In addition, all patients necessarily have a pathological report available. Bony metastases were determined from the bone scan studies and no further correlation with histopathology or other imaging modalities were performed. To preserve patient confidentiality, direct patient identifiers were not collected. In all the patients, Prostate specific antigen values and skeletal scintigraphy were evaluated. Results: The mean age, mean PSA, and incidence of bone metastasis on bone scintigraphy were 68.35 years, 370.51 ng/mL and 19/42 (45.23%) respectively. According to PSA levels, patients were divided into 5 groups < 10ng/mL (10/42), 10-20 ng/mL (5/42), 20-50 ng/mL (2/42), 50-100 (3/42), 100- 500ng/mL (3/42) and more than 500ng/mL (0/42) presenting negative bone scan. The incidence of positive bone scan (%) for bone metastasis for each group were O1 patient (5.26%), 0%, 03 patients (15.78%), 01 patient (5.26%), 04 patients (21.05%), and 10 patients (52.63%) respectively. From the 42 patients 19 (45.23%) presented positive scintigraphic examination for the presence of bone metastasis. 1 patient presented bone metastasis on bone scintigraphy having PSA level less than 10ng/mL, and in only 1 patient (5.26%) with bone metastasis PSA concentration was less than 20 ng/mL. therefore, when the cutting point adopted for PSA serum concentration was 10ng/mL, a negative predictive value for bone metastasis was 95% with sensitivity rates 94.74% and the positive predictive value and specificities of the method were 56.53% and 43.48% respectively. When the cutting point of PSA serum concentration was 20ng/mL the observed results for Positive predictive value and specificity were (78.27% and 65.22% respectively) whereas negative predictive value and sensitivity stood (100% and 95%) respectively. Conclusion: Results of our study allow us to conclude that serum PSA concentration of higher than 20ng/mL was the most accurate cutting point than a serum concentration of PSA higher than 10ng/mL to predict metastasis in radionuclide bone scintigraphy. In this way, unnecessary cost can be avoided, since a considerable part of prostate adenocarcinomas present low serum PSA levels less than 20 ng/mL and for these cases radionuclide bone scintigraphy could be unnecessary.

Keywords: bone scan, cut off value, prostate specific antigen value, scintigraphy

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116 The Role of International Organizations in Educational Reform in Iraq

Authors: Thanaa M. Sulaiman

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The Iraqi education system has suffered greatly as a result of wars, political instability, and economic problems. After the fall of Saddam’s regime in 2003, the Iraqi education system was proportionally the most impacted sector. The new administration prioritized educational reforms. International organizations, as well as foreign countries, were in the lead to achieve educational reforms. The current study aims to shed light on the reformation process and the roles of different stakeholders, especially international organizations. It also aims to explore the current problems facing the Iraqi education system. Additionally, it aims to explore the different programs and projects that are funded and implemented by international organizations and the impact of these programs and projects.

Keywords: Iraq, Iraqi education system, educational reform, international organizations

Procedia PDF Downloads 100