Search results for: mortality rate (MR)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8654

Search results for: mortality rate (MR)

8354 Characterization of Internet Exchange Points by Using Quantitative Data

Authors: Yamba Dabone, Tounwendyam Frédéric Ouedraogo, Pengwendé Justin Kouraogo, Oumarou Sie

Abstract:

Reliable data transport over the Internet is one of the goals of researchers in the field of computer science. Data such as videos and audio files are becoming increasingly large. As a result, transporting them over the Internet is becoming difficult. Therefore, it has been important to establish a method to locally interconnect autonomous systems (AS) with each other to facilitate traffic exchange. It is in this context that Internet Exchange Points (IXPs) are set up to facilitate local and even regional traffic. They are now the lifeblood of the Internet. Therefore, it is important to think about the factors that can characterize IXPs. However, other more quantifiable characteristics can help determine the quality of an IXP. In addition, these characteristics may allow ISPs to have a clearer view of the exchange node and may also convince other networks to connect to an IXP. To that end, we define five new IXP characteristics: the attraction rate (τₐₜₜᵣ); and the peering rate (τₚₑₑᵣ); the target rate of an IXP (Objₐₜₜ); the number of IXP links (Nₗᵢₙₖ); the resistance rate τₑ𝒻𝒻 and the attraction failure rate (τ𝒻).

Keywords: characteristic, autonomous system, internet service provider, internet exchange point, rate

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8353 Pyrethroid and Organophosphate Susceptibility Status of Aedesaegypti (Linnaeus), Aedes albopictus (Skuse) and Culex quinquefasciatus (Say) in Penang, Malaysia

Authors: Hadura Abu Hasan, Zairi Jaal, P. J. McCall

Abstract:

Dengue is a serious problem in Malaysia, particularly in high-density urban communities with lower socio-economic levels. This study evaluated the susceptibility of local populations of Aedesaegypti (Linnaeus), Aedesalbopictus (Skuse) and Culexquinquefasciatus (Say) from the traditional community of BaganDalam, Penang, Malaysia to lambdacyhalothrin and pirimiphos-methyl using standard World Health Organization (WHO) adult bioassay test. Unfed female mosquitoes aged 3-5 days were exposed to WHO recommended dosages of insecticides over fixed time periods with results presented as knock-down time (KT50) for each strain.The insecticide susceptible VCRU laboratory strain was usedas control. All three specieswere highly resistant to lambda-cyhalothrin with less than 10% mortality at 24 hours after treatment. In contrast, Ae.aegypti and Ae. albopictus were susceptible to pirimiphos-methyl, showing 100% mortality recorded 24 hoursafter treatment. Cx. quinquefasciatuswasclassed as ‘suspected resistant’ to pirimiphos-methyl as mortality recorded 24 hours after treatment was 94-96%. The results indicate that organophosphates such as pirimiphos-methyl might be used as alternative to pyrethroid for dengue vector control in this dengue-prone area.

Keywords: vector control, aedes aegypti, aedes albopictus, dengue, culex quinquefasciatus, residuals insecticides, pyrethroid, organophosphate, resistant, mosquito

Procedia PDF Downloads 238
8352 Test of Capital Account Monetary Model of Floating Exchange Rate Determination: Further Evidence from Selected African Countries

Authors: Oloyede John Adebayo

Abstract:

This paper tested a variant of the monetary model of exchange rate determination, called Frankel’s Capital Account Monetary Model (CAAM) based on Real Interest Rate Differential, on the floating exchange rate experiences of three developing countries of Africa; viz: Ghana, Nigeria and the Gambia. The study adopted the Auto regressive Instrumental Package (AIV) and Almon Polynomial Lag Procedure of regression analysis based on the assumption that the coefficients follow a third-order Polynomial with zero-end constraint. The results found some support for the CAAM hypothesis that exchange rate responds proportionately to changes in money supply, inversely to income and positively to interest rates and expected inflation differentials. On this basis, the study points the attention of monetary authorities and researchers to the relevance and usefulness of CAAM as appropriate tool and useful benchmark for analyzing the exchange rate behaviour of most developing countries.

Keywords: exchange rate, monetary model, interest differentials, capital account

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8351 Bioprophylaxis of Saprolegniasis in Incubated Clarias gariepinus Eggs Using Pyocyanin Extracted from Pseudomonas aeruginosa

Authors: G. A. Oladosu1, P. O. Ogbodogbo, C. I. Makinde1, M. O. Tijani, O. A. Adegboyega

Abstract:

Saprolegniasis is a major pathogenic infection that contributes significantly to poor hatching rates in incubated fish eggs in the Africa catfish hatchery in Nigeria. Malachite green known to be very effective against this condition has been banned because it is carcinogenic. There is, therefore, the need for other effective yet safer methods of controlling saprolegniasis in incubated fish eggs. A total of 50 ml crude, chloroform extract of pyocyanin from which solvent was removed to attain 30 ml, having a concentration of 12.16 ug/ml was produced from 700 ml broth culture of Pseudomonas aeruginosa isolated from a previous study. In-vitro susceptibility of the fungus was investigated by exposing fungal infected eggs to two different time-concentration ratios of pyocyanin; 0.275 ug/ml and 2.75 ug/ml for 1 and 24 hours, and 5 mg/L malachite green as positive control while normal saline was the control. The efficacy of pyocyanin was evaluated using the degree of mycelial growth inhibition in different treatments. Fertilized Clarias gariepinus eggs (between 45 to 64 eggs) were then incubated in 20 ml of medium containing similar concentrations of pyocyanin and malachite green, with freshwater as a control for 24 hours. Hatching rates of the incubated eggs were observed. Three samples of un-hatched eggs were taken from each medium and observed for the presence of fungal pathogens using microscopy. Another batch of three samples of un-hatched eggs from each treatment was also inoculated on Sabourand dextrose agar (SDA) using Egg-Agar Transfer Technique to observe for fungal growth. Mycelial growth was inhibited in fungal infected eggs treated with 2.75 ug/ml for 24 hrs and the 5 mg/L malachite green for both 1 hr and 24 hrs. The mortality rate was 100% in fertilized C. gariepinus eggs exposed for 24 hrs to 0.275 and 2.75 ug/ml of pyocyanin. The mortality rate was least in malachite green followed by the control treatment. Embryonic development was observed to be arrested in the eggs treated with the two pyocyanin concentrations as they maintain their colour but showed no development beyond the gastrula stage, whereas viable eggs in the control and malachite green treatments developed fully into healthy hatchlings. Furthermore, microscopy of the un-hatched eggs revealed the presence of a protozoan ciliate; Colpidium sp, (Tetrahymenidae), as well as a pathogenic fungus; Saprolegnia sp. in the control but not in the malachite green and pyocyanin treatments. Growth of Saprolegnia sp was also observed in SDA culture of un-hatched eggs from the control, but not from pyocyanin and malachite green treated eggs. Pyocyanin treatment of incubated eggs of Clarias gariepinus effectively prevented fungal infection in the eggs, but also arrested the development of the embryo. Therefore, crude chloroform extract of pyocyanin from Pseudomonas aeruginosa cannot be used in the control of Saprolegniasis in incubated Clarias gariepinus eggs at the concentration and duration tested in this study.

Keywords: African catfish, bioprophylaxis, catfish embryo, Saprolegniasis

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8350 An Improved Transmission Scheme in Cooperative Communication System

Authors: Seung-Jun Yu, Young-Min Ko, Hyoung-Kyu Song

Abstract:

Recently developed cooperative diversity scheme enables a terminal to get transmit diversity through the support of other terminals. However, most of the introduced cooperative schemes have a common fault of decreased transmission rate because the destination should receive the decodable compositions of symbols from the source and the relay. In order to achieve high data rate, we propose a cooperative scheme that employs hierarchical modulation. This scheme is free from the rate loss and allows seamless cooperative communication.

Keywords: cooperative communication, hierarchical modulation, high data rate, transmission scheme

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8349 Prognosis, Clinical Outcomes and Short Term Survival Analyses of Patients with Cutaneous Melanomas

Authors: Osama Shakeel

Abstract:

The objective of the paper is to study the clinic-pathological factors, survival analyses, recurrence rate, metastatic rate, risk factors and the management of cutaneous malignant melanoma at Shaukat Khanum Memorial Cancer Hospital and Research Center. Methodology: From 2014 to 2017, all patients with a diagnosis of cutaneous malignant melanoma (CMM) were included in the study. Demographic variables were collected. Short and long term oncological outcomes were recorded. All data were entered and analyzed in SPSS version 21. Results: A total of 28 patients were included in the study. Median age was 46.5 +/-15.9 years. There were 16 male and 12 female patients. The family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43+/- 9.09 months. Lower limb was the commonest site among all which constitutes 46.4%(n=13). On histopathological analyses, ulceration was seen in 53.6% (n=15) patients. Unclassified tumor type was present in 75%(n=21) of the patients followed by nodular 21.4% (n=6) and superficial spreading 3.5%(n=1). Clark level IV was the commonest presentation constituting 46.4%(n=13). Metastases were seen in 50%(n=14) of the patients. Local recurrence was observed in 60.7%(n=17). 64.3%(n=18) lived after one year of treatment. Conclusion: CMM is a fatal disease. Although its disease of fair skin individuals, however, the incidence of CMM is also rising in this part of the world. Management includes early diagnoses and prompt management. However, mortality associated with this disease is still not favorable.

Keywords: malignant cancer of skin, cutaneous malignant melanoma, skin cancer, survival analyses

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8348 Assessing Level of Pregnancy Rate and Milk Yield in Indian Murrah Buffaloes

Authors: V. Jamuna, A. K. Chakravarty, C. S. Patil, Vijay Kumar, M. A. Mir, Rakesh Kumar

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Intense selection of buffaloes for milk production at organized herds of the country without giving due attention to fertility traits viz. pregnancy rate has lead to deterioration in their performances. Aim of study is to develop an optimum model for predicting pregnancy rate and to assess the level of pregnancy rate with respect to milk production Murrah buffaloes. Data pertaining to 1224 lactation records of Murrah buffaloes spread over a period 21 years were analyzed and it was observed that pregnancy rate depicted negative phenotypic association with lactation milk yield (-0.08 ± 0.04). For developing optimum model for pregnancy rate in Murrah buffaloes seven simple and multiple regression models were developed. Among the seven models, model II having only Service period as an independent reproduction variable, was found to be the best prediction model, based on the four statistical criterions (high coefficient of determination (R 2), low mean sum of squares due to error (MSSe), conceptual predictive (CP) value, and Bayesian information criterion (BIC). For standardizing the level of fertility with milk production, pregnancy rate was classified into seven classes with the increment of 10% in all parities, life time and their corresponding average pregnancy rate in relation to the average lactation milk yield (MY).It was observed that to achieve around 2000 kg MY which can be considered optimum for Indian Murrah buffaloes, level of pregnancy rate should be in between 30-50%.

Keywords: life time, pregnancy rate, production, service period, standardization

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8347 Nacre Deposition Rate in Japanese and Hybrid Mother Oysters, Pinctada Fucata, and Its Relationship with Their Respective Pearls

Authors: Gunawan Muhammad, Takashi Atsumi, Akira Komaru

Abstract:

Pinctada fucata has been the most important pearl culture species in Japan and known as Japanese Akoya Pearl Oyster. However, during summer 1994, mass mortality devastated pearl culture in most parts of Japan. Therefore, pearl farmers started to import Chinese Pearl Oysters from Hainan Island that came from the same species because they are believed to be more resistant towards high water temperature, despite their lack of ability in producing high-quality pearls. The local farmers were then hybridized Japanese and Chinese pearl oysters and currently known as Hybrid pearl oysters, as an attempt to produce a new oyster's strain which is more resistant towards high temperature but also able to produce higher quality pearls. However, despite both strains were implanted by mantle tissues from the same group of donors, the thickness of pearl nacre produced by both strains was different, even though tablet thickness shows a rather similar pattern. Hence, this leads to a question of whether mother oysters play a major role in both nacre deposition rate and tablet thickness of pearls or not. This study first describes the nacre deposition rate of the shells of Japanese and Hybrid mother oysters towards the water temperature condition in Ago Bay, Mie Prefecture, Japan. Later, a comparative study was conducted among 4 shell positions that had been chosen according to the mantle tissue location and shell growth directions. A correlative study was then taken between shells and pearls nacre deposition rate to know whether mother oyster ability in depositing nacre on their shells is related to that of pearls. All the four shell positions were significantly different in shell nacre growth rate (Kruskal-Wallis, p-value < 0.05), and the third position have faster nacre growth among the other three both in Japanese and Hybrid strains, especially in warm temperature. The ability to deposit nacre between Japanese and Hybrid during warm water conditions (August and September) is also significantly different in almost all positions (Mann Whitney U, p-value < 0.01), Japanese oyster growth faster than Hybrid in all four positions. This leads to a different total growth among the two strains and a higher possibility of thicker nacre thickness in Japanese shell nacre. Tablet thickness is significantly different among all positions of shells (Kruskal-Wallis, p-value < 0.01), the 2nd position deposited rather thinner tablet thickness than the other three, including on the 6th month of culture which is more desirable in producing pearls with good luster. This result gives us new information that pearl growth rate is highly affected by the mother oysters; however, nacre tablet thickness might be the result of the shell matrix expressed by different mantle position from donor oysters.

Keywords: nacre, deposition, biomineralization, pearl aquaculture, pearl oyster, Akoya pearl, pearl

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8346 Neonatology Clinical Routine in Cats and Dogs: Cases, Main Conditions and Mortality

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

The neonatal care of cats and dogs represents a challenge to veterinarians due to the small size of the newborns and their physiological particularities. In addition, many Veterinary Medicine colleges around the world do not include neonatology in the curriculum, which makes it less likely for the veterinarian to have basic knowledge regarding neonatal care and worsens the clinical care these patients receive. Therefore, lack of assistance and negligence have become frequent in the field, which contributes towards the high mortality rates. This study aims at describing cases and the main conditions pertaining to the neonatology clinical routine in cats and dogs, highlighting the importance of specialized care in this field of Veterinary Medicine. The study included 808 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, between January 2018 and November 2019. Of these, 87.3% (705/808) were dogs and 12.7% (103/808) were cats. Among the neonates admitted, 57.3% (463/808) came from emergency c-sections due to dystocia, 8.7% (71/808) cane from vaginal deliveries with obstetric maneuvers due to dystocia, and 34% (274/808) were admitted for clinical care due to neonatal conditions. Among the neonates that came from emergency c-sections and vaginal deliveries, 47.3% (253/534) was born in respiratory distress due to severe hypoxia or persistent apnea and required resuscitation procedure, such as the Jen Chung acupuncture point (VG26), oxygen therapy with mask, pulmonary expansion with resuscitator, heart massages and administration of emergency medication, such as epinephrine. On the other hand, in the neonatal clinical care, the main conditions and alterations observed in the newborns were omphalophlebitis, toxic milk syndrome, neonatal conjunctivitis, swimmer puppy syndrome, neonatal hemorrhagic syndrome, pneumonia, trauma, low weight at birth, prematurity, congenital malformations (cleft palate, cleft lip, hydrocephaly, anasarca, vascular anomalies in the heart, anal atresia, gastroschisis, omphalocele, among others), neonatal sepsis and other local and systemic bacterial infections, viral infections (feline respiratory complex, parvovirus, canine distemper, canine infectious traqueobronchitis), parasitical infections (Toxocara spp., Ancylostoma spp., Strongyloides spp., Cystoisospora spp., Babesia spp. and Giardia spp.) and fungal infections (dermatophytosis by Microsporum canis). The most common clinical presentation observed was the neonatal triad (hypothermia, hypoglycemia and dehydration), affecting 74.6% (603/808) of the patients. The mortality rate among the neonates was 10.5% (85/808). Being knowledgeable about neonatology is essential for veterinarians to provide adequate care for these patients in the clinical routine. Adding neonatology to college curriculums, improving the dissemination of information on the subject, and providing annual training in neonatology for veterinarians and employees are important to improve immediate care and reduce the mortality rates.

Keywords: neonatal care, puppies, neonatal, conditions

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8345 Application Use of Slaughterhouse Waste to Improve Nutrient Level in Apium glaviolens

Authors: Hasan Basri Jumin

Abstract:

Using the slaughterhouse waste combined to suitable dose of nitrogen fertilizer to Apium glaviolen gives the significant effect to mean relative growth rate. The same pattern also showed significantly in net assimilation rate. The net assimilation rate increased significantly during 42 days old plants. Combination of treatment of 100 ml/l animal slaughterhouse waste and 0.1 g/kg nitrogen fertilizer/kg soil increased the vegetative growth of Apium glaviolens. The biomass of plant and mean relative growth rate of Apium glaviolens were rapidly increased in 4 weeks after planting and gradually decreased after 35 days at the harvest time. Combination of 100 ml/l slaughterhouse waste and applied 0.1 g/kg nitrogen fertilizer has increased all parameters. The highest vegetative growth, biomass, mean relative growth rate and net assimilation rate were received from 0.56 mg-l.m-2.days-1.

Keywords: Apium glaviolent, nitrogen, pollutant, slaughterhouse, waste

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8344 Effects of Some Factors Affecting Optimum Reproductive Capacity of Local Breeds of Sheep in Nigeria

Authors: D. Zahraddeen, N. M. Lemu, P. P. Barje, I. S. R. Butswat

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This study was conducted to investigate some of the factors affecting the optimum reproductive capacity of the indigenous breeds of sheep in Nigeria. A total of 767 sheep of different breeds were investigated. The reproductive indices considered were birth/weaning weights, litter size, parity, mortality, reproductive problems/disorders, body condition score (BCS), as well as growth traits. The results showed that litter size, parity, and BCS had significant (p < 0.05) effects on birth/weaning weights, mortality rates and growth traits of the sheep breeds studied. Similarly, the rearing method/system significantly (p < 0.05) influenced other reproductive traits such as birth/weaning weights, mortality, growth performance of lambs. However, the major reproductive problems/disorders in the ewes were dystocia (30.94%), retained placenta (16.91%), mastitis (15.83), pregnancy toxaemia (11.51%), uterine prolapse (6.48%) and vaginal prolapse (3.24%). In the rams, the incidence of reproductive problems included cryptorchidism (1.08%), orchitis (2.87%) and scrotal dermatophilosis (1.79%), among others. This study concludes that the four breeds of sheep (Balami, Yankasa, Uda, and West African Dwarf sheep) and their crosses exhibited varied genetic make-up and potentials. However, the large number of sheep farmers practicing the extensive production system might be responsible for the low reproductive performance of this species in the country. It is, therefore, recommended that significant improvement could be achieved through enhanced management practices of these animals.

Keywords: sheep, breeds, reproduction, disorders

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8343 Minimal Invasive Esophagectomy for Esophageal Cancer: An Institutional Review From a Dedicated Centre of Pakistan

Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

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8342 Environmental Related Mortality Rates through Artificial Intelligence Tools

Authors: Stamatis Zoras, Vasilis Evagelopoulos, Theodoros Staurakas

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The association between elevated air pollution levels and extreme climate conditions (temperature, particulate matter, ozone levels, etc.) and mental consequences has been, recently, the focus of significant number of studies. It varies depending on the time of the year it occurs either during the hot period or cold periods but, specifically, when extreme air pollution and weather events are observed, e.g. air pollution episodes and persistent heatwaves. It also varies spatially due to different effects of air quality and climate extremes to human health when considering metropolitan or rural areas. An air pollutant concentration and a climate extreme are taking a different form of impact if the focus area is countryside or in the urban environment. In the built environment the climate extreme effects are driven through the formed microclimate which must be studied more efficiently. Variables such as biological, age groups etc may be implicated by different environmental factors such as increased air pollution/noise levels and overheating of buildings in comparison to rural areas. Gridded air quality and climate variables derived from the land surface observations network of West Macedonia in Greece will be analysed against mortality data in a spatial format in the region of West Macedonia. Artificial intelligence (AI) tools will be used for data correction and prediction of health deterioration with climatic conditions and air pollution at local scale. This would reveal the built environment implications against the countryside. The air pollution and climatic data have been collected from meteorological stations and span the period from 2000 to 2009. These will be projected against the mortality rates data in daily, monthly, seasonal and annual grids. The grids will be operated as AI-based warning models for decision makers in order to map the health conditions in rural and urban areas to ensure improved awareness of the healthcare system by taken into account the predicted changing climate conditions. Gridded data of climate conditions, air quality levels against mortality rates will be presented by AI-analysed gridded indicators of the implicated variables. An Al-based gridded warning platform at local scales is then developed for future system awareness platform for regional level.

Keywords: air quality, artificial inteligence, climatic conditions, mortality

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8341 Pathogenicity of Entomopathogenic Fungi, Beauveria bassiana Against Red Palm Weevil, (Rhynchophorus ferrugineus)

Authors: Muhammad Mamoon-Ur-Rashid, Gul Rehman

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Entomopathogenic fungi are considered effective bio-control agents for the management of a range of insect pests including red palm weevil. The research studies were conducted under laboratory and field conditions against 5th and 6th instars larvae and adults of [Rhynchophorus ferrugineus (Olivier)] at the faculty of Agriculture, Gomal University Dera Ismail Khan (KPK) Pakistan. The 5th instar larvae were used under field conditions whereas, the 6th instar larvae and newly emerged adults were used under lab conditions. Conidial suspensions were used at five different concentrations of 1×10⁴, 1×10⁵, 1×10⁶, 1×10⁷ and 1×10⁸, conidia per ml. The data were recorded on the mortality, total larval duration, weight of larvae, pre-pupal and pupal durations, percent pupal formation, pupal weight, percent adult emergence, and adult longevity (♂ and ♀) of red palm weevil. The B. bassiana had varying degrees of pathogenicity against different developmental stages of red palm weevil. The maximum larval duration (113.40 days) was noted when 5th instar larvae were treated with the maximum concentration (1 × 10⁸) of B. bassiana, whereas; the minimum total larval duration of 87.20 days was recorded on the lowest concentration (1 × 10⁴) of B. bassiana. The maximum pre-pual and pupal durations were noted at the maximum concentration. The maximum life span of adult male and females were noted at the lowest concentration, whereas; the minimum values were noted at the maximum concentration. The earliest mortality of red palm weevil was observed 1-day after treatment at higher concentrations of 1 × 10⁷ and 1 × 10⁸, whereas; it was recorded 3 and 4 days after treatment at lower concentrations of 1 × 10⁵ and 1 × 10⁴. At 10 days after treatment, the entomopathogenic fungus caused > 80% cumulative mortality of 5th and 6th instar larvae and adult weevils at the maximum concentrations which were more than double than those recorded at the lowest concentration. Overall, the 5th instar larvae of red palm weevils were most susceptible to the fungus compared to the 6th instar larvae and adult weevils. Based on current findings, it is suggested that entomopathogenic fungi could be used for the safer management of red palm weevil.

Keywords: entomopathogenic nematodes, mortality, red palm weevil, sub-lethal effects

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8340 Forecasting Unemployment Rate in Selected European Countries Using Smoothing Methods

Authors: Ksenija Dumičić, Anita Čeh Časni, Berislav Žmuk

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The aim of this paper is to select the most accurate forecasting method for predicting the future values of the unemployment rate in selected European countries. In order to do so, several forecasting techniques adequate for forecasting time series with trend component, were selected, namely: double exponential smoothing (also known as Holt`s method) and Holt-Winters` method which accounts for trend and seasonality. The results of the empirical analysis showed that the optimal model for forecasting unemployment rate in Greece was Holt-Winters` additive method. In the case of Spain, according to MAPE, the optimal model was double exponential smoothing model. Furthermore, for Croatia and Italy the best forecasting model for unemployment rate was Holt-Winters` multiplicative model, whereas in the case of Portugal the best model to forecast unemployment rate was Double exponential smoothing model. Our findings are in line with European Commission unemployment rate estimates.

Keywords: European Union countries, exponential smoothing methods, forecast accuracy unemployment rate

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8339 Outcome of Naive SGLT2 Inhibitors Among ICU Admitted Acute Stroke with T2DM Patients a Prospective Cohort Study in NCMultispecialty Hospital, Biratnagar, Nepal

Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel

Abstract:

Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.

Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke

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8338 The Toxicity Effects of HICIDE VD-9 on the Mortality of Lucilia cuprina under Laboratory Conditions

Authors: Mehdi Shahmoradi Moghadam, Saba Kavian, Mehdi Zabihzadeh, Amir Mohammad Alborzi, Reza Sadeghi

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Cypermethrin is one of the most widely used synthetic insecticides to control pests in veterinary, industrial and agricultural environments. In the present study, the mortalities of Lucilia Cuprina as the key pest of meat were studied after being exposed to HICIDE VD-9 (a ready-to-use disinfectant/insecticide containing cypermethrin, polyhexanide and quaternary ammonium compounds produced by Dana pharmed lotus Co., Iran) within 15 minutes. The experimental results showed that moralities percentage of egg, larvae and adults of Lucilia Cuprina were 48%, 81% and 70%, respectively. Based on the obtained results, it can be predicted that in addition to controlling the insect pests of blow flies, HICIDE VD-9, as a cost-effective and environmentally friendly disinfectant/insecticide, can be effective against other insects, e.g., biting flies, fleas, midges, mosquitoes and ticks.

Keywords: cypermethrin, HICIDE VD-9, Lucilia cuprina, mortality, toxicity

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8337 A Perspective on Emergency Care of Gunshot Injuries in Northern Taiwan

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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8336 Chocomerr (Merr Leaves Chocolate) Alternative Food in Increasing Breastmilk Quantity

Authors: Rara Wulan Anggareni, Narita Putri, Riski Septianing Astuti

Abstract:

Breastfeeding is a key to prevent mortality and morbidity in children. It is also the second highest risk responsible for Disability Adjusted Life Years (DALYs) among children below five years old. UNICEF estimates that during 1995 – 2003, there are only about 38% infants in developing countries who get to be exclusively breastfed during the first six months of their lives. According to Demography and Health Survey in Indonesia 2007, breastfeed practice rate still considered as low which is about 41%. One of the factors causing the low breastfeed practice rate in Indonesia is the anxiety and postpartum depression, and also the weanling dilemma in which mother feels that her breastmilk cannot suffice infant needs. Those factors finally resulting into low or even stopped production of breastmilk. Breastmilk production can be enhanced by consuming food containing phytosterol and lactogoga effect. Food with the highest phytosterol level is Sauropus androgynus (L.) Merr leaf (merr leaf). In this study, we made alternative food which named Chocomerr for breastfeeding mothers. Chocomerr consists of merr leaves which have lactogoga effect and chocolate for relaxation. Based on organoleptic tests conducted towards 2 age groups, which are 18 – 21 and 25 – 40 years old, this product gets good acceptance in taste, texture, and colour categories. Chocomerr can be used as an alternative way for increasing breastmilk production to aim for the decreasing number of DALYs among children aged under 5 years old.

Keywords: breastfeeding, increasing, chocolate, merr leaves

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8335 Modelling Exchange-Rate Pass-Through: A Model of Oil Prices and Asymmetric Exchange Rate Fluctuations in Selected African Countries

Authors: Fajana Sola Isaac

Abstract:

In the last two decades, we have witnessed an increased interest in exchange rate pass-through (ERPT) in developing economies and emerging markets. This is perhaps due to the acknowledged significance of the pattern of exchange rate pass-through as a key instrument in monetary policy design, principally in retort to a shock in exchange rate in literature. This paper analyzed Exchange Rate Pass-Through by A Model of Oil Prices and Asymmetric Exchange Rate Fluctuations in Selected African Countries. The study adopted A Non-Linear Autoregressive Distributed Lag approach using yearly data on Algeria, Burundi, Nigeria and South Africa from 1986 to 2022. The paper found asymmetry in exchange rate pass-through in net oil-importing and net oil-exporting countries in the short run during the period under review. An ERPT exhibited a complete pass-through in the short run in the case of net oil-importing countries but an incomplete pass-through in the case of the net oil-exporting countries that were examined. An extended result revealed a significant impact of oil price shock on exchange rate pass-through to domestic price in the long run only for net oil importing countries. The Wald restriction test also confirms the evidence of asymmetric with the role of oil price acting as an accelerator to exchange rate pass-through to domestic price in the countries examined. The study found the outcome to be very useful for gaining expansive knowledge on the external shock impact on ERPT and could be of critical value for national monetary policy decisions on inflation targeting, especially for countries examined and other developing net oil importers and exporters.

Keywords: pass through, exchange rate, ARDL, monetary policy

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8334 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

Abstract:

Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

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8333 Effect of Heating Rate on Microstructural Developments in Cold Heading Quality Steel Used for Automotive Applications

Authors: Shahid Hussain Abro, F. Mufadi, A. Boodi

Abstract:

Microstructural study and phase transformation in steels is a basic and important step during the design of structural steel. There are huge efforts and study has been done so far on phase transformations, due to so many steel grades available commercially the phase development in steel has different consequences. In the present work an effort has been made to study the effect of heating rate on microstructural features of cold heading quality steel. The SEM, optical microscopy, and heat treatment techniques have been applied to observe the microstructural features in the experimental steel. It was observed that heating rate has the strong influence on phase transformation of CHQ steel under investigation. Heating rate increases the austenite formation kinetics with respect to holding time, and this austenite has been transformed to martensite upon cooling. Heating rate also plays a vital role on nucleation sites of austenite formation in the experimental steel.

Keywords: CHQ steel, austenite formation, heating rate, nucleation

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8332 To Study the Effect of Optic Fibre Laser Cladding of Cast Iron with Silicon Carbide on Wear Rate

Authors: Kshitij Sawke, Pradnyavant Kamble, Shrikant Patil

Abstract:

The study investigates the effect on wear rate of laser clad of cast iron with silicon carbide. Metal components fail their desired use because they wear, which causes them to lose their functionality. The laser has been used as a heating source to create a melt pool over the surface of cast iron, and then a layer of hard silicon carbide is deposited. Various combinations of power and feed rate of laser have experimented. A suitable range of laser processing parameters was identified. Wear resistance and wear rate properties were evaluated and the result showed that the wear resistance of the laser treated samples was exceptional to that of the untreated samples.

Keywords: laser clad, processing parameters, wear rate, wear resistance

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8331 Assessment of the Role of Plasmid in Multidrug Resistance in Extended Spectrum βEtalactamase Producing Escherichia Coli Stool Isolates from Diarrhoeal Patients in Kano Metropolis Nigeria

Authors: Abdullahi Musa, Yakubu Kukure Enebe Ibrahim, Adeshina Gujumbola

Abstract:

The emergence of multidrug resistance in clinical Escherichia coli has been associated with plasmid-mediated genes. DNA transfer among bacteria is critical to the dissemination of resistance. Plasmids have proved to be the ideal vehicles for dissemination of resistance genes. Plasmids coding for antibiotic resistance were long being recognized by many researchers globally. The study aimed at determining the antibiotic susceptibility pattern of ESBL E. coli isolates claimed to be multidrug resistance using disc diffusion method. Antibacterial activity of the test isolates was carried out using disk diffusion methods. The results showed that, majority of the multidrug resistance among clinical isolates of ESBL E. coli was as a result of acquisition of plasmid carrying antibiotic-resistance genes. Production of these ESBL enzymes by these organisms which are normally carried by plasmid and transfer from one bacterium to another has greatly contributed to the rapid spread of antibiotic resistance amongst E. coli isolates, which lead to high economic burden, increase morbidity and mortality rate, complication in therapy and limit treatment options. To curtail these problems, it is of significance to checkmate the rate at which over the counter drugs are sold and antibiotic misused in animal feeds. This will play a very important role in minimizing the spread of resistance bacterial strains in our environment.

Keywords: Escherichia coli, plasmid, multidrug resistance, ESBL, pan drug resistance

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8330 Relationship between Food Inflation and Agriculture Lending Rate in Ghana: A Vector Autoregressive Approach

Authors: Raymond K. Dziwornu

Abstract:

Lending rate of agriculture loan has persistently been high and attributed to risk in the sector. This study examined how food inflation and agriculture lending rate react to each other in Ghana using vector autoregressive approach. Quarterly data from 2006 to 2018 was obtained from the Bank of Ghana quarterly bulletin and the Ghana Statistical Service reports. The study found that a positive standard deviation shock to food inflation causes lending rate of agriculture loan to react negatively in the short run, but positively and steadily in the long run. This suggests the need to direct appropriate policy measures to reduce food inflation and consequently, the cost of credit to the agricultural sector for its growth.

Keywords: food inflation, agriculture, lending rate, vector autoregressive, Ghana

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8329 Simulation of the Asphaltene Deposition Rate in a Wellbore Blockage via Computational Fluid Dynamic

Authors: Xiaodong Gao, Pingchuan Dong, Qichao Gao

Abstract:

There has been lots of published work focused on asphaltene deposited on the smooth pipe under steady conditions, while particle deposition on the blockage wellbores under transient conditions has not been well elucidated. This work attempts to predict the deposition rate of asphaltene particles in blockage tube through CFD simulation. The Euler-Lagrange equation has been applied during the flow of crude oil and asphaltene particles. The net gravitational force, virtual mass, pressure gradient, saffman lift, and drag forces are incorporated in the simulations process. Validation of CFD simulation results is compared to the benchmark experiments from the previous literature. Furthermore, the effect of blockage location, blockage length, and blockage thickness on deposition rate are also analyzed. The simulation results indicate that the maximum deposition rate of asphaltene occurs in the blocked tube section, and the greater the deposition thickness, the greater the deposition rate. Moreover, the deposition amount and maximum deposition rate along the length of the tube have the same trend. Results of this study are in the ability to better understand the deposition of asphaltene particles in production and help achieve to deal with the asphaltene challenges.

Keywords: asphaltene deposition rate, blockage length, blockage thickness, blockage diameter, transient condition

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8328 Strength Parameters and the Rate Process Theory Applied to Compacted Fadama Soils

Authors: Samuel Akinlabi Ola, Emeka Segun Nnochiri, Stephen Kayode Aderomose, Paul Ayesemhe Edoh

Abstract:

Fadama soils of Northern Nigeria are generally a problem soil for highway and geotechnical engineers. There has been no consistent conclusion on the effect of the strain rate on the shear strength of soils, thus necessitating the need to clarify this issue with various types of soil. Consolidated undrained tests with pore pressure measurements were conducted at optimum moisture content and maximum dry density using standard proctor compaction. Back pressures were applied to saturate the soil. The shear strength parameters were determined. Analyzing the results and model studies using the Rate Process Theory, functional relationships between the deviator stress and strain rate were determined and expressed mathematically as deviator stress = β0+ β1 log(strain rate) at each cell pressure where β0 and β1 are constants. Also, functional relationships between the pore pressure coefficient Āf and the time to failure were determined and expressed mathematically as pore pressure coefficient, Āf = ψ0+ѱ1log (time to failure) where ψ0 and ѱ1 are constants. For cell pressure between 69 – 310 kN/m2 (10 - 45psi) the constants found for Fadama soil in this study are ψ0=0.17 and ѱ1=0.18. The study also shows the dependence of the angle of friction (ø’) on the rate of strain as it increases from 22o to 25o for an increase in the rate of strain from 0.08%/min to 1.0%/min. Conclusively, the study also shows that within the strain rate utilized in the research, the deviator strength increased with the strain rate while the excess pore water pressure decreased with an increase in the rate of strain.

Keywords: deviator stress, Fadama soils, pore pressure coefficient, rate process

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8327 Exchange Rate Variation and Balance of Payments: The Nigerian Experience (1970-2012)

Authors: Vitus Onyebuchim Onyemailu, Olive Obianuju Okalibe

Abstract:

The study tried to examine relationship between exchange rate variations on the balance of payments in Nigeria from 1970 to 2012. Using time series on econometric measures such as Granger causality and ordinary least square (OLS), the study found that exchange rate movements especially the depreciation of naira has not contributed significantly on the balance of payments under the year of the study. The granger result conform the Marshall-Lerner short and long run prepositions that exchange rate devaluation enhances balance of payments. On disaggregation exchange rate granger causes current and capital account balances give the Nigeria data from 1970 to 2012. Overall in the long run OLS regression analysis, exchange rate on semi log functional form, exchange rate variation did not record significant effect on balance of payment equation. This height was also maintained in the current or trade balance which does not match the Marshall-Lerner. The capital account balance in reverse reported a significant impact of exchange rate variability on the capital account balance. Finally, on exchange rate determination equation, where many fundamentals were considered including lagged of exchange rate. Thus, the lagged of exchange rate recorded a positive and significant influence on the present exchange rate. This means that players in the financial markets usually out plays authority’s policy’s stances through their speculative tendencies. The work therefore, recommend that effort should be made by the authorities to providing enabling environment for production of goods and services to triumph in order to take advantages of steady devaluation of its currency. This is done by providing infrastructure, provision of science and technology. Thus, when this is done Nigeria would be able to have competitive power against the rest of the world.

Keywords: exchange rate variation, balance of payments, current account, capital account, Marshall-Lerner hypothesis

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8326 Comparison of Maternal and Perinatal Outcomes of Obstetric Population Diagnosed with Covid-19 in Reference to Influenza A/H1N1: A Systematic Review and Meta-Analysis

Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

Abstract:

In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

Procedia PDF Downloads 194
8325 Therapeutic Challenges in Treatment of Adults Bacterial Meningitis Cases

Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

Abstract:

Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

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