Search results for: safe use of medicines
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1881

Search results for: safe use of medicines

1641 Modeling and Implementation of a Hierarchical Safety Controller for Human Machine Collaboration

Authors: Damtew Samson Zerihun

Abstract:

This paper primarily describes the concept of a hierarchical safety control (HSC) in discrete manufacturing to up-hold productivity with human intervention and machine failures using a systematic approach, through increasing the system availability and using additional knowledge on machines so as to improve the human machine collaboration (HMC). It also highlights the implemented PLC safety algorithm, in applying this generic concept to a concrete pro-duction line using a lab demonstrator called FATIE (Factory Automation Test and Integration Environment). Furthermore, the paper describes a model and provide a systematic representation of human-machine collabora-tion in discrete manufacturing and to this end, the Hierarchical Safety Control concept is proposed. This offers a ge-neric description of human-machine collaboration based on Finite State Machines (FSM) that can be applied to vari-ous discrete manufacturing lines instead of using ad-hoc solutions for each line. With its reusability, flexibility, and extendibility, the Hierarchical Safety Control scheme allows upholding productivity while maintaining safety with reduced engineering effort compared to existing solutions. The approach to the solution begins with a successful partitioning of different zones around the Integrated Manufacturing System (IMS), which are defined by operator tasks and the risk assessment, used to describe the location of the human operator and thus to identify the related po-tential hazards and trigger the corresponding safety functions to mitigate it. This includes selective reduced speed zones and stop zones, and in addition with the hierarchical safety control scheme and advanced safety functions such as safe standstill and safe reduced speed are used to achieve the main goals in improving the safe Human Ma-chine Collaboration and increasing the productivity. In a sample scenarios, It is shown that an increase of productivity in the order of 2.5% is already possible with a hi-erarchical safety control, which consequently under a given assumptions, a total sum of 213 € could be saved for each intervention, compared to a protective stop reaction. Thereby the loss is reduced by 22.8%, if occasional haz-ard can be refined in a hierarchical way. Furthermore, production downtime due to temporary unavailability of safety devices can be avoided with safety failover that can save millions per year. Moreover, the paper highlights the proof of the development, implementation and application of the concept on the lab demonstrator (FATIE), where it is realized on the new safety PLCs, Drive Units, HMI as well as Safety devices in addition to the main components of the IMS.

Keywords: discrete automation, hierarchical safety controller, human machine collaboration, programmable logical controller

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1640 The Reason Why Al-Kashi’s Understanding of Islamic Arches Was Wrong

Authors: Amin Moradi, Maryam Moeini

Abstract:

It is a widely held view that Ghiyath al-Din Jamshid-e-Kashani, also known as al-Kashi (1380-1429 CE), was the first who played a significant role in the interaction between mathematicians and architects by introducing theoretical knowledge in Islamic architecture. In academic discourses, geometric rules extracted from his splendid volume titled as Key of Arithmetic has uncritically believed by historians of architecture to contemplate the whole process of arch design all throughout the Islamic buildings. His theories tried to solve the fundamental problem of structural design and to understand what makes an Islamic structure safe or unsafe. As a result, al-Kashi arrived at the conclusion that a safe state of equilibrium is achieved through a specific geometry as a rule. This paper reassesses the stability of al-Kashi's systematized principal forms to evaluate the logic of his hypothesis with a special focus on large spans. Besides the empirical experiences of the author in masonry constructions, the finite element approach was proposed considering the current standards in order to get a better understanding of the validity of geometric rules proposed by al-Kashi for the equilibrium conditions of Islamic masonry arches and vaults. The state of damage of his reference arches under loading condition confirms beyond any doubt that his conclusion of the geometrical configuration measured through his treaties present some serious operational limits and do not go further than some individualized mathematical hypothesis. Therefore, the nature of his mathematical studies regarding Islamic arches is in complete contradiction with the practical knowledge of construction methodology.

Keywords: Jamshid al-Kashani, Islamic architecture, Islamic geometry, construction equilibrium, collapse mechanism

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1639 Investigation of Irrigation Water Quality at Al-Wafra Agricultural Area, Kuwait

Authors: Mosab Aljeri, Ali Abdulraheem

Abstract:

The water quality of five water types at Al-Wuhaib farm, Al-Wafra area, was studies through onsite field measurements, including pH, temperature, electrical conductivity (EC), and dissolved oxygen (DO), for four different water types. Biweekly samples were collected and analyzed for two months to obtain data of chemicals, nutrients, organics, and heavy metals. The field and laboratory results were compared with irrigation standards of Kuwait Environmental Public Authority (KEPA). The pH values of the five samples sites were within the maximum and minimum limits of KEPA standards. Based on EC values, two groups of water types were observed. The first group represents freshwater quality originated from freshwater Ministry of Electricity & Water & Renewable Energy (MEWRE) line or from freshwater tanks or treated wastewater. The second group represents brackish water type originated from groundwater or treated water mixed with groundwater. The study indicated that all nitrogen forms (ammonia, Total Kjeldahl nitrogen (TKN), Total nitrogen (TN)), total phosphate concentrations and all tested heavy metals for the five water types were below KEPA standards. These macro and micro nutrients are essential for plant growth and can be used as fertilizers. The study suggest that the groundwater should be treated and disinfected in the farming area. Also, these type of studies shall be carried out routinely to all farm areas to ensure safe water use and safe agricultural produce.

Keywords: salinity, heavy metals, ammonia, phosphate

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1638 A New Approach in a Problem of a Supersonic Panel Flutter

Authors: M. V. Belubekyan, S. R. Martirosyan

Abstract:

On the example of an elastic rectangular plate streamlined by a supersonic gas flow, we have investigated the phenomenon of divergence and of panel flatter of the overrunning of the gas flow at a free edge under assumption of the presence of concentrated inertial masses and moments at the free edge. We applied a new approach of finding of solution of these problems, which was developed based on the algorithm for an analytical solution finding. This algorithm is easy to use for theoretical studies for the wides circle of nonconservative problems of linear elastic stability. We have established the relation between the characteristics of natural vibrations of the plate and velocity of the streamlining gas flow, which enables one to draw some conclusions on the stability of disturbed motion of the plate depending on the parameters of the system plate-flow. Its solution shows that either the divergence or the localized divergence and the flutter instability are possible. The regions of the stability and instability in space of parameters of the problem are identified. We have investigated the dynamic behavior of the disturbed motion of the panel near the boundaries of region of the stability. The safe and dangerous boundaries of region of the stability are found. The transition through safe boundary of the region of the stability leads to the divergence or localized divergence arising in the vicinity of free edge of the rectangular plate. The transition through dangerous boundary of the region of the stability leads to the panel flutter. The deformations arising at the flutter are more dangerous to the skin of the modern aircrafts and rockets resulting to the loss of the strength and appearance of the fatigue cracks.

Keywords: stability, elastic plate, divergence, localized divergence, supersonic panels flutter

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1637 Integrating Road Safety into Mainstreaming Education and Other Initiatives with Holistic Approach in the State: A Case Study of Madhya Pradesh, India

Authors: Yogesh Mahor, Subhash Nigam, Abhai Khare

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Road safety education is a composite subject which should be viewed holistically if taken into accoubehavior change communication, safe road infrastructure and low enforcement. Specific and customized road safety education is crucial for each type of road user and learners in the formal and informal teaching and various kind of training programs directly sponsored by state and center government, as they are active contributors to shaping a community and responsible citizens. The aim of this discussion article is to explore a strategy to integrate road safety education into the formal curriculum of schools, higher education institutions, driving schools, skill development centers, various government funded urban and rural development training institutions and their work plans as standing agenda. By applying the desktop research method, the article conceptualizes what the possible focus of road safety education and training should be. The article then explores international common practices in road safety education and training, and considers the necessary synergy between education, road engineering and low enforcement. The article uses secondary data collected from documents which are then analysed in a sectoral way. A well-designed road safety strategy for mainstreaming education and government-sponsored training is urgently needed, facilitating partnerships in various sectors to implement such education in the students and learners in multidisciplinary ways.

Keywords: road safety education, curriculum-based road safety education, behavior change communication, low enforcement, road engineering, safe system approach, infrastructure development consultants

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1636 Yawning Computing Using Bayesian Networks

Authors: Serge Tshibangu, Turgay Celik, Zenzo Ncube

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Road crashes kill nearly over a million people every year, and leave millions more injured or permanently disabled. Various annual reports reveal that the percentage of fatal crashes due to fatigue/driver falling asleep comes directly after the percentage of fatal crashes due to intoxicated drivers. This percentage is higher than the combined percentage of fatal crashes due to illegal/Un-Safe U-turn and illegal/Un-Safe reversing. Although a relatively small percentage of police reports on road accidents highlights drowsiness and fatigue, the importance of these factors is greater than we might think, hidden by the undercounting of their events. Some scenarios show that these factors are significant in accidents with killed and injured people. Thus the need for an automatic drivers fatigue detection system in order to considerably reduce the number of accidents owing to fatigue.This research approaches the drivers fatigue detection problem in an innovative way by combining cues collected from both temporal analysis of drivers’ faces and environment. Monotony in driving environment is inter-related with visual symptoms of fatigue on drivers’ faces to achieve fatigue detection. Optical and infrared (IR) sensors are used to analyse the monotony in driving environment and to detect the visual symptoms of fatigue on human face. Internal cues from drivers faces and external cues from environment are combined together using machine learning algorithms to automatically detect fatigue.

Keywords: intelligent transportation systems, bayesian networks, yawning computing, machine learning algorithms

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1635 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

Abstract:

Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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1634 Assessment of Drinking Water Quality in Relation to Arsenic Contamination in Drinking Water in Liberia: Achieving the Sustainable Development Goal of Ensuring Clean Water and Sanitation

Authors: Victor Emery David Jr., Jiang Wenchao, Daniel Mmereki, Yasinta John

Abstract:

The fundamentals of public health are access to safe and clean drinking water. The presence of arsenic and other contaminants in drinking water leads to the potential risk to public health and the environment particularly in most developing countries where there’s inadequate access to safe and clean water and adequate sanitation. Liberia has taken steps to improve its drinking water status so as to achieve the Sustainable Development Goals (SDGs) target of ensuring clean water and effective sanitation but there is still a lot to be done. The Sustainable Development Goals are a United Nation initiative also known as transforming our world: The 2030 agenda for sustainable development. It contains seventeen goals with 169 targets to be met by respective countries. Liberia is situated within in the gold belt region where there exist the presence of arsenic and other contaminants in the underground water due to mining and other related activities. While there are limited or no epidemiological studies conducted in Liberia to confirm illness or death as a result of arsenic contamination in Liberia, it remains a public health concern. This paper assesses the drinking water quality, the presence of arsenic in groundwater/drinking water in Liberia, and proposes strategies for mitigating contaminants in drinking water and suggests options for improvement with regards to achieving the Sustainable Development Goals of ensuring clean water and effective sanitation in Liberia by 2030.

Keywords: arsenic, action plan, contaminants, environment, groundwater, sustainable development goals (SDGs), Monrovia, Liberia, public health, drinking water

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1633 Antiinflammatory and Wound Healing Activity of Sedum Essential Oils Growing in Kazakhstan

Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

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1632 Maternal Health Care Mirage: A Study of Maternal Health Care Utilization for Young Married Muslim Women in India

Authors: Saradiya Mukherjee

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Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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1631 Rt. Side Sleeping Position Prevents Sudden Infant Death Syndrome

Authors: Othman Salim Hussein Al-Fleesy

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Background: Studies showed that sudden infant death syndrome (SIDS) has association with sleeping positions. Up-to-date no study explained how could they prevent it? Objectives: 1-To determine which sleeping position is certainly safe one to prevent SIDS. 2-To establish criteria for suggesting definition and making diagnosis for SIDS. 3-To discuss the controversy surrounding SUND, ALTE, NM, as compared to SIDS. Method: This literature review was built on a previous literature. Articles were obtained randomly according to their availability to the author. For the purpose of this work an easy approach was built by modeling an overview on SIDS topic after clarifying the misconception and misinterpretation of a number of controversial issues in regard to SIDS such as: asphyxia, sudden unexpected death among adults (Bangungut or Pokkuri), apparent life threatening event (ALTE), Nightmare, and comparing the findings with the literature review results..By this unique method we got a clue for prevention of Sudden Infant Death Syndrome. Results: The revision revealed with no doubt that no study before have studied right-side sleeping position at all. The author determined right side as the only safe position to preventing SIDS. A new definition for SIDS is suggested. The author postulated a Right side position hypothesis (Alfleesy hypothesis) which is a testable hypothesis in front of all researchers for further study . Conclusion: Our results contradict totally all previous studies and recommendations. We recommended strongly the right side position only for sleeping to prevent SIDS. New definition is suggested and a new hypothesis is postulated.

Keywords: SIDS, ALTE, nightmare, forensic sciences

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1630 Relation between Low Thermal Stress and Antioxidant Enzymes Activity in a Sweetening Plant: Stevia Rebaudiana Bert

Authors: T. Bettaieb, S. Soufi, S. Arbaoui

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Stevia rebaudiana Bert. is a natural sweet plant. The leaves contain diterpene glycosides stevioside, rebaudiosides A-F, steviolbioside and dulcoside, which are responsible for its sweet taste and have commercial value all over the world as sugar substitute in foods and medicines. Stevia rebaudiana Bert. is sensitive temperature lower than 9°C. The possibility of its outdoor culture in Tunisian conditions demand genotypes tolerant to low temperatures. In order to evaluate the low temperature tolerance of eight genotypes of Stevia rebaudiana, the activities of superoxide dismutase (SOD), ascorbate peroxidase (APX) and catalases (CAT) were measured. Before carrying out the analyses, three genotypes of Stevia were exposed for 1 month at a temperature regime of 18°C during the day and 7°C at night similar to winter conditions in Tunisia. In response to the stress generated by low temperature, antioxidant enzymes activity revealed on native gel and quantified by spectrophotometry showed variable levels according to their degree of tolerance to low temperatures.

Keywords: chilling tolerance, enzymatic activity, stevia rebaudiana bert, low thermal stress

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1629 Formulation Development and Characterization of Oligonucleotide Containing Chitosan Nanoparticles

Authors: Gyati Shilakari Asthana, Abhay Asthana

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Purpose: The therapeutic potential of oligonucleotide (ODN) is primarily dependent upon its safe and efficient delivery to specific cells overcoming degradation and maximizing cellular uptake in vivo. The present study is focused to design low molecular weight chitosan nanoconstructs to meet the requirements of safe and effectual delivery of ODNs. LMW-chitosan is a biodegradable, water soluble, biocompatible polymer and is useful as a non-viral vector for gene delivery due to its better stability in water. Methods: LMW chitosan ODN nanoparticles (CHODN NPs) were formulated by self assembled method using various N/P ratios (moles ratio of amine groups of CH to phosphate moieties of ODNs; 0.5:1, 1:1, 3:1, 5:1 and 7:1) of CH to ODN. The developed CHODN NPs were evaluated with respect to gel retardation assay, particle size, zeta potential and cytotoxicity and transfection efficiency. Results: Complete complexation of CH/ODN was achieved at the charge ratio of 0.5:1 or above and CHODN NPs displayed resistance against DNase I. On increasing the N/P ratio of CH/ODN, particle size of the NPs decreased whereas zeta potential (ZV) value increased. No significant toxicity was observed at all CH concentrations. The transfection efficiency was increased on increasing N/P ratio from 1:1 to 3:1, whereas it was decreased with further increment in N/P ratio upto 7:1. Maximum transfection of CHODN NPs with both the cell lines (Raw 267.4 cells and Hela cells) was achieved at N/P ratio of 3:1. The results suggest that transfection efficiency of CHODN NPs is dependent on N/P ratio. Conclusion: Thus the present study states that LMW chitosan nanoparticulate carriers would be acceptable choice to improve transfection efficiency in vitro as well as in vivo delivery of oligonucleotide.

Keywords: LMW-chitosan, chitosan nanoparticles, biocompatibility, cytotoxicity study, transfection efficiency, oligonucleotide

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1628 Officinal Quality Assurance: Investigation near the Pharmacists Dispensary at Oran- Algeria

Authors: S. Boulenouar, A. Boukli Hacene, S. Brahmi

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Quality is an old concept but which recently became omnipresent in the society. It is a pledge of the well done job and therefore the satisfaction of the customer. Now, dispensing pharmacies seem to be held away from this approach. Officinal staff is called to dispense drugs. However this essential function is rarely studied and taken into account. To contribute to the good use of medicines and to reduce the dangers, it is important to consider the dispensation of drugs practised in the pharmacies. It is a both descriptive and retrospective study .The descriptive part is to conduct a survey near to the dispensary pharmacists. The retrospective section concentrates on the analysis of medicine prescriptions dispensed to patients. Following the survey that we carried out near the pharmacists of dispensary of the town of Oran, it appears that in majority, they are not inclined, by themselves, to take up the challenge of quality at the dispensary. The approach requires time and a motivation that pharmacists do not have for the moment. Efforts are still needed on the part of pharmacists, but also of authorities and organizations in charge of quality in the dispensary. At the end of this work, it seems to us that the implementation of a quality approach is part of our reflection on the added value of the pharmacist of dispensary in the drug chain.

Keywords: customer satisfaction, dispensary, dispensing of the drug, quality approach

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1627 Disability and Sexuality: A Human Right Approach to Sexual and Reproductive Health of the Hearing Impaired Adolescents In Developing Countries

Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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1626 Developing Effective Strategies to Reduce Hiv, Aids and Sexually Transmitted Infections, Nakuru, Kenya

Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi

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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.

Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach

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1625 Treatment of Mycotic Dermatitis in Domestic Animals with Poly Herbal Drug

Authors: U. Umadevi, T. Umakanthan

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Globally, mycotic dermatitis is very common but there is no single proven specific allopathic treatment regimen. In this study, domestic animals with skin diseases of different age and breed from geographically varied regions of Tamil Nadu state, India were employed. Most of them have had previous treatment with native and allopathic medicines without success. Clinically, the skin lesions were found to be mild to severe. The trial animals were treated with poly herbal formulation (ointment) prepared using the indigenous medicinal plants – viz Andrographis paniculata, Lawsonia inermis and Madhuca longifolia. Allopathic antifungal drugs and ointments, povidone iodine and curabless (Terbinafine HCl, Ofloxacin, Ornidazole, Clobetasol propionate) were used in control. Comparatively, trial animals were found to have lesser course of treatment time and higher recovery rate than control. In Ethnoveterinary, this combination was tried for the first time. This herbal formulation is economical and an alternative for skin diseases.

Keywords: allopathic drugs, dermatitis, domestic animals, poly herbal formulation

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1624 In Search of a Safe Haven-Sexual Violence Leading to a Change of Sexual Orientation

Authors: Medagedara Kaushalya Sewwandi Supun Gunarathne

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This research explores the underlying motivations and consequences of individuals changing their sexual orientation as a response to sexual violence. The primary objective of the study is to unravel the psychological, emotional, and social factors that drive individuals, akin to Celie in Alice Walker’s ‘The Color Purple’, to contemplate and undergo changes in their sexual orientation following the trauma of sexual violence. Through an analytical and qualitative approach, the study employs in-depth textual and thematic analyses to scrutinize the complex interplay between sexual orientation and violence within the selected text. Through a close examination of Celie’s journey and experiences, the study reveals that her decision to switch sexual orientation arises from a desire for a more favorable and benevolent relationship driven by the absence of safety and refuge in her previous relationships. By establishing this bond between sexual orientation and violence, the research underscores how sexual violence can lead individuals to opt for a change in their sexual orientation. The findings highlight Celie’s transformation as a means to seek solace and security, thus concluding that sexual violence can prompt individuals to alter their sexual orientation. The ensuing discussion explores the implications of these findings, encompassing psychological, emotional, and social consequences, as well as the societal and cultural factors influencing the perception of sexual orientation. Additionally, it sheds light on the challenges and stigma faced by those who undergo such transformations. By comprehending the complex relationship between sexual violence and the decision to change sexual orientation, as exemplified by Celie in ‘The Color Purple’, a deeper understanding of the experiences of survivors who seek a safe haven through altering their sexual orientation can be attained.

Keywords: sexual violence, sexual orientation, refuge, transition

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1623 Serum Potassium Before, During and After Exercise at 70% Maximal Heart Rate: The Safe Exercise Dosage Across Different Parameters of Health and Fitness Level

Authors: Omar bin Mihat

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The number of sudden deaths is increasing over the past years. These deaths occur not during physical activities but upon cessation. Post-mortem confirms these deaths as cardiac arrest non-specifically. Congenital heart disease is a condition undiagnosed whereby only surface upon physical exertion leading to sudden death is unavoidable. Channelopathy, a condition that refers to any disease from the defect in iron-channel function, particularly the sodium-potassium pump, during the cessation of the exercise can be controlled. The derivation of heart rate return (HRrtn) is a procedure of a control cooling down process according to the heart rate (HR). Empirically, potassium rises linearly with intensity and falls sharply upon abrupt cessation of exertion, resulting in fatal arrhythmia due to hypokalaemia. It is vital that the flux of potassium should be maintained within the normal range during physical activities. To achieve this, the dosage of physical exertion (exercise) should be identified. Various percentages of the intensity of maximum heart rate (MHR) will precipitate different adaptations and remodeling of various organs. 70% of MHR will surface physiological adaptations, including enhancement of endurance, fitness level, and general health, and there was no significant rise of serum potassium (K+) during the entire phase of the treadmill brisk walk at a different rate of perceived exertion (RPE) from the subject of various fitness background. There was also no significant rise in blood pressure (BP) during the entire phase of the treadmill brisk walk, substantiating 70% MHR is the safe dosage across different parameters of health and fitness level.

Keywords: potassium, maximal heart rate, exercise dosage, fitness level

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1622 Outdoor Physical Play as Critical to Early Childhood Development: Findings from Saudi Arabia

Authors: Rana S. Alghamdi

Abstract:

Play in early childhood education has been stifled across the world due to an overemphasis on academic achievement and a reduced focus on physical play and motor development. In Saudi Arabia, teachers reticent to allocate more time to play for fear of retribution from parents and administrators that children are losing academic seat time. This practice has proven to be detrimental to the social, emotional, physical, and cognitive development of children. Teachers are pressured to prioritize Arabic, math, and science while providing minimal time for physical activities. Administrators tend to push for an ever-increasing emphasis on academia in order to achieve higher test scores. However, young children often find it difficult to concentrate if they are not able to get out energy through physical play. Furthermore, many youth educators are not qualified to oversee physical activities, and many facilities are unprepared for safe, outdoor play. This results in children getting little to no outdoor activity. They are stuck in a strict academic regimen that may dampen the creativity and imagination easily fostered through cooperative play. For a stronger educational system and more well-rounded students, Saudi schools should enact policies that extend the number of required hours dedicated to outdoor and physical play. They should also offer training for unqualified teachers. This training should focus on the benefits of physical play and instruct them on how to facilitate these activities safely and effectively. School administrators must focus on providing adequate equipment and safe environments for the purpose of outdoor play and education. In doing so, they will be setting their students up for a successful future and improving their abilities in all aspects of education.

Keywords: early childhood education, play, outdoor, Saudi Arabia

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1621 An Analysis on the Appropriateness and Effectiveness of CCTV Location for Crime Prevention

Authors: Tae-Heon Moon, Sun-Young Heo, Sang-Ho Lee, Youn-Taik Leem, Kwang-Woo Nam

Abstract:

This study aims to investigate the possibility of crime prevention through CCTV by analyzing the appropriateness of the CCTV location, whether it is installed in the hotspot of crime-prone areas, and exploring the crime prevention effect and transition effect. The real crime and CCTV locations of case city were converted into the spatial data by using GIS. The data was analyzed by hotspot analysis and weighted displacement quotient(WDQ). As study methods, it analyzed existing relevant studies for identifying the trends of CCTV and crime studies based on big data from 1800 to 2014 and understanding the relation between CCTV and crime. Second, it investigated the current situation of nationwide CCTVs and analyzed the guidelines of CCTV installation and operation to draw attention to the problems and indicating points of domestic CCTV use. Third, it investigated the crime occurrence in case areas and the current situation of CCTV installation in the spatial aspects, and analyzed the appropriateness and effectiveness of CCTV installation to suggest a rational installation of CCTV and the strategic direction of crime prevention. The results demonstrate that there was no significant effect in the installation of CCTV on crime prevention. This indicates that CCTV should be installed and managed in a more scientific way reflecting local crime situations. In terms of CCTV, the methods of spatial analysis such as GIS, which can evaluate the installation effect, and the methods of economic analysis like cost-benefit analysis should be developed. In addition, these methods should be distributed to local governments across the nation for the appropriate installation of CCTV and operation. This study intended to find a design guideline of the optimum CCTV installation. In this regard, this study is meaningful in that it will contribute to the creation of a safe city.

Keywords: CCTV, safe city, crime prevention, spatial analysis

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1620 The Anti-Allergic Activity of Prasaprohyai Preparation Extract after Accelerated Stability Testing

Authors: Sunita Makchuchit, Arunporn Itharat

Abstract:

Prasaprohyai, a Thai traditional medicine preparation listed in the Thai National List of Essential Medicines, is commonly used for treatment of fever and colds. Prasaprohyai preparation consists of 21 different plants, with Kaempferia galanga (50% w/w) as the main ingredient. The objective of this study was to investigate the anti-allergic activity of the crude extract from Prasaprohyai after accelerated stability test procedure. The method of extract used maceration in 95% ethanol and the crude extract was kept under accelerated condition at 40 ± 2 oC and 75 ± 5% relative humidity (RH) for six months. After six months of storage at 40 oC, the crude sample in various storage times (0, 15, 30, 45, 60, 90, 120, 150 and 180 days) were investigated for anti-allergic activity using IgE-sensitized RBL-2H3 cell lines. The results showed that the stability of crude ethanolic extract from Prasaprohyai under accelerated testing had no significant effect of anti-allergic activity when compared with day 0. The results showed that the ethanolic extract could be stored for two years at room temperature without loss of activity.

Keywords: accelerated stability, anti-allergy, prasaprohyai, RBL-2H3 cell lines

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1619 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population

Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

Abstract:

Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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1618 Influence of Infinite Elements in Vibration Analysis of High-Speed Railway Track

Authors: Janaki Rama Raju Patchamatla, Emani Pavan Kumar

Abstract:

The idea of increasing the existing train speeds and introduction of the high-speed trains in India as a part of Vision-2020 is really challenging from both economic viability and technical feasibility. More than economic viability, technical feasibility has to be thoroughly checked for safe operation and execution. Trains moving at high speeds need a well-established firm and safe track thoroughly tested against vibration effects. With increased speeds of trains, the track structure and layered soil-structure interaction have to be critically assessed for vibration and displacements. Physical establishment of track, testing and experimentation is a costly and time taking process. Software-based modelling and simulation give relatively reliable, cost-effective means of testing effects of critical parameters like sleeper design and density, properties of track and sub-grade, etc. The present paper reports the applicability of infinite elements in reducing the unrealistic stress-wave reflections from so-called soil-structure interface. The influence of the infinite elements is quantified in terms of the displacement time histories of adjoining soil and the deformation pattern in general. In addition, the railhead response histories at various locations show that the numerical model is realistic without any aberrations at the boundaries. The numerical model is quite promising in its ability to simulate the critical parameters of track design.

Keywords: high speed railway track, finite element method, Infinite elements, vibration analysis, soil-structure interface

Procedia PDF Downloads 245
1617 Preparation and Characterization of Chitosan Nanoparticles for Delivery of Oligonucleotides

Authors: Gyati Shilakari Asthana, Abhay Asthana, Dharm Veer Kohli, Suresh Prasad Vyas

Abstract:

Purpose: The therapeutic potential of oligonucleotide (ODN) is primarily dependent upon its safe and efficient delivery to specific cells overcoming degradation and maximizing cellular uptake in vivo. The present study is focused to design low molecular weight chitosan nanoconstructs to meet the requirements of safe and effectual delivery of ODNs. LMW-chitosan is a biodegradable, water soluble, biocompatible polymer and is useful as a non-viral vector for gene delivery due to its better stability in water. Methods: LMW chitosan ODN nanoparticles (CHODN NPs) were formulated by self-assembled method using various N/P ratios (moles ratio of amine groups of CH to phosphate moieties of ODNs; 0.5:1, 1:1, 3:1, 5:1, and 7:1) of CH to ODN. The developed CHODN NPs were evaluated with respect to gel retardation assay, particle size, zeta potential and cytotoxicity and transfection efficiency. Results: Complete complexation of CH/ODN was achieved at the charge ratio of 0.5:1 or above and CHODN NPs displayed resistance against DNase I. On increasing the N/P ratio of CH/ODN, the particle size of the NPs decreased whereas zeta potential (ZV) value increased. No significant toxicity was observed at all CH concentrations. The transfection efficiency was increased on increasing N/P ratio from 1:1 to 3:1, whereas it was decreased with further increment in N/P ratio upto 7:1. Maximum transfection of CHODN NPs with both the cell lines (Raw 267.4 cells and Hela cells) was achieved at N/P ratio of 3:1. The results suggest that transfection efficiency of CHODN NPs is dependent on N/P ratio. Conclusion: Thus the present study states that LMW chitosan nanoparticulate carriers would be acceptable choice to improve transfection efficiency in vitro as well as in vivo delivery of oligonucleotide.

Keywords: LMW-chitosan, chitosan nanoparticles, biocompatibility, cytotoxicity study, transfection efficiency, oligonucleotide

Procedia PDF Downloads 822
1616 Composite 'C' Springs for Anti-Seismic Building Suspension: Positioning 'Virtual Center of Pendulation above Gravity Center'

Authors: Max Sardou, Patricia Sardou

Abstract:

Now that weight saving is mandatory, to author best knowledge composite springs, that we have invented, are best choice for automotive suspensions, against steel. So, we have created a Joint Ventures called S.ARA, in order to mass produce composite coils springs. Start of Production of composite coils springs was in 2014 for AUDI. As we have demonstrated, on the road, that composite springs are not a sweet dream. The present paper describes all the benefits of ‘C’ springs and ‘S’ springs for high performance vehicles suspension, for rocket stage separation, and for satellite injection into orbit. Developing rocket stage separation, we have developed for CNES (Centre National d’Etudes Spatiales) the following concept. If we call ‘line of action’ a line going from one end of a spring to the other. Our concept is to use for instance two springs inclined. In such a way that their line of action cross together and create at this crossing point a virtual center well above the springs. This virtual center, is pulling from above the top stage and is offering a guidance, perfectly stable and straight. About buildings, our solution is to transfer this rocket technology, creating a ‘virtual center’ of pendulation positioned above the building center of gravity. This is achieved by using tilted composite springs benches oriented in such a way that their line of action converges creating the ‘virtual center’. Thanks to the ‘virtual center’ position, the building behaves as a pendulum, hanged from above. When earthquake happen then the building will oscillate around its ‘virtual center’ and will go back safely to equilibrium after the tremor. ‘C’ springs, offering anti-rust, anti-settlement, fail-safe suspension, plus virtual center solution is the must for long-lasting, perfect protection of buildings against earthquakes.

Keywords: virtual center of tilt, composite springs, fail safe springs, antiseismic suspention

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1615 Design of a Hand-Held, Clamp-on, Leakage Current Sensor for High Voltage Direct Current Insulators

Authors: Morné Roman, Robert van Zyl, Nishanth Parus, Nishal Mahatho

Abstract:

Leakage current monitoring for high voltage transmission line insulators is of interest as a performance indicator. Presently, to the best of our knowledge, there is no commercially available, clamp-on type, non-intrusive device for measuring leakage current on energised high voltage direct current (HVDC) transmission line insulators. The South African power utility, Eskom, is investigating the development of such a hand-held sensor for two important applications; first, for continuous real-time condition monitoring of HVDC line insulators and, second, for use by live line workers to determine if it is safe to work on energised insulators. In this paper, a DC leakage current sensor based on magnetic field sensing techniques is developed. The magnetic field sensor used in the prototype can also detect alternating current up to 5 MHz. The DC leakage current prototype detects the magnetic field associated with the current flowing on the surface of the insulator. Preliminary HVDC leakage current measurements are performed on glass insulators. The results show that the prototype can accurately measure leakage current in the specified current range of 1-200 mA. The influence of external fields from the HVDC line itself on the leakage current measurements is mitigated through a differential magnetometer sensing technique. Thus, the developed sensor can perform measurements on in-service HVDC insulators. The research contributes to the body of knowledge by providing a sensor to measure leakage current on energised HVDC insulators non-intrusively. This sensor can also be used by live line workers to inform them whether or not it is safe to perform maintenance on energized insulators.

Keywords: direct current, insulator, leakage current, live line, magnetic field, sensor, transmission lines

Procedia PDF Downloads 146
1614 Asparagus racemosus Willd for Enhanced Medicinal Properties

Authors: Ashok Kumar, Parveen Parveen

Abstract:

India is bestowed with an extremely high population of plant species with medicinal value and even has two biodiversity hotspots. Indian systems of medicine including Ayurveda, Siddha and Unani have historically been serving humankind across the world since time immemorial. About 1500 plant species have well been documented in Ayurvedic Nighantus as official medicinal plants. Additionally, several hundred species of plants are being routinely used as medicines by local people especially tribes living in and around forests. The natural resources for medicinal plants have unscientifically been over-exploited forcing rapid depletion in their genetic diversity. Moreover, renewed global interest in herbal medicines may even lead to additional depletion of medicinal plant wealth of the country, as about 95% collection of medicinal plants for pharmaceutical preparation is being carried out from natural forests. On the other hand, huge export market of medicinal and aromatic plants needs to be seriously tapped for enhancing inflow of foreign currency. Asparagus racemosus Willd., a member of family Liliaceae, is one of thirty-two plant species that have been identified as priority species for cultivation and conservation by the National Medicinal Plant Board (NMPB), Government of India. Though attention is being focused on standardization of agro-techniques and extraction methods, little has been designed on genetic improvement and selection of desired types with higher root production and saponin content, a basic ingredient of medicinal value. The saponin not only improves defense mechanisms and controls diabetes but the roots of this species promote secretion of breast milk, improved lost body weight and considered as an aphrodisiac. There is ample scope for genetic improvement of this species for enhancing productivity substantially, qualitatively and quantitatively. It is emphasized to select desired genotypes with sufficient genetic diversity for important economic traits. Hybridization between two genetically divergent genotypes could result in the synthesis of new F1 hybrids consisting of useful traits of both the parents. The evaluation of twenty seed sources of Asparagus racemosus assembled different geographical locations of India revelled high degree of variability for traits of economic importance. The maximum genotypic and phenotypic variance was observed for shoot height among shoot related traits and for root length among root related traits. The shoot height, genotypic variance, phenotypic variance, genotypic coefficient of variance, the phenotypic coefficient of variance was recorded to be 231.80, 3924.80, 61.26 and 1037.32, respectively, where those of the root length were 9.55, 16.80, 23.46 and 41.27, respectively. The maximum genetic advance and genetic gain were obtained for shoot height among shoot-related traits and root length among root-related traits. Index values were developed for all seed sources based on the four most important traits, and Panthnagar (Uttrakhand), Jodhpur (Rajasthan), Dehradun (Uttarakhand), Chandigarh (Punjab), Jammu (Jammu & Kashmir) and Solan (Himachal Pradesh) were found to be promising seed sources.

Keywords: asparagus, genetic, genotypes, variance

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1613 Impact of Water Interventions under WASH Program in the South-west Coastal Region of Bangladesh

Authors: S. M. Ashikur Elahee, Md. Zahidur Rahman, Md. Shofiqur Rahman

Abstract:

This study evaluated the impact of different water interventions under WASH program on access of household's to safe drinking water. Following survey method, the study was carried out in two Upazila of South-west coastal region of Bangladesh namely Koyra from Khulna and Shymnagar from Satkhira district. Being an explanatory study, a total of 200 household's selected applying random sampling technique were interviewed using a structured interview schedule. The predicted probability suggests that around 62 percent household's are out of year-round access to safe drinking water whereby, only 25 percent household's have access at SPHERE standard (913 Liters/per person/per year). Besides, majority (78 percent) of the household's have not accessed at both indicators simultaneously. The distance from household residence to the water source varies from 0 to 25 kilometer with an average distance of 2.03 kilometers. The study also reveals that the increase in monthly income around BDT 1,000 leads to additional 11 liters (coefficient 0.01 at p < 0.1) consumption of safe drinking water for a person/year. As expected, lining up time has significant negative relationship with dependent variables i.e., for higher lining up time, the probability of getting access for both SPHERE standard and year round access variables becomes lower. According to ordinary least square (OLS) regression results, water consumption decreases at 93 liters for per person/year of a household if one member is added to that household. Regarding water consumption intensity, ordered logistic regression (OLR) model shows that one-minute increase of lining up time for water collection tends to reduce water consumption intensity. On the other hand, as per OLS regression results, for one-minute increase of lining up time, the water consumption decreases by around 8 liters. Considering access to Deep Tube Well (DTW) as a reference dummy, in OLR, the household under Pond Sand Filter (PSF), Shallow Tube Well (STW), Reverse Osmosis (RO) and Rainwater Harvester System (RWHS) are respectively 37 percent, 29 percent, 61 percent and 27 percent less likely to ensure year round access of water consumption. In line of health impact, different type of water born diseases like diarrhea, cholera, and typhoid are common among the coastal community caused by microbial impurities i.e., Bacteria, Protozoa. High turbidity and TDS in pond water caused by reduction of water depth, presence of suspended particle and inorganic salt stimulate the growth of bacteria, protozoa, and algae causes affecting health hazard. Meanwhile, excessive growth of Algae in pond water caused by excessive nitrate in drinking water adversely effects on child health. In lieu of ensuring access at SPHERE standard, we need to increase the number of water interventions at reasonable distance, preferably a half kilometer away from the dwelling place, ensuring community peoples involved with its installation process where collectively owned water intervention is found more effective than privately owned. In addition, a demand-responsive approach to supply of piped water should be adopted to allow consumer demand to guide investment in domestic water supply in future.

Keywords: access, impact, safe drinking water, Sphere standard, water interventions

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1612 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

Abstract:

Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain

Procedia PDF Downloads 233