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Lupine Publishers | Lupine Publishers | The Possibility of Complex Treatment of Optic Nerve Atrophy based on Etiopathogenetic Approach using the New Classification of this Ophthalmopathology

Open Access Journal of Biomedical Engineering and Biosciences

Lupine Publishers |  Open Access Journal of Biomedical Engineering and Biosciences

Abstract

Application of treatment, differentiated based on the degree of functional changes and stages of atrophy, type of atrophy and nature of the lesion, significantly alters the effectiveness of treatment when compared to the isolated electropharmocological stimulation and even more so compared to the traditional medication method of treatment.

Keywords: New clinical classification and treatment of optic nerve atrophy

Abbrevations:  ONA: Optic Nerve Atrophy; PONA: Partial Optic Nerve Atrophy

Introduction

Optic nerve atrophy (ONA) is the end result of disease, intoxication, genetically determined abnormality or injury of retinal ganglion cells and/or their axons situated between the retina and the lateral geniculate bodies of the brain. The prevalence percentage of various optic nerve diseases in the eye disease hospital is approximately 1-1.5%, 19 to 26% of those cases resulting in complete atrophy of the optic nerve and incurable blindness. Causes of ONA are: diseases of retina and optic nerve (inflammation, dystrophy, including glaucomatic and involutional, poor circulation due to hypertension, atherosclerosis, diabetes, etc., swelling, profuse bleeding, compression and damage of the optic nerve), diseases and injuries of the orbit, Central nervous system diseases (optic-chiasm leptomeningitis, abscesses and brain tumors with increased intracranial pressure, neurosyphilis, demyelinating disease, traumatic brain injury), intoxication with methyl alcohol, antibiotics (streptomycin, gentamicin), anti- malarial drugs (quinine, hingamin). ONA may be a component or sole manifestation of a number of hereditary diseases (congenital amaurosis, hereditary optic nerve atrophy, etc.) [1,2].

Table 1:Clinical Classification of the Partial Optic Nerve Atrophy.

Treatment of optic nerve atrophy is a very complex and difficult problem because of the extremely limited regenerative ability of the neural tissue. All depends on how widespread the degenerative process in the nerve fibers is and whether their viability is preserved. Some progress in the treatment of optic nerve atrophy has been achieved with the help of pathogenetically directed influences aimed to improve the viability of nervous tissue. The development of new methods of treatment of partial optic nerve atrophy (PONA) has greatly enhanced the possibility of rehabilitation of patients with this pathology. However, the abundance of methods in the absence of clear indications complicates the choice of a treatment plan in each individual case. [1,3,4,5,6,7] The analysis of literature on diagnosis and treatment of PONA showed lack of clear classification and the existence of various approaches to the assessment of the severity of the disease[2,8,9,10]. The following classification presented in Table 1 was used to determine the treatment plan [7,9]. The purpose of work. To create a method of optic nerve atrophy treatment differentiated depending on severity and other individual characteristics of the patient and to analyze the effect of the application of this technique.

Material and Methods

To treat the patients with partial atrophy of the optic nerve, we use the following methods. Infita-a low-frequency pulse physiotherapy device designed to expose the central nervous system (CNS) to low-frequency pulse electromagnetic field (without direct contact with the patient), which results in an improved central blood flow, saturation of blood with oxygen, and increased redox processes in the nervous tissue. It has as the following characteristics: no output signal - a triangular voltage pulse with negative polarity, pulse frequency 20 - 80 Hz (most frequently used 40 - 60 Hz), pulse duration of 3 ± 2 V, recommended number of procedures 12 - 15, starting with 5 minutes, increasing to 10 and then 12 minutes beginning with the fifth procedure and so on up to 12 treatments. Treatment method, hereinafter called the direct electropharmacological stimulation (EPS), includes installation of a soft PVC catheter into the retrobulbar space and a repeated inoculation of various medications through it into the retrobulbar space selected based on the etiopathogenesis of the atrophy. All patients were infused with a 10% solution of piracetam and exposed to electrical stimulation through a needle electrode inserted into the retrobulbar space through the catheter with the device "AMPLIPULS" 40 minutes later [11,12].

Also the following surgical methods can be used -ligation of the superficial temporal artery, implantation of a collagen sponge into the subtenon space, decompression of the optic nerve. In connection with the specifics of performing of surgical procedures in our clinic the technique of their execution is given below. Ligation of the superficial temporal artery. Local anesthesia - lidocaine 2.0 % subcutaneously. A 3 cm long skin incision is made 1 cm in front of the tragus. The tissue is bluntly separated. The superficial temporal artery is ligated with two stitches and overlaps between them. Albucidum powder is infused into the wound. The soft tissue is sutured with catgut suture. Silk sutures are placed on the skin. The wound is treated with a solution of brilliant green dye, aseptic sticker is placed. Implantation of a collagen sponge into the subtenon space. Local anesthesia - lidocaine 2,0 % subcutaneously and dicain 0,5 epibulbarly. A 5-6 mm long skin incision is made in the upper nasal quadrant 5-6 mm away from the limbus, parallel to the limbus. A tunnel is formed between the sclera and the capsule of tenon to the posterior pole using a spatula. An implant of a collagen sponge 10 - 8 mm long and 5 - 6 mm wide, pre-soaked with the solution of emoxipine (cortexin, retinalamin and other drugs or their combinations) is implanted into the tunnel closer to the optic nerve. The suture is placed on the conjunctiva and under the conjunctiva, followed by antibiotics and dexamethasone. After the implantation, antibiotics and a solution of diclofenac is applied locally for 5 - 7 days [13,14].

Decompression of the optic nerve is performed under general anesthesia. Blepharostat is used. An incision is made on the inner side of the conjunctiva. The internal straight muscle is sutured up in front the tendon and is clipped off. Three incisions of the scleral ring around the optic nerve are made. The solution of albucid is applied, and the muscle is locked in place. The suture is placed on the conjunctiva. Dixon and antibiotics are placed under the conjunctiva. The following scheme of treatment was suggested for the peripheral section of the optic nerve:

i. Degree: Emoksipin + dexamethasone subcutaneously in the region of the mastoid process, mildronat + emoxipin subcutaneously in the temple region, vitamin B1 1,0, alternate vitamin B6 1.0 V/m with piracetam 5.0 V/m, low-frequency electromagnetic stimulation.

ii. Degree: Catheterization of the retrobulbar space, direct EPS + long-term melioration: dexamethasone + emoksipin 2 times, piracetam (or other schemes depending on etiology), implantation of a collagen sponge with emoxipin into the subtenon space (ICS), piracetam 20,0 intravenously with physiological saline 200,0.

iii. Degree: Catheterization of the retrobulbar space, direct EFS + piracetam, dexamethasone, emoksipin 2 times a day. Implantation of a collagen sponge with emoxipin into the subtenon space, ligation of the superficial temporal artery, piracetam 20,0 intravenously with physiological saline 200,0.

iv. Degree: Step 1 - decompression of the optic nerve, step 2 or in case step 1 is not possible (severe somatic pathology) - catheterization + direct EFS, piracetam, dexamethasone, emoksipin 2 times retrobulbarly into the catheter. Ligation of the superficial temporal artery (if not done earlier). Implantation of a collagen sponge with emoxipin into the subtenon space, fenotropil tablets according to the treatment scheme, piracetam 20,0 intravenously with physiological saline 200,0.

Treatment scheme for the lesion of the central part of the visual pathway.

a. Stage I: Glycine 1 tablet 3 times a day sublingually for one month, cavinton according to the treatment scheme, then phenotropil (tablets) according to the treatment scheme. "Infita” - percutaneous low-frequency electrical stimulation.

b. Stage II: Cortexin intramuscularly No. 10. Trental intravenously in a physiological saline No. 5 (or aminophylline). Cerebrolysin intravenously No. 5. Glycine 1 tablet 3 times a day for one month. "Infita” low-frequency electrical stimulation.

c. Stage III: Cortexin intramuscularly No. 10. Glycine sublingually 1 tablet 3 times a day for one month. Trental intravenously in a physiological saline No. 5 (or aminophylline). Cerebrolysin or actovegin intravenously No. 5. Piracetam 5,0 intramuscularly No. 10. Antiplatelet agents (aspirin, clopidogrel) if necessary.”Infita” - percutaneous low-frequency electrical stimulation.

d. Stage IV: Cortexin intramuscularly No. 10.Emoxipin intramuscularly No. 10. Trental intravenously No. 5. Cerebrolysin or actovegin or solkoseril No. 10 Piracetam 5,0 intramuscularly No. 10. Antiplatelet agents (aspirin, clopidogrel) if necessary. Catheterization with direct EPS, dexamethasone, piracetam, emoksipin retrobulbarly into the catheter.

In case of total lesion of the visual pathway the elements of both treatment schemes of the corresponding stages are combined. To compare the effectiveness of different PONA treatment schemes three groups of patients were formed. The first group consisted of 358 patients (508 eyes) with optic atrophy of various etiology and pathogenesis, getting treatment, differentiated based on the stage, localization and duration of existence of atrophy. The second group consisted of patients who, regardless of the stage of atrophy, were subjected to a course of electropharmacological stimulation: 107 patients (152 eyes). The control group consisted of 77 patients (126 eyes) who received only medication treatment. The percentage composition of the main types of dystrophy in all three groups was similar.

The main study group consisted of 136 glaucoma patients (183 eyes), 81 patients (122 eyes) with the atrophy of vascular origin, post-inflammatory atrophy was observed in 51 (76 eyes), cerebral in 25 patients (50 eyes), traumatic 52 patients (52 eyes), toxic in 13 patients (25 eyes). The second group included 36 patients with glaucoma (46 eyes), 14 patients (38 eyes) with the atrophy of vascular origin, post-inflammatory atrophy was observed in 16 (24 eyes), cerebral in 5 patients (10 eyes), traumatic in 18 patients (18 eyes), toxic in 8 patients (16 eyes). The control group consisted of 24 patients with glaucoma (42 eyes), 21 patients (32 eyes) with the atrophy ofvascular origin, post-inflammatory atrophy was observed in 14 people (22 eyes), cerebral in 3 patients (6 eyes), traumatic in 8 patients (10 eyes), and toxic in 7 patients (14 eyes). Patients of this group were treated in a conservative manner: emoxipin with mildronate subcutaneously in the temple region, emoksipin with dexamethasone subcutaneously in the area of the mastoid process, taufon under the conjunctiva, piracetam intramuscularly. The result of the treatment of patients with partial atrophy of the optic nerve depending on the type of treatment can be seen in Tables 2 & 3.

Table 2:Results of treating patients with partial atrophy of the optic nerve.

Table 3:Results of treating patients with partial atrophy of the optic nerve.

Note: p<0.01, compared to the values before treatment.

No cases of deterioration were recorded.

Conclusion

Medication therapy combining medications which have various effects on the nervous tissue is effective only for the initial stages of atrophy of the optic nerve. Also, the use of non-invasive physiotherapeutic methods is effective in early stages. The use of direct electropharmacological stimulation is more reasonable for advanced stages, and surgical methods - for severe cases. The use of treatment, differentiated based on the degree of functional changes, the type of atrophy and the nature of the lesion, significantly increases the effectiveness of treatment compared to the isolated use of EPS and even more so compared to medical treatment.

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Lupine Publishers| Hypertrophic Cardiomiopathy in Children: The Need of Heart Transplantation

Lupine Publishers | Cardiovascular Research

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common cardiac disease affecting the cardiac muscle. It can manifest in different forms with or without left ventricular outflow obstruction, with or without right ventricle involvement. Forms with biventricular hypertrophy seem to have poor prognosis. In our case, we describe a young patient with sarcomeric biventricular hypertrophic cardiomyopathy (MYH7 mutation), the poor prognosis of this form and strategies options adopted after failure of medical treatment. It is not always easy the management of hypertrophic cardiomiopathy, after medical treatment failure, especially in children. In some cases, heart transplantation is the only one therapeutic option.

Keywords: Hypertrophic Cardiomiopathy; Right Ventricular Hypertrophy; Heart Transplantation

Introduction

Hypertrophic cardiomiopathy (HCM) is the most common cardiac disease affecting the cardiac muscle and is characterized by heterogeneous genetic, morphological, functional, and clinical features. It is also one of the main causes of sudden cardiac death (SDC) in the young. Left ventricular hypertrophy with left ventricular outflow obstruction (LVOTO) is the most characteristic feature of HCM. There are also variant of HCM without LVOTO, with apical hypertrophy, with medio-ventricular obstruction and with right ventricular hypertrophy. The treatment and the prognosis of HCM seem to be variable on the basis of different forms, the age at presentation, sarcomeric gene mutations or rare phenocopies. Heart transplantation (HT) is the only therapeutic option for selected patients with HCM and refractory heart failure. In effect ESC guidelines recommend heart transplantation in eligible patients who have an LVEF < 50% and NYHA functional Class III–IV symptoms despite optimal medical therapy or intractable ventricular arrhythmia (II a); in eligible patients with normal LVEF (50%) and severe drug refractory symptoms (NYHA functional Class III–IV) caused by diastolic dysfunction (II b)[1].

Right ventricular hypertrophy (SRVH) is a relatively rare subtype of HCM. The anatomic, genetic, clinical, and prognostic characteristics of patients with SRVH and the clinical relevance of these characteristics have not been described widely in the literature [2,3]. MYBPC3 gene mutations have previously been described in two patients with RV hypertrophy. In a recent study, 90% of HCM patients with SRVH were found to possess relevant sarcomere protein mutations and variations in the MYH7 (Myosin heavy chain 7) and TTN genes, followed by variations in MYBPC3. Always in this study 73% of HCM patients with SRVH and multiple sarcomere gene mutations had poor prognosis. 7 In addiction MYH7 mutations can cause hypertrophic cardiomyopathy or skeletal myopathies with or without cardiac involvement, on the basis of the side of mutation. In our case, we describe the poor prognosis and treatment strategies of a young patient with biventricular hypertrophic cardiomyopathy and MYH7 mutation.

Case Report

A 12-year-old young woman with familiarity for hypertrophic cardiomyopathy (mother and mother’s twin with biventricular hypertrophic cardiomiopathy and MYH7 mutation) was hospitalized in our hospital for dyspnea after mild-moderate efforts and reduced functional capacity (NYHA Class II). Mother and aunt of the patient were asymptomatic with good functional capacity. Patient had the same genetic mutation of mother and aunt (p.Asn696Ser heterozygosis MYH7) but with increased and poor phenotypic expression [4]. Echocardiography and cardiac magnetic resonance were performed showing a hypertrophic cardiomyopathy with right ventricular involvement. Precisely, cardiovascular imaging showed left ventricle asymmetric hypertrophy especially at the level of anterior and inferior wall (basal and mild anterior wall =14 mm, z score= 3,5; antero-lateral basal wall = 12 mm, z score 2,78; mild inferior wall = 14 mm and apical inferior wall = 12 mm) with normal ejection fraction (FE = 62% at CMR) and moderate diastolic dysfunction (panel B and D). In addiction wall thickness of right ventricle outflow and basal-mild free wall were increased (= 13 mm) with apical obstruction and development of maximum gradient of 10 mmHg (PANEL A and C) [5,6] (Figure 1).

Figure 1.  

The function of right ventricle was at inferior limits (FE = 51% at CMR, TAPSE = 16 mm at echocardiography). Thus the patient had an interesting right ventricle involvement and moderate diastolic dysfunction of left ventricle. She had not arrhythmia at ECG-Holter but she had reduced functional capacity. also demonstrated at stress test. Stress test was suspended at 6 min (Bruce Protocol) after pre-syncopal symptoms: lack of adaptation of the blood pressure to the effort was observed. In addition, from several months she had pre-syncopal episodes at the peak of the effort. ECG showed left ventricular hypertrophy and biatrial enlargement. Pro BNP was increased = 5841 pg/ml. Considering clinical situation, we decided to start medical treatment with betablockers (bisoprolol) but the patient didn’t tolerate medical treatment. Thus, we decided to start low dose of captopril without improvement of symptomatology. Also, treatment with diuretic was not tolerate by patient [7,8]. Therefore, considering symptom refractory to medical therapy, the poor prognosis and the impossibility to optimize medical treatment, we decided to plan cardiac transplantation, the only option possible at this moment.

Thus right catheterization was performed and patient was inserted in heart transplantation list. ICD implantation was not considered in the absence of ventricular arrhythmia and other factors. Discussion: hypertrophic cardiomyopathy associated with MYH7 mutation and right ventricle involvement seems to have poor prognosis, especially if right ventricle hypertrophy is severe [9]. In effect the young patient had a greater right ventricular hypertrophy compared than mother and aunt. In these cases, after medical treatment failure, heart transplantation seems to be the only strategy to improve symptomatology and quality of the life of the patient. Especially in pediatric population, it is not always easy the management of hypertrophic cardiomiopathy after medical treatment failure and heart transplantation seems to be the only one therapeutic option. Other study are needed to study some variants of HCM with right ventricle hypertrophy, their treatment and prognosis.

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Lupine Publishers | Recognizing, Detecting and Understanding the Development of Lipid Oxidation Off-Flavors in Foods and Beverages

Lupine Publishers | Agriculture Open Access Journal

Lipid oxidation is a major cause of off-flavor problems in the food industry. Lipid oxidation products can be difficult to detect and identify. New sample preparation techniques to extract lipid oxidation products prior to GC-MS analysis and innovative more sensitive GC-TOFMS instrumentation that performs peak de convolution with co eluting chromatographic peaks are critical to detecting these chemicals and diagnosing possible mechanisms of lipid oxidation. The goal of this article is to show how these new analytical technologies have been applied to solving lipid oxidation problems in milk, ice cream, onion dip, sour cream, powdered nondairy creamer, bottled water, and omega-3 fortified foods.

Keywords: Lipid oxidation products; Aldehydes; Ketones, Dimethyl disulfide; Odor synergy effects

Abbreviations: GC-TOFMS: Gas Chromatography Time-of-Flight Mass Spectrometry; DTD: Direct Thermal Desorption; PDMS: Polydimethyl Siloxane; SBSE: Stir Bar Sorptive Extraction; HSSE: Headspace Sorptive Extraction; TDU: Thermal Desorption Unit; CIS: Cooled Injector System; MPS: Multi-Purpose Sampler; TIC: Total Ion Chromatogram; DHA: Docosa Hexaenoic Acid; EPA: Eicosa Pentaenoic Acid; DHS: Dynamic Headspace

Introduction

The majority of customer off-flavor complaints about food and beverage products are probably related to lipid oxidation products (aldehydes, ketones, etc.). Since lipid oxidation problems can cause product recalls and expensive lawsuits, they must be dealt with quickly. This article will discuss examples of lipid oxidation problems and how, in many cases, the lipid oxidation off-flavor contaminants couldn’t be readily characterized as originating from lipid oxidation. It will discuss how new technology in sample preparation/extraction coupled with gas chromatographic time-offlight mass spectrometry (GC-TOFMS) instrumentation and peak deconvoluton software can provide insights into the nature of lipid oxidation off-flavors. As the following examples will demonstrate, it is remarkable how many types of foods and beverages are impacted by oxidation, how many unusual ways lipid oxidation contaminants can form, how difficult it is to detect and measure the causative chemicals, and how new analytical techniques are assisting in the elucidation of the oxidation mechanisms involved.

Results and Procedure

Unprecedented levels of oxidation off-flavor complaints in milk

Dairy food companies have long been aware of off-flavors caused by butterfat oxidation when milk is exposed to direct sunlight or fluorescent lights in the supermarket dairy case. Companies have gone to great lengths to minimize light exposure from artificial light in supermarkets. A few years ago, the largest domestic fluid milk producer was encountering unprecedented off-flavor complaints in the late winter and early spring. While the problem has been a common industry occurrence, it had been getting worse in recent years. Based on initial sensory testing, the complaints seemed to be related to lipid oxidation even though the company employed packaging to mitigate the problem. Light exposure causes chemical reactions in milk that can modify the proteins and fats to produce many negative flavors, ranging from burnt (burnt feathers or hair) to cardboard or metallic. The resulting off-flavors are dependent upon various factors such as exposure time, intensity and wavelength of light exposure, and composition of the milk [1]. Gas Chromatography-mass spectrometry (GC-MS) testing revealed higher levels of hexanal, heptanal and other lipid oxidation aldehydes and ketones had formed in the milk, in addition to elevated levels of dimethyl disulfide, an off-flavor chemical that forms from the degradation of the sulfur-containing amino acid methionine when it is exposed to UV radiation. The aldehydes, ketones and dimethyl disulfide were detected in ppb levels by a technique called headspace solid-phase micro extraction (SPME) GC-MS.

Elevated levels of dimethyl disulfide in all complaints confirmed that light abuse was the cause of the lipid oxidation off-flavors. The critical questions facing dairy technologists: Why were unusually high concentrations of lipid oxidation off-flavors forming in the milk, and how could the problem be eliminated? Chemists used different GC-MS techniques to analyze butterfat profiles. To their surprise, the composition of the butterfat triglycerides was atypical in complaints, containing significantly higher levels of linoleic acid than normal, thus making it more susceptible to lipid oxidation. Further investigation revealed the reason for the change in the fatty acid profile of the milk. During the past few years, dairy farmers were feeding their cows increasing levels of soybeans, a cheap feed source, in their winter rations. This modification in their diet caused modification in the fatty acids profile of milk, increasing levels of linoleic and linolenic acids in the butterfat and elevating levels of malodorous lipid oxidation byproducts. Dairy farmers who supplied milk to the company were told to decrease levels of soybean meal in their winter rations and to add higher levels of vitamin E (antioxidant) supplements to reduce lipid oxidation. Headspace SPME-GC-MS was used to monitor milk from individual dairy farms to ensure compliance.

Vanilla ice cream with “burnt-feathers” off-flavor

Another interesting problem related to photo degradation of dairy components occurred with vanilla ice cream samples that were stored in a new freezer warehouse facility in Milwaukee, WI. The dairy company began receiving off-flavor complaints (putrid, burnt-feathers malodor) immediately after ice cream samples were shipped to supermarkets from their new freezer warehouse. Food technologists suspected samples were contaminated with a foreign chemical present in the warehouse. However, when they inspected the warehouse, no source could be identified. The complaints continued. GC-MS analysis using a technique called purge-and-trap GC-MS (with Tenax TA as the trapping sorbent followed by GC-MS analysis) revealed the offending chemical was dimethyl disulfide. Protein degradation reactions by microbial enzymes could be a source of the dimethyl disulfide. But high concentrations of hexanal from lipid oxidation reactions in the complaints compared to normal tasting samples from the same lot indicated that the samples may have experienced photo degradation reactions. Other clues supported this theory. For example, the ice cream packaging had a clear plastic lid that allowed light exposure. Not all the samples placed in the warehouse developed the off-flavor.

Food technologists returned to inspect the warehouse a second time – this time looking for potential light sources. The warehouse was equipped with high intensity lights, which were suspected as the cause. It was noted that product stored on the top shelf’s in the warehouse were in close proximity to the lights. A new production lot of ice cream was brought into the warehouse. Half of the ice cream on the top shelf was covered with a tarpaulin. Uncovered samples stored on the top shelves developed high levels of dimethyl disulfide (from photo degradation of methionine), while none of the covered samples developed the off-odor. Figure 1 shows chromatograms of a control (normal tasting sample covered by tarpaulin and a complaint uncovered sample with excessive formation of dimethyl disulfide. Technically lipid oxidation wasn’t the cause of the off-flavor. However, excessive concentration of hexanal indicated that photo oxidation could be a potential problem because of the degradation of methionine by high intensity lights. This is a good example of how chromatographic testing can be used to supply important indirect information regarding the origins of off-flavor development. In the milk sample discussed in section A, dimethyl disulfide was a confirmatory marker pointing to lipid oxidation products as the cause of off-flavor formation; in this ice cream example, elevation in hexanal levels in complaints was a good marker that the dimethyl disulfide was formed by photo degradation problems with the sulfur containing amino acid.

Figure 1:  Light-induced putrid off-flavor in vanilla ice cream by purge-and-trap (Tenax TA) GC-MS.

French onion dip exposed to lights in the supermarket

Sometimes the problem with resolving lipid oxidation off-flavors is that they’re not always easy to identify or are even suspected as a possibility. For example, samples of French onion dip were submitted for analysis because of an unidentified off-flavor. After extensive sensory paneling of ingredients used in the manufacture of the dip, no clear cause was evident. The dip manufacturer considered supermarket lighting could be the source of the offflavor problem but tended to rule it out because the product was sold in light-blocking packaging and the off-flavor wasn’t similar to the typical off-flavors that taint oxidized milk. The company resorted to SPME GC-MS testing but couldn’t detect any unusual chemical markers typical of lipid oxidation. As a last resort, the food chemists looked to more sensitive GC-MS sample preparation techniques prior to GC-MS. The technique that provided the first clues to the problem was headspace stir bar sorptive extraction (HSSE) GCTOFMS. Figure 2 shows a diagram explaining the experimental steps. To further improve GC-MS analysis, the Leco Pegasus HT time-of-flight mass spectrometer was used to increase sensitivity and provide peak de convolution advantages. A study was set up where normal-tasting control onion dip samples were exposed to UV lights under refrigerated conditions for up to a week of storage. The more sensitive extraction technique detected the tell-tale aldehyde and ketone lipid oxidation products in onion dip samples exposed to UV light for 7 days. HSSE using a PDMS Twister stir bar with 50 times more sorbent phase than a SPME fiber can be significantly more sensitive than SPME, and unlike SPME does not suffer from analyte competition effects with active sorbent sites. As in SPME testing, samples were heated to 50 °C for an hour during extraction while stirring a mixture of the onion dip and water with a Teflon-coated stir bar. Using a substantially more sensitive extraction technique generated complicated chromatograms with approximately 120 analytes being detected. Overlapping analyte peaks can be a problem. Peak de convolution capabilities become imperative for accurate quantization. The complaint had higher concentrations of all 15 oxidation products compared to control samples. Most significant off-flavor contributing lipid oxidation products were 2-hexenal; heptanal; 2,4-hexadienal; 2-pentyl furan; (E,E)-2,4-decadienal; t-2-nonenal; and nonanal.

Figure 2:  HSSE set up for PDMS Twister extraction using thermal desorption tube, thermal desorption unit (TDU), and cooled injection system (CIS) packed with glass wool.

These chemicals generated the stale taste of the product. Packaging related chemicals detected were styrene (plastic odor) and benzophenone (a photoinitiator used in inks on packaging). However, levels of these two chemicals were too low to be of concern. Approximately 25 different sulfur-containing onion flavor compounds were detected in the samples and were not significantly different in control and complaint sample. Six different lactones were detected in samples with higher levels present in complaint and light-exposed samples vs. controls. These included -caprolactone, -heptalactone, -octalactone, nonalactone, -decalactone, and -dodecalactone. While low levels of lactones can impart creamy desirable flavors to dairy products, higher levels can impart burnt, fruity, stale, and coconut off-flavors. Lipid oxidation was not initially suspected as the cause of the problems because of the packaging used and because the off-flavor was not recognized as a lipid oxidation off-flavor by sensory panelists – even though they were trained to identify lipid oxidation offflavors in milk. Background flavor chemicals from the onion flavoring were obscuring the lipid oxidation off-flavors, making them unrecognizable. In addition, a more sensitive extraction GCMS technique had to be used to detect the oxidation malodorants. The chemicals were difficult to extract by other sample preparation techniques because of the high fat content of the product. In addition, the Leco Pegasus GC-TOFMS was required because of its higher sensitivity and peak de convolution capabilities. The fast sampling rates of time-of-flight mass spectrometers generate higher data density than scanning quadruple mass spectrometers, thus providing superior peak de convolution capabilities [2]. Of course, the HSSE GC-TOFMS technique is useful for studying other types of off-flavors in French onion dip and other dairy products. One dip manufacturer was concerned about styrene contamination migrating from packaging and wanted a test that could reliably detect less than 5 ppb styrene in the dip. While SPME GC-MS couldn’t detect styrene levels at that low of level, HSSE GC-TOFMS was shown to detect as little as 0.1 ppb styrene.

Sour cream oxidation in pilot plant samples

A food company was experiencing off-flavor problems with a processing line that was used for sour cream production in its pilot plant research facility. It replaced all of the ingredients multiple times and still the problem persisted. Sensory paneling was unable to determine the cause of the off-flavor. Processing temperatures and heat exposure times were carefully monitored. Researchers speculated the problem was related to a microbial culture problem. SPME GC-MS was used to analyze samples. In this case, lipid oxidation aldehydes and ketones were detected but no dimethyl disulfide. While sensory paneling was incapable of recognizing oxidation off-flavors again because of background flavors associated with sour cream, GC-MS analysis clearly showed the off-flavors were caused by lipid oxidation of the butterfat. GC- -MS analysis provided even more insight into the cause for the formation of the lipid oxidation byproducts. Photo degradation was not likely the cause since dimethyl disulfide was not detected in the off-flavor samples. Contamination by contact with prooxidant metals was suspected. Inspection of chromatographic peaks identified by mass spectrometry ruled out bad fermentation metabolites. After consultation with the maintenance department that had recently performed “upgrades” to the processing line, food technologists learned that a new copper valve had been installed. After replacing the copper value with a stainless steel valve, the off-flavor problem disappeared. This is a good example of how profiling volatile chemicals with GC-MS can provide useful clues for investigating the source of off-flavor contamination. Using wet chemistry tests like TBARS assay and peroxide value test would not have provided the key clue that dimethyl disulfide was absent and that light oxidation was unlikely.

Detection of oxidation products in nondairy creamer

A large manufacturer of nondairy creamer (NDC) was experiencing off-flavor complaints with its NDC powder. Sensory analysis pointed to lipid oxidation, a common problem for this product. However, SPME GC-MS could only detect slightly elevated concentrations of hexanal in the complaints compared to the controls but could not detect other unsaturated oxidation chemicals that contribute more potent off-flavors. Again, chemists turned to a different, more sensitive analytical method direct thermal desorption (DTD) using a slitted microvial followed by GC-TOFMS [3]. A slitted microvial with 30mg of a vegetable oil is shown in Figure 3; for NDC testing, 30 mg of powder was placed in the slitted vial. Compared to the normal non-slitted vial that was typically used, the slitted vial extracted higher levels of volatiles from samples since the carrier gas flow generates more turbulence in the vial to flush out the volatiles analytes resulting in better sensitivity and lower detection limits Figures 4 & 5 shows a NDC sample in the slitted vial and in the vial placed in the thermal desorption tube tray of the auto sampler in preparation for thermal desorption in the Gerstel Thermal Desorption Unit (TDU). During the thermal desorption process, volatiles are cryogenically trapped with liquid nitrogen cooling in the Cooled Injector System (CIS). The system is the same as shown in Figure 2, only substituting the thermal desorption tube with a PDMS Twister stir bar with a tube containing the NDC sample in the microvial. The SPME GC-MS test used one gram sample weights of NDC added to 4 milliliters of deionized water and 1 gram of sodium chloride (Figure 6).

Figure 3:  Microvial with slit 1 cm from bottom of vial with 30 mg edible oil sample for direct thermal desorption (DTD).

Figure 4:  Analysis of edible oil by DTD GC-TOFMS with slitted microvial showing carrier gas flow with increased turbulence.

Figure 5:  Analysis nondairy creamer by DTD with slitted vial and tube tray holder for automated analysis.

Figure 6:  30 mg nondairy creamer analyzed by DTD GC-TOFMS showing lipid oxidation products and added flavorants.

The sample, water, and salt were added to a 20mL GC vial, heated to 50°C for 20 min and extracted with a SPME fiber. Hexanal was the only lipid oxidation product detected. The top trace in Figure 7, shows these results. With the new DTD-GC-TOFMS technique using a slitted microvial and robotic thermal desorption instrumentation from Gerstel Inc., 30 mg of NDC was added to a Gerstel thermal desorption tube. The sample tube was placed in the Gerstel Multi- Purpose Sampler (MPS), the auto sampler. The sample was heated to 100°C for 15 min, while the eluting volatiles were cold trapped in a PTV injector (Gerstel CIS) cooled to -80°C. Once all the volatiles were trapped, the PTV was rapidly heated to 260°C, releasing the volatiles into the GC capillary column where they could be separated and sent to the TOFMS detector for detection and identification. Even though the DTD sample preparation technique used only 30mg of sample, it detected eleven different lipid oxidation products that the SPME GC-MS method could not detect. The improved sensitivity of the DTD test vs. SPME is attributed to the fact that DTD testing is an exhaustive volatile extraction technique. SPME is, by nature, an equilibrium extraction technique. Therefore, greater amounts of analytes are extracted by DTD than by SPME. In effect, much higher analyte recoveries are afforded by DTD than by SPME.

The chemists worried that the higher heating temperature used for DTD compared to SPME was generating more lipid oxidation products. They rationalized that increased oxidation was not likely occurring because of the higher heating temperature used in DTD compared to SPME because during thermal desorption of volatiles from the thermal desorption tube; the sample is continually flushed with helium so no air (oxygen) reaches the NDC sample. Additional experimentation, illustrated by the chromatograms in Figure 7, showed that this, indeed, was the case. A one gram sample of NDC was placed in the 20mL GC vial and heated to 100°C for 15 min. The sample was allowed to cool, and the water and salt were added. The sample was then subjected to the normal SPME test. No additional lipid oxidation chemicals were detected in the sample that was heated to 100°C for 15 min. However, some new chemicals were generated from the heating – furfural and furan methanol from thermal decomposition of sugars in the NDC. These chemicals were not detected in the sample when the DTD method was used, as illustrated in the chromatograms in Figure 6.

Figure 7:  Same nondairy creamer sample as Figure 6 by SPME GC-MS with Agilent 5973 MS.

DTD testing of control and complaint samples with DTD-GCTOFMS (Leco Pegasus HT GC-TOFMS) clearly showed that lipid oxidation products were a source of the off-flavors in the complaint samples. However, it also provided important clues as to the possible origin of these malodorous aldehydes and ketones. In addition to elevated levels of lipid oxidation products, DTD chromatograms revealed elevated levels of free fatty acids and other carboxylic acids (especially hexanoic acid) in complaint samples. These acids likely originated from the casein powder used in the product formulation. Casein powder has been shown to develop a characteristic “wetdog” malodor from microbiological spoilage, generating hexanoic acid and other volatiles acids. Sensory studies with hexanoic acid added to caseinate show positive correlation with a barny/ animal-like sensory attribute [4]. Follow-up studies showed that the lipid oxidation products as well as hexanoic and other acids in the retained caseinate powders were unusually high and were the primary contributors to the malodor of the complaint NDCs. So again, testing with GC-MS was able to not only reveal that lipid oxidation products were contributing off-flavors to the product, but that they were originating from the caseinate ingredient, not the more likely suspect – the vegetable oil used in the product. This is another example of potential of GC-MS techniques to reveal the source of off-flavors in food products.

Complaint with bottled water samples

Complaint and control bottled drinking water samples were submitted for analysis. Customers complained the water samples had a malodor reminiscent of motor oil. SPME-GC-MS, a common technique now employed in food industry laboratories for flavor studies, was used for testing volatiles. In this case, an olfactometry detector was added to the analytical instrumentation. With this accessory, the chemist injects a sample extract into the GC injector. The mixture of volatiles passes through the column, separate into component peaks, and exit the column. Half of the effluent is directed to the MS detector for peak identification and peak intensity measurement, while the other half goes to the olfactometry detector. Chemists or sensory scientists can then sniff each peak as it elutes from the column and determine the odor characteristics of each eluting peak. SPME GC-MS analysis of control and complaint samples did not reveal any significant chemical differences in the samples or any significant odors by olfactometry. The samples were reanalyzed using stir bar sorptive extraction (SBSE) GC-MS, a technique employing polydimethyl siloxane (PDMS) sorbent as an extract ant that can be 1000 times more sensitive than SPME-GCMS. It is further explained in Figure 8. SBSE is based on the Gerstel Twister→ (Baltimore, MD). For these samples, the 2cm PDMS Twister with 0.5mm film thickness (63μL volume) was used to increase analyte sensitivity. Thirty millilters of sample was stirred for 2hr. As shown in Figure 8, hexanal, heptanal, octanal, nonanal and decanal–all potential lipid oxidation products–were detected in all complaint samples but not in any of the control samples (or were at least at levels 10 higher in complaints vs. controls). Only hexanal was detected by SPME GC-MS even though the same type of GC column and chromatographic conditions were used. Flavor chemists know that this group of aliphatic aldehydes are potential lipid oxidation products but certainly don’t smell like motor oil. Furthermore, when the samples were injected into the GC-MS using SBSE-GC-MS, no odors were detected, except for octanal which had a slightly sweet/green odor. No other chemicals clues were present that could explain the cause of the malodor in the complaints. More testing that was conducted.

Figure 8:  Odor syngergy effects with aldehydes in bottled water by PDMS SBSE GC-TOFMS.

In every case, complaint waters had significantly higher levels of aliphatic aldehydes than controls. Aldehydes were the only significant peaks detected. On a hunch, the chemists considered possible odor synergy effects. Combinations of single chemicals can produce enhancing or masking effects odor sensory effects. In addition, cases of odor synergy effects have been known to create odors unrelated to the individual contributing chemicals, as explained in the next example for fishy malodors. Researchers conducted experiments to determine if various combinations of aldehydes smell like motor oil even though the individual aldehyde components did not [5]. When odor synergy effects are observed, combinations of two or more chemicals can generate odors that are total different and unrelated to the individual compounds when they are smelled individuals. To test if this was the case, chemists conducted a model systems study–subjecting a series of standards containing various combinations and concentrations of the aldehydes in DI water to sensory analysis. They were able to determine that a mixture of octanal and nonanal (>4.0 ppb and >6.0 ppb, respectively) generated the identical motor oil malodor. This was astonishing to the chemists and sensory scientists involved in the study since these well known chemicals had never been associated with a motor-oil type malodor. Figure 8 shows SBSE GC-TOFMS total ion chromatogram (TIC) results for the sensitive SBSE technique. One baffling question: What was the source of the lipid oxidation products present in bottled water–a product with no added unsaturated fat? Further investigation revealed the source of the aldehydes was photo degradation of erucamide, the amide of C22 mono-unsaturated erucic acid, the slip agent used in closures of the bottled water samples.

Omega-3 fortification causing fishy malodors

While oxidation reactions of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are responsible for fishy off-flavors in marine oils, gas chromatography-olfactometry (GC-O) and other types of analytical studies have failed to reveal which specific oxidation products are involved – until recently. GC-MS-O studies of marine oils with fishy malodors revealed approximately 32 lipid oxidation products irrespective of the analytical extraction technique used including SPME, dynamic headspace (DHS), or HSSE, but none were characterized as fishy. However, when all sample volatiles were captured together and then desorbed simultaneously in GC-O experiments, the fishy malodor was evident, indicating odorant synergy effects were responsible. By trapping various combinations of lipid oxidation products and then eluting them in GC-O experiments researchers were able to identify that the combination of two lipid oxidation products – heptanal and (E,Z)-3,5-octadien-2-one were responsible for the fishy malodor that develops with omega-3 products. Excluding either heptanal or (E,Z)-3,5-octadien-2-one eliminated the fishy malodor from omega-3 products [6]. To prove that heptanal and (E,Z)-3,5- octadien-2-one were synergistically involved with creating fishy malodor, researchers just trapped these two chemicals from a sample and released them simultaneously to the olfactometry port. A strong fishy malodor was observed. Next, they tried omission experiments. They injected a sample with fishy malodor and trapped all chemicals accept heptanal. When all chemicals minus the heptanal were released to the olfactometry detector, no fishy odor was detected. They repeated the experiment, but this time eliminating only the (E,Z)-3,5-octadien-2-one. Again no fishy malodor was detected.

Conclusion

The examples discussed in this report, show that detection of lipid oxidation products in complex samples and determining their mechanism of formation can be challenging. However, with the aid of modern innovative extraction techniques like SBSE, HSSE and DTD in combination with highly sensitive TOFMS detectors (e.g., Leco Pegasus HT TOFMS or the Leco BT TOFMS), it is possible to decipher critical causes of lipid oxidation off-flavors in foods and beverages so adjustments in ingredients, processing conditions or sample storage, can be made quickly to avoid product recalls and damage to a product’s reputation

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Lupine Publishers| Long Term Winter Season 2017/2018 Northern Hemisophere and Their Impact over Indonesia Maritime Continent Area

Lupine Publishers| Journal of Oceanography and petrochemical sciences

Short Communication

The winter season 2017/2018 could be one of the unusual condition with increasing the winter storm activities over Northern Hemisphere to affect aerodrome closed for certain airports in big city of the United States of America and Canada in Northern America Continent, it could be over European Countries and North Asian Continent. The freezing water Niagara for the first time during last 50 years could be additional condition from coolest than normal and it might longer than usual based upon public information and collecting the global climatic chart from National Climate Centers under coordination from the World Meteorological Organization. If the condition winter season 2017/2018 compared with previous condition especially in the 17 years or it could be more than that period, the winter season 2017/2018 could be worst condition and situation especially with winter storm occurrences over most northern hemisphere. Reversal condition over southern hemisphere with summer season with few day occurrences of the heat wave over Australia continent last January 2018. To assess the weather and climatic over the earth’s surface that weather and climate development came from uneven solar radiation (solar activities) received by the earth’s surface, it meant that solar radiation could consider as the main subject to asses/study the global circulation over lower atmosphere of the earth. Where we could consider solar radiation to have closed relation with solar activities in term of the sunspot and solar flare to investigate how much solar radiation/ energy emits from the center of the solar system.

In this case, the sunspot number counted every month could be used as the quantity and quality sun radiation/energy with high number of sunspot to represented large sun radiation received by the earth surface to the universe of the earth – sun system. It could also be with small number of sunspot with respect with the time especially daily, weekly, monthly, seasonally up to yearly basis to be represent less of the sun radiation received by the earth surface. From further assessment and study of the sunspot number has a relation with the weather and climate condition over the earth surface especially formation of the global air circulation both north – south between equator – north and south poles and east – west direction over the equator. High or maximum number of the sunspot on the monthly basis for 6 – 12 months duration could encourage global phenomena of the El Nino (warming sea surface temperature over equator east Pacific Ocean) and small or minimum number of the sunspot could encourage reversal El Nino in term of the La Nina. Both of the global phenomena would affect certain weather and climatic condition globally arising unusual weather and climatic pattern over the earth’s surface.

Based on the sunspot number on the monthly basis could be arranged in term of the sunspot cycle to represent from minimum number toward maximum as the peak sunspot number then to be going down toward minimum number. Now, there 24 sunspot cycles with one cycle having duration at about 11 years. It means every sunspot cycle has period between 10 – 12 years. At this period 2017/2018, sunspot cycle number 24 would be toward small number of minimum of the sunspot or minimum sun’s radiation received by the earth surface. Such that La Nina episode would active starting middle of the year 2016 up to beginning 2018. Where La Nina episode has large contribution in the developing equatorial wave of the so called Madden Julian Oscillation (MJO) which create intra seasonal weather and climatic condition over the tropical area especially over Indian Ocean Indonesia Maritime Continent and West Pacific Ocean. During MJO passing over the consecutive areas Indian Ocean – West Pacific Ocean, array of the large tower of cumulonimbus cloud would be active to support the tropical cyclone formation and other local storm. Beside the global perspective, there would be regional perspective phenomena coincide with Asian winter monsoon activities in terms of the cold surge to form the Borneo Vortex mostly over west Indonesia Maritime Continent. With having long period and cooler condition during winter season 2017/2018, the Borneo Vortex frequently forms during lack MJO activities or when MJO move eastward toward East Pacific and Atlantic Ocean.

By the frequent MJO episode of occurrence over Indonesia Maritime Continent as part the global perspective from the dynamical meteorology and oceanoanography, there was two tropical cyclones formation closer with the Java island namely tropical cyclones “ Cempaka” and “Dahlia” during period November 27th, 2017 – December 2nd, 2017 . From the operational point of view, the formation tropical cyclone Cempaka on November 2017 was closer to the coastline of southern Java island causing flash flood, no storm surge over the coast line, land slide, flooding over some areas in central and eastern Java island. Then tropical cyclone Dahlia might cause low storm surge over Sundae Strait and some coastal area over southern west Java Island and strong wind along northern coast of west and central Java Island.

The formation of the unusual Tropical cyclone would be in advance and generating over low latitudes approaching equator line. Then end of the year 2017 up to end January 2018, Indonesia Maritime Continent would suppress the cloud cover and rainfall due to the cooler than normal of the sea surface temperature Indian ocean west of Indonesia Maritime Continent. Unfortunately during February, activities of the cloud cover and rainfall would be increasing even MJO over Pacific – Atlantic Oceans.

The Cold surge would not encourage the formation the Borneo Vortex, but the convergence zone of northerly and southerly would be part from the Inter Tropical Convergence frequently occurs with more active cloud cover and rainfall. The flooding areas and landside arose including Jakarta and adjoining area frequently occurs with additional condition coolest of the environment most over Java up to lesser of Sundae Island beginning March 2018. Where these meteorological conditions are a little bit anomaly from the normal condition that peak of the rainy season coincide with cooler environment usually be in the end year – beginning next year around December – January/February. In the last that impact from long winter season over northern hemisphere would be in terms of frequently wet, cooled and windy weather, climate and environment condition especially over southern area of Indonesia Maritime Continent and also longer as usual period of the peak rainy season 2017/2018. The dynamical meteorology and oceanography would be interesting in further study if we refer with the global warming and climate change as arising environmental issue starting 1990 up to present time.

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Lupine Publishers | Lasers & Pedodontics

Lupine Publishers | Journal of Pediatric Dentistry

Introduction

The medical terms such as magical and lightening quick are used to represent lasers [1]. Theodore H. Maiman in 1960 coined the term laser, which was initially termed as maser which stands for “microwave amplification by stimulated emission of radiation”. However, the term LASER is an acronym for light amplification by stimulated emission of radiation [2,3]. Three types of lasers used for surgical therapy in the oral cavity are neodymium lasers - YAG (Nd: YAG), of argon (Ar) and carbon dioxide (CO2) [3]. Lasers have largely replaced scalpels and other instruments in the field of medicine because of its advantages [4-6]. Different laser wavelengths have different absorption coefficients wherein laser energy can be absorbed or transmitted based on the structure of the target tissue. The presence of water, which is an essential component of all biologic tissues, is important for the use of lasers [2,6]. For hard tissues, Er lasers are used whereas any laser can be used for soft tissue components [2,6,7].

Applications of Lasers in Pediatric Dentistry

For caries removal

Erbium group of lasers are preferred for deep enamel, dentin, and caries removal, whereas the Nd: YAG laser is designated for superficial pigmented caries removal. The other advantages being the non-requirement of anesthesia and the use of conventional drills, which cause micro-fracture of tooth during preparation [1,2]. During cavity preparation, after the removal of enamel, the settings are adjusted to reduce the energy levels as dentin is less mineralized and has higher water content than enamel [2].

Removal of restorations (including amalgam)

Lasers should never be directed towards amalgam and should be pointed towards the surrounding enamel to create a small trough, and hand instruments are used to elevate the restoration out and later the cavity preparation is completed. Also, other restorations like composite and glass ionomer can be removed/replaced [1,2].

Preventive treatment

At the early stages after tooth eruption, enamel grooves are the site of early caries. This can be treated using lasers by cleaning, sterilizing and restoring the same. Also, many studies have reported that etched enamel by erbium has properties like the acid-etched enamel [2].

Treatment of peri coronal problems in erupting teeth

Lasers are used in non-contact mode to remove the pericoronal tissue covering the newly erupted tooth, which might help in relieving any discomfort, swelling, or infection in the tissue overlying the emerging tooth [2,9].

Gingival re-contouring and orthodontic purposes

Excess gingival growth by the use drugs or by poor oral hygiene, and during other surgical procedures including orthodontics requires removal of tissue in some cases. This can be accomplished by the use of lasers which can be done without the need for a local anesthesia. Use of topical anesthetic can be supplemented for the treatment procedures [8].

Treatment of ankyloglossia

Tongue is stabilized with a hemostat and the frenum is revised, while avoiding any damage to the glands on the floor of the mouth [8].

Treatment of aphthous ulcers and herpetic lesions

Use of low power settings with the laser energy directed at the target tissue in the non-contact mode, for a duration of 15-30 second intervals for three to four times, helps in pain relief. The use of laser in the initial stages in herpes labialis may prevent its further progression and provide a palliative effect for the area and prevent its progression [2,8].

Pulp therapy

The ability of laser to close the dentinal tubules and provide a sedative effect on pulpitis has somewhat encouraged the use of laser in indirect pulp capping [8]. Also, the use of lasers to sterilize the canals and also create a hemostatic environment in adjunct to the conventional procedures has created a stir for the use of lasers.

Other surgical procedures

Other surgical procedures like apicectomies and amputation of impacted teeth underneath the bone also can be performed with the use of lasers. The erbium lasers are ideal for these surgeries and a variety of tips, settings and water sprays can be used. Softtissue ablation does not require water spray whereas removal of bone needs to be done with water [2,9].

Advantages of laser therapy

a) Decreasing inflammation and pain.

b) Reduced healing period [3,4,9].

c) Good & faster healing properties.

d) Reduced chances of infection.

e) Reduced bleeding.

f) Instant hemostatic achievement.

g) Good margins.

h) Patients apprehensive for blade.

Contraindication of Laser Therapy

a) Patients with pacemakers, however it can be used with precautions in some case [9].

b) Patients who are sensible to light.

c) In epileptic patients.

d) In patients with antecedent of arrhythmia or chest pain.

e) Avoided on tumorous tissues or benign tumors with malignant potential.

Conclusion

Natural light is and has been considered as the curator [10]. Lasers have gained tremendously over the years; its advantages far outweigh its disadvantages. However, there still exists some limitations as well as some contraindications, which stop its usage with the cost factor being one of it. Nevertheless, it would be the future instrument of choice for most of the procedures included in all the fields with surgery, periodontics, endodontics and orthodontics being one of them.

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Lupine Publishers| The Effect of Soil Moisture Level on Growing of Two Common Bean (Phaseolus Vulgaris L) Cultivars

Lupine Publishers| Journal of Oceanography and petrochemical sciences

Abstract

The amounts of water use efficiency vary with climatic, soils and crop ability to extract water in the soil. It has been frequently reported, lack of water availability reduce the amount and yield of common bean. The aim of study was to determine the effect of soil moisture level on growth of two common bean cultivars. The study was conducted in greenhouse. The design was factorial arrangement in randomized complete block design. Forty eight treatment pots were used for two common bean cultivars. Four seeds were sown in 48 pots filled with 5cm soil depth and irrigated until water dripping through perforated base. From total pots, 24 pots selected randomly and labeled as BULGA-70 cultivar and the rest as CS-20-DK cultivar. After germination, only one uniform plant was kept and five water treatments levels, 100 % (Control), 75%, 50% and 25% were applied by field capacity. Plant height, leaf area and dry matters were measured. As results, plant height, leaf area and dry weight in both cultivars were significant to soil moisture condition. However, no significant difference was observed 100% and 75% water levels in both cultivars. Therefore, 75% water treatment level is advisable for farmers to minimize water wastage.

Abbrevations: Soil moisture; Common bean; Cultivars; Water treatment

Introduction

Common bean is one of the most important pulse crops in Ethiopia, due to its richness in protein content. Common bean is also an important crop in crop rotation due to its fixation of atmospheric nitrogen, organic matter and improving water use efficiency of the cropping system [1,2]. Crop rotations can increase crop yield than monoculture due to its diversity in plant water use, rooting pattern and crop type [3]. The beneficial effects of crop rotation include;

(i) better soil moisture use and nutrients uptake,

(ii) Reduced disease, insects, weeds and phytotoxic compounds [4]. Inadequate variable water supply has a negative effect on crop production across different climatic regions.

The problem is more prominent in tropical countries including Ethiopia and subtropical semiarid and arid climates, in which water losses through evaporation and evapotranspiration are high [5].

Drought, which can occur at any stage during plant growth, reduces pod yield and pod quality of common bean. Drought reduces the number of flowers, pod setting and leaf area in bean By 51, 63 and 60%, respectively [6]. Many study reported that drought stress at all growth stages reduces yield and yield components in bean, but the effect was worst when drought occurred during reproductive stages [7]. Although there are reports that common bean is susceptible to drought stress or water deficit, the production of this crop in many places of the world is carried out under drought stress conditions [8]. This is due to insufficient water supply by rainfall and/or irrigation. This indicated that drought stress is not only in Ethiopia but also a worldwide production constraint for common bean [9].

Therefore, Water stress has been reported to reduce the expression of many characteristics in faba beans. In common beans, accelerated maturity of crop along with reducing grain yield and mean weight of hundred seeds following water stress, have been reported [3,10]. Furthermore, common bean cultivar has reported to respond differently to soil moisture stress depending on the severity of water stress [9]. In fact, different management techniques like irrigation can contribute to the increase of grain yield under water stress conditions, but the development of tolerant cultivars becomes an efficient and economical production strategy. Therefore, this study aimed to the effect of some water stress treatments (25, 50, 75 and 100% of field capacity) on growth and development of two common bean cultivars (Bulga-70 and CS-20-DK) which were released in 1977 and 1994 respectively by Holeta Research Centre, Ethiopia.

Materials and Methods

Description of the Study Area

The study was conducted at DebreMarkos University greenhouse demonstration site in the year 2016. Debremarkos University is geographically located in DebreMarkos town at latitude and longitude of 10°20′N 37°43′E and an elevation of 2,446 meters above sea level (m.a.s.l). The annual average temperature is 18.70c while the minimum and maximum recorded temperature being 40c and 240c, respectively. Annual average rain fall ranges from 900- 1800mm. The climate condition is characterized by woyna dega (1500-2300 m.a.s.l). The soil characteristics of the study area are mainly is clay ranging from 50-73%, silt fraction 15.88%-40.21% and sand fraction 0.36-13.28.

Research Design and Sampling Procedures

The design of study was by 2*4 (two verities with four water treatment level) factorial arrangement in randomized complete block design (RCBD) with replicated in six times. Total of 48 treatment pots were arranged randomly. At beginning, four seeds were sown in 48 pots filled with soil and sand mixture of 3:1 ratio and a depth of 5cm soil depth. Irrigated the 48 pots until water is begins dripping through the perforated base. Then, from the total pots, 24 pots were selected randomly and labeled as BULGA-70 cultivar and the rest as CS-20-DK cultivar. After germination, only one uniform plant was kept in each pot throughout the experiment. Five levels of plant available water treatments of 100 % (as Control), 75%, 50% and 25% capacity by weight), imposed when the plants were established with two true leaves for the two cultivars. The pots were weighed in two days intervals to compensate the water loss by evapotranspiration and therefore, the pot soil moisture was kept at 100, 75, 50 and 25% of field capacity according to treatments.

The plant height, leaf area and leaf dry matters were measured at 35 days after planting. The leaf area, plant height and leaf dry matter was measured by using squared pare method, ruler and oven-dried for 48 hr in 600c., respectively All collected data were statistically elaborated using analysis of variance (ANOVA), followed by means separation using the Least Significant Difference (LSD) at P<0.05. All calculations were performed using SAS 9.0 software package.

Results and Discussions

Plant Height

Plant height was significantly affected by at high water stress level in both cultivars (Table 1). CS-20-DK cultivar produced the tallest plants at all water stress level. Water stress depressed plant height in both cultivars and the shortest plants were produced at higher water stress levels (Table 1). There is no a statically significance between 100% , 75% and 50% water treatment in Bulga-70, but there is significant difference between 100% and 75% with 50% water treatment in CS-20-DK cultivar (Table 1). This finding is in line with the results of Emam et al. [11] and Shenkut and Brick [12] who reported on plant height is affected by severe influence from environmental factors such as water stress.

Table 1: Effect of water stress levels on plant height (cm) of two common bean cultivars.

Mean values followed by different small letter (s) within the same row and different capital letter(s) within the same column are significantly different at p < 0.05(LSD test)

Plant leaf areas

Table 2: Effect of water stress levels on plant leaf area (cm2/plant) of two common bean cultivars.

Mean values followed by different small letter (s) within the same row and different capital letter(s) within the same column are significantly different at p < 0.05(LSD test)

Plant leaf area was significantly affected by high water stress level in both cultivars (Table 2). There is no statically difference between the two cultivars at all water stress level (Table 2). CS-20- DK produces the highest broad leafed plants at 100% and 75% water stress level. Water stress depressed plant leaf area in both cultivars and the narrow leafed plants were produced at higher water stress levels (Table 2). There is no statically significant difference between 100% and 75%, and also between 50% and 25% water stress levels in Bulga-70 cultivar but there is significant difference between 100 % and 75% with 50% and 25% water stress level. Similarly, in CS- 20-DK cultivar no statistically significant difference between 100% and 75%, but there is statistically significant between 100% and 75% with 50% and 25%.in water stress level (Table 2).

This study also in lines with finding of Emam [13], Emam et al. [11] who were reported that leaf area was reduced when the plant exposed to drought stress during vegetative growth stages. Furthermore, the study also consisted with Nielsen 1998 observed that there is significant reduction in the common bean leaf area index under drought condition. Markhart [14] also found significant reductions in the leaf area under drought condition at 23 days after planting for two bean species. The loss of leaf area which could be resulted from reduced size of younger leaves and inhibition of the expansion of developing foliage is also considered as an adaptation mechanism to moisture deficit.

Plant leaf dry weight

Plant dry weight was decreased as increased of water stress level in both cultivars (Table 3). There is no statistically significant difference between 100% and 75% water stress levels in CS-20- DK. But, there is significant difference with 50 % and 25% water stress level. There is no significant difference between 100%, 75% and 50% water treatment levels in Bulga-70 (Table 3). Water stress significantly decreased dry weight at 50% and 25% in both cultivars. The highest and the lowest percentage reductions in leaf dry weight were observed in both cultivars. Barrios et al. (2005) reported that leaf dry weight of common beans reduced when plants are exposed to drought stress. Other studies like Emam [15] and Rosales Serna et al. [16] have also reported significant differences in shoot biomass accumulation among dry bean cultivars grown under moderate to severe drought stress conditions.

Table 3: Effect of water stress levels on leaf dry weight (gm) of two common bean cultivars.

Conclusions and Recommendations

The result of this study confirm that water availability play a major role in plant height, plant leaf area and plant leaf dry weight of growing common bean. Common bean production depends mainly on soil water condition. A high level of soil water availability usually ensures an optimal common bean growth. Any restriction in the supply of irrigation water induces decrease plant growth. The impact of deficient irrigation on plant growth can be insignificant where the water stress is applied to the plant during specific growth stage that are less sensitive to moisture deficiency .The result of the study confirms these ideologies. Therefore, for effective utilization of irrigation water and optimum growth of common bean cultivars, 75% water treatment level is advisable for farmers to use so as to avoid wastage of water.

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Lupine Publishers| Sequential Endogenous Endophthalmitis

Lupine Publishers| Ophthalmology Open Access Journal 

Abstract

  This report describes an unusual case of culture-proven bilateral endogenous endophthalmitis secondary to an underlying psoas abscess in a 54 year old male. The patient first was found to have endophthalmitis in the left eye, and, in spite of being on the appropriate intravenous antibiotics, he subsequently developed endophthalmitis in the right eye two days later With timely treatment and close communication with the primary team, the patient recovered with a successful visual outcome.

Keywords: Endogenous endophthalmitis; Bilateral; Psoas abscess; Vitrectomy; Staph aureus

Abbreviation: EE: Endogenous Endophthalmitis; MSSA: Methicillin-Sensitive Staph Aureus; STEMI: ST-Elevation myocardial Infarction

Introduction

  Endogenous endophthalmitis (EE) is a severe vision threatening disease that occurs as a result of hematogenous spread of bacteria or fungi into the eye from distant sites of the body. It is a rare cause of endophthalmitis causing less than 10% of all endophthalmitis cases [1]. EE presenting bilaterally has been reported in up to 33% of EE cases [2]. EE is associated with co morbidities such as diabetes mellitus, liver disease, cardiac disease, malignancy, immunosuppressant, in-dwelling catheters, and intravenous drug abuse [3-7]. The initial diagnosis is incorrect in up to 50% of cases, so a high level of suspicion for this disease is vital in order to perform prompt treatment that could preserve useful vision [5,8]. We describe a case of endophthalmitis presenting first in the left eye followed two days later in the right eye with the infectious source ultimately being found to be an occult psoas abscess.

Case Report

  A 54 year-old Caucasian male with hypertension, diabetes mellitus, hyperlipidemia, and prostate cancer and no ocular history presented to the emergency room with dull abdominal pain. He was found to have an ST-elevation myocardial infarction (STEMI) and underwent urgent coronary stenting. The following day he was septic with Methicillin-sensitive staph aureus (MSSA) bacteremia and started on appropriate intravenous antibiotics. Urine cultures and echocardiogram were unremarkable. Two days later he developed blurry vision in the left eye with a visual acuity (VA) of 20/300, and he was found to have a hypopyon, anterior chamber inflammation, and vitreous membranes all while the right eye was unremarkable. He was diagnosed with endophthalmitis of the left eye and due to the rapid nature of the findings he underwent a pars planavitrectomy with intravitrealvancomycin and amikacin (Figure 1).

Figure 1: Hypopyon of the left eye.

  Two days later he complained of new blurry vision in the right eye and was found to have a hypopyon and vitreous inflammation on exam with a VA of 20/200. This eye was diagnosed with endophthalmitis and treated with vitreous tap and intravitrealvancomycin and amikacin. Both vitreous samples grew   MSSA. We discussed with the primary team that further efforts should be done to find the source of the bilateral endogenous endophthalmitis. A transesophageal echocardiogram was unremarkable. The patient was still having persistent abdominal pain since presentation, which was initially attributed to the STEMI, so a CT-scan of the abdomen and pelvis was performed revealing a large left-sided psoas abscess which was drained with cultures being positive for MSSA (Figure 2).

Figure 2: Axial cut of computed-tomography imaging of the abdomen and pelvis revealing a large left-sided psoas abscess demonstrated by the blue arrows.

Discussion

  Endogenous endophthalmitis (EE) is a devastating ocular disease. This case demonstrates that despite being on the appropriate intravenous antibiotics, patients can still develop endophthalmitis due to poor ocular penetration of the antibiotics. Older reports suggested intravenous antibiotics are the definitive treatment for EE while intravitreal antibiotics with/without vitrectomy make a limited contribution [9]. In the recent past, a more active approach is taken to manage EE with vitreous tap and inject and possible vitrectomy in addition to intravenous antibiotics [10,11]. In a review by Jackson, there was less of a trend for enucleations or eviscerations when patients received intravitreal antibiotics. Further, when vitrectomy was performed, there was a better visual acuity outcome and fewer rates of enucleations or eviscerations [5]. Connell found that with bacterial EE, vitrectomized eyes had better VA and none required enucleation when compared to non-vitrectomized where 50% required enucleation [4]. Treatment options should be weighed on a case-by-case basis, but one should be cognizant not to directly follow the guidelines of the Endophthalmitis Vitrectomy Study as the pathogenesis of EE is markedly different than for post-cataract extraction endophthalmitis [12].

  In our case the bacterium isolated from eyes, blood, and abscess was MSSA. In terms of bacterial EE, studies do vary, but generally in western nations there is a predominance of grampositive bacteria, while in Asian countries the cause is mostly gram-negative [1,3]. Interestingly, with Methicillin-resistant Staph Aureus EE that is unresponsive to vancomycin, there are recent reports about the effectiveness of intravitreal and intravenous daptomycin, which crosses the blood-ocular barrier [5,11,13]. This patient had risk factors predisposing him to EE such as diabetes mellitus, hypertension, and a history of malignancy. Many studies have shown these to be risk factors for EE with other risk factors including: intravenous drug use, HIV infection, liver disease, chronic obstructive pulmonary disease, end-stage renal disease, immunosuppressant, indwelling catheters, hypertension, and more [14,15]. When evaluating a patient with the aforementioned risk factors, one should be cognizant of the warning signs and consider endophthalmitis in the differential; however, there have been reports of healthy individuals with no risk factors who developed EE [16]. In conclusion, to the author’s knowledge, this is the fourth documented case of endogenous endophthalmitis secondary to a psoas abscess. Further, this is a unique case of EE in that one eye presented days after the first even while being treated with the appropriate intravenous antibiotics, but this serves as a lesson that EE can still occur in that situation. A more aggressive approach was taken to treat the first eye with vitrectomy, and since the bacteria was known at the time of the second eye’s presentation, it was decided to treat more conservatively with tap & inject. With rapid diagnosis and proactive treatment, this case resulted in a successful visual outcome for the patient. Early recognition of EE with aggressive management of vitreous tap and antibiotic injection with or without vitrectomy- in addition to systemic antibiotics- should be considered to ensure a successful visual outcome. Close follow up and communication with the primary team is also vital in terms of locating and treating the underlying pathology.

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Lupine Publishers | On Mammography and Hormone Replacement Therapy

Lupine Publishers | Journal of Gynaecology

Introduction

About 250 years ago, French philosopher Francois-Marie Arouet Voltaire, wrote:

“Doctors prescribe medicine of which they know little, to cure diseases of which they know less, in human beings, of which they know nothing”.

Has this state of affairs changed very much since then? I believe so. However, many would argue “hardly”, aside from new technological advances and certain heroic surgical procedures. Our model continues to be population-based (also known as “mass medicalization”) rather than patient-centric. Further, notwithstanding the current dogma on “evidence-based” medicine, meaning that the health care provided is based on solid scientific evidence of utility, a large proportion of tests and prescriptions used frequently have little or no such supportive evidence. Another flaw of today’s “evidence-based” medicine is what has been termed “eminence-based” medicine wherein experts make recommendations or “guidelines” for a large proportion of decisions for which no or minimal data exists. These guidelines have a pronounced impact, as they are believed to represent the standard of care, even though they are based on opinion with a paucity of facts. Actually, even the prestigious U.S. Institute of Medicine concluded that “any valid evidence supports “well below half” of the practice of medicine (!)”. Examples abound such as, statins and statin combinations, prostate specific antigen tests, mammography, hormone replacement therapy, etc., I will discuss here mammography and hormone replacement therapy, which are of particular importance in women’s healthcare.

Mammography

Mammography for breast cancer screening for women parallels the prostate specific antigen (PSA) test in men. This imaging test uses low-energy X-radiation to examine the human (female but also male) breast. It is used both as a screening and a diagnostic test. The goal of any screening procedure is to examine a large population of patients to find that small number most likely to have a serious condition. These patients are then referred for further, usually more invasive, testing. Thus a screening exam is not intended to be definitive, rather to have sufficient sensitivity to detect a useful proportion of cancers. The cost of higher sensitivity is a larger number of results that would be regarded as suspicious in patients without disease. In mammography, the goal is the early detection of breast cancer through the detection of characteristic masses and/or micro-calcifications. Its use as a screening tool for the detection of early breast cancer in otherwise healthy women without symptoms is controversial. Like all X-rays, mammograms use doses of ionizing radiation (lower than those employed in bone radiography) to create images that are subsequently analyzed for any abnormal findings.

A. Adjunct procedures to mammography are:

a. Ultrasound: For further evaluation of masses, including palpable masses not seen on mammograms;

b. Ductography (not generally used): For further evaluation of questionable findings as well as for screening pre-surgical evaluation in patients with known breast cancer to detect any additional lesions that might change the surgical approach, for instance from breast-conserving lumpectomy to mastectomy;

c. Magnetic resonance mammography: For greater spatial resolution of mammographic tissue imaging;

d. Positron emission mammography; and

e. New procedures, including breast tomosynthesis.

B. Currently recommended guidelines for having mammography screening tests for the average woman are:

a. U.S. Preventive Services Task Force (2009): Screening of women aged between 40 and 49 should not be routine but based on individual’s risk factors and values (because the benefits of screenings do not outweigh the risks). Every two years between the ages of 50 and 74;

b. American Cancer Society, American College of Radiology, American Congress of Obstetricians and Gynecologists: Annually beginning at age 40;

c. National Cancer Institute: Every one to two years for women ages 40 to 49;

d. American College of Physicians: Individualized screening plans as opposed to wholesale biannual screening of women aged 40 to 49;

e. Canadian Task Force on Preventive Health Care (2012): Every 2-3 years between the ages of 50 and 69. It found that for women aged 50-69, screening 720 women once every 2-3 years for 11 years would prevent 1 death from breast cancer. For women age 40-49, 2100 women would need to be screened at the same frequency and period to prevent 1 death from breast cancer; and

f. European Cancer Observatory (2011): Every 2-3 years between the ages of 50 and 69.

The reports from the above task forces note that the risks of more frequent mammograms include a small but significant increase in breast cancer induced by radiation, a risk that is greater for younger women. On the other hand, the Cochrane Collaboration (2011) analysis of screening further concluded that: “Mammograms reduce mortality from breast cancer by an absolute amount of 0.05% or a relative amount of 15%, but also result in unnecessary surgery and anxiety such that it is not clear whether mammography screening does more good than harm… and that universal screening may not be reasonable”. It also states that “the best quality evidence does not demonstrate a reduction in mortality generally or a reduction in mortality from all types of cancer from screening mammography”. In addition, the Nordic Cochrane Collection (2012) states that “advances in diagnosis and treatment make mammography screening no longer effective today in decreasing deaths in breast cancer, and therefore no longer recommend routine screening for healthy women at any age as the risks might outweigh the benefits… and warns of misleading information on the internet”. Further, their analysis showed that “one in 2,000 women will have her life prolonged by 10 years of screening, however, another 10 healthy women will undergo unnecessary breast cancer treatment. Additionally, 200 women will suffer from significant psychological stress due to false positive results”.

Repeated mammography starting at age 50 saves about 1.8 lives over 15 years for every 1,000 women screened. This result must be gauged against the negatives of errors in diagnosis, overtreatment and radiation exposure. Also, screening mammography does not reduce death overall, but causes significant harm by inflicting cancer scare and unnecessary surgical interventions. About 7% (more realistically, 10%-15%) of women screened with mammography will be called back (with great distress) for a diagnostic session. However, most of these recalls will result in “false positive” results. For 1,000 recalls, about 60 will have benign growths and 10 will be referred for a biopsy (of which about 3.5 will have a cancer of which about 2 will be a low stage cancer that will be essentially cured after treatment, and 6.5 will not). Mammography may also produce “false negatives” (not seeing the cancer), usually around 10%-30%, and due to

(a) observer error,

(b) cancer hidden by other dense tissue in the breast, and

© Cancer overlapping normal tissues.

Furthermore, one form of breast cancer, lobular cancer, has a growth pattern that produces shadows on the mammogram which are indistinguishable from normal breast tissue. A meta-analysis review of programs in countries with organized screening found 52% over-diagnosis. Women whose breast cancer was detected by screening mammography before the appearance of a lump or other symptoms commonly assume that the mammogram “saved their lives”. In practice, the vast majority of these women received no practical benefit from the mammogram. There are four categories of cancers found by mammography:

i. Cancers that are so easily treated that a later detection would have produced the same total cure (that is, the woman would have lived even without mammography);

ii. Cancers so aggressive that even “early” detection is too late (the woman dies despite detection by mammography);

iii. Cancers that would have receded on their own or are so slow-growing that the woman would die of other causes before the cancer produces symptoms (mammography results in overdiagnosis and over-treatment); and

iv. The small number of breast cancers that are detected by screening mammography and whose treatment outcome improves as a result of earlier detection. Clinical trial data suggest that 1 woman per 1,000 healthy women screened over 10 years falls into this category. Screening mammography produces no benefit to any of the remaining 87% to 97% of women.

C. In summary

The guidelines for screening mammography advocated by the several professional associations or/and governmental organizations are conflicting and even confusing. Would it not be helpful for patients if these entities were to agree to a uniform set of guidelines (even though these would still be “guidelines”)? Further, because mass screening as a tool for the detection of early breast cancer in otherwise healthy women without symptoms is controversial, shouldn’t this screening be conducted on an individual basis and only in case of significant risk? Still further, since the radiation sensitivity of the breast in women under age 35 is greater than in older women, should it not be generally imperative that these women be screened only if there is a significant risk of cancer (such as, BrCa positive, very positive family history, palpable mass) and even in these circumstances to employ ultrasound or magnetic resonance for imaging? Also, and likewise, should screening of women aged between 40 and 49 not be routine but based on individual’s risk factors and values (because the benefits of screenings do not outweigh the risks)? Additionally, beyond age 50, should screening not be conducted systematically and only infrequently at appropriate time intervals to be defined? Lastly,based on the important Cochrane Collaboration and the Nordic Cochrane Collection, should not routine screening be discouraged for healthy women of any age as the risks might outweigh the benefits? The above provides more evidence that population medicine (in this case, mass screening) disregards individual variability and promotes considerably more unnecessary medical testing and procedures.

Conclusion

a. Since the guidelines for screening mammography advocated by the several professional associations or/and governmental organizations are conflicting and even confusing, this screening should be conducted on an individual basis and only in case of significant risk.

b. Since the radiation sensitivity of the breast in women under age 35 is possibly greater than in older women, it would be generally imperative that these women be screened only if there is a significant risk of cancer (such as, BrCa positive, very positive family history, palpable mass), and even in these circumstances the screening should employ ultrasound or magnetic resonance for imaging.

c. Screening of women aged between 40 and 49 should not be routine but based on individual’s risk factors and values (because the benefits of screenings do not outweigh the risks).

d. Beyond age 50, screening should not be conducted systematically but only infrequently at appropriate time intervals to be defined.

e. Based on the important Cochrane Collaboration and the Nordic Cochrane Collection, routine screening should be discouraged for healthy women of any age as the risks might outweigh the benefits. Whereas much more could be said about the mammography test, I would now like to proceed to the example of hormone replacement therapy.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) refers to any form of hormone therapy wherein, in the course of medical treatment, the patient receives hormones, either to supplement a lack of naturally occurring hormones or to substitute other hormones for naturally occurring hormones. We are here interested solely in HRT for menopausal women. The idea is that treatment may prevent the discomfort caused by diminished circulating estrogen and progesterone hormones or, in the case of the surgically or prematurely menopausal women, that it may prolong life and may reduce the incidence of dementia. It involves the use of one or more of a group of medications designed to artificially boost hormone levels. The main types of hormones involved are estrogens, progesterone or progestins, and sometimes testosterone. It is often referred to as “treatment” rather than therapy.

Many studies on the effects of HRT have been conducted on rats. Overall, the results of these studies are non-conclusive and more research in this area is needed. Nonetheless, some important results can be gathered:

a. Differing brain regions may respond in a variety of ways to HRT;

b. Timing of the therapy is integral to the chances of success; and

c. How the hormones are administered, either chronically or cyclically, may make an important difference in their effectiveness.

As recently as 2005, women have had a positive and overly optimistic attitude towards HRT. Currently, however, most women do not find HRT to be an effective solution: It is initially helpful but, if used for a long period of time, it loses its effectiveness, and there are times when it is not only ineffective but actually detrimental to people. In the case of menopausal women, HRT has had the following adverse effects:

a. Impaired hearing including decrease in the functionality of many regions of the ear,

b. Reduction of the effectiveness in parts of the central nervous system used for hearing, and

c. Increased chance for cardiovascular disease (particularly in the case of women caregivers who experience more acute stress in their lives).

However, HRT can have beneficial effects:

a. Positive effects on the prefrontal cortex by boosting the working memory,

b. No additional weight gain compared to women who do not use HRT, and

c. Positive effects in their sex life (mainly increasing their sex drive and sexual sensitivity) that can dissipate after receiving HRT for extended periods of time … but the effects are inconsistent across women. For decades, HRT was widely recommended to women to reduce heart disease.

However, the Women’s Health Initiative (WHI) trial (over 16,000 post-menopausal women) compared the combination (estrogen + progestin) to placebo. The findings included significant increases in breast cancer, heart disease and heart attacks, strokes, and dangerous blood clots. These findings far over-rode the alleged benefit of less colon cancer and fewer hip fractures. The results of the WHI trial were so negative that it was stopped prematurely at 5.6 years (instead of the planned 15 years) of follow-up. New results released in 2011 continue to engender confusion, suggesting disparate outcomes with hormone replacement as a function of what age the treatment was initiated.

Nonetheless, after a slowing period following the announcement of the trial’s negative results, the practice continues under the guise (true perhaps for some women) that HRT (estrogen and/or progestin) palliates the unpleasant “hot flashes” post-menopausal women experience. But, this latter “benefit”, even if true, is not the premise on which HRT was advocated and sold. Of last note, a recent report in the Archives of Internal Medicine revealed that “post-menopausal women who were treated with statin drugs to lower their cholesterol had a nearly 48% increased risk of developing diabetes compared to those who were not given the drug. This is even more critical when we consider that becoming diabetic doubles the risk for Alzheimer’s disease. The combination (HRT + statins) is of serious concern.

Summary

Whereas initially helpful, HRT loses its effectiveness when used for a long period of time, and there are times when it is not only ineffective but actually detrimental. In the case of menopausal women, HRT has multiple adverse effects (impaired hearing including decrease in the functionality of many regions of the ear, reduction of the effectiveness in parts of the central nervous system used for hearing, and increased chance for cardiovascular disease particularly in the case of highly stressed women). However, it can also have beneficial effects (boosting the working memory, no additional weight gain, and positive effects in the sex life) that unfortunately can dissipate after receiving HRT for extended periods of time. Whereas significant increases in breast cancer, heart disease and heart attacks, strokes, and dangerous blood clots were found in a large and important clinical trial, HRT was discontinued for a time period but is witnessing resurgence for alleged other benefits (palliation of hot flashes). Again, even when the surrogate end point is no longer tenable, another surrogate end point is found to justify the continued use of the therapy (a common marketing ploy). What then is the key to the change in this population medicine paradigm? It resides in the 6 rights: “right” doctor, “right” screen test, “right” patient, “right” drug, “right dose”, and “right” cost. This should be tackled and hopefully implemented.

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Lupine Publishers | Actinomycetes: Dependable Tool for Sustainable Agriculture

Lupine Publishers | Agriculture Open Access Journal

Abstract

  In fast developing countries, especially in countries like India where there is always huge demand for food grains, the most important question that arises is whether we are running towards depletion or growing towards sustainable future. The balance towards more sustainable future could be attained only by finding and employing most efficient and multi-faceted alternate farming techniques instead of completely depending upon chemicals. One of the most efficient tools in achieving this is organic farming especially the usage of rhizobacteria with multiple PGPR traits. Actinomycetes are one of the most important groups of the rhizosphere colonizing bacteria with multiple growth promoting traits. They are already well-known for their ability to produce broad spectrum antibiotics. In recent years Actinomycetes are widely studied for their plant growth promoting activities and few are commercialized. This article shows the importance of this group of bacteria as potential tools for more eco-friendly and sustainable agriculture.

Keywords: Actinomycetes; PGPR; Streptomyces; Plant growth; Phytopathogens; Agriculture

Introduction

  In modern agriculture, there are a lot of challenges especially in developing countries, where the fast growing population increases the demand for food grains and the need for trading and economic development increase the demand for various cash crop products. Another challenge the modern agriculture faces is the emergence of many phytopathogens that pose serious threat to productivity and quality of the products produced. These challenges are contained to a great extent by the usage of fertilizers and chemical agents like fungicides, insecticides, etc. While on one hand these chemicals help farmers reap benefits, there is always a negative side to excessive usage of chemicals in agricultural fields. The major downside is that the chemicals often deplete the soil of its fertility and natural composition, thereby making it sterile and lose its natural biodiversity and beneficial microorganisms. Also biomagnification and residual activity of these chemicals pose serious threats to human health. So there is a pressing urgency to reduce these harmful chemicals and improve the soil fertility by embracing eco-friendly practices. In order to replenish the soil with its natural fertility, it is essential to reintroduce the beneficial bacteria in the soil. Usage of this plant growth promoting rhizobacteria can be helpful in two ways that is they can act as biofertilizers as well as biocontrol agents [1]. Among these bacteria, Actinomycetes have a very special place because of their ability to inhibit the growth of wide range of bacterial and fungal phytopathogens by producing different bioactive compounds that are toxic to phytopathogens but do not give any toxic effect to humans or environment [2,3]. These traits make Actinomycetes an attractive alternate for chemical use.

Plant Growth Promotion by Actinomycetes

  The most abundantly occurring Actinomycete in soil is Streptomyces. The genera, Nocardia, Micromonospora and Streptosporangium are less abundant Actinomycetes. Actinomycete species can grow in close association with plant roots and they are one of the most important root colonizing organisms, especially Streptomyces. Their thread-like filamentous colonial morphology helps them to colonize the rhizosphere area efficiently, which in turn enables to establish host - rhizobacteria symbiosis very effectively [4]. After they establish effective colonization, the Actinomycetes are able to produce many organic compounds and enzymes that are beneficial to plants (Table 1). The ability to produce these compounds enables the actinomycetes to break down complex organic matter in the soil into simpler forms for the plants to absorb easily. Also they have many pathways to produce plant growth promoting compounds such as IAA, Siderophores, etc. [5-9]. It has been reported that around 60% of insecticides and bioactive compounds were discovered in the past 5 years from Actinomycetes especially Streptomyces sp. [10,11].

Table 1: Enzymes and compounds produced by various Actinomycete species [7-10].

  This makes Actinomycetes efficient as biocontrol agents against a wide range of fungal and bacterial phytopathogens (Table 2). The isolate Streptomycesgresioviridis is commercialized as biofungicide [12,13]. Many researchers have demonstrated the Plant Growth Promoting efficacy of Actinomycete species in various plants such as pea, beans, tomato, wheat and rice under field conditions [14-16]. Moreover they also interact synergistically with beneficial vesicular arbuscular mycorrhizal (VAM) fungi which are considered very important in plant uptake of nutrients from the soil. Actinomycetes also help in nutrient cycling and degradation of complex organic matters in the soil into simpler forms and play important role in the bio-geo cycles and help maintain equilibrium in the soil environment. Thus they also play a crucial role in maintaining a healthy ecosystem. One more desirable trait in this group of bacteria is the ability of many Actinomycete isolates to form spores, so they can survive through draught or salinity and they can resume their growth in favorable conditions, so that their population in soil environment will not dwindle, as in the case of non-spore-forming eubacteria [17].

Table 2: Various Actinomycete species showing biocontrol activity against phytopathogens [9,10,14,15].

Conclusion

  Actinomycete isolates have proved to be effective in a multidimensional way. They involve in various plant growth promoting activities such as IAA production, siderophore production, phosphate solubilization, Nitrogen fixation, complementing VA Mycorrhizal fungi and also balancing out the ecological balance in the soil system. Moreover there are great numbers of evidences that prove Actinomycetes as potential biocontrol agents. All these qualities of this special group of bacteria make them inevitable tools in increasing agricultural productivity and quality. Considering all these aspects, it is high time that we focus on Actinomycetes as alternative tool for reducing harmful chemical usage to promote eco-friendly and sustainable farming practices.

https://lupinepublishers.com/agriculture-journal/pdf/CIACR.MS.ID.000122.pdf

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Lupine Publishers | Transition in Knitwear Design Education towards Professionalism: A Framework for Creative Knitwear Education Using Finger Knitting- Based System

Lupine Publishers | Journal of Textile and Fashion Designing

Abstract

Due to the fast-growing knitwear markets and revival of knitting, knitwear design became important elements in design. Nevertheless, knitting was perceived as an inferior subject under current curriculum due to the deep traditional rooted role of it. Thanks to the passive learning cultures and unbalanced proportion of design and technology teaching modules, there was lack of systematic training of the knitwear design professions. This study thus aimed to develop an innovative finger knitting-based educational method to link the fundamental knowledge, realistic application and service setting of knitting. Historical development of knitting, how its impact on knitting education and the newly developed education method was discussed. Survey and informal interviews the effectiveness of this method was done. Students felt satisfied with the subject teaching method and found it useful to understand the principles of knitting.

Keywords: Finger Knitting; Knitwear Design; Knitting Technology; Service-Learning; Design Education

Introduction

Traditionally, when talking with knitting, it was usually associated with femininity, woolly stuff and old-fashion. It was even being considered as unattractive domestic craft that only elderly will perform it. It even being considered as unattractive domestic craft that only elderly will perform it. Nonetheless, knitting was undergoing resurgence that the knitting population was increasing rapidly and noticeably, 18-34 years old people is accounted for almost 20% of knitting population [1]. In the light of ubiquitous social network, like YouTube, knitting skills spread quickly and thus support its growth [2]. Also, numerous benefits were brought by knitting as supported by literatures. It also could be served as a medium of therapy [3-6]. It was even considered as a new yoga that performing it could bring the effect of claiming and relaxation [7]. Moreover, due to the refusal of consumption culture, there was a rise of “Do-It-Yourself” and “Craft Revolution” [8]. Nowadays, people appreciated hand-made products and regarded knitting as an art form. For example, Sayeg utilized colourful yarns and knitting methods to create street art that provided a warm feeling to the unforgiving city [9]. Knitwear design also became an important element in high fashion.

However, knitting was still perceived as an inconsequential subject under current curriculum due to the deep rooted role of it. Knitting was taught under home economics, which was usually overlooked and regarded as leisure-based activities. For fashion design major in university study, traditional cut-and-sewn dominated the core subjects; while for textile technology subject, the subject focused on the operation of knitting machinery instead of its principles and techniques. It was clear that insufficient and unsystematic education has been provided. This hinders the development of knitwear design and the training of knitwear profession.

Apart from this, service-learning was the prior concern of current education. This provided opportunities for students to apply their knowledge and skills acquired in university education to deal with complex issues in the service setting. Students could deepen their understanding of the academic concepts and grasped the chance to practice while build up a reciprocal relationship with the community. For future knitwear design education, knitwear profession should integrated fashion design, knitting technology and social service. Hence, this study aimed to develop an innovative finger knitting-based educational method to link the fundamental  knowledge, realistic application and service setting of knitting. This paper was thus investigated the historical development of knitting and how its impact on knitting education. Then, the newly developed finger knitting-based system would be introduced and both survey and informal interview research on the effectiveness of this method would be discussed.

Knitting Development and its Impact on Knitwear Education

It is believed that knitting is originated in the Middle East that the first knit product was the ‘Coptic socks’ found in Egypt [10,11]. Knitting was then thrived for a long period of time that everyone, even young men, worked with it to fabricate knit products, like socks, sweaters and hats. Nevertheless, owing to the invention of knitting machines and the Industrial Revolution, knit products could be mass-produced and hand knitting became home craft that performed by housewife. Although knitting regained popularity slightly during the Great Depression and the World War, it was considered as old-fashion and rejected by young generation [11]. The revival of knitting is started from around 2000. With reference to The UK Hand Knitting Association [12], there were approximately 7.2 million of knitters in UK and there is 12% growth rate stably. Thanks to the rapid development of social network, the knitting techniques are shared swiftly. Terms related to knitting have been searched by an increasing rate of 250% a year [2,12]. Moreover, campaigns or projects regarding knitting are carried out to promote knitting. For example, the “Stitch 'N Pitch Night” game held in 2005 that around 1600 people joined and knitted [13]. Young people think that knitting is a creative and trendy activity now [14]. Therefore, it is doubtless that there is increasing number of people participating in knitting and shows a revival of knitting.

Knitting is also now associated with art and design, and sometimes political and social acts. There is a famous term called graffiti knitting (or yarn bombing) that, in fact, regarded as a kind of street art. A well-known example is “Knit the City” that aimed to utilize knitting and crochet with underlying subversive, feminist and political objectives. Artists cover the city by knitted pieces and tell “stitched stories” [15]. Previous research also considered knitting was associated with feminist movement [16,17]. Academic studies regarding knitting usually focus on feminist ideology rather than its benefits and development in educational aspects.

Furthermore, with the increasing popularity and world population, the market of knitwear product was growing rapidly. According to The NPD Group, Inc./Consumer Tracking Service, the total U.S. hosiery market had 3% growth to $7.3 billion in the past 12 months since May 2014 [18]. Population growth was a double edged sword. It brought business opportunity yet challenges to current knitwear industry. Consumers were looking for variety on styles with high quality. To survive in such highly competitive and fast-growing global market, designers and manufacturers had to improve overall versatility and creativity of their products. This heavily replied on the profession training offered in schools. Nevertheless, current knitwear design training was far from meeting the market needs.

In the light of the prolonged historical role of knitting, knitting was regarded as domestic leisure-based activity that usually performed by housewife. The existence of systematic education on knitting can be traced back to the mid-20th century [19]. After the Second World War ended, western countries such as United States and United Kingdom, introduced the home economics curriculum consisting knitting based on the circumstances that it trained girls to meet the requirements of housewifery. This situation was even more obvious in eastern countries, where inability constitutes the virtue of women [20]. Knitting was also marginalized by current educational authorities. It was classified as an optional subject under home economics in secondary school and an elective subject under fashion design in tertiary study. The complexity and its philosophical base were neglected. Insufficient and superficial education programs and shortage of professional teachers were resulted [19,21]. These were not favourable for the development of the knitting industry globally.

What make the situation more badly was that the learning styles of students were relatively passive in eastern culture. Traditional Chinese learning style was influenced by Confucian values [22]. Students should not question about the knowledge of teachers and should respect the opinions of people with higher rank. Challenges to teachers were regarded as improper behaviour that might cause them to lose face. The education system required students to memorize knowledge rather than understand or criticize it. This was exemplified by the examination system, which surface learning was promoted [19,22]. Even for the technical subjects, like knitting, students were trained to memorize the steps instead of understand its principles to manipulate the skills. Therefore, students might not able to understand, create and correspond to changes. It was expected that under such an education environment, the profession was not sustainable, not to mention providing the industry with talent to cope with the challenge in the dynamic garment market.

Although some universities incorporated knitwear as an elective subject or specialism under fashion and textile design study in recent years, the focus of the subject might not be the best fit to current ever-changing world. Though people generally agreed that design should comprise of art and technology, they argued about the relative importance and the proportion on design education [23]. This resulted in imbalanced training provided. Besides, fashion design students in eastern countries were relatively weaker on science due to their learning style. Even they underwent the knitting technological training, they were usually just memorized the necessary information without real understanding in order to survive in the examination. They were hardly comprehended the principles and not able to apply it in real situation. In some situation, students were usually required to learn knitting methods   by machinery and the knitting theory separately. This, as a result, was sadly found that students were sometimes not able to link up their works with the principles. This might further limit their design potential.

Furthermore, service-learning was become more important in current education as it brought numerous benefits, such as increasing sense of personal efficacy and awareness towards world issues [24,25]. It was defined as a kind of experiential education approach [26]. Experiential learning was believed to be beneficial to design education as it promoted experiencing, reflecting and thinking [27,28]. Knit products were usually used as gift or for charity purposes. It was a good medium for social service. This was also important for students to see their part in the larger community and learn why it is important to help others. Through community service, their learning in the classroom could be enriched and their sense of social and civic responsibility could be enhanced. These qualities were preferred, either by local or global employers. Hence, current knitwear design should incorporate art, technology and service-learning to equip students with higher competitiveness (Figure 1).

To tackle with the current plight, this paper suggested an innovative finger knitting-based system to train university students who studied knitwear design. This method aimed at filling up the linkage between fundamental knowledge and realistic application of knitting. It integrated well-balanced art, technology and service-learning to meet the market needs. Comprehensive guide explaining its principles and research on the effectiveness of this method would be discussed.

Finger knitting-based education system

Fundamental knitwear design subject was recommended to employ this novel teaching method. Students were required to learn the knitting principles and techniques by finger knitting. Both weft and wrap knitting, flat and circular knitting methods can be exemplified by finger knitting methods. Finger knitting could also perform almost all knitted patterns and structures, like such as jersey, cable, jacquard, floating, tuck and missing stitch. This thus provides a simple yet effective way to help students to have better understanding of knitting technology. Below are the brief introduction and demonstration of finger knitting and its techniques (Figure 2).

The teaching and learning of knitwear design by finger knitting-based system involved essential textile fabrication steps as usual. For example, it included materials selection, yarns design, size measurement, and knitting design and so on. Underwent those processes enabled students to familiar with real knitting industry practices. The materials selection processes required students to understand the yarns properties and predominate the yarns design skills. In addition, finger Knitting imitated the technique of machine knitting. Hands replaced the knitting bed while fingers replaced the needles, such as latches, to complete the knitting processes. The movements of the fingers demonstrated the loop formation steps, included clearing the old loop, feeding the yarn and knocking-over.

The distance between fingers imitated the machine gauge to control the density. The knit pieces were also having similar characteristics of traditional machine knitted fabric, such as edge curling. With real-time finger knitting demonstration and practice, students could link up the theoretical principles and machine manipulation (Figure 3). Students were expected to attend a series of small group lectures and tutorials focused on providing them a critical understanding of knitting principles by finger knitting methods and offering them with practical training on finger knitting and machine knitting. It hoped that the relationship between finger knitting and machine knitting could demonstrate the complicated yet essential knitting theory in a simple way step by step. For one semester learning and teaching, students had to imitate the whole process in knitting industry, including yarn design, pattern making, garment design and production and finishing. Eventually, students had to submit a knitted garment that involved these processes. Hence, students were not just grasping the knowledge of knitting techniques, but also the procedures in knitting industry. As a result, this enhanced their learning and facilitated their future employment in industry.

It also hoped that students could involve in a service learning session that they organized and shared their finger knitting with others. Finger knitting was also an effective means of improving hand functions and muscle strengths as simple hands and fingers’ functions were needed. It was especially good for elderly service to tackle with recent ageing and health problems in the society. Students were thus required to plan and organize the workshops for their group’s target. During their community service, reflective seminars could be organized to provide opportunity for students to share their service experiences with other students and supervisors, and discuss their learning and serving strategies and techniques in order to successfully apply their knowledge to support community service. This, hence, helped to link their academic content of subject with the service learning activities and deepened their understanding on their learning at university (Figure 4).

The Study

To understand and investigate the effectiveness of this method, pilot study was done. The study took “knitwear design” subject of university as the pilot subject to employ the new teaching method. This teaching and learning method had employed for 6 years in the university subjects of knitwear design. All students were from fashion and textile study. More than 300 of students enrolled in the past years. To investigate the effectiveness and acceptance of this finger knitting-based education method, student feedback questionnaire developed by the university was adopted. Also, informal interviews and observations were the major methods to investigate the acceptance of students and the effectiveness of this method (Figure 5). For one semester learning and teaching, students had to imitate the whole process in knitting industry, including yarn design, pattern making, garment design and production and finishing. Finally, they were encouraged to bring their learning into community to share the finger knitting techniques (Figure 6).

From the student feedback questionnaire, it used 5-point scale to test the level of agreement of the sentences. It asked questions regarding the comments of the subjects and the views of the teachers. For instance, a sentence concerning the opinions on the subject was “teaching and learning activities helped me to achieve the subject learning outcomes”. There were totally 4 questions regarding the views on subjects, 5 questions regarding the teachers and 2 questions regarding the overall views. 128 students completed the form. The mean scores of the past years were more than 4.5, which were significantly higher than the faculty mean of 3.9 and placed among the top 10% of the institution. This clearly showed that the teaching and learning method was highly accepted and appreciated by students. Table 1 shows the means and standard deviations of each category of questions(table 1).

There were also questions concerning about the workload and average hours that students spent per week on this subject in order to understand the level of suitability of course setting. The results were shown on Figure 7. More than 90% of students thought that the workload and assignments were appropriate. Majority of students spent around 8-10 hours per week, followed by 5-7 hours. The time included the lectures, tutorials, workshop and other related works done. Hence, the workloads were acceptable by students (Figure 7).

From the informal interviews and observation, all of the students felt satisfied with the subject teaching method and found it useful to understand the principles of knitting and linked up with their laboratory learning’s. Below was the discussion concerning their opinions and this responded to objectives of the finger knitting-based education system by thematic analysis? The main themes were threefold:

a) Learning and personal growth

b) Creativity and empowerment

c) Enjoyment.

Learning and personal growth

During the finger knitting learning process, all students found it easy-to-learn yet useful. Students knew neither knitting nor finger knitting before and only a few of them know hand knitting. They learned it during the lessons and found that it was amazing. Only some of them needed to repeat the steps and tries more times to grasp the skills. However, all of them were able the grasp the basic techniques at the end of the first practicing lesson. With demonstration and practicing activities, they were able to integrate the theory with the practical skills.

“It is a bit challenging at first. I need to pay attention and follow the steps carefully. But after I grasp the basic techniques, I find it very interesting to change a little step to create new patterns… I also can understand the principles of knitting easily and able to apply it on the laboratory lesson (where machine knitting was employed).”

“With the practice of finger knitting, I understand the importance and underlying principles of machine gauge and yarn tension. Before, I just memorized the calculation formula of them.”

“Making the knit garment by hand (finger knitting) really helped me understand the structure of knit garments and how machines work.”

“The way that how the knitting needles move up and down and the setting of needles, all can be learned from using my fingers to knit garment easily”

“I learned the teaching skill of knitting, the real situation of the industry and how to do the work of knitwear designer.”

Apart from better understanding of the principles and grasping of machine knitting, more examples regarding the benefits of finger knitting as a teaching method could be found. Since students found it “amazing”, they were curious about the techniques and the effects on the knit pieces. Some of them would ask questions concerning about finger knitting. This active questioning situation was seldom appeared with traditional teaching methods on Chinese classroom. Take edge curling as an example. After finger knitting a knit piece, edge curling would happen as usual. Students would then ask for the reasons why this situation would occur and how to avoid it. Also, many of them even tried to apply it for creating new patterns and made their own pieces afterwards. These showed an encouragement of active classroom.

"The most useful to my learning is that the principles of knitting and different styles of knitting. at least I can knit something in the future even I don’t have a needle. But we do finger knitting.”

“Different stitch can be learned and understood easily by finger knit. it will be great if more stitches can be taught in class.”

As students were required to accomplish a knit garment by finger knitting as their final assignment, they needed to do all the planning and preparation, such as yarn selection, time control, measurement, costs calculation and design. This was not just enabled them to undergo the whole production process of a knit garment, but also help to improve their ability of management and thus facilitated personal growth.

“A very all-rounded syllabus.”

“Interesting. I need to find suitable yarn and choose suitable knitting construction to match my theme. Next time, I may try to create yarn as well.”

'After I finished my assignment, I found that it is not easy to make a knit garment. It involved so many procedures and required plenty of planning. It is a good learning process for me. I learned problem-solving skill and became more patient.“

Furthermore, with the experience of sharing their skills with others and brought it into social setting, students could link their academic content of subject with the service learning activities and deepened their understanding on their learning at university. They also could have better understanding towards the community and thus might devote themselves in community service and balanced their academic study with social servicing activities. This, eventually, might facilitate positive growth.

Creativity and empowerment

The creative power was unquestionable that students were able to create a piece of their own knit garment successfully. This also brought them a sense of achievement and empowered them to create their own piece and express their views via knitwear design. All of them were able to transform their idea into a well-finished knit garment. During the process, they had to make the knit garment step- by-step. Through these, they were able to understand themselves more. They knew more about their strength and weakness and this helped in facilitating positive change. For instance, when they chose to knit a pattern or structure, they had to understand the knitting principles and apply the skills flexibly to achieve it, especially if the pattern or structure was not conventional one. This improved their creative thinking and problem-solving skills.

"It is a bit challenging at first. I need to pay attention and follow the steps carefully. But after I grasp the basic techniques, I find it very interesting to change a little step to create new patterns.”

“I knew more knitting skills and changed my mind to knit.”

“Finger knitting is a skill that can be well used in fashion design.”

“Finger knitting is very useful and has good effect.”

Another obvious empowerment observed was that students were able to share their skills and thoughts. As a major activity in class, students learned and shared new skills together. They could ask for help when they had problems. On the other side, they taught others, either in class or in social setting. This might help to build up sense of belongings and self-confidence, which involved numerous benefits.

Enjoyment

Noticeably, many students found that finger knitting brought “enjoyment” and “satisfaction” to them. They thought it was interesting and unique.

“I never knit or crochet before. I think it is fun, cute and enjoyable.”

“Machine knitting is convenient but finger knitting bring satisfaction.”

“Finger knitting is very interesting for me. It is a fanny experience.”

Students also felt satisfaction due to the sense of achievement obtained. They were all able to accomplish a knit garment and most of them were wearable and even marketable. In addition, they felt relaxed and happy when compared with other subjects. Some of them thought it even helped to alleviate their stress.

“When I feel stressful with studying, I try to do something else as a break… A bit surprise that after a half hour knitting, I free from the nervous feeling of my studying and concentrate on knitting. Although I still feel pressure from the exam, I am more relax and happier.”

Another major reason of enjoying the finger knitting-based teaching and learning method might relate to the peer support and active classroom learning. Learning was through activities and active participation instead of passive and memorizing methods. Apart from this, it was generally believed that helping and serving others is the foundation of happiness. Service learning and sharing skills might enable students to be happier. Also, through this, people in the community might find that students do care the community and helped to bring the community closer and closer.

Conclusion

In the light of the prolonged history of knitting, it was traditionally regarded as an insignificant subject in current curriculum. Even through knitting was undergoing revival and regained popularity, there was lacked of systematically education method to integrate knitwear design, knitting technology and service learning. The case was even more serious in Chinese culture as passive learning style was prevalent. Hence, this study suggested an innovative finger knitting-based education method for knitwear design. It linked the fundamental knowledge, realistic application and service setting of knitting. It hoped to provide a systematic and professional training to future knitwear designer.

Finger knitting imitated machine knitting. It helped to demonstrate weft knit, wrap knit, flat knitting and circular knitting. Finger knitting could perform almost all knitted patterns and structures. Yet, it was easy-to-learn and could help students to understand the underlying principles of knitting. It also would not limit students’ creativity and enabled them to create their own garment freely. Moreover, knitting was usually regarded as a good way for social service. This also enabled the service learning. Students could apply their academic learning in social setting. Hence, this could deepen their knowledge understanding and arouse their awareness towards society.

In order to study its effectiveness and acceptance, survey, informal interviews and observation were employed. Students were very satisfied with this teaching and learning method. Thematic analysis showed their major themes regarding their perceptions and thoughts were

a. Learning and personal growth

b. Creativity and empowerment

c. Enjoyment.

To sum up, it was clear that finger knitting-based education method might be a good solution for current knitwear education dilemma. More study should be done to validate its effectiveness. For example, in future study, students’ demographic background might take into consideration since art background students might weaker in science than technological background students, vice versa. Nevertheless, finger knitting was still worth for future investigation due to its advantages showed in this study.

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Lupine Publishers | Outcome Analysis of Anticoagulant Therapy in Critical Care Unit: The Need for a Pharmacy Managed Anticoagulant Service

Lupine Publishers | Cardiovascular Research

Abstract

Background: In our center, NCTCE, there are 2 intensive care units (general and cardiac), where critically ill patients are admitted and managed. Anticoagulation is usually indicated in such patients for atrial fibrillation, valve replacement and DVT prophylaxis.

Objective: To determine the role of a clinical pharmacist in the therapeutic and clinical appraisal of such patients on anticoagulation.

Materials and Method: Over a 2-year period (June 2015 –May 2017), a study design to determine the role of a clinical pharmacist in anticoagulant treatment was made in both ICU. This was a prospective longitudinal study. Here, demography, the anticoagulation on which interventions were made on, duration of admission, areas and determinants of a clinical pharmacist’s interventions were incorporated. Others included, were levels of intervention, acceptance and rejection of the interventions as well as the outcome.

Results: During the study period, 168 patients were used. Male (72) and female (96), with a female to male ratio of 1:1.3. Indications for anticoagulation were DVT prophylaxis (14.88%), valves (83.90%) and AF (1.10%). Among the anticoagulants on which interventions were made on, warfarin was the highest (53.57%) while heparin was the least (2.90%). Duration of admission ranged from 2-40 days. Areas of intervention were on effectiveness of therapy (18.70%), drug-drug interactions (16.43%), adverse events (32.86%), dosage (11.05%), Kidney function (1.70%), adherence (6.70%) and drug selection (2.27%). Levels of intervention were at prescriber (30.51%), drug (38.56%), patient (25.42%) and laboratory (5.51%). The outcome was that majority of patients (78.74%) had their problems resolved.

Conclusion: Anticoagulation therapy of patients in ICU requires precise damaging, monitoring and appropriate patient education so as to ensure that patients benefit maximally. A clinical pharmacist has a vital role to play in the above areas.

Abbreviations: ICU: Intensive Care unit; PhRs: Pharmacist Recommendations; INR: International Normalized Ratio; ACCP: American Critical Care Physician; ADES: Adverse Events; VTE: Venous Thromboembolism; DTPS: Drug Therapies; DDI/DFI: Drug Drug/Dug Food Interactions; LMWH: Low Molecular Weight Heparins; CVP: Central Venous Pressure; CHADS: Congestive Heart failure, Hypertension, Age, Diabetes, Stoke

Introduction

Intensive Care Unit is a unit of the hospital where critically ill patients are treated by specially trained staff (ICU-Multidisciplinary team), comprising of doctors, nurse specialists, respiratory therapists, clinical pharmacists, physiotherapists, dieticians, theatre technicians, biomedical engineers and social workers. In our center, there are 2 ICU: -

a) The general ICU for general surgery, orthopedic, neuro-, obstetrics, thoracic and trauma surgical and medical patients.

b) The cardiac ICU for perioperative open-heart surgery patients as well as those patients with myocardial infarction and acute coronary syndromes.

Critical care pharmacy services in the ICU have expanded from traditional dispensing responsibilities to being recognized as an essential component of multidisciplinary care for critically ill patients. Augmented by technology and resource utilization, this shift in roles has allowed clinical pharmacists to provide valuable services in the form of assisting physicians and clinicians with pharmacotherapy decision making, reducing medication errors and improving medication safety systems to optimize patient outcomes. Documented improvements in the management of infections, anticoagulant therapy, sedation, and analgesia for patients receiving mechanical ventilation and in emergency response help to justify the need for clinical pharmacy services for critically ill patients [1].

ICU patients have similar general risk factors for venothrombosis and pulmonary embolism as well as arterial thromboembolism manifesting as stroke, mesenteric vascular occlusion and peripheral acute limb ischemia, with other patients (age, obesity, immobilization, past personal/family history of venothrombembolism, sepsis, cancer, stroke, respiratory, heart failure, pregnancy, trauma or recent surgery) [2-4]. In addition, they have other peculiar risk factors as a result of their illnesses and/ or treatment (vasopressor use, respiratory failure, heart failure, pharmacologic sedation, mechanical ventilation, central venous pressure (CVP) catheter and end stage renal failure) [3,5]. CVP catheter in the femoral, subclavian, internal jugular and superior vena cava veins have catheter related thrombosis occurrence rate ranging from 10-69%, 2-10%, 40-56% and 7-17% respectively [2,5-7]. There is also 4-fold increased risk of pulmonary embolism from lower limb DVT in ICU patients [8]. Catheter related VTE risks increases proportionate to the duration of placement and if patient is not on LMWH anticoagulant [9]. Sepsis induce procoagulant status and favor catheter related VTE [6,10]. Vasopressor treatment is not an independent risk factor for VTE [5], however it is still linked with decreased absorption of subcutaneous heparin due to the vasoconstriction of peripheral blood vessels [11]. Platelet transfusion and high platelet levels, a common finding in ICU patients are risk factors for VTE [12]. Pharmacologic sedation is not an independent risk factor for VTE, however, when used alongside mechanical ventilation, it is. Mechanical ventilation by decreasing venous return and requiring sedation and immobilization is a risk for VTE, however, critical ill patients requiring long mechanical ventilation was compared with those who did not and the relationship between duration of mechanical ventilation and VTE was not established [2].

The implantation of an artificial heart valves exposes the patient to an increased risk of valve thrombosis and embolism; thus life- long oral anticoagulation is imperative [13]. The factors that lead to increased thromboembolism in such patients are the number of valves implanted, types of valves implanted (more in ball and cage variety), atrial fibrillation, left atrial enlargement, left ventricular dysfunction, clotting disorder and previous embolic events [14]. Atrial fibrillation is the most common arrhythmia in patients admitted in intensive care units (ICUs) and is associated with increased morbidity and mortality [15,16]. The problems of atrial fibrillation are low cardiac output, heart failure, hypotension and organ dysfunction as well as thromboembolism. CHADS algorithm defines the risk factors, which many critically ill patients have [17]. In addition, patients with rheumatic heart diseases, prosthetic heart valves, prio thromboembolism and persistent atrial thrombus detected by TEE as well as AF with complex atherosclerotic aortic plaque are considered at highest risk of embolic stroke if not on thromboprophylaxis [18]. In our ICU, the clinical pharmacist supervises the prescribed anticoagulant, dispenses them, monitors adverse effects, drug-drug interactions as well as compliance. These factors among others have a great role to play in the successful thromboprophylaxis and treatment of VTE and prevention of anticoagulant induced bleeding including arterial thromboembolism on account of prosthetic mechanical heart valves and atrial fibrillation.

Materials and Method

Over a 2-year period (June 2015 –May 2017), a study was designed to determine the role of a clinical pharmacist in anticoagulant treatment was made in both general and cardiac ICU of a tertiary hospital in Nigeria, a developing country. This was a prospective study. Here, demography, types of anticoagulation intervention was made on, duration of admission, areas and determinants of a clinical pharmacist’s interventions were incorporated. Others included were levels of intervention, acceptance and rejection of the interventions as well as the outcome. The general ICU admits critical general, orthopedic, neuro-, thoracic, trauma surgical and medical patients. The cardiac ICU admits perioperative open-heart surgical patients including patients with myocardial infarction and acute coronary syndromes. The data were analyzed using Microsoft Excel 2010 and presented as frequencies and percentages using tables and charts.

The study design was approved by the hospital ethical committee.

Transplantation eligibility is always considered with regard to risk factors, especially, pulmonary hypertension (Figure 2). Right heart catheterization must be performed in all potential candidates for heart transplantation in order to quantify pulmonary vascular resistance [7]. Right heart failure is a substantial cause of mortality. Right ventricular failure is likely when post implant pulmonary artery pressures exceed 50 mmHg. Patients with chronic heart failure may develop pulmonary hypertension due to elevated left ventricular end diastolic pressure with elevated left atrial and pulmonary venous pressures. This is a reactive form of pulmonary hypertension and may fall when the cardiac output is increased with inotropes or unloaded with nitrate infusions [7]. The transpulmonary gradient is calculated by subtracting the left atrial filling pressure from the mean pulmonary artery pressure. A fixed transpulmonary gradient in excess of 14 mmHg is associated with greatly elevated risk, and thus this cut off is used in the UK [8]. In such patients a destination therapy strategy may be used with continuous flow LVADS.

Results

Figure 1 shows the age ranges of patients admitted during the study period. Highest range is 31-40 years. Least is 81-90 years. Also Figure 2 shows additional indications for anticoagulation, with mechanical prosthetic heart valves having the highest number while atrial fibrillation takes the least. Table 1 shows the anticoagulants administered and the number of interventions made on them. The highest number of interventions was made on warfarin, followed by enoxaparin while the least intervention was made on nonpharmacologic anticoagulant, elastic stockings. Table 2 of the 353 interventions made, adverse events (32.86%0 was the highest followed by effectiveness of therapy (18.70%), using laboratory indices of International Normalized Ratio (INR). The least determinant of intervention was drug-drug interaction of which (2.27%) interventions were made. Figure 3 depicts the duration of admission in days. Here the shortest duration of admission was in most people (66.7%) while the longest admission in a few patients (1.2%).

Table 1:  Anticoagulants on which intervention was made.

Table 2:  Highlights the roles of a pharmacist.

Figure 1:  Age range of patients admitted in ICU.

Figure 2:  Indications for anticoagulation.

Figure 3:  Duration of admission (days).

Discussion

Intensive care Unit (ICU) is a potential area for drug therapy problems (DTPs): patients treated are complex patients [19]. The use of thromboprophylaxis or prophylactic anticoagulant in critically ill patients is pertinent. ACCP recommends thromboprophylaxis for prevention of VTE in critical care patients (grade 1a – strong recommendation with high quality of evidence [20,21]. Omission of thromboprophylaxis within the first 24 hrs of ICU admission without obvious reasons is associated with a higher risk of mortality [22]. Demographically, 168 patients admitted in ICU over 2 years (84-patients/year) had anticoagulation therapy. 96 females and 72 males were involved with a ratio of 1.3:1. The age ranges were from 0-10 to 81-90 years with highest number that received anticoagulation being 31-40 years. The bulk of those with valve prostheses replacement came from this group. Duration of anticoagulation therapy paralleled relatively the duration of admission in ICU. In this study, the longest duration was 40 days while the least was 5 days. Overall, the average length of hospital stays amounted to 0.24 day/patient. Prospective evaluation of daily pharmacist-managed inpatient anticoagulation services was compared with a matched historical control group who received physician-managed anticoagulation in a 400-bed university teaching hospital [23]. *26A. Those who received pharmacistmanaged anticoagulation had significantly shorter hospital length of stay (6.8 days vs 9.5 days, P 5 .009), fewer supratherapeutic INR 3.5 (27% vs 62%, P , .001),Fewer readmission rates for bleeding or thrombosis within 1 to 3 months after discharge and no differences were noted between the groups INR ratio at discharge (2.6 vs 3.3, P 5 .07) as well as number of bleeding complications (6 vs 1, P 5 .11).

Pharmacists have been incorporated into ICU multiprofessional staff to improve the care provided to patients, particularly by monitoring the drugs administered and assessing their efficacy, thus contributing to improving patient safety [24]. The participation of clinical pharmacists in routine ICU care mainly includes active involvement in daily rounds, where they provide relevant information to the medical and nursing staff, analysis and monitoring of the efficacy of pharmacological treatments, implementation of medication reconciliation, and prevention, identification, and reporting of adverse reactions [25-27]. The actions performed by clinical pharmacists relative to the monitoring of pharmacological treatment are referred to as pharmacist interventions or recommendations (PhRs) [24,28]. Such professional interventions presuppose actions targeting pharmacological treatment to correct or prevent negative clinical outcomes derived from the use of medications. In the light of the above, the pharmacist role in the anticoagulant therapy for patients admitted in our institutional ICU was done. His/her actions in managing patients in anticoagulation in ICU in terms of monitoring of the pharmacological therapy of the anticoagulants are referred as interventions or recommendations. There have been several reports related to such interventions internationally in patients admitted in ICU [1,29]. Similar reports are rare in developing countries like Brazil including Nigeria. A retrospective chart review conducted at Baylor College in USA, in 2000 [30], showed four main variances related to warfarin therapy. They were inappropriate administration of warfarin loading dose, use of vitamin K when not recommended by American College of Chest Physicians guidelines, inconsistent overlapping of heparin with warfarin and inconsistent provision of patient education [30]. In this study, the determinants of the interventions ranged from effectiveness of therapy to drug selection, see Table 2. With this subgroup of effectiveness of therapy, international Normalized Ratio was used to monitor dosages which enabled the pharmacist to classify them as sub therapeutic, therapeutic and supratherapeutic.

Figure 4:  Level of intervention.

Figure 5:  Acceptance of intervention.

Figure 6:  Outcome of intervention.

In this same scenario, drug-drug or drug-food interactions were monitored and classified as minor, significant or serious, see Table 3. When the effectiveness of therapy was supra or sub therapeutic, and when the DDI/DFIs were significant or serious, pharmacist intervened or made recommendations. The same scenario applied to adverse reactions, adherence to therapy as well as kidney function. These recommendations were made at multiple levels ranging from physicians/prescribers’ level to laboratory level. In view of the fact this pharmacist’s interventions or recommendations are novel in our institution and indeed in Nigeria, many interventions were accepted while some were rejected, see Figure 4. The outcome of such interventions is shown in Figures 5 & 6, indicating excellence when such recommendations are accepted. In a prospective, interventional study in a multidisciplinary ICU of a rural district hospital in Bathalapalli, Andhra Pradesh, India by Pichala et al. 72 patients were screened for DTPs, 947 drug doses prescribed, 148 prescriptions, 6.39 drugs per prescription and 13.15 drugs per patients of 243 DTPs identified, 1.67 DTPs present were prescriptions, drug interactions 78%, inappropriate indication 7.4%, ADRs and therapeutic duplications 2%. 47% of the interventions were accepted. This was significantly lower when compared with our study. ICU SUCCESS DEDICATED PHARMACIST study done by Leape et al., concluded that: participation of the pharmacist on medical round can be a powerful means of reducing the risks of ADEs, in the ICU 99% of pharmacist recommendations to medical staff were well accepted, an existing pharmacist intervention required no additional resources; instead it represented a different use of existing pharmacists’ time.

Table 3:  Determinants of pharmacist’s roles.

Conclusion

Anticoagulation treatment of patients in ICU requires precise dosing, a defined anticoagulant management programme, approved protocols, proper monitoring by clinical pharmacist (base line and follow-up INRs), education of patients and families about: dietary restrictions, monitoring follow up, drug interactions for outpatient and inpatient components. All these will result in improvement in the INR results, significant clinical outcomes and overall quality of care

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Lupine Publishers| Contact Lens Materials and Modalities

Lupine Publishers| Ophthalmology Open Access Journal

Abstract

Introduction: Past two decades have seen a steep rise in the usage of contact lenses and that brought a major revolution in the materials research, design and manufacturing technologies. This also impacted the optometrists thus influencing the patient usage, modalities and duration. The current article briefs the changes in the field of contact lenses and the changing trends.

Methods: Contact lens materials and its manufacturing, wearing modalities and changing trends in prescribing them were identified, reviewed and summarized as per the topic requirements from scientific papers, authentic articles, books and websites to cover the challenges our ancestors have faced and the solutions that were provided in the past were summarized for the reader in an easy accessible way.

Conclusion: Newer generation of contact lens materials made an average contact lens wearer comfortable by wearing lenses for longer hours without discomfort and with minimal complications. Due to the advent of newer lens materials, practitioners have been given more options for choosing a best suited lens based on specific wearer requirements and needs. In this way, newly available materials and designs make the lens wear safer and less prone to complications by shifting the patient from conventional to planned replacement lenses (PRL) and from PRL to daily disposables to ensure a healthy and safer vision.

Keywords: PMMA; Rigid Gas Permeable Lenses; HEMA; Silicone Hydrogels; Extended Wear; Flexible Wear; Daily Disposables; Multifocal Contact Lenses; Aspheric; Toric

Abbreviation: CAB: Cellulose Acetate Butyrate; RGP: Rigid Gas Permeable Lens; P-HEMA: Poly Hydroxy Ethyl Methacrylate; PVP: Poly Vinyl Pyrolidone

Introduction

Contact lenses are medical devices commonly used to correct the vision without the need of spectacles. Even though the concept was very old, till 1887, a structure similar to our today’s contact lens was not made. A first contact lens like structure was made in 1887 by F. A Muller by blowing glass to make a prosthetic eye. In 1930’s a first contact lens made up of glass was used which covers whole the cornea and a small part of sclera was used for vision correction making glass the first contact lens material [1]. In 1937, a material named Poly methyl methacrylate (PMMA) was introduced as a contact lens material which mimics todays’ scleral lens of a larger diameter. In 1948, Kevin Tuohy made a contact lens called “Microlens” which covers only cornea with 10 to 12 mm diameter [1,2]. After using PMMA as a contact lens material for some time, hypoxic complications arise due to it’s very poor oxygen permeable nature after use, making.com to explore for newer lens materials. Currently, due to its zero-oxygen permeability, it is used to make diagnostic trial contact lenses instead of actual contact lenses due to its ability to retain the parameters, ease of care and maintenance [3].

Rigid Gas Permeable Lenses (RGP)

Noting the importance of Oxygen permeability, few developments were made to the material to be permeable to oxygen. In the year 1972, Cellulose acetate butyrate (CAB) was proposed as a material to use by Irving Fatt, later in 1978 CAB as a contact lens material got FDA approved. A term (RGP) Rigid gas permeable lens was coined and the lens made with this (CAB) material was manufactured in 1978 in United States [2,4]. In the advent of silicone usage in the medical industry, Siloxane methacrylate material was developed in 1970 by using silicone molecules bonded to methyl methacrylate structures making a contact lens more oxygen permeable [2]. Siloxane acrylates material was patented in 1974 under the name Polycon and was introduced commercially in 1979 which lead the wearing time longer than CAB due to its high oxygen permeability without showing any hypoxic changes in the cornea. However, it was observed that the siloxane acrylate lenses tend to attract more of lipid and less of protein deposits on the lens surface, making the care and regime of newer RGP lens materials different than the previous lens. These deposits lead to lesser lens life than the previous lenses [2].

“Boston” a contact lens material manufacturing company started to develop working towards parameters like oxygen permeability, strength and deposit resistance for improved lens on eye performance since 1972. Elements Fluorine and Carbon were used in specific proportions to synthesize Fluoro-siloxane acrylates and Fluorocarbon acrylates were found effective in controlling the lipid deposits to occur on the lens surface with increased oxygen permeability. These materials still stand good in terms of availability, deposit resistance with good oxygen permeability [5]. Addition of Silicone, Fluorine and Carbon with appropriate amounts made it possible to achieve highest levels of oxygen permeability ever, leading to continuous wear, flexible wear and extended wear modalities possible. During this period in 1987, Fluoro-silicone acrylate material was made available [6]. Due to changing trends in the contact lens market and due to innovations in soft contact lens materials, there is a constant and a sharp decline in the RGP wearers that was observed in the past two decades due to the comfort achieved by soft contact lenses [7].

Silicone Elastomer

In 1956, Silicone elastomer material was developed by Walter Becker which has a highest ever oxygen permeability which is more flexible than RGP lenses, making the contact lens industry to explore newer ways of improvising the lens material in terms of flexibility But, for a product to manufacture out of silicone elastomer was not possible at that time due to its flexible nature, poor wettability and the material adheres to the cornea(suction). Later in 1981 a lens made up of silicone elastomer material was commercialized for correcting children to use as an overnight wear lens due to its exceedingly high oxygen permeability. This material got approved for 30 day continuous wear for non-aphakic prescriptions in 1983 making it the first extended wear lens to be produced [6,8]. Till now these elastomer lenses are available as a mode of correction for aphakia (congenital and acquired) cases mostly in children [9]. The only drawback with these lenses is the brittleness of the material and affinity to attract lipid deposits, making its usage declined in this decade [6,8].

Soft Contact Lens (Hydrogels)

Progress in contact lens materials was extremely rapid and the market equations of using RGP lenses were quickly changed after the development of Poly hydroxy ethyl methacrylate (P-HEMA) as a lens material in 1963 by Otto Wichterle. This material coined a new term called “soft contact lens” due to its soft and flexible nature. The lens made with HEMA was available in 1971 as a commercial product [2,6]. The usage of HEMA as a lens material in the current contact lens market still holds good. After the invention of HEMA as a hydrogel material, the comfort obtained by a wearer lead the path for a term called intermittent contact lens wear, which is not possible with RGP due to the discomfort it caused to an average wearer. However, the water content which is the only source of oxygen transmission through the hydrogel lens was too less when compared to RGP lenses due to their movement and tear exchange. There is a need for a diverse care and regime to be followed to soft contact lens wearers for which different contact lens solutions were devised to clean, rinse, disinfect, and hydrate and to store these lenses.

Due to limitation of water content and oxygen permeability in hydrogel lenses, there were diverse complications that were seen in the soft contact lens users and the users due to the comfort of the lenses, tend to sleep with the lenses on the cornea making the condition more worsen [10]. Observing these diverse ocular changes, few of the traditional RGP practitioners were reluctant to shift their practice and keep on dispensing RGP lenses only [11]. As there is a limitation in increasing the water content that we achieve with hydrogel lenses, scientists started to explore new ways to increase the oxygen passing through the lens which can enable the wearer to achieve better comfort lens with lesser complications [12]. Concept of Disposable soft contact lenses came into the field in 1985-1986 as the increasing complications can be counteracted by discarding the lenses before the deposits on the lens surface become sufficient enough to create problems like discomfort, bulbar conjunctival redness, allergic reactions in the upper tarsal conjunctiva and lack of oxygen supply due to deposits [13]. Gradually, frequent replacement lenses were so frequently replaced due to increasing in water content of the lenses that there is a need for a modality termed Daily disposable lenses in 1994-1995 to ensure maximum comfort and good ocular health with no requirement of care and maintenance which is a boon for existing, new contact lens wear. As the production need to meet the consumer needs a new manufacturing method called cast moulding turned the disposable modality a practically possible reality [2,14].

Even now, majority of the contact lens market share in developing countries is still contributing to Hydrogel lenses where as in developed countries, majority of the population is using silicone hydrogels and daily disposable hydrogel lenses for their visual needs [15-17]. In this stage, Silicone elastomers were more easily available and used in the market as a commercial product leading the materials science experts to turn their vision towards it. This change made them to think and combine the silicone with hydrogel lenses which set a stage for the generation of silicone hydrogels. The first silicone hydrogel lens was marketed in 2002 [2,9].

Silicone Hydrogels

In soft contact lenses the silicone material is incorporated based on the skeletal structures of classical hydrogel materials like HEMA and thereby making it a better lens material by incorporating:

a) OH groups for increasing the bound water content of the lens materials [18]

b) Materials like polyvinyl pyrolidone (PVP) for improving the wettability of the lenses [18]

Due to the innovation of Silicone hydrogel contact lenses, high oxygen transmissibility is made possible, hence by minimizing corneal hypoxia changes that include corneal oedema, Descemet’s membrane folds, microcysts, limbal hyperaemia and neovascularisation [19]. There are a few patient related .difficulties with these new lenses due to increased stiffness than existing hydrogels, hydrophobic nature and more attraction of lipid deposits. So, there is a need for a better and improved materials and designs making them readily acceptable by the patient [9]. In 2010, Custom made silicone hydrogel lenses are made available in the market [20]. In case of Silicone hydrogel lenses, these inventions can be technically classified into three phases in which the lens materials are synthesized by not only decreasing the stiffness of the lens material, but also by increasing the wettability and water content to a desired level for enhancing the comfort level of silicone hydrogel wearer equal to that achieved by a hydrogel contact lens wearer [18,19,21,22].

Developments in Silicone Hydrogel Materials

Table 1:  First generation lenses.

1. Good Dk

2. Slightly stiffer

3. Deposit prone surface

4. Decreased Wettability

Table 2:  Second generation lenses

b) Properties (Table 2)

2. Flexible lens material

1. Improved wettability

c) Properties (Table 3)

Table 3:  Third generation lenses.

1. Better Water content

2. Decrease stiffness

3. It is a Breakthrough technology, which redefines the soft contact lens relationship between Dk and water content by having a higher Dk than water content predicts!

Contact lens advancements in the Future

a) Myopia control contact lenses are very soon going to be available in Asian countries where Myopia is more prevalent.

b) Aberrometers values combined with prescription can help customize the correction to a personalized contact lens manufacturing is possible soon [23].

c) A Multifocal design of contact lens which can have an autofocus capability near the pupillary centres of the eyes using fluid dynamics can be manufactured and fitted which can help.com gain complete visual satisfaction to the wearer [23].

d) Health monitoring systems embedded in the form of a computer chip in contact lenses will help.com plan our diet and treatment plan based on the parameters like blood sugar level, intraocular pressure [24].

e) The use of LCD crystals in the bulk of a silicone hydrogel lens can help.com to use virtual projection; digital screens in the near future will aim for [23].

f) In Contact lens materials, even though the penetration of silicone hydrogels in the current market is low, majority of the market share will shift using this material due to its break thought the invention of improved oxygen permeability, it can retain their share well in the markets in the future [17,23].

g) Improvements like anti bacterial coating on contact lenses are giving promising results which can help use them for extended wear without any worry of infections. Possibilities for making a Photo chromatic contact lenses are explored and will be achieved soon [25-29].

Modality

Silicone hydrogels will take the majority of the market and will exist even in future. Mostly the contact lenses have a freedom to wear and remove easily whenever we want and where ever you want [30-34].

Conclusion

Contact lenses have an exponential growth in material development, design and production in the last two decades.Newer technologies in the coming years can help.com make a more productive, versatile, comfortable and safer wearing lenses for the coming generations ahead [35-39].

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Lupine Publishers | Assessment of Honeybee Colony Performance in the Agro-Ecological Zones of Uganda

Lupine Publishers | Agriculture Open Access Journal

Abstract

Honeybee colony performance is the ability of the honeybees to defend the colony and also to effectively collect nectar and pollen and thus productivity. The colony performance of honeybees in nine agro-ecological zones of Uganda was assessed from September 2012 to May 2013. Observations were made on the colonies for brood pattern, proportion of worker bees and combs filled with honey and pollen. The obtained data were analyzed using the SPSS statistical package. The results indicated that both colony strength and productivity varied significantly within agro-ecological zones. Mid North agro-ecological zone had significantly stronger colonies with the highest productivity compared to other agro-ecological zones while Lake Victoria Crescent and Southern Dry land agro-ecological zone had the lowest indicating that the Lake Victoria Crescent agro-ecological zone is not the best for beekeeping in Uganda. The colony strength and productivity did not vary with the vegetation cover, honeybee race, type of bee hive used and the elevation gradient. When promoting beekeeping in Uganda, more efforts should be put in areas such as the mid north agro ecological zone.

Keywords: Colony strength; Productivity; Brood pattern; Apiary management; Vegetation cover

Introduction

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Honeybees (Apis mellifera) live in colonies composed of worker groups of diverse genotypes and behaviours which are artificially altered when a beekeeper moves combs between colonies [1,2]. A honeybee colony is composed of three castes: a) a single queen, who is the sole reproductive female in the hive; b) drones who are the male honeybees; and c) the workers who are the sexually sterile females and perform several activities in the colony. In addition to the adult bees, a healthy colony has brood which is a collective term for eggs, larvae, and pupae (the immature stages in the life cycle of bees) [3]. The honeybee colony performance (strength and productivity) is measured by the total area of comb in the colony, containing stored honey, pollen, and brood, adult bee population, weight per bee, and the colony nest cavity volume ratio [4,5]. In Uganda, information on colony performance in all the AEZs is still lacking. Honeybee colony strength determines how the colony is capable of fighting pests and withstanding diseases [6-8]. Where honeybee colonies are used for commercial pollination purposes, evaluation of colony strength is necessary as it is a known fact that stronger colonies collect significantly large amount of pollen [9]. Utilization of honeybee colonies for pollination of coffee and sunflower is taking root in Uganda and thus the need to evaluate the honeybee colony strength in order get maximum benefit from the service.

Information on honeybee colony strength is important for pollination and beekeepers who provide pollination services to get the average number of colonies needed for pollination, basic honey bee biology in context of pollination, and pollination contracts [3]. Despite such importance of understanding honeybee colony strength, beekeepers in Uganda rarely inspect their honeybee colonies because they are not very well informed of the importance. Honeybee colony strength is directly correlated to productivity [10-12] and colony health [13] and is easily visually estimated. It has been noted that colony productivity is closely associated with forging activity [5]. In a strong colony of honeybees, there is a large population of mature honeybees referred to as foragers who gather pollen and nectar to the colony [14] and colony size has been found to affect foraging [9]. Good foraging strategy means having enough pollen store and increased brood production [14] and thus colony strength and productivity. A reduction in foraging activities leads to reduced colony fitness and productivity [15]. This study compared the honeybee colony strength and productivity in the agro ecological zones (AEZs) of Uganda with the aim of providing information on the most productive honeybee race and the AEZs where most productive honeybees with strong colonies are found.

Materials and Methods

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This study was conducted in nine out of the ten AEZs of Uganda described in Kasangaki [16] between September 2012 and May 2013. Honeybee colony performance was estimated following methods described by Spivak [6], Vaudo [4] and Delaplane [17] (Subjective mode). This method was chosen because the colonies evaluated belonged to beekeepers most of whom did not want the honey harvested at the time of the experiment. The method is also the most appropriate for very defensive honeybees. At least twenty honeybee colonies were observed in each of the nine AEZs studied. The colonies were selected from four different sites within each AEZ (five colonies per site). To estimate the strength and productivity of the colony, the hives were opened and the combs lifted and the following observations made:

a) The number of combs and proportion of the combs covered by the adult bee population (Figure 1): the combs were observed on both sides and scored 1-3. Also, the average score for the number and proportion of combs for each colony was recorded.

b) The number and proportion of the combs covered by brood (Figure 2): these were also scored as in (a) above.

Figure 1: Adult honeybee pattern assessment. (a) A comb completely covered by adult bees; (b) Comb with less than ½ of it covered by adult bees; © Comb with less than ¼ of it covered by adult bees.

Figure 2: Brood pattern assessment. (a) Comb with >50% of it uniformly covered by both open and sealed brood; (b) Comb with about 50% of it covered by brood; © Comb with <25% of it covered by brood.

Figure 3: Assessment of the amount of honey gathered by the bees. (a) A comb completely covered by sealed honey; (b) Comb with 50% covered by sealed honey; © Comb with <25% covered by sealed honey

c) The amount of pollen and nectar collected (Figure 3): this was estimated by observing the proportion of the comb filled with pollen and honey and also scored as in (a) above.

The average scores for each of the observations (a-c) were obtained. The average for each colony were made and then taken as the average performance of that colony (1=Strong; 2=Moderate; 3=Weak). The number and proportion of sealed honey in the hive was used to estimate the productivity of the colony as 1=>50% of the combs with sealed honey (High productivity); 2=25-50% of the combs with sealed honey (moderate productivity); 3=<25% of the combs with sealed honey (low productivity). A GPS receiver was used to record the geographical coordinates and altitude. The vegetation cover was observed and estimated as 1=Thick; 2=Moderate; 3=Sparse. The type of bee hive used was also recorded.

Data Analysis

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Kruskal-Wallis test was used to compare the colony strength among honeybee colonies from different AEZs in different vegetation types, type of bee hive and elevation gradient. The same test was used to compare colony productivity in different AEZs, different vegetation types, honeybee race, type of bee hive and elevation gradient. Where significant differences were obtained, Mann-Whitney U test was used to compare pairs of categories. Furthermore, Mann-Whitney U test was used to compare the colony strength among the two honeybee races.

Results

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Colony strength

Honeybee colony strength varied significantly across the AEZs (X2 (df=8)=32.62, P<0.01; (Kruskal-Wallis test). Specifically, the colony strength of honeybees in the Victoria Crescent (VC) was significantly lower than for honeybees from all the AEZs except the Southern Dryland (SD) (Table 1) and (Figure 4). The honeybee colony strength did not vary significantly with other factors: vegetation cover (X2 (df=2)=1.41, P=0.47), honeybee race (X2 (df=2)=3.56, P=0.06), bee hive type used (X2 (df=1)=6.08, P=0.11) and elevation gradient (X2 (df = 2)=3.57, P=0.17).

Table 1: Comparison of colony strength among agro-ecological zones of Uganda.

Figures in bold (P-values) indicate where the colony strengths are significantly different between the AEZ (E=East; LAC=Lake Albert Crescent; LVC=Lake Victoria Crescent; MN=Mid North; SE=South East; SD=Southern Dryland; SH=Southern Highland; WN=West Nile; WH=Western Highland).

Productivity

Table 2: Comparison of colony productivity among the AEZs of Uganda.

Figures in bold (P-values) indicate where the colony strengths are significantly different between the AEZ (E=East; LAC=Lake Albert Crescent; LVC=Lake Victoria Crescent; MN=Mid North; SE=South East; SD=Southern Dry land; SH=Southern Highland; WN=West Nile; WH=Western Highland).

Honeybee productivity varied significantly across the AEZs (X2 (df=8)=32.93, P <0.01; Kruskal-Wallis test). Specifically, the productivity ofthe honeybees in the MN AEZ was significantly higher than in all the other AEZs (Table 2) and (Figure 4). The productivity did not vary significantly with the other factors: vegetation cover (X2 (df=2)=2.28, P=0.32), honeybee race (X2 (df=1)=2.86, P=0.09), bee hive type used (X2 (df=3)=4.29, P=0.23) and elevation gradient (X2 (df=2)=5.26, P=0.07).

Figure 4: Comparison of mean honeybee colony strength and productivity in the AEZs of Uganda.

Discussion

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Both the colony strength and productivity varied significantly across the AEZs of Uganda. The MN AEZ had colonies with higher colony strength and productivity compared to the rest but generally the productivity was low in all the AEZs and lowest in the LVC AEZ. Many studies have found a decline in colony strength and productivity [18,19] which has been attributed to factors such as pests and diseases, pesticide use and poor forage sources. Number of foraging bees has been used in determining colony success in terms of colony weight gain [14,20] Honeybee colony strength is one of the measures of population of adult bees and brood [17] and productivity [9] since colony strength has an effect on the foraging pattern. It is expected that, the stronger the colony, the more is the productivity [21].

There was no significant variation in the colony strength and productivity among the two honeybee races (A.m. scutellata and A.m. adansonii). Generally all races of A. mellifera have similar morphological, behavioural and innate characteristics compared to other species such as A. cerana [22] which could be the reason for no variation in the colony strength and productivity. However, there is need to monitor the strength and productivity of Ugandan honeybee colonies since new threats like Varroa mites [23,24] and viruses [25] have been detected. The colony strength and productivity did not vary with vegetation cover, type of bee hive used and the elevation gradient. Similar studies conducted in Nigeria by Babarinde [26] found no variation in colony strength and productivity of the honeybees. Colony losses have been reported in some parts of Uganda as a result of vegetation loss (forage source) due to effects of bush burning [27]. Decline in honeybee forage sources could have profound impacts on honeybee colony strength and productivity [28]. Although Kugonza [29] stated that bee hives in thick vegetation could have higher colony strength than those in sparse vegetation due to a favourable micro climate, this study did not find any significant variation in colony strength with vegetation cover.

Chahbar [30] while assessing honey production in South Western Ethiopia found out that moveable frame hives have significantly stronger colonies than fixed comb hives. The architecture of the different bee hive types may differ but honeybees have mechanisms of manipulating conditions within the hives [31] which could be the reason why there was no variation in colony strength and productivity with the type of bee hive used. There has been contradicting results on the honeybee productivity using different types of bee hives. For example, Kinati [32] found out that moveable top bar and frame hives were more productive than traditional bee hives. Muli [33] also stated that the Langstroth hives yield honey compared to the traditional bee hives in Kenya. However, this was not the case in this study probably because we did not measure yields. There is need for a longer study to investigate the seasonal changes in colony strength in the different AEZs of Uganda. From the results obtained, it can be seen that the colony strength and productivity in all the AEZs was low. Chemurot [34] while assessing honey production levels of honeybees in one of the AEZs of Uganda found that honey production per hive was generally low which is in agreement with the results of this study. Improved colony strength and productivity can be achieved through good apiary management practices and pest and disease control [8].

Honeybees with strong colonies have been found to have good hygienic behaviour [35,36] which is good for quality honey production. Strong honeybee colonies are also known to provide good defence against honeybee pests [37]. Some reasons put forward for low honeybee colony strength and productivity in Uganda include poor apiary management [38]. However, honeybee colony strength and productivity in Uganda can be improved by practicing good apiary management, bee forage improvement and optimizing the carrying capacity in a particular place [39].

Conclusion

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a) Most productive honeybee colonies with high colony strength in Uganda are found in the Mid North agro-ecological zone.

b) There was no difference in the colony strength and productivity between A. m. adansonii and A. m. Scutellata

c) Vegetation cover does not influence colony strength and productivity because not all the plants that constitute the vegetation cover provide good source of nectar and pollen required for the colony growth.

Recommendations

Government and development partners promoting beekeeping in Uganda should put more efforts and resources to develop beekeeping in the Mid North agro-ecological zone in order to realize the potential from the industry and raise more income to the farmers and the country at large. Further investigations into factors influencing colony strength and productivity should be conducted over a long period of time

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Lupine Publishers | A Comparative Study of Bonwire Kente and Daboya Benchibi

Lupine Publishers | Journal of Textile and Fashion Designing 

Abstract

Weaving is one of the indigenous crafts, very common in the Ghanaian tradition. This craft is very much associated with three regions in Ghana. These are Volta region in the southern sector, Ashanti region in the middle sector and Northern region in the northern sector. Prominent areas within these regions are AvetimeKpetoe in the Volta region, Bonwire in the Ashanti region and Daboya in the Northern region. Woven fabrics produced from each of these areas possess specific characteristics different from other. The purpose of the study was to ascertain the production processes involved in the manufacturing of Daboya"Benchibi" and Bonwire"Kente". The study aimed at bringing out the similarities and differences in the Daboya"Benchibi" and Bonwire"Kente". The study centred on the qualitative design paradigm and employed the descriptive research method. The study used observation and interview as data collection instruments to identify, describe and analyse the production process, differences and similarities in the production processes of the two weaving traditions.

The purposive sampling was used to select six weavers for the study. Three each from the selected communities. The descriptive method was used to analyse the data. The study found out that designing, warping, heddling, reeding, tying-up and actual weaving constituted the production processes involved in the production of both Daboya"Benchibi" and Bonwire"Kente". The study revealed that Daboya"Benchibi" and Bonwire"Kente" have differences in terms of style of weave, designs and materials used. The study recommends that the physical features, techniques and various skills in these traditions of weaving should be upheld to serve as a unique trademark and legacy for both communities.

Keywords: Kente; Benchibi; Weaving; Master weavers; Warp; Weft

Introduction

Woven fabrics are produced by the process of weaving. Weaving is the interlacing of two or more yarns, using a loom. It is very challenging or even impossible to associate the commencement of any useful art upon which the necessity and comfort of mankind depends on to a particular race or nation. Due to the importance and urgency associated with clothing and other prerequisites of mankind, weaving was done by almost every race in one way or the other [1]. He further traces weaving to as far back as the time of Job of the Old Testament in the Bible when Job did not hesitate to draw a comparison of his life predicaments to that of the swiftness of the weaver’s shuttle. This reveals how the ancient art and craft of weaving is, if it can be traced to the era of the Old Testament of the Bible. Rozental [2] narrates that about 20,000 to 30,000 years ago, early man established the first string by twisting together plant fibres. She opines that the early man prepared thin bundles of plant material and stretched them out while twisting them together to produce a fine string or thread. The ability to produce string and thread was the starting place for the development of weaving, spinning, and sewing.

Stone Age Man’s early experiments with string and thread led to the first woven textiles. Threads and strings of different sizes were knotted and laced together to make many useful things. Finger weaving, lacing and knotting together of threads by hand, is still used today by many weavers [3]. According to Appiah [4], in Africa, cloths generally, are woven out of fibres; cotton, raffia, straws, barks of trees or plants, like jute and linen. This unravels the variations in fibre and other filaments relevant for textile activities of cloth production. However, the principle underlying the technique of weaving remains similar. That is sets of yarns or threads made to interlace at right angles. This textile practice has evolved in many cultures across the world simultaneously and the Ghanaian culture is not left out. In Ghana, this craft of weaving is very much associated within three regions. These are Volta, Ashanti and the Northern regions. Prominent areas within these regions are AvetimeKpetoe in the Volta region, Bonwire in the Ashanti region and Daboya in the Northern region. Woven fabrics produced from each of these areas possess specific characteristics different from other.

The Bonwirekente is of a complex and intricate designs that identifies the rich culture of the Ashanti kingdom. Just like any other society, the people of Daboya being part of the Gonjaethnic group in the Northern Region of Ghana have peculiar forms of arts that also identify them. It is also in these art forms that the Ashanti and the Gonja exhibit some aspect their cultural values such as ethics, attributes and royalties. The woven cloth produced by the Bonwire people is called “kente” characterized by geometric shapes. Daboya is also known for the production of its woven cloth known as Benchibi. The entire fabric is hand woven but in narrower strips and designed with stripes. Weaving is one of the main occupations of these two traditional areas.

Historically, the origin of Kente can be traced back to the weaving traditions of West African kingdoms that thrived between 300A.D. and 1600A.D. Kente is the improved form of the numerous weaving traditions that existed in West Africa preceding the birth of the Asante Kingdom. Samples of strips of woven fabrics were discovered in West Africa in the 11th Century in the excavation of archaeologist. These strips of cloth presumed to be used for burial purposes perhaps during the era of Ghana, Mali and Songhai empires have similar features to many woven cloth in West Africa likewise, the Asante Kente. It is therefore believed that craft men of the Asantes might have learnt weaving skills from their neighbours of the west and north and subsequently polished their skill to come out with their unique style of cloth [5].

The Daboya Benchibi and Bonwire Kente are made into various designs for different occasions like weddings, rituals, funerals, child naming ceremonies and further for leisure and informal occasions. Kente and Benchibi are desirable to be worn by everyone especially on special occasions. Kente and Benchibi have become the attire for national events. The Benchibi cloth is usually used in the production of “Fugu” (smock) Politicians and State officials put on Kente and Fugu during state functions like swearing-in-of the President of the Republic of Ghana and Independence Day celebrations. Eminent citizens of Ghana by wearing Kente and Benchibi have aided in the placement of the two respective cloths as a Ghanaian identity abroad [6].

Bonwire Kente and Daboya Benchibi are prominent and important media by which Ghanaian cultural heritage can be preserved. Kente and Benchibi are irrefutable evidence and have utmost impact so far on the cultural heritage of Ghana. These woven fabrics have been done over the centuries and are one of the famous traditional arts in Ghana. However, similar the weaving process are, there are inherent differences that are characterised in the nature of materials, tools, accessories and equipment that these traditions of weaving poses. The study therefore was to ascertain the production processes involved in the manufacturing of Daboya Benchibi and Bonwire Kente, The study also aimed at comparing and contrasting the materials, tools, accessories and equipment used in the weaving processes of these two weaving traditions in Ghana.

Methodology

The study is situated in the qualitative paradigm of research. Creswell et al. [7] describe qualitative paradigm as an inquiry approach in which the inquirer explores a central phenomenon of a one key concept, asks participants broad, general questions and collects detailed views of participants in the form of words, images or words and images. Qualitative research is characterised by its aims, which relate to understanding some aspect of social life, and its methods which (in general) generate words, rather than numbers, as data for analysis [8]. Thomas [9] explains qualitative studies as those in which the descriptions of observation are not typically expressed in quantitative terms, but not suggesting that numerical measures are never used. Rather, other means of descriptions are emphasised. Sidhu [10] describes that qualitative research emphasises holistic description of whatever is being observed rather than comparing the effects of a particular treatment. This means that in qualitative inquiry, there is an exhaustive description of a particular activity or situation so that whoever has not witnessed the phenomena may have the opportunity to understand whatever is being studied. These formed the basis on which the study was conducted. The descriptive and observation research methods were employed. The descriptive method encompasses describing and interpreting what exist at present in the form of conditions, practices, processes, trends, effects, attitudes and beliefs [11]. Descriptive research method scrutinises the situation as it is and does not operate the situation under investigation nor is it anticipated to verify cause and affect relationship.

The researchers chose the descriptive research to reveal the current materials, tools, equipment and the step by step processes involved in the weaving ofthe Benchibi and kente without influencing the situation under study. The direct observation technique which was also employed by the researchers for the study, helped by providing a checklist to systematically conduct and record relevant data. Observation also helped in the verification and nullification of the information provided in the face to face interviews. The researchers observed the environment within which the weaving takes place, design, production process and finishing of the end product. The data was transcribed and assembled in text and pictorial form critically analysed and discussed.

The population used for this study was master weavers in Daboya and Bonwire. The selection for this study was based on immense consideration of their total commitment and contributions to the maintenance of the weaving tradition among the people of the two communities of Daboya and Bonwire. The purposive sampling was used to select six master weavers from the communities for in-depth study, three from each community. This confirms Kothari [12] assertion that items in the sample are selected deliberately by the researchers, the choice of which remains supreme for the researchers.

Discussion

The discussions for this study are done in two main categories. These are:

A. The processes prior to weaving and the weaving processes

B. Accessories, tools and materials.

Processes Prior to Weaving and the Weaving Processes

Designing: Design is a conscious activity, guided by aims and objectives. It refers to planned and organized actions intended to bring about some predetermined outcome although there may also be accidental or unexpected results [13]. This clearly reveals that before one produces a design, the item, artefact or product to be executed should be perceived in mind. Kirkpatrick [14] describes design (verb) as creating or fashioning of an object, form or function, the process of making a drawing, pattern, or sketch of something to show how it will look like, to conceive and plan out in the mind. Design in the light of a noun is described as the arrangement scheme of something, a pattern for decorating something a drawing that shows how something will be made or what it will look like, a plan that someone has in mind. From the interviews the respondents said designing is the first step of the weaving process. During the designing, one has to decide on the colours to form the background of the cloth and the colour that would form the weft. The weavers called the activity “colour mixing”.

The length and width of the cloth and the number of strips to be woven is also determined at the stage of designing. The kind of motifs and patterns (design) to weave are also considered. Hardt [15] states that five factors are important in designing- Functionality, aesthetics, long-range identity, cultural, political and ethical relations. The weavers in Bonwire and Daboya do not design on paper because of the manner of their training. That is the weavers are trained to design out of memory. This indicates that designing is an essential aspect of creative disciplines as established by Tettehfio [16] that designing is an integral aspect of product development and as such, the Bonwire and Daboya weavers are involved in designing even though this is not done on paper.

Designing is the foremost and considered the most important step in the pre-weaving process. During designing, the weaver decides on the weaving pattern, the colour to use, the length and width of the cloth as well as the number of strips required to obtain a complete cloth in one’s memory before commencing the weaving process. The capability to ascertain and blend colours and pattern to achieve an aesthetically pleasing piece is an excellent novelty of the weaver. Adu-Akwaboa [17] adds that design can simply be an arrangement of accepted elements following certain principles. The elements which include lines, shapes, colours, texture, form, tone and light form the building blocks with which the work is constructed. This is what the weavers from this tradition do.

Warping

Straightening or stretching of the background yarns is executed after designing. The background (warp yarns) lay according to the width, yardage and design of the cloth. The width of the cloth is sometimes dependent on the design to be woven. For instance the width of the Bonwire kente “Angelina” (name given to a designed woven cloth) is wider than the width of a Benchibi named “kayitiwala”. All the respondents from Bonwire affirmed that the stretching is done on wooden pegs (ntenennua) inserted into the ground with a device called “menko me nam” (literally meaning "I walk alone”) or “baanu ye nna”. (Literally meaning “two are better than one”). Warping is done by going round with the warp yarn around a metallic pegs (kenyabi) that are driven into the ground. It was observed that two spools of yarns were placed on the ground. The yarns were passed through a looped metallic guide called “katentenyambi” in Gonja language which is usually fixed at the top of the weaving shed before going round the metallic pegs. Both respondents from Bonwire and Daboya admitted that before the stretching process, the weaver has to consider the weather since the process is done outside in the open. Care is taken ensure that the weather clear.

This is because, if it rains the yarns will get wet, entangle and destroyed. The respondents from both Daboya and Bonwire agreed that warping is a very wearisome process. This point out that warping is the next stage that comes after designing in the weaving process, where long yarns that run lengthwise (warp) of the woven fabric is put together as confirmed by Asmah [18]. Among the Asantes, warping is known as "ntomatene” (straightening the cloth) while the Gonjas refer to the process as "katente”. The Bonwire weavers do the warping with the use of several spools arranged on a device known as bobbin carrier. This is referred to as “menko me nam/ Baanu ye nna” in Asante. Weavers of Bonwire drove wooden pegs whilst weavers in Daboya drove metallic pegs into ground and yarns are moved around the pegs which are wide apart to obtain the total length and number of warp ends required for the cloth. The wooden pegs are called “ntenennua” (straitening) in Asante and the metallic pegs are called “kenyabi” in Gonja.

The warp yarns are normally prepared a little longer than the exact length of the cloth, to provide allowance for shrinkage and unpredicted wastage during weaving. The crosses created are carefully preserved by holding them together with a cord before the warp is removed from the pegs. In removing the warp, the yarn wound around the last peg farther away from the crosses is first removed. After this, the entire length is wound by folding the warp around the hand which is latter removed and spirally wound to reduce the warp to a convenient length for easy handling (Figures 1A & 1B).

Figure 1a: A weaver warping in Bonwire.

Figure 1b: A weaver in Daboya taking off the warp yarns from the metallic pegs (kenyabi).

Heddling

After stretching the yarns that forms the background of the cloth, the background yarns are then passed through the “asa” or “aniri”. These processes are called “hyehye” (arrange) in Asante and “kapewonta” in Gonja. Bonwire loom has two sets of heddles “asa”, the first set is “asatia”(short heddles) that is responsible for plain weave and the second set “asanan”(four heddles) which controls the design weave whilst the Daboya loom has only a set of heddles “aniri” that is responsible for the plain weave. In the kente heddling process a set of yarns are passed through the “asanan” and then the yarns are spread through the “asatia”. Respondents from Daboya said two yarns are combined and then passed through the “aniri” (heddles) with the help of the fingers.

This shows that after warping, the warp ends are ready to be passed through the eyes of the heddles (“asa” and “aniri”). This heddling process is also referred to as “drawing-in” by Appiah [4] and Coffie [19]. The heddling is known as “kepawonta” and ”hyehye“ in Gonja and Asante respectively. The kente loom is equipped with two pairs of heddles. The "asatia” and the second pair is “asanan”. The first set is usually retained for plain weaves whereas the other set is reserved for the design weave. This ensures that two different categories of heddling are done on the kente loom which functions concurrently. The heddling is usually began with the design category with bundles of the warp in four or six being inserted through the individual heddle eyes of the design heddles to cover the whole total of warp ends and on completion, these bundles of warp are then divided and inserted through the heddles of the plain weave heddles (asatia).

The Benchibi loom is provided with only a pair of heddles known as “aniri”. This is used for plain weave which is the only technique of weave in Daboya. The warp yarns are made into two ply and inserted into the eyes of the individual healds. The middle part of the heddles is usually left empty without a yarn in order not to leave the ends of the heddles empty and to facilitate shedding, a weaving operation described by Adu-Offei, Coffie, Sackey [1921] as raising alternate warp yarns to create an opening called a shed. The heddles with the yarn are referred to as “aniri” while the heddles without the yarns are called “aniribawu”. Leaving some of the heddles with warp yarns is also dependent on the number of healds in the heddle (Figures 2A & 2B).

Figure 2a: A Weaver in Bonwireheddling.

Figure 2b: A Weaver in Daboyaheddling.

Reeding

The next process is the reeding, which is passing the yarn through the dents of the reed. The reed is known as “kafa” or “peri” in Gonja language and “kyere” in Asante’s language. The warp yarns are spread through the reed according to the width of the cloth. Reeding is called “kepawuntakafato” and “hyehye” in Gonja and Asante languages respectively. Respondents from Daboya said the warp yarns are grouped in fours and then passed through the reed with the fingers whiles respondents from Bonwire said the yarns are made into two ply before inserting through the dents of the reed with the help of a small stick. This reveals that reeding follows heddling which involves passing the heddled warp ends through the dents of the reed. This process necessitates the distribution of warp to the required width of the cloth. Thus, the reeding determines the width of the cloth. In the process, each warp yarn from the heddles is inserted through the dent of the reed. Amankwa & Oppong [3] state that the selvedge yarns are usually doubled to strengthen the edges of the fabric. However, this is not done during the reeding process of both Kente and Benchibi (Figures 3A & 3B).

Figure 3a: A weaver reeding in Bonwire.

Figure 3b: A weaver reeding in Daboya.

Tying-Up

The next process after reeding is fixing the warp yarns to the cloth roller known as “kamasidibi” in Gonja and “ayaasedua” in Asante. Tying -up is called “kekerewutakamasidibi” in Gonja and “ntomatibo” in Asante. The warp is then attached to the “tweso” or “kagberi”. The cloth roller is then rolled to stretch taut the warp yarns. It must be ensured that the right tension is obtained. Respondents in Daboya and Bonwire revealed that the warp ends are first knotted to a small stick which is connected to the cloth roller with cord. This small stick is called “kebilempo” in Gonja. This shows that, at this stage of the weaving process, warp ends are attached to the cloth roller. The reed and heddles are at this stage tied up to the pulleys and hanged onto bar at the top of the loom. The wound warp is then unrolled, stretched and attached to a drag weight known as “tweso” in Asante and “kagberi” in Gonja. The cloth roller is then revolved to ensure the right tension in the warp. After this, the warp is then tied up to the cloth roller. The warp tensioned yarn is called “ntomaasaase” in Asante and “katenyijesey” in Daboya (background of the cloth). The process of tying up is known as “kekerewutakamasidibi” and “ntomatibo” in Gonja and Asante respectively (Figures 4A & 4B).

Figure 4a: A Kente weaver tying up.

Figure 4b: A Benchibi weaver tying up the warp on the small stick (kebilempo) attached to the cloth roller (kamasidibi) .

Weft Preparation

According to the respondents from the interview, Daboya weavers prepare only a set of weft yarns for weaving. The weft yarn is usually locally dyed with blue-black locally prepared dyes with some parts remaining white (as a result resist-dyeing method). Bonwire weavers usually employ two sets of yarns, one in the shuttle and the other set for hand picking design which is not contained in a shuttle. During weft preparation, yarns in hank are fixed onto skein winder and a spool rack respectively and wound onto bobbins with the help of a bobbin winder. Yarns on cones are wound onto bobbins directly with bobbin winder. This reveals that amongst Bonwire weavers, two sets of weft yarns are usually utilised and these are the binding weft usually carried in a shuttle and the pattern weft which is handpicked. Pattern wefts are usually thick as a result of arranging many yarns together depending on the design to be created and also to determine the weight of the fabric to be produced. During weft preparation, yarns in hank are fixed onto skein winder and a spool rack respectively and wound onto bobbins with the help of a bobbin winder. Wefts of different colours are prepared in accordance with the number of colours meant for the design. Several bobbins are wound to facilitate quick weaving process. In Daboya, only one set of weft which is of one colour is prepared for the weaving. The weft is carried in a shuttle during weaving. The process of preparing the weft yarns is simpler than warp yarns as affirmed by Adu-Offei [17] and Asmah [18]. This process is referred to as “mfamu” or “ahomaboro” in Asante and “kamligikadoro” in Gonja (Figures 5A & 5B).

Figure 5a: A weaver in Bonwire preparing the weft.

Figure 5b: A weaver in Daboya preparing the weft.

The Weaving Process

The respondents expressed that in weaving, the treadles are pressed down to create a space between the background yarns and the weft yarn is left between the spaces left. The weft yarn is then pushed to the end of the cloth by the reed. Respondents from Bonwire expressed that when weaving Kente, one has to know how to weave “ahwepan” (plain weave) and the design weave (adwene). In weaving the plain weave, it was observed that only the shuttle containing the weft was used. The design weave employed the hand in picking the weft yarn in accordance with the design to be woven. It was found out that during weaving (ntomadwene) of Bonwire Kente, a treadle (ntiamu) is depressed to open a shed. A shuttle containing the weft (plain weave) is thrown through the shed from one side of the loom to the other. This operation is referred to as picking by Adu-Offei, Coffie, Fiadzo, Sackey [17-21]. The treadle is released and the weft beaten-up with the reed. The process is repeated alternatively until the required plain weave is produced.

Figure 6a: A weaver weaving in Bonwire.

Figure 6b: A weaver weaving in Daboya.

In the case of designing the weave in Bonwire, the treadle that controls the design heddles is pressed and a design weft inserted with the finger along the part of the warp that corresponds with the design. The treadle is released and the inserted design weft beaten- up with the reed. After a design weave, a plain weave is done to bind it. In some situations, a swordstick (tabon) is used to keep hold of the shed before the handpicking is done. After a complete design, the plain weave is repeated to bind the design. Weaving the Daboya Benchibi, a treadle (aniribaya) is depressed to open a shed. A shuttle containing the weft is thrown through the shed from one side of the loom to the other. The treadle is released and the weft beaten- up with the reed (kafa/peri). The process is repeated alternatively until the completion of the entire cloth. There is no hand picking   since the cloth is produced only with the plain weave technique. The process of weaving is called “kalor” in Gonja (Figures 6A & 6B). Having identified the various processes involved in the weaving of Daboya Benchibi and Bonwire Kente, Adu-Offei [17], Amankwa & Oppong [10], Sackey [20] agree with the processes identified in the study as being designing, warping, heddling, reeding, tie up, weft preparation and actual weaving. However, beaming as identified by Adu-Akwaboah [21] is not among the processes involved in the manufacturing of Kente and Benchibi.

Accessories, Tools and Materials

Materials: The main material for weaving is yarn. The basic character of a woven fabric depends largely on the type of weave structure and the type of yarn used. According to the respondents, the final nature of a cloth is determined importantly on the type of yarns used for the weaving. This is very important in the sense that the type of yarn has effect on the final cloth. Daboya weavers expressed the use of factory spun cotton yarns for their weaving. They said, they used to weave with the hand spun yarns, spun by the women of Daboya in the olden days [22]. The hand spun yarn is thick, rough and heavy hence cloth produced from this yarn is heavy and rough but durable. From the weavers, cotton yarn is used for weaving their cloth since mostly; the yarn is locally dyed before weaving.

On the other hand, weavers from Bonwire said, they weave with cotton, polyester and rayon yarns. Cotton is best used for the black and white cloth called the “Fufuontoma” since the white cotton yarn which dominates the cloth brightens well than rayon. Rayon and polyester yarns are good for the multi-coloured cloth. According to them, the preferred yarn for design weave is rayon. Hence, in the shortage of rayon yarn, some weavers have to put on hold weaving for another time until the rayon yarn is available. Previously, they used to use silk yarn which is the best of yarn but has been replaced with rayon when the silk yarn is in scarcity on the market. Rayon and polyester yarns are used for the design weave. The rayon yarn is very fine and soft and the draping effect of the cloth is desirable. Cotton is preferable for the plain weave (ahwepan) to make the cloth heavy. This shows that the type of yarn material is very crucial to a weaver to be capable to attain a quality work. The type of yarn determines the durability and qualities such as drape, thickness and stiffness of the cloth.

From the study, weavers in both Daboya and Bonwire weave with cotton yarns. The cotton yarns are best used for the plain weave as confirmed by Adu-offei [17], Glime [23].Cotton is desirable for plain or single weave to make cloth a little denser. From the study, rayon and polyester yarns are utilised in Bonwire Kente but not used in the weaving of Daboya Benchibi. Weavers of Bonwire prefer and commend to weave with rayon and sometimes polyester yarns for the design weave. It is the preference of weavers in Bonwire to utilise rayon and polyester for the design weave because rayon yarn is thin and soft which makes the woven cloth flexible and drape well as affirmed by Asmah [18]. Cotton when used for design weaves results in a stiff, lowly finished cloth as well as reduction in draping effect of the cloth (Figures 7,8).

Figure 7a: Rayon Yarn used in Bonwire.

Figure 7b: Cotton yarn dyed and used in Daboya.

Figure 7c: Factory-dyed cotton yarns used in Bonwire.

Figure 7d: Polyester yarns used in Bonwire.

Figure 8a: Sample cloth of �Benchibi�.

Figure 8b: Sample cloth of �kente�.

The loom (Tool)

Figure 9a: Mobile loom at Bonwire.

The loom called “korey” in Gonja and “nsadua” in Asante is made of wood. The loom is the main frame on which weaving is done. The “nsadua” is constructed in wood and in such a way that the “nsadua” is mobile. It can be carried from one place to the other. Respondents from Daboya said the “Korey” is constructed by inserting logs of wood into the ground where the weaver wishes to weave. This is done by the weaver himself with assistance of friends, family members who may be weavers. The “nsadua” and the “korey” are made of wood. Nonetheless, the “nsadua” is a mobile loom constructed by carpenters. Thus, it can be placed anywhere provided there is enough space for the stretched warp and its drag weight. The “korey” is an immovable loom with similar parts as the “nsadua”. It is shorter than the “nsadua” and it is made of tree log cut from the bush by the weaver and then fixed to the ground (Figures 9A & 9B).

Figure 9b: Fixed loom of Daboya

Accessories

A. Heddles: This is called “aniri” in Gonja and “asa” in Asante. The heddles is a rectangular device consisting of two resilient sticks one at the top and the other down and joined by fine strings with loops in the middle of each string. The warp passes through the loops in the middle of the string (Figure 10).

Figure 10: Heddles.

B. Bobbin: This is a piece of bamboo (“prampro” in Asante and “kachebi” in Gonja) with a hole that carries the weft for weaving. Bobbin is known as “kadoro” and “drodowa” in Gonja and Asante languages respectively (Figure 11).

Figure 11: Bobbin.

C. Reed/beater: one of the most important accessories in weaving Benchibi and Kente is the reed or beater. This is known in Gonja and Asante respectively as “peri”/ “kafa” and “kyere” The size of the beater or reed determines the width of strip to be woven. The beater is rectangular in shape, built of two fine strips of bamboo with holes cut at each end, joined by reeds. The reed is suspended by two strings from a beam across the top of the loom (Figure 12).

Figure 12: Reed

D. Seat: This is sat on when weaving. Some of the weavers in both Daboya and Bonwire put foam or pillow on the stool for comfort sitting during weaving. Stool is the seat typically used by weavers. Yet pieces of logs and spoilt mortars serve as seat for some weavers. Bonwire weavers mostly use the stool while Daboya weavers mostly sat on pieces of logs and abandoned mortars (Figures 13A & 13B).

Figure 13a: Stool with a pillow used in Bonwire.

Figure 13b: Mortar with foam used in Daboya as seat.

E. Cutting edge: This may be scissors, knife or blade which is used for cutting strips of cloth from the cloth roller and excess and unwanted threads from the woven cloth (Figure 14).

Figure 14: Scissors.

F. Shuttle: this is used for passing the weft in between the created shed in warp. This is passed back and forth through the shed between the warp yarns. It is made of wood, smooth and boat-like. This is called “gambo” and “krokrowa” in Gonja and Asante respectively (Figures 15A & 15B).

Figure 15a: Shuttle with bobbin used in Bonwire.

Figure 15b: Shuttle with bobbin used in Daboya.

Figure 16a: Bobbin winder used in Bonwire.

G.  Bobbin Winder: A device used for winding yarn onto bobbins. This is called “krokro” and “afidie” in Gonja and Asante respectively (Figures 16A & 16B).

Figure 16b: Bobbin winder used in Daboya.

H. Skein Winder: This device known as “hwiridie” in Asante and “fan” in Gonja is used for unwinding hanks. This rotates for the yarn to be rewound onto bobbins. The rotational nature of the device helps the weavers to wind their yarns onto the bobbins (Figure 17).

Figure 17: Skein winder.

I. Drag weight: This helps to keep taut the warp. This is known as “kagberi” and “ntweso” in Gonja and Asante respectively (Figures 18A & 18B).

Figure 18a: Drag weight used in Daboya

Figure 18b: Drag weight used in Bonwire.

J. Treadles: This is depressed to create the shed during weaving. Treadles are known as “aniribaya” and “ntiamu” in Gonja and Asante respectively (Figure 19).

Figure 19: Treadles.

i. Distinctive tools and Equipment used

ii. There are specific implements that are peculiar in the production of Bonwire Kente and Daboya Benchibi. These weaving implements include:

a) Shed Stick: The shed stick is used to maintain a shed when design weave is being woven. This tool is peculiar to weavers of Bonwire but not used in Daboya (Figures 20A & 20B).

Figure 20a: Sword stick.

Figure 20b: Sword stick inserted in the warp.

b)    Spool Rack: This device is known as “menko me nam” or "baanuye nna”. It is used in Bonwire for warping (Figure 21).

Figure 21: A weaver with the spool rack.

c)     Thread Guide: This device is unique to weavers in Daboya. It is called “katentenyambi” and it guides the warp during warping (Figure 22).

Figure 22: Thread guide (katentenyambi).

Weaving Area

It was observed that weaving goes on in Daboya outside (under trees and hurts constructed by the weavers themselves). Bonwire weavers were similarly noticed weaving outdoors under trees and hurts built by the weavers themselves. However, some weavers in Bonwire were found weaving on verandas, porches at the comfort of their homes as well as indoors- in houses and well-constructed sheds. No weaver was detected weaving indoors or on verandas in Daboya due to the immobile nature of the loom they used. Weaving areas were generally neat and tidy in both Daboya and Bonwire weaving towns. This reveals that weaving has to be done at a shady and cool area to enable one to weave for a long time. Weaving under the scorching sun is not a permissible condition for weaving. Weaving is done under a conductive condition and not harsh environment. Weaving is not supposed to be done in an unclean and filthy environment.

Duration for Weaving and the Type of Weave

According to the respondents of both Bonwire and Daboya, the period of time for weaving a particular cloth depends on the design to be woven and the length and width of the cloth. Daboya weavers claim it takes 2-3 days to weave a standard cloth. Bonwire weavers say that it may take between one and four weeks to weave a simple design and two to six months to weave complex designs. They said, usually the length of a cloth is determined by the gender use of the cloth, thus whether the cloth will be used by a male or a female. Kente weavers revealed that, the length of women cloth is six yards whilst that of men is between eight and ten yards depending on height of the individual. It was observed that Benchibi weavers employ plain weave and with warp yarns being more visible than the weft yarns. Kente weavers employ both plain weave and design weave. With Kente, the weft yarn is very conspicuous, concealing the warp yarns.

Conclusion

The study described the production process involved in the manufacturing of Kente and Benchibi by the people of Bonwire and Daboya respectively. The study outlines the processes in the production of woven fabric as designing, warping, heddling; reeding, tie-up, weft preparation and actual weaving. The study found that weavers of both traditions in spite of modernity still employ crude and outdated production processes. The study also found out that both Kente and Benchibi can be produced using factory spun cotton yarns and characterised by various types of lines. However, Daboya weavers principally utilise hand spun cotton yarns manufactured and dyed locally in Ghana. They believe this will help in maintaining the tradition of smock production. They also believe that the hand spun cotton yarn brings out the uniqueness of the fabric produced, hence, the unique nature of the smock. Kente is woven with factory spun cotton and rayon yarns imported from other countries. The multi-coloured yarn provides the kente cloth with its unique character. Weavers in Bonwire use portable mobile looms that could be placed in a room or veranda for weaving whiles weavers in Daboya operate with looms that are fixed to the ground on open space limiting weaving to be done only when the weather is favourable. These two traditional communities have been able to maintain this ancient craft of weaving in Ghana.

Recommendation

In the interest of cultural maintenance, weavers in the woven industry, in spite of modernity, still employ crude and outdated production processes. Modern and advanced technology could be introduced by research institutions to help improve the weaving of Kente and Benchibi. Weavers of Bonwire Kente and Daboya Benchibi should utilise a weaving apparatus known as the warping mill to ease the work load and energy exerted during warping. Rain will not hinder warping since the warping mill can even be used indoors. Yarns used in weaving Bonwire Kente are imported from other countries. The government and investors should setup a yarn manufacturing factory in Ghana to feed the Bonwire weaving industry. Daboya weavers should maintain the use of cotton yarns manufactured in Ghana and dyed locally in Daboya in order to help sustain both the textile factory and the Daboya local dyeing industry. Weavers in Daboya should adopt the mobile looms that can make it possible for weaving to be accomplished in rooms and porches, so that the activity of weaving will not be dependent on the weather.

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Lupine Publishers| Implication of Intrinsic Intraocular Risk Factors at Ocular Blood Flow to Primary Glaucoma

Lupine Publishers| Ophthalmology Open Access Journal

Abstract

Purpose: To assess the implication of intrinsic intraocular risk factors at ocular blood flow (OBF) to primary glaucoma (POAG).

Method: In a retrospective control study included 51 consecutive patients, mean age 50, 5±7, in follow-up 2008-2012 divided in control group (CG) 15 patients without POAG, group A (GRA) 15 patients with POAG, group B (GRB) 21 patients with POAG, 9 of them with disc hemorrhage (DH) and 12 with peripapillary atrophy (PPA). We performed baseline glaucoma examination including monitoring pulsatile ocular blood flow (POBFA), pulse amplitude (PA), central corneal thickness (CCT), OCT and visual field (VF) examination. Exclusion criteria: Previous ocular trauma and surgery, pathologies with evident VD. Paired T-test and linear regressions used for statistical analysis.

Results: Our findings indicated a strong correlation between OBFA, IOP and an interrelation between POAG and intrinsic risk factors, DH and PPA (P=0,001). In GRB versus CG,GRA POBF were very sensible and fluctuated depending on the intraocular VD.CCT and IOP changes (P=0,002), showed the abnormality auto regulation(r=0,650). In GRB the POBF and PA were lower ≥8% than other subgroups (P<0,001). LATANOPROST with IOP reduction from baseline 30, 8%, POBF improved 16,6%, PA 10% was the best therapy in GRA. In GRB the switch therapy DORZOLAMIDE + LATANOPROST, DORZOLAMIDE + BIMATOPROST IOP reduction 33.0% from baseline, POBF improved 36%, PA 22%, with added therapy NILVADIPIN 60 mgr + GINKGO BILOBA 150 mg, VISIONACE plus the hemodynamic parameters further improved ≥5%.

Keywords: Vascular Dysregulation; pulsatile ocular blood flow; Pulse Amplitude; Factor Risk; Disc Hemorrhage; Peripapillary Atrophy; Primary Glaucoma; Hemodynamic Parameters; Selective Therapy.

Abbrevations: VDR: Vascular Dysregulation; POAG: Primary Glaucoma; POBF: Pusatile Ocular Blood Flow; PA: Pulse Amplitude; DH: Disc Hemorrhage; PPA: Peripapillary Atrophy; CCT: Central Corneal Thickness; VF: Visual Field

Introduction

Glaucoma is multifactorial disease [1-3]. Investigations of vascular theory in Glaucoma, changed the treatment strategy [4,5]. Vascular dysregulation (VDR) as a systemic dysfunction develop more efficient treatment approach [4,6] compound by extra ocular and intraocular factors [6,7]. DH and PPA are intrinsic important expressions of VDR [8].

Purpose: To assess the implication of intrinsic intraocular risk factors at ocular blood flow (OBF) to primary glaucoma (POAG) patients evaluating medical strategy.

Method

In a retrospective control study included 51 consecutive patients, mean age 50, 5±7, in follow-up 2008-2012 divided in control group (CG) 15 patients without POAG, group A(GRA) 15 patients with POAG , no significant vascular dysregulation(VDR) factor , group B (GRB) 21 patients with POAG, 9 of them with disc hemorrhage (DH), identified supratemporal in 5 cases, infratemporal 4 cases, and 12 with peripapillary atrophy (PPA) was measured in three sectors around the disc circumference 1-5 o'clock . We performed standardized protocol of baseline glaucoma examination including monitoring pulsatile ocular blood flow (POBFA), pulse amplitude (PA), central corneal thickness (CCT), OCT, and visual field (VF) examination. Exclusion criteria: Previous ocular trauma and surgery, pathologies with evident VD. Paired T-test and linear regressions used for statistical analysis.

Results

Our findings indicated a strong correlation between OBFA, IOP and an interrelation between POAG and intrinsic risk factors, DH and PPA (P=0,001). In GRB versus CG,GRA POBF were very sensible and fluctuated depending on the intraocular VD.CCT and IOP changes (P=0, 002), showed the abnormality auto regulation(r=0,650). GRB showed a mean decrease of OBF=26, 5%, PA=28, 5% from control group and OBF and PA were lower ≥10% than GRA (P<0,001), explained by correlated vascular risk factors. OCT shows a significant difference between CG and eyes with PPA (p=0, 0005), which remained unchanged. LATANOPROST with IOP reduction from baseline 30, 8%, POBF improved 16, 6%, PA 10% was the best therapy in GRA. In GRB the switch therapy DORZOLAMIDE + LATANOPROST, DORZOLAMIDE + BIMATOPROST IOP reduction 33.0% from baseline, POBF improved 36%, PA 22%, with added therapy NILVADIPIN 60 mgr + GINKGO BILOBA 150 mg, VISIONACE plus the hemodynamic parameters further improved ≥10%.

Discussion

These findings indicated a multifactorial VDR not only “extrinsic” but also intrinsic [9,10]. DH, PPA must be considered risk factor of glaucoma progression [9]. DH theorized that they are as result of a micro vascular occlusion of the disc blood supply or by optic nerve neurodegenerative [11,12]. PPA describes as atrophy or thinning of retinal layers and retinal pigment epithelium [2,13]. In GRB the circadian fluctuations of OBF with PA reduction are significant predictor of glaucoma progression, reflected to VF and OCT. Our selective therapy is to get IOP as low as possible with important OBF improved [14-16].

Conclusion

DH and PPA must be considered risk factor of glaucoma progression and intrinsic important expressions of VDR. Ocular hemodynamic parameters are compromised by DH and PPA in glaucomatous eyes. Fluctuations of OBF and PA reduction are indices of vascular dysregulations. Careful observations and multimodal therapy are necessary [10,13,15].

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Lupine Publishers| Influence of Globalization on Environment

Lupine Publishers| Journal of Oceanography and petrochemical sciences

Background

Globalization is a process of interaction and integration among the people, Companies and governments of different nations, a process driven by international trade and investment and Aided by information technology. Globalization has also contributed more in environmental degradation as well. It has led to increase in the consumption of products, affected the ecological cycle, increased consumption leads to an increase in the production of goods, which also creates or puts more stress on the environment. Globalization also causes rise in pollution level in the environment. It has also led to an increase in transportation of raw materials and food from one place to another. Transportation has also put a strain on the non renewable sources of energy such as gasoline. Due to globalization depletion of ozone layer, increasement of green house gases enhancement of deforestation, killing of many underwater organism due to overproduction of industrial wastes and ultimately deposition of harmful chemicals in oceans take place.

Some learned person’s definitions are presented here with reference to environment as- Girberts “Environment is anything immediately surrounding an object and exerting direct influence on it.” Douglas and Holland “the term environment is used to describe in the aggregate all the external factors, influence and conditions which and effect the life, nature, behavior growth development and maturation of living organism.” Ross “Environment is any external force which influence.com” Woodworth “Environment cover all the outside factors that have acted on the individual since he began his life”. Herskovits “Environment is the sum total of all those external conditions and influences which affect the lives and development of living or organic thing.”

a) Aim: This study will give some measures to bring harmony between development and environment Sustainability in this globalization world.

b) Result: We thoroughly studied and analyzed the process of globalization and their challenging impacts on our healthy ecosystem and environment. We have to develop some effective mechanism and also support to building a better structure that can check the extent to which it can impact the environment and certainly it would economically feasible and ecofriendly too.

Conclusion

Due to globalization pollution level will become reduce.

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Lupine Publishers | Silk Threading-A New Revolutionary Jewellery from India

Lupine Publishers | Journal of Textile Science and Technology

Short Communication

Jewellery is a mesmerizing term which any feminine gender would love to admire and afford. Instantly, this magic term recalls about ornaments made up of gold, silver, platinum etc., in our minds. But the 21st century scenario is very different where the word jewellery has a different connotation. In the recent years, may be women would have felt jaded of using the above mentioned ornaments which led to a change in artificial jewellery. Popularly termed as funky, imitation, bling, modern or fashion etc., are the new terms and the current trends go on. Though, such discernments are stated to revelation on the social status, invariably such artificial jewellery is worn right from the poor to the rich. No doubt that so called artificial jewellery has made a mini industrial revolution among the metropolitan women who are supposed to admire such antiques wearables from head-to-toe [1,2].

Artificial Jewellery

Indian Jewellery is legendary all over the world as they are royal inspired by the old Indian tradition and is considered to be one of the oldest ways to flaunt women’s beauty. Today in India where real Jewellery has become extremely expensive and trend setting is moving towards imitation Jewellery. These are only look alike real Jewellery but are much economical and affordable to common Indian women. Conversely with artificial Jewellery, it is more convenient to innovate multiple and numerous designs and ideas than the regular Jewellery designs. Also, it is not an unacceptable fact that these do not have good appreciable deterioration unlike the other ones.

Silk-Threading

Commercial silks originate from reared silkworm pupae that square measure bred to provide a white coloured silk thread with no mineral on the surface. The pupae square measure killed by either dipping them in boiling water before the adult moths emerge or by piercing them with a needle. These factors all contribute to the flexibility of the entire cocoon to be unravelled joined continuous thread, allowing a far stronger artefact to be plain-woven from the silk. Wild silks additionally tend to be tougher to die than silk from the cultivated silkworm. A way called demineralising permits the mineral layer round the cocoon to be removed, deed solely variability in colour as a barrier from making an ad silk trade supported wild silks in components of the planet wherever wild silk moths thrive, like continent and South America. The entire production method of silk is divided into many steps that square measure generally handled by totally different entities (Figure 2).

Silk-Threaded Jewellery

The typical groundwork on the silk threading artificial Jewellery starts from simply covering an acrylic or plastic ornamental material with such threads. The artistic skill set starts here at the precision and accuracy of the cover over such ornaments. Innovation and designs goes unlimited by use of various colours and mixing it with warp ribbing, crossing over, stretching, bending, overlapping, etc. Further, creativity adds up with attachment of artificial stones over it which may add blink to the jewel. Beads which are made of glass, gemstones, metal, wood, shells, clay and polymer clay etc., are most commonly used in encompassing necklaces, bracelets, earrings, belts and rings. The use of seed beads is an embroidery technique where seed beads are sewn onto fabric backings to create broad collar neck pieces and beaded bracelets. Bead embroidery, a popular type of handwork during the Victorian era, is enjoying a renaissance in modern Jewellery making. Beading, or beadwork, is also very popular in many African and indigenous North American cultures.

Designs

A tentative design with patterns are listed as below for the readers reference.

a) Goddess-Lakshmi

Neckpiece with Pink & Green Silk Thread beads embellished with spacers & antique connecter & Beautiful Antique Lakshmi Pendent. Green Silk threads Jumukas & pink Silk Thread beads Embellished with golden ball chain paired up with beautiful antique Lakshmi studs. Nakshatra Bangles as side bangles with green & pink mix Bangles makes the set grand & elegant (Figure 1).

Figure 1: Goddess-Lakshmi.

b) Lorials Set

Beautiful Neckpiece is made of pink silk thread beads with Lorials pearl with Medium Pink Jumukas embellished with pearl chains & golden chains paired up with antique dancing small peacock studs. A set of elegant bangles with double design pattern worked with pearl & stone. Matching Tic Tac hair clips embellished with pearl & stone work (Figure 2).

Figure 2: Lorials Set.

c) Peacock Set

Large peacock blue Jhumkas embellished with golden beads packed up with peacock studs. Neck piece with silk thread beads and antique peacock pendant matching the stud which is embellished with golden kundans. A set of simple elegant bangles with crisscross design stoned in on the outer layer (Figure 3).

Figure 3: Peacock Set.

Developments

The targeted market is obviously on typical Indian ladies and hence, metropolitan hunt is continual across online and social media. Numerous FB and twitter follow-ups are common happenings on the internet users. Online Jewellery entrepreneur’s viz., caratlane, bluestone etc., are troubled that needless to mention on the typical Indian hesitation on investing for purchasing it without having a visual of it. However, as economical and affordable artificial Jewellery to a common Indian girl, this silk threading is no doubt an emerging revolution feasible by any innovators and creative human beings.

Acknowledgement

The author is one such innovator in home-made silk threaded Jewellery famed in the social media. Readers are advised to check the references for further reading.

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