\r\n\tThis cell has evolved an effective defense system to counteract the challenges as it is always in an oxygen-rich environment. The evolution of hemoglobin and deformability of erythrocyte membrane adapting to its function in circulation is especially striking. Erythrocyte aging and eryptosis strike a balance - the mixed population of cells and constant recycling every 120 days is a very distinct feature. Its metabolic shunt pathways and metabolites/enzymes alter and adapt with age and changes in the microenvironment.
\r\n
\r\n\tErythrocyte and its cytoskeleton responses to various situations such as infections, hypoxia, hypothermia, intrigues researchers and biologists alike. This book aims to throw light on the significance of erythrocyte and its characteristic nature and survival in different physiological situations as it plays a very crucial role.
\r\n
\r\n\tThis book hopes to bring different perspectives from various aspects and provide insights into the effective mechanisms evolved by erythrocytes, to counteract the challenges faced in its oxidation environment and the further research approaches.
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1. Introduction
Differential diagnosis and treatment of tachycardias is a common dilemma encountered by physicians or cardiologists. Although such tachycardias often occur in patients with a normal heart, they may cause bothersome symptoms and rarely represent life-threatening conditions. Among these tachycardias with a heart rate greater than 100 beats per minute (bpm), the narrow QRS complex tachycardias (NCTs) are defined by the presence in a 12-lead electrocardiogram (ECG) of a QRS complex duration less than 120 ms and the wide QRS complex tachycardias (WCTs) are defined by the presence in a 12-lead ECG of a QRS complex duration more than 120 ms (Figure 1) [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. The NCTs are typically of supraventricular origin above or within the His bundle, although rarely narrow complex ventricular tachycardias (VT) have been reported in the literature in which early activation of the His bundle can also occur in high septal VT, resulting in relatively narrow QRS complexes of 110–140 ms (Table 1, [1, 2, 3, 4, 5]]. The WCTs can be VT or supraventricular tachycardia (SVT) with right or left bundle branch block (BBB) or right or left accessory pathway (Table 1, [6, 7, 8, 9, 10]]. Because administration of medications based on misdiagnosis of these tachycardias can be harmful and sometimes fatal, diagnosis of these tachycardias is critical [11, 12, 13]. The accurate, rapid diagnosis in patients with these tachycardias still remains a significant clinical dilemma, because the published numerous ECG algorithms and criteria are complicated and difficult to recall in urgent clinical situations [11, 12, 13]. We have reviewed ECG findings of the NCTs and WCTs in order to reduce the possible diagnostic errors on the ECGs.
Figure 1.
Differential diagnostic algorithm of NCTs and WCTs.
The NCTs are common problems encountered in clinical situations [1, 2, 3, 4, 5, 14, 15, 16, 17, 18, 19, 20, 21]. The key to approaching the diagnosis of these arrhythmias is identifying atrial activity (P waves) on the ECG and classifying these tachycardias according to the presence of AV dissociation (Figure 2) and then re-classifying according to long RP or short RP (Table 2) [1, 2, 3, 4, 5, 14, 15, 16, 17, 18, 19, 20, 21]. On the basis of these algorithm, a differential diagnosis can be generated, logical therapy can be delivered for termination of the tachycardia, and a plan can be developed to prevent recurrence.
Figure 2.
Differential diagnostic algorithm of NCTs with regular rhythm.
Short RP (RP < PR)
Long RP (RP > PR)
AVNRT
Sinus tachycardia
AVRT
Sinus nodal reentrant tachycardia
Junctional tachycardia
Atrial tachycardia
Junctional tachycardia
PJRT
AVNRT (unusual type, fast-slow)
AVRT (atypical type)
Table 2.
Differential diagnosis of NCTs according to RP interval.
Short RP tachycardias are defined as regular tachycardias in which interval from QRS complex to P wave (upper arrows, Figure 3) much less than interval from P wave to subsequent QRS complex, whereas long RP tachycardias are defined as regular tachycardias in which interval from QRS complex to P wave much more than interval from P wave to subsequent QRS complex (lower arrows, Figure 3) [1, 2, 3, 4, 5, 14, 15, 16, 17, 18, 19, 20, 21].
Figure 3.
Schematic demonstration of short RP and long RP.
2.1 NCTs with regular rhythm
2.1.1 Sinus tachycardia
Sinus tachycardia is defined as an increase in sinus rate to more than 100 bpm with regular rhythm. The rate increases gradually and may show beat to beat variation. Although generally identifiable by a P wave of normal morphologic features that precedes each QRS complex, sinus tachycardia can be difficult to recognize when the P wave begins to fuse with the T wave of the preceding QRS complex. Sinus tachycardia is usually a physiological response such as fever, anxiety, pain, hyperthyroidism but may be precipitated by sympathomimetic drugs or endocrine disturbances [5, 14, 15, 16, 17, 18, 19, 20, 21].
2.1.2 Sinus nodal reentrant tachycardia
The morphologic appearance of sinus nodal reentrant tachycardia is identical to that of sinus tachycardia. In contrast to sinus tachycardia, the rate is very regular and initiation and termination are abrupt without an underlying physiological stimulus. Vagal maneuver may be successful in stopping the arrhythmia [5, 14, 15, 16, 17, 18, 19, 20, 21].
2.1.3 Atrial tachycardia
Atrial tachycardia (AT) is usually a NCTs accounting for 5–15% of SVT. Other than sinus tachycardia, AT is the most common long RP tachycardia. In AT, an atrial source outside the sinoatrial node due to focal automatic activity or re-entry circuit activates the atria. Accordingly, P-wave morphologic characteristics vary depending on the site of this source. Digitalis toxicity should be suspected in patients with paroxysmal AT with AV block [5, 14, 15, 16, 17, 18, 19, 20, 21, 22].
2.1.4 Atrial flutter
Atrial flutter is a reentrant rhythm of the right atrium typically with an atrial rate of 250 to 350 beats/min. The flutter may circulate in a counterclockwise direction around the tricuspid annulus in the frontal plane (typical, counterclockwise flutter) or in a clockwise direction (atypical, clockwise flutter). P waves have a characteristic “sawtooth” appearance, and 2:1 AV block is common. Because one flutter wave occurs in the ST-T segment and another flutter wave occurs before each QRS complex in atrial flutter with 2:1 AV conduction, atrial flutter is neither a short RP nor a long RP tachycardia [5, 14, 15, 16, 17, 18, 19, 20, 21, 22].
2.1.5 Junctional tachycardia
Non-paroxysmal junctional tachycardia (NPJT) is a tachycardia that arises in the AV junction. Although often described as a short RP tachycardia, because NPJT causes ventricular activation almost concurrently with atrial activation, a substantial portion (25%), which is described as a long RP tachycardia, actually show P waves that slightly precede the QRS complex. and in some cases, AV dissociation may be present. Unlike AVNRT and AVRT, initiation and termination are gradual. NPJT is often associated with digitalis intoxication, inferior myocardial infarction, myocarditis, and mitral valve surgical procedures [5, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23].
2.1.6 Paroxysmal SVT (AVNRT/Orthodromic AVRT)
2.1.6.1 AVNRT
AV nodal reentrant tachycardia (AVNRT) is characterized by a tachycardia with supraventricular origin, with sudden onset and termination generally at rates between 150 and 250 beats/min and is the most common cause of SVT except atrial fibrillation, atrial flutter, and sinus tachycardia. In majority of patients (noted as the “typical” or “slow-fast” AVNRT), anterograde conduction to the ventricle occurs over the “slow” pathway and retrograde conduction to the atrium occurs over the “fast” pathway and the atria are activated either simultaneously with or just after activations of the ventricles and this common type is classified as a short RP tachycardia. Rarely, in “atypical” or “fast-slow” AVNRT, the reentry occurs in the opposite direction in which anterograde conduction occurs over the “fast” pathway, while retrograde conduction occurs over “slow” pathway, and this rare type is classified as a long RP tachycardia [24, 25, 26, 27, 28, 29, 30, 31].
2.1.6.2 AVRT
AV reentrant tachycardia (AVRT) involves reentry between the atria and ventricles with use of the AV node-His bundle conduction as the anterograde and slow pathway and an accessory conduction as the retrograde and fast pathway. This pattern is also known as orthodromic reciprocating tachycardia (ORT). This type is not apparent by analysis of the ECG during sinus rhythm because the ventricle is not pre-excited and the accessory pathway is said to be “concealed”. In tachycardia, retrograde conduction over the accessory pathway is fast and yields a short RP tachycardia [24, 25, 26, 27, 28, 29, 30, 31].
In contradistinction to ORT resulting in NCTs, antidromic AVRT has anterograde conduction over the accessory pathway and retrograde conduction over the AV node-His bundle resulting in WCTs [24, 25, 26, 27, 28, 29, 30, 31].
The following factors are important differences between AVNRT and AVRT [24, 25, 26, 27, 28, 29, 30, 31]:
In contradistinction to AVNRT, an 1:1 relationship is necessary for AVRT because both the atria and the ventricles are part of the reentry circuit. Therefore, if AV block occurs during tachycardia, AVRT is excluded.
If bundle branch block occurs during ORT and the length of the tachycardia cycle increases, AVNRT is excluded because the His-Purkinje system is not part of the tachycardia reentry circuit in AVNRT. The converse is not necessarily true because the absence of cycle length change with the occurrence of bundle branch block does not exclude AVRT.
As discussed with AVRT, certain types of reentrant circuits exist in which the accessory AV connection has AV nodal properties such as slow conduction. In PJRT, excitation over the postero-septal accessory pathway conducts very slowly, because of a long and tortuous route of pathway. Tachycardia is maintained by anterograde AV nodal conduction and retrograde conduction over slow accessory pathway. Because of slow conduction property of accessory pathway, retrograde atrial activation is delayed, and a long RP tachycardia results. Patients with this type of accessory pathway almost never have preexcitation (a delta wave) on ECGs during sinus rhythm [5, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23].
2.2 NCTs with irregular rhythm
2.2.1 Atrial tachycardia with variable AV conduction
Atrial tachycardia with atrioventricular block is typically seen with digoxin toxicity. The ventricular rhythm is usually regular but may be irregular if atrioventricular block is variable [5, 14, 15, 16, 17, 18, 19, 20, 21].
2.2.2 Multifocal atrial tachycardia (MAT)
MAT is characterized by P waves with variable morphologies and variable PR intervals. Differential diagnosis between MAT and atrial fibrillation can be possible by the presence of isoelectric baselines between the P waves in MAT. MAT is seen typically in patients with chronic obstructive pulmonary disease or digoxin toxicity [5, 14, 15, 16, 17, 18, 19, 20, 21, 32].
2.2.3 Atrial flutter with variable AV conduction
Atrial flutter is due to a re-entry circuit in the right atrium with secondary activation of the left atrium. This produces atrial contractions at a rate of about 300 beats/min as flutter (F) waves. F waves show broad and saw-tooth appearances and are best seen in lead V1 and the inferior leads [5, 14, 15, 16, 17, 18, 19, 20, 21].
2.2.4 Atrial fibrillation
This is the most common sustained arrhythmia with overall prevalence is 1% to 1.5%. Atrial fibrillation is caused by multiple re-entrant circuits or “wavelets” of activation sweeping around the atrial myocardium without effective atrial contraction. Atrial fibrillation is seen on the ECG as irregular baseline undulations of variable amplitude and morphology (called f waves) discharging at a frequency of 350 to 600 beats/min.
With normal conduction, ventricular rate shows frequency between 100 and 150 beats/min. Atrial fibrillation with slow ventricular responses or AV block is seen typically in patients with digoxin toxicity [5, 14, 15, 16, 17, 18, 19, 20, 21, 33, 34, 35, 36].
3. WCTs
3.1 WCTs with regular rhythm
3.1.1 VT/ventricular flutter
Monomorphic ventricular tachycardia is common in patients with a history of previous myocardial infarction. Other rare causes of monomorphic VT include right or left ventricular outflow tract ventricular tachycardia and right ventricular dysplasia.
Ventricular flutter appears as a sine wave pattern with regular, large oscillations on the ECG and can progress to ventricular fibrillation [37, 38, 39, 40, 41, 42, 43, 44].
3.1.2 Antidromic AVRT
Antidromic AVRT includes a reentrant circuit with accessory pathway as the anterograde pathway, and AV node–His bundle as the retrograde pathway. Some patients (3 to 8%) with WPW syndrome show mechanisms of antidromic AVRT [24, 25, 26, 27, 28, 29, 30, 31].
SVT with aberrant conduction/BBB
Atrial tachycardia with accessory pathway
Junctional tachycardia with accessory pathway
3.2 WCTs with irregular rhythm
3.2.1 Polymorphic VT/ventricular fibrillation
Polymorphic VT is most commonly caused by abnormalities of ventricular muscle repolarization. The predisposition to this problem usually manifests on the ECG as a prolongation of the QT interval. Congenital problems include long QT syndrome and catecholaminergic polymorphic ventricular tachycardia. Acquired problems are usually related to drug toxicity or electrolyte abnormalities, myocardial ischemia. Class III anti-arrhythmic drugs such as sotalol and amiodarone prolong the QT interval and may in some circumstances be pro-arrhythmic. Other relatively common drugs include some antibiotics and antihistamines [37, 38, 39, 40, 41, 42, 43, 44].
Ventricular fibrillation is a terminal arrhythmia in which ventricular contractions are uncoordinated and too weak to eject blood. The ECG shows irregular, chaotic deflections of varying amplitude and shape [37, 38, 39, 40, 41, 42, 43, 44].
Antidromic AVRT with variable VA conduction
Pre-excited AF (AF with ventricular pre-excitation)
Torsades de pointes
The ECG demonstrates a polymorphic VT characterized by the QRS complexes of changing amplitude that appear to twist around the isoelectric line and occur at the rates of 200 to 250 beats/min. Most data suggest that early afterdepolarizations are responsible for both the QT prolongation and the torsades de pointes. The most common causes are congenital severe bradycardia, potassium depletion and use of class IA and IC drugs. Clinical features depend on whether torsades de pointes is due to acquired or congenital long QT syndrome. Some episodes may persist and progress to ventricular fibrillation, leading to sudden death. In congenital long QT syndrome, long QT intervals predispose the patient to an R-on-T phenomenon, wherein the R-wave, representing ventricular depolarization, occurs during the relative refractory period at the end of repolarization [37, 38, 39, 40, 41, 42, 43, 44].
AF or atrial flutter or focal atrial tachcyardia with varying block conducted with aberration
4. ECG criteria favoring ventricular rather than supra-ventricular tachycardia in WCTs
There are several algorithms that are currently used to help distinguish Supraventricular Tachycardia (SVT) with aberrancy and Ventricular Tachycardia (VT) (Table 3). Many of these algorithms and criteria have limitations [44, 45, 46, 47, 48, 49, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71].
If the initial 20 ms of the QRS are the same in WCT as in sinus rhythm, SVT is favored with a positive predictive value (PPV) of 92%. The sinus rhythm ECG must be available for this analysis.
[RBBB morphology] An rSR’ where S crosses baseline = SVT with a PPV of 91%.
[RBBB morphology] Triphasic QRS in V1 = SVT with a PPV of 92%.
[RBBB morphology, LBBB morphology] Precordial concordance = VT. A QRS, which is predominantly positive or predominantly negative in every precordial lead, overwhelmingly favors VT with specificity of 95–100% and a PPV of 89–100% [44, 45, 46, 47, 48, 49, 50, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71].
4.2 Wellens criteria of right bundle branch block
AV dissociation = VT. Of all criteria, this is the most secure with specificity of 100% and PPV of 100%. It holds true regardless of bundle branch pattern or other morphology criteria.
[RBBB morphology] QRS duration >140 ms = VT with specificity of 57–75% and PPV of 89%.
[RBBB morphology] Left axis deviation = VT with PPVs of 88–94%. With extreme left axis (more negative than −90°), the PPV is 98%.
[RBBB morphology] Mono- or biphasic QRS morphologies in V1 favors VT with PPV of 82–83%.
If the V1 QRS is triphasic, an R:S ratio < 1 in V6 (that is, R wave smaller than S wave) favors VT with PPV of 90%.
[RBBB morphology] Rsr’ (‘Rabbit ears’) = VT. In an unusual triphasic V1, with the left R wave taller than the right, and the S wave not crossing the baseline, favors VT with PPV of 100% [44, 45, 46, 47, 48, 49, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71].
4.3 Griffith criteria
A history of myocardial infarction, QRS morphology in leads aVF and V1 ([1] predominant negative deflection in aVF in tachycardia with RBBB pattern and Q wave, [2] a monophasic or biphasic waveform in V1 in tachycardia with RBBB pattern, [3] QS or qR waveform in tachycardia with LBBB pattern favored a diagnosis of VT) and frontal plane axis > 40° when compared with baseline the ECG favored a diagnosis of VT. The presence of AV dissociation and/or the presence of premature ventricular beats during sinus rhythm that show morphologies same to that observed in tachycardia favored a diagnosis of VT [51, 52, 53, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71].
4.4 Kindwall criteria of left bundle branch block (LBBB)
[LBBB morphology] V1 or V2 with initial R > 30 ms = VT.
[LBBB morphology] V1 or V2 QRS onset to nadir of S wave >60 ms = VT.
[LBBB morphology] V1 or V2 with notching on the S wave downstroke = VT.
4.5 Pava criteria using the measurement of the R-wave peak time (RWPT) in lead II
An R-wave peak time, with the interval from QRS onset to first change in polarity (R or S peak) in lead II ≥ 50 ms, independent of whether the complex is positive or negative, has been reported to have a sensitivity of 93% and specificity of 99% for identifying VT (Figure 4) [55, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71].
Figure 4.
The R-wave peak time (RWPT) in lead II.
4.6 Vereckei aVR algorithm
Vereckei et al. published four-step algorithms with the incorporation of new criteria of Vi/Vt (Figure 5) [56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71].
Figure 5.
Vereckei aVR algorithm.
The four steps were used in the following sequence:
If an initial R wave was present in lead aVR, VT was diagnosed.
If an initial, non-dominant q or r in aVR > 40 ms, VT was diagnosed.
If the morphology of WCT did not correspond to BBB or fascicular block, VT was diagnosed.
In the last step when the Vi/Vt ratio, obtained by measuring the voltage of the initial 40 ms (Vi) and the terminal 40 ms of a QRS (Vt) in any ECG lead, was ≤1 the diagnosis of VT, if the Vi/Vt was >1 the diagnosis of SVT was made (Figure 5).
During WCT due to SVT, after the initial rapid septal activation over the normal His-Purkinje system, the slow intraventricular activation occurs in the mid to terminal portion of the QRS, thus the Vi/Vt > 1.
Is there concordance present in the precordial leads (leads V1-V6)?
“Are all of the QRS complexes completely upright, or downward in the precordial leads?”
If the answer is yes, then VT is the diagnosis
Is the R to S interval (between the onset of the R wave and the nadir of the S wave) > 100 ms in any one precordial lead?
If the answer is present, then VT is the diagnosis
Is AV dissociation present?
“AV dissociation occurs when P waves are seen at different rates than the QRS complexes.”
If the answer is present, then VT is the diagnosis
Examine the morphology of the QRS complex to see if it meets the specific criteria for VT, as Table 4.
QRS duration
> 160 ms with LBBB pattern or > 140 ms with RBBB pattern
QRS duration during tachycardia is narrower than in sinus rhythm
QRS axis
Right superior (northwest) axis
RBBB pattern with left axis deviation
RBBB pattern with normal axis
LBBB pattern with right axis deviation
QRS axis shift >40 degrees between sinus rhythm and tachycardia
Precordial QRS concordance
Positive or negative concordance in all precordial leads
AV dissociation
AV ratio < 1
VA ratio > 1 (VA block)
Fusion beats
Capture beats
RBBB morphology
Lead V1
Lead V6
mono or biphasic QRS
R/S < 1, QS, QR, monophasic R
R, qR, Rs, broad R
Triphasic QRS (Rsr’ [‘Rabbit ears’])
LBBB morphology
Lead V1–2
Lead V6
Initial r wave ≥40 ms
Any Q wave (QR, QS)
Onset of QRS to S nadir interval ≥ 70 ms
(Absence of Q wave favors SVT)
Notching on the downstroke of S wave
Initial R wave (+) in lead aVR
R wave peak time in lead II ≥ 50 ms
Vi/Vt≤ 1
Table 3.
ECG criteria favoring ventricular rather than supra-ventricular tachycardia in WCTs.
RBBB; right bundle branch block, LBBB; left bundle branch block, SVT; supra-ventricular tachycardia.
Right bundle branch block morphology
Lead V1: Monophasic R, biphasic qR, broad R (>40 ms), Rsr’ (the so-called ‘rabbit ears’ sign) Lead V6: R:S ratio < 1
Left bundle branch block morphology
Lead V1–2: Broad R wave, slurred or notched downstroke of S wave, delayed nadir of S wave Lead V6: Q or QR or QS wave
Table 4.
Morphology criteria for VT in leads V1, V2 and V6.
5. Conclusions
The ECG criteria or algorithms for the diagnosis of NCTs and WCTs has undergone evolution and development in concert with the field of cardiology itself, but the necessity of a correct diagnosis remains unchanged [57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71]. The world has not yet seen the ‘one criterion to end all criteria’ or ‘simplest criterion’ with high sensitivity and specificity, and it seems unlikely to appear in our near future. Therefore, physicians or cardiologists should be cautioned against overreliance in these ECG criteria or algorithms for the interpretation of the ECGs.
\n',keywords:"narrow QRS tachycardia, wide QRS tachycardia, tachycardia, electrocardiograms",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/80619.pdf",chapterXML:"https://mts.intechopen.com/source/xml/80619.xml",downloadPdfUrl:"/chapter/pdf-download/80619",previewPdfUrl:"/chapter/pdf-preview/80619",totalDownloads:79,totalViews:0,totalCrossrefCites:0,dateSubmitted:"December 16th 2021",dateReviewed:"January 10th 2022",datePrePublished:"February 26th 2022",datePublished:null,dateFinished:"February 25th 2022",readingETA:"0",abstract:"Narrow QRS complex tachycardias or Wide QRS complex tachycardias are common problems encountered in clinical practices. Although such tachycardias often occur in patients with a normal anatomy and/or function of heart and rarely represent life-threatening conditions, they are common sources of morbidity and/or mortality. Narrow QRS complex tachycardias are fast cardiac rhythms with QRS duration of 120 ms or less while wide QRS complex tachycardias are fast cardiac rhythms with QRS duration of 120 ms or more. Origins of narrow QRS complex tachycardias are above or within the His bundle. Wide QRS complex tachycardias can be ventricular tachycardias, supra-ventricular tachycardias with bundle branch block or accessory pathway. The purpose of this chapter is to present the differential diagnosis of narrow and wide QRS complex tachycardias.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/80619",risUrl:"/chapter/ris/80619",signatures:"Bong Gun Song",book:{id:"11218",type:"book",title:"Electrocardiograms",subtitle:null,fullTitle:"Electrocardiograms",slug:null,publishedDate:null,bookSignature:"Dr. Umashankar Lakshmanadoss",coverURL:"https://cdn.intechopen.com/books/images_new/11218.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-529-4",printIsbn:"978-1-80355-528-7",pdfIsbn:"978-1-80355-530-0",isAvailableForWebshopOrdering:!0,editors:[{id:"13913",title:"Dr.",name:"Umashankar",middleName:null,surname:"Lakshmanadoss",slug:"umashankar-lakshmanadoss",fullName:"Umashankar Lakshmanadoss"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"32974",title:"Prof.",name:"Bong Gun",middleName:null,surname:"Song",fullName:"Bong Gun Song",slug:"bong-gun-song",email:"aerok111@hanmail.net",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Sungkyunkwan University",institutionURL:null,country:{name:"Korea, South"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. NCTs",level:"1"},{id:"sec_2_2",title:"2.1 NCTs with regular rhythm",level:"2"},{id:"sec_2_3",title:"2.1.1 Sinus tachycardia",level:"3"},{id:"sec_3_3",title:"2.1.2 Sinus nodal reentrant tachycardia",level:"3"},{id:"sec_4_3",title:"2.1.3 Atrial tachycardia",level:"3"},{id:"sec_5_3",title:"2.1.4 Atrial flutter",level:"3"},{id:"sec_6_3",title:"2.1.5 Junctional tachycardia",level:"3"},{id:"sec_7_3",title:"2.1.6 Paroxysmal SVT (AVNRT/Orthodromic AVRT)",level:"3"},{id:"sec_7_4",title:"2.1.6.1 AVNRT",level:"4"},{id:"sec_8_4",title:"2.1.6.2 AVRT",level:"4"},{id:"sec_10_3",title:"2.1.7 Permanent junctional reciprocating tachycardia (PJRT)",level:"3"},{id:"sec_12_2",title:"2.2 NCTs with irregular rhythm",level:"2"},{id:"sec_12_3",title:"2.2.1 Atrial tachycardia with variable AV conduction",level:"3"},{id:"sec_13_3",title:"2.2.2 Multifocal atrial tachycardia (MAT)",level:"3"},{id:"sec_14_3",title:"2.2.3 Atrial flutter with variable AV conduction",level:"3"},{id:"sec_15_3",title:"2.2.4 Atrial fibrillation",level:"3"},{id:"sec_18",title:"3. WCTs",level:"1"},{id:"sec_18_2",title:"3.1 WCTs with regular rhythm",level:"2"},{id:"sec_18_3",title:"3.1.1 VT/ventricular flutter",level:"3"},{id:"sec_19_3",title:"3.1.2 Antidromic AVRT",level:"3"},{id:"sec_21_2",title:"3.2 WCTs with irregular rhythm",level:"2"},{id:"sec_21_3",title:"3.2.1 Polymorphic VT/ventricular fibrillation",level:"3"},{id:"sec_24",title:"4. ECG criteria favoring ventricular rather than supra-ventricular tachycardia in WCTs",level:"1"},{id:"sec_24_2",title:"4.1 Sandler and Marriott criteria (1965)",level:"2"},{id:"sec_25_2",title:"4.2 Wellens criteria of right bundle branch block",level:"2"},{id:"sec_26_2",title:"4.3 Griffith criteria",level:"2"},{id:"sec_27_2",title:"4.4 Kindwall criteria of left bundle branch block (LBBB)",level:"2"},{id:"sec_28_2",title:"4.5 Pava criteria using the measurement of the R-wave peak time (RWPT) in lead II",level:"2"},{id:"sec_29_2",title:"4.6 Vereckei aVR algorithm",level:"2"},{id:"sec_30_2",title:"4.7 Brugada algorithm",level:"2"},{id:"sec_32",title:"5. Conclusions",level:"1"}],chapterReferences:[{id:"B1",body:'Bellet S. Clinical disorders of the heart beat. 3rd ed. Philadelphia: Lea & Febiger; 1971'},{id:"B2",body:'Hayes JJ, Stewart RB, Greene HL, et al. Narrow QRS ventricular tachycardia. Annals of Internal Medicine. 1991;114:460-463'},{id:"B3",body:'Katritsis DG, Josephson ME. 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Reciprocating tachycardia in overt and latent preexcitation: influence of functional bundle branch block on the rate of the tachycardia. European Journal of Cardiology. 1974;1:423-436'},{id:"B27",body:'Kossaify A, Zeeny M. Electrocardiographic and electrophysiologic insights into atrioventricular nodal re-entry tachycardia: Diagnostic update. Clinical Medicine Insights Cardiology. 2012;6:111-117'},{id:"B28",body:'Kwaku KF, Josephson ME. Typical AVNRT--an update on mechanisms and therapy. Card Electrophysiol Rev 2002;6:414'},{id:"B29",body:'Letsas KP, Weber R, Siklody CH, et al. Electrocardiographic differentiation of common type atrioventricular nodal reentrant tachycardia from atrioventricular reciprocating tachycardia via a concealed accessory pathway. Acta Cardiologica. 2010;65:171-176'},{id:"B30",body:'Willems S, Shenasa M, Borggrefe M, et al. Atrioventricular nodal reentry tachycardia: Electrophysiologic comparisons in patients with and without 2:1 infra-His block. 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Electrophysiologic testing in the management of patients with the Wolff–Parkinson–White syndrome and atrial fibrillation. The American Journal of Cardiology. 1983;51:1623-1628'},{id:"B37",body:'Yadav AV, Nazer B, Drew BJ, et al. Utility of conventional electrocardiographic criteria in patients with idiopathic ventricular tachycardia. JACC Clinical Electrophysiology. 2017;3:669-677'},{id:"B38",body:'Steurer G, Gursoy S, Frey B, et al. The differential diagnosis on the electrocardiogram between ventricular tachycardia and preexcited tachycardia. Clinical Cardiology. 1994;17:306-308'},{id:"B39",body:'Klein GJ, Bashore TM, Sellers TD, et al. Ventricular fibrillation in the Wolff–Parkinson–White syndrome. The New England Journal of Medicine. 1979;301:1080-1085'},{id:"B40",body:'Klein GJ, Gulamhusein SS. Intermittent preexcitation in the Wolff–Parkinson–White syndrome. The American Journal of Cardiology. 1983;52:292-296'},{id:"B41",body:'Littmann L, McCall MM. Ventricular tachycardia may masquerade as supraventricular tachycardia in patients with preexisting bundle-branch block. Annals of Emergency Medicine. 1995;26:98-101'},{id:"B42",body:'Dancy M, Camm AJ, Ward D. Misdiagnosis of chronic recurrent ventricular tachycardia. Lancet. 1985;2:320-323'},{id:"B43",body:'Garner JB, Miller JB. Wide complex tachycardia – ventricular tachycardia or not ventricular tachycardia. that remains the question. Arrhythmia and Electrophysiology Review. 2013;2(1):23-29'},{id:"B44",body:'Wellens HJJ. Electrophysiology. Ventricular tachycardia: Diagnosis of broad complex tachycardia. Heart. 2001;86:579-585'},{id:"B45",body:'Jastrzebski M, Kukla P, Czarnecka D, et al. Comparison of five electrocardiographic methods for differentiation of wide QRS-complex tachycardias. Europace. 2012;14:1165-1171'},{id:"B46",body:'Katritsis DG, Brugada J. Differential diagnosis of wide QRS tachycardias. Arrhythm Electrophysiol Rev. 2020;9(3):155-160'},{id:"B47",body:'Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology. 2016;67:e27-e115'},{id:"B48",body:'Vereckei A. Current algorithms for the diagnosis of wide QRS complex tachycardias. Current Cardiology Reviews. 2014;10(3):262-276'},{id:"B49",body:'Alzand BSN, Crijns HJGM. Diagnostic criteria of broad QRS complex tachycardia: Decades of evolution. Europace. 2011;13:465-472'},{id:"B50",body:'Sandler IA, Marriott HJL. The differential morphology of anomalous ventricular complexes of RBBB-type in lead V1. Ventricular ectopy versus aberration. Circulation. 1965;31:551-556'},{id:"B51",body:'Griffith M, de Belder MA, Linker NJ, et al. Multivariate analysis to simplify the differential diagnosis of broad complex tachycardia. British Heart Journal. 1991;66:166-174'},{id:"B52",body:'Griffith M, de Belder MA, Linker NJ, et al. Difficulties in the use of electrocardiographic criteria for the differential diagnosis of left bundle branch block pattern tachycardia in patients with structurally normal heart. European Heart Journal. 1992;13:478-483'},{id:"B53",body:'Griffith MJ, Garratt CJ, Mounsey P. Ventricular tachycardia as default diagnosis in broad complex tachycardia. Lancet. 1994;343:386-388'},{id:"B54",body:'Kindwall KE, Brown J, Josephson ME. Electrocardiographic criteria for ventricular tachycardia in wide complex left bundle branch block morphology tachycardias. The American Journal of Cardiology. 1988;61:1279-1283'},{id:"B55",body:'Pava LF, Perafan P, Badiel M, et al. R-wave peak time at DII: A new criterion for differentiating between wide complex QRS tachycardias. Heart Rhythm. 2010;7:922-926'},{id:"B56",body:'Vereckei A, Duray G, Szénási G, et al. A new algorithm using only lead aVR for the differential diagnosis of wide QRS complex tachycardia. Heart Rhythm. 2008;5:89-98'},{id:"B57",body:'Jastrzebski M, Moskal P, Kukla P, et al. Specificity of wide QRS complex tachycardia criteria and algorithms in patients with ventricular preexcitation. Annals of Noninvasive Electrocardiology. 2018;23:e12493'},{id:"B58",body:'Lau EW, Ng GA. Comparison of the performance of three diagnostic algorithms for regular broad complex tachycardia in practical application. Pacing and Clinical Electrophysiology. 2002;25:822-827'},{id:"B59",body:'Jastrzebski M, Sasaki K, Kukla P, et al. The ventricular tachycardia score: A novel approach to electrocardiographic diagnosis of ventricular tachycardia. Europace. 2016;18:578-584'},{id:"B60",body:'Brady WJ, Skiles J. Wide QRS complex tachycardia: ECG differential diagnosis. The American Journal of Emergency Medicine. 1999;17:376-381'},{id:"B61",body:'Oreto G, Luzza F, Satullo G, et al. Wide QRS complex tachycardia: An old and new problem. Giornale Italiano di Cardiologia. 2009;10:580-595'},{id:"B62",body:'Roberts-Thomson KC, Lau DH, Sanders P. The diagnosis and management of ventricular arrhythmias. Nature Reviews. Cardiology. 2011;8:311-321'},{id:"B63",body:'Gupta AK, Thakur RK. Wide QRS complex tachycardias. The Medical Clinics of North America. 2001;85:245-266'},{id:"B64",body:'Barold SS, Stroobandt RX, Herweg B. Limitations of the negative concordance pattern in the diagnosis of broad QRS tachycardia. Journal of Electrocardiology. 2012;45:733-735'},{id:"B65",body:'Volders PG, Timmermans C, Rodriguez LM, et al. Wide QRS complex tachycardia with negative precordial concordance: Always a ventricular origin? Journal of Cardiovascular Electrophysiology. 2003;14:109-111'},{id:"B66",body:'Antunes E, Brugada J, Steurer G, et al. The differential diagnosis of a regular tachycardia with a wide QRS complex on the 12-lead ECG: Ventricular tachycardia. Supra-ventricular tachycardia with aberrant conduction and supraventricular tachycardia with anterograde conduction over an accessory pathway. PACE. 1994;17:1515-1524'},{id:"B67",body:'Lau EW, Pathamanathan RK, NG GA et al. The Bayesian approach improves the electrocardiographic diagnosis of broad complex tachycardia. Pacing and Clinical Eelectrophysiology. 2000; 23:1519-1526'},{id:"B68",body:'Sternick EB, Timmermans C, Sosa E, et al. The elctrocardiogram in sinus rhythm and during tachycardia in patients with anterograde conduction over Mahaim fibers: The role of the “rS” pattern in lead III. Journal of the American College of Cardiology. 2004;44:1626-1635'},{id:"B69",body:'Grimm W, Menz V, Hoffmann J, et al. Value of old and new electrocardiographic criteria for differential diagnosis between ventricular tachycardia and supraventricular tachycardia with bundle branch block. Zeitschrift für Kardiologie. 1996;85:932-942'},{id:"B70",body:'Alberca T, Almendral J, Sanz P, et al. Evaluation of the specificity of morphological electrocardiographic criteria for the differential diagnosis of wide QRS complex tachycardia in patients with intraventricular conduction defects. Circulation. 1997;96:3527-3533'},{id:"B71",body:'Isenhour JL, Craig S, Gibbs M, et al. Wide-complex tachycardia: continued evaluation of diagnostic criteria. Academic Emergency Medicine. 2000;7:769-773'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Bong Gun Song",address:"aerok111@hanmail.net",affiliation:'
Cardiac and Vascular Center, Seongnam Citizens Medical Center (SCMC), Republic of Korea
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Question one searches for answering: nowadays, in global age, why is a thinker like John Locke still so important in order to support reflections about epistemological, political, religious and educational questions? Kind of research reported is a theoretical approach. Discourse development has followed these steps: first, considerations about his theory of knowledge; second, approaches concerning his political theory; third, reflections under his ideas on religion; fourth, discussions concerning his thoughts over education. Results of this inquiry: he is one of the most eminent theorists of experience and it is essential to build knowledge; therefore, his thought must not be neglected; he is also very important to reflect about natural rights of mankind, which must be granted by Commonwealth; his ideas over toleration, which reinforce distinction between Church and Commonwealth, are still useful to think about how to deal with several religious beliefs and political opinions; his educational thought outlines that education is a psychophysical process that must equally treat both body and soul. 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Open Access Funding
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For Authors who are still unable to obtain funding from their institutions or research funding bodies for individual projects, IntechOpen does offer the possibility of applying for a Waiver to offset some or all processing feed. Details regarding our Waiver Policy can be found here.
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Added Value of Publishing with IntechOpen
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During the launching phase journals do not charge an APC, rather they will be funded by IntechOpen.
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*These prices do not include Value-Added Tax (VAT). Residents of European Union countries need to add VAT based on the specific rate in their country of residence. Institutions and companies registered as VAT taxable entities in their own EU member state will not pay VAT as long as provision of the VAT registration number is made during the application process. This is made possible by the EU reverse charge method.
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Services included are:
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An online manuscript tracking system to facilitate your work
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Personal contact and support throughout the publishing process from your dedicated Author Service Manager
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Assurance that your manuscript meets the highest publishing standards
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English language copyediting and proofreading, including the correction of grammatical, spelling, and other common errors
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XML Typesetting and pagination - web (PDF, HTML) and print files preparation
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Discoverability - electronic citation and linking via DOI
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Permanent and unrestricted online access to your work
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What isn't covered by the Open Access Publishing Fee?
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If your manuscript:
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Exceeds the number of pages defined by the publishing guidelines, an additional fee per page may be required
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If a manuscript requires Heavy Editing or Language Polishing, this will incur additional fees.
\n
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Your Author Service Manager will inform you of any items not covered by the OAPF and provide exact information regarding those additional costs before proceeding.
\n\n
Open Access Funding
\n\n
To explore funding opportunities and learn more about how you can finance your IntechOpen publication, go to our Open Access Funding page. IntechOpen offers expert assistance to all of its Authors. We can support you in approaching funding bodies and institutions in relation to publishing fees by providing information about compliance with the Open Access policies of your funder or institution. We can also assist with communicating the benefits of Open Access in order to support and strengthen your funding request and provide personal guidance through your application process. You can contact us at funders@intechopen.com for further details or assistance.
\n\n
For Authors who are still unable to obtain funding from their institutions or research funding bodies for individual projects, IntechOpen does offer the possibility of applying for a Waiver to offset some or all processing feed. Details regarding our Waiver Policy can be found here.
\n\n
Added Value of Publishing with IntechOpen
\n\n
Choosing to publish with IntechOpen ensures the following benefits:
\n\n
\n\t
Indexing and listing across major repositories, see details ...
\n\t
Long-term archiving
\n\t
Visibility on the world's strongest OA platform
\n\t
Live Performance Metrics to track readership and the impact of your chapter
\n\t
Dissemination and Promotion
\n
\n\n
Benefits of Publishing with IntechOpen
\n\n
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Proven world leader in Open Access book publishing with over 10 years experience
\n\t
+5,700 OA books published
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Most competitive prices in the market
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Fully compliant with OA funding requirements
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Optimized processes that assure your research is made available to the scientific community without delay
\n\t
Personal support during every step of the publication process
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+184,650 citations in Web of Science databases
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Currently strongest OA platform with over 175 million downloads
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Generally, the phytochemical constituents of plants fall into two categories based on their role in basic metabolic processes, namely primary and secondary metabolites. Primary plant metabolites are involved in basic life functions; therefore, they are more or less similar in all living cells. On the other hand, secondary plant metabolites are products of subsidiary pathways as the shikimic acid pathway. In the course of studying, the medicinal effect of herbals is oriented towards the secondary plant metabolites. Secondary plant metabolites played an important role in alleviating several aliments in the traditional medicine and folk uses. In modern medicine, they provided lead compounds for the production of medications for treating various diseases from migraine up to cancer. Secondary plant metabolites are classified according to their chemical structures into various classes. In this chapter, we will be presenting various classes of secondary plant metabolites, their distribution in different plant families and their important medicinal uses.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Rehab A. Hussein and Amira A. El-Anssary",authors:[{id:"212117",title:"Dr.",name:"Rehab",middleName:null,surname:"Hussein",slug:"rehab-hussein",fullName:"Rehab Hussein"},{id:"221140",title:"Dr.",name:"Amira",middleName:null,surname:"El-Anssary",slug:"amira-el-anssary",fullName:"Amira El-Anssary"}]},{id:"64851",doi:"10.5772/intechopen.80348",title:"Herbal Medicines in African Traditional Medicine",slug:"herbal-medicines-in-african-traditional-medicine",totalDownloads:14525,totalCrossrefCites:33,totalDimensionsCites:58,abstract:"African traditional medicine is a form of holistic health care system organized into three levels of specialty, namely divination, spiritualism, and herbalism. The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ozioma Ezekwesili-Ofili",slug:"josephine-ozioma-ezekwesili-ofili",fullName:"Josephine Ozioma Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"54028",doi:"10.5772/67291",title:"Chemical Composition and Biological Activities of Mentha Species",slug:"chemical-composition-and-biological-activities-of-mentha-species",totalDownloads:7520,totalCrossrefCites:13,totalDimensionsCites:50,abstract:"The genus Mentha L. (Lamiaceae) is distributed all over the world and can be found in many environments. Mentha species, one of the world’s oldest and most popular herbs, are widely used in cooking, in cosmetics, and as alternative or complementary therapy, mainly for the treatment of gastrointestinal disorders like flatulence, indigestion, nausea, vomiting, anorexia, and ulcerative colitis. Furthermore, it is well documented that the essential oil and extracts of Mentha species possess antimicrobial, fungicidal, antiviral, insecticidal, and antioxidant properties. The economic importance of mints is also evident; mint oil and its constituents and derivatives are used as flavoring agents throughout the world in food, pharmaceutical, herbal, perfumery, and flavoring industry. To provide a scientific basis for their traditional uses, several studies have been conducted to determine the chemical composition of mints and assess their biological activities. This chapter describes the therapeutic effects and uses of Mentha species and their constituents, particularly essential oils and phenolic compounds; some additional biological activities will also be considered.",book:{id:"5612",slug:"aromatic-and-medicinal-plants-back-to-nature",title:"Aromatic and Medicinal Plants",fullTitle:"Aromatic and Medicinal Plants - Back to Nature"},signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",slug:"fatiha-brahmi",fullName:"Fatiha Brahmi"},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",slug:"khodir-madani",fullName:"Khodir Madani"},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",slug:"pierre-duez",fullName:"Pierre Duez"},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",slug:"mohamed-chibane",fullName:"Mohamed Chibane"}]},{id:"58270",doi:"10.5772/intechopen.72437",title:"Toxicity and Safety Implications of Herbal Medicines Used in Africa",slug:"toxicity-and-safety-implications-of-herbal-medicines-used-in-africa",totalDownloads:3447,totalCrossrefCites:16,totalDimensionsCites:40,abstract:"The use of herbal medicines has seen a great upsurge globally. In developing countries, many patronize them largely due to cultural acceptability, availability and cost. In developed countries, they are used because they are natural and therefore assumed to be safer than allopathic medicines. In recent times, however, there has been a growing concern about their safety. This has created a situation of ambivalence in discussions regarding their use. Some medicinal plants are intrinsically toxic by virtue of their constituents and can cause adverse reactions if inappropriately used. Other factors such as herb-drug interactions, lack of adherence to good manufacturing practice (GMP), poor regulatory measures and adulteration may also lead to adverse events in their use. Many in vivo tests on aqueous extracts largely support the safety of herbal medicines, whereas most in vitro tests on isolated single cells mostly with extracts other than aqueous ones show contrary results and thus continue the debate on herbal medicine safety. It is expected that toxicity studies concerning herbal medicine should reflect their traditional use to allow for rational discussions regarding their safety for their beneficial use. While various attempts continue to establish the safety of various herbal medicines in man, their cautious and responsible use is required.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Merlin L.K. Mensah, Gustav Komlaga, Arnold D. Forkuo, Caleb\nFirempong, Alexander K. Anning and Rita A. Dickson",authors:[{id:"190435",title:"Dr.",name:"Caleb",middleName:null,surname:"Firempong",slug:"caleb-firempong",fullName:"Caleb Firempong"},{id:"212111",title:"Dr.",name:"Gustav",middleName:null,surname:"Komlaga",slug:"gustav-komlaga",fullName:"Gustav Komlaga"},{id:"217045",title:"Dr.",name:"Arnold Forkuo",middleName:null,surname:"Donkor",slug:"arnold-forkuo-donkor",fullName:"Arnold Forkuo Donkor"},{id:"217049",title:"Prof.",name:"Merlin Lincoln Kwao",middleName:null,surname:"Mensah",slug:"merlin-lincoln-kwao-mensah",fullName:"Merlin Lincoln Kwao Mensah"},{id:"217488",title:"Dr.",name:"Alexander K.",middleName:null,surname:"Anning",slug:"alexander-k.-anning",fullName:"Alexander K. Anning"},{id:"223959",title:"Prof.",name:"Akosua Rita",middleName:null,surname:"Dickson",slug:"akosua-rita-dickson",fullName:"Akosua Rita Dickson"}]},{id:"26489",doi:"10.5772/28224",title:"Alternative and Traditional Medicines Systems in Pakistan: History, Regulation, Trends, Usefulness, Challenges, Prospects and Limitations",slug:"alternative-and-traditional-medicines-systems-in-pakistan-history-regulation-trends-usefulness-chall",totalDownloads:9226,totalCrossrefCites:9,totalDimensionsCites:21,abstract:null,book:{id:"542",slug:"a-compendium-of-essays-on-alternative-therapy",title:"A Compendium of Essays on Alternative Therapy",fullTitle:"A Compendium of Essays on Alternative Therapy"},signatures:"Shahzad Hussain, Farnaz Malik, Nadeem Khalid, Muhammad Abdul Qayyum and Humayun Riaz",authors:[{id:"73162",title:"Dr.",name:"Shahzad",middleName:null,surname:"Hussain",slug:"shahzad-hussain",fullName:"Shahzad Hussain"},{id:"82266",title:"Dr.",name:"Farnaz",middleName:null,surname:"Malik",slug:"farnaz-malik",fullName:"Farnaz Malik"},{id:"124185",title:"Dr.",name:"Humayun",middleName:null,surname:"Riaz",slug:"humayun-riaz",fullName:"Humayun Riaz"},{id:"124186",title:"Mr.",name:"Muhammad Abdul",middleName:null,surname:"Qayyum",slug:"muhammad-abdul-qayyum",fullName:"Muhammad Abdul Qayyum"},{id:"125340",title:"Mr.",name:"Nadeem",middleName:null,surname:"Khalid",slug:"nadeem-khalid",fullName:"Nadeem Khalid"}]}],mostDownloadedChaptersLast30Days:[{id:"64851",title:"Herbal Medicines in African Traditional Medicine",slug:"herbal-medicines-in-african-traditional-medicine",totalDownloads:14512,totalCrossrefCites:33,totalDimensionsCites:58,abstract:"African traditional medicine is a form of holistic health care system organized into three levels of specialty, namely divination, spiritualism, and herbalism. The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ozioma Ezekwesili-Ofili",slug:"josephine-ozioma-ezekwesili-ofili",fullName:"Josephine Ozioma Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"61866",title:"Plants Secondary Metabolites: The Key Drivers of the Pharmacological Actions of Medicinal Plants",slug:"plants-secondary-metabolites-the-key-drivers-of-the-pharmacological-actions-of-medicinal-plants",totalDownloads:9021,totalCrossrefCites:60,totalDimensionsCites:153,abstract:"The vast and versatile pharmacological effects of medicinal plants are basically dependent on their phytochemical constituents. Generally, the phytochemical constituents of plants fall into two categories based on their role in basic metabolic processes, namely primary and secondary metabolites. Primary plant metabolites are involved in basic life functions; therefore, they are more or less similar in all living cells. On the other hand, secondary plant metabolites are products of subsidiary pathways as the shikimic acid pathway. In the course of studying, the medicinal effect of herbals is oriented towards the secondary plant metabolites. Secondary plant metabolites played an important role in alleviating several aliments in the traditional medicine and folk uses. In modern medicine, they provided lead compounds for the production of medications for treating various diseases from migraine up to cancer. Secondary plant metabolites are classified according to their chemical structures into various classes. In this chapter, we will be presenting various classes of secondary plant metabolites, their distribution in different plant families and their important medicinal uses.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Rehab A. Hussein and Amira A. El-Anssary",authors:[{id:"212117",title:"Dr.",name:"Rehab",middleName:null,surname:"Hussein",slug:"rehab-hussein",fullName:"Rehab Hussein"},{id:"221140",title:"Dr.",name:"Amira",middleName:null,surname:"El-Anssary",slug:"amira-el-anssary",fullName:"Amira El-Anssary"}]},{id:"77433",title:"Extraction of Bioactive Compounds from Medicinal Plants and Herbs",slug:"extraction-of-bioactive-compounds-from-medicinal-plants-and-herbs",totalDownloads:1428,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"Human beings have relied on herbs and medicinal plants as sources of food and remedy from time immemorial. Bioactive compounds from plants are currently the subject of much research interest, but their extraction as part of phytochemical and/or biological investigations present specific challenges. Herbalists or scientists have developed many protocols of extraction of bioactive ingredients to ensure the effectiveness and the efficacy of crude drugs that were used to get relief from sickness. With the advent of new leads from plants such as morphine, quinine, taxol, artemisinin, and alkaloids from Voacanga species, a lot of attention is paid to the mode of extraction of active phytochemicals to limit the cost linked to the synthesis and isolation. Thus, the extraction of active compounds from plants needs appropriate extraction methods and techniques that provide bioactive ingredients-rich extracts and fractions. The extraction procedures, therefore, play a critical role in the yield, the nature of phytochemical content, etc. This chapter aims to present, describe, and compare extraction procedures of bioactive compounds from herbs and medicinal plants.",book:{id:"10356",slug:"natural-medicinal-plants",title:"Natural Medicinal Plants",fullTitle:"Natural Medicinal Plants"},signatures:"Fongang Fotsing Yannick Stéphane, Bankeu Kezetas Jean Jules, Gaber El-Saber Batiha, Iftikhar Ali and Lenta Ndjakou Bruno",authors:[{id:"224515",title:"Dr.",name:"Fongang Fotsing",middleName:null,surname:"Yannick Stéphane",slug:"fongang-fotsing-yannick-stephane",fullName:"Fongang Fotsing Yannick Stéphane"},{id:"227816",title:"Dr.",name:"Bankeu Kezetas",middleName:null,surname:"Jean Jules",slug:"bankeu-kezetas-jean-jules",fullName:"Bankeu Kezetas Jean Jules"},{id:"227817",title:"Prof.",name:"Lenta Ndjakou",middleName:null,surname:"Bruno",slug:"lenta-ndjakou-bruno",fullName:"Lenta Ndjakou Bruno"},{id:"349790",title:"Prof.",name:"Gaber",middleName:null,surname:"El-Saber Batiha",slug:"gaber-el-saber-batiha",fullName:"Gaber El-Saber Batiha"},{id:"357350",title:"Dr.",name:"Iftikhar",middleName:null,surname:"Ali",slug:"iftikhar-ali",fullName:"Iftikhar Ali"}]},{id:"26491",title:"Homeopathy: Treatment of Cancer with the Banerji Protocols",slug:"homeopathy-treatment-of-cancer-with-the-banerji-protocols",totalDownloads:54241,totalCrossrefCites:1,totalDimensionsCites:2,abstract:null,book:{id:"542",slug:"a-compendium-of-essays-on-alternative-therapy",title:"A Compendium of Essays on Alternative Therapy",fullTitle:"A Compendium of Essays on Alternative Therapy"},signatures:"Prasanta Banerji and Pratip Banerji",authors:[{id:"79939",title:"Dr",name:"Prasanta",middleName:null,surname:"Banerji",slug:"prasanta-banerji",fullName:"Prasanta Banerji"},{id:"79943",title:"Dr.",name:"Pratip",middleName:null,surname:"Banerji",slug:"pratip-banerji",fullName:"Pratip Banerji"}]},{id:"54028",title:"Chemical Composition and Biological Activities of Mentha Species",slug:"chemical-composition-and-biological-activities-of-mentha-species",totalDownloads:7515,totalCrossrefCites:13,totalDimensionsCites:50,abstract:"The genus Mentha L. (Lamiaceae) is distributed all over the world and can be found in many environments. Mentha species, one of the world’s oldest and most popular herbs, are widely used in cooking, in cosmetics, and as alternative or complementary therapy, mainly for the treatment of gastrointestinal disorders like flatulence, indigestion, nausea, vomiting, anorexia, and ulcerative colitis. Furthermore, it is well documented that the essential oil and extracts of Mentha species possess antimicrobial, fungicidal, antiviral, insecticidal, and antioxidant properties. The economic importance of mints is also evident; mint oil and its constituents and derivatives are used as flavoring agents throughout the world in food, pharmaceutical, herbal, perfumery, and flavoring industry. To provide a scientific basis for their traditional uses, several studies have been conducted to determine the chemical composition of mints and assess their biological activities. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"7",title:"Bioinformatics and Medical Informatics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",isOpenForSubmission:!0,editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",slug:"slawomir-wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",biography:"Professor Sławomir Wilczyński, Head of the Chair of Department of Basic Biomedical Sciences, Faculty of Pharmaceutical Sciences, Medical University of Silesia in Katowice, Poland. 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He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. 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Dr. Villarreal is the editor in chief and founder of the Revista de Ciencias Tecnológicas (RECIT) (https://recit.uabc.mx/) and is a member of several editorial and reviewer boards for numerous international journals. He has published more than thirty international papers and reviewed more than ninety-two manuscripts. 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For 20 years, he has studied the analysis and processing of biomedical images, emphasizing the full automation of measurement for a large inter-individual variability of patients. Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. 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His fields of interest are anterior segment disease, keratoconus, glaucoma, corneal dystrophies, and cataracts. His research topics include\nintraocular lens power calculation, eye modification induced by refractive surgery, glaucoma progression, and validation of new diagnostic devices in ophthalmology. \nHe has published more than 100 papers in international and Italian scientific journals, more than 60 in journals with impact factors, and chapters in international and Italian books. 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Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}}]},{type:"book",id:"6843",title:"Biomechanics",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6843.jpg",slug:"biomechanics",publishedDate:"January 30th 2019",editedByType:"Edited by",bookSignature:"Hadi Mohammadi",hash:"85132976010be1d7f3dbd88662b785e5",volumeInSeries:4,fullTitle:"Biomechanics",editors:[{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",institutionURL:null,country:{name:"Canada"}}}]}]},openForSubmissionBooks:{paginationCount:2,paginationItems:[{id:"11474",title:"Quality of Life Interventions - Magnitude of Effect and Transferability",coverURL:"https://cdn.intechopen.com/books/images_new/11474.jpg",hash:"5a6bcdaf5ee144d043bcdab893ff9e1c",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"July 7th 2022",isOpenForSubmission:!0,editors:[{id:"245319",title:"Ph.D.",name:"Sage",surname:"Arbor",slug:"sage-arbor",fullName:"Sage Arbor"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"11473",title:"Social Inequality - Structure and Social Processes",coverURL:"https://cdn.intechopen.com/books/images_new/11473.jpg",hash:"cefab077e403fd1695fb2946e7914942",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"July 13th 2022",isOpenForSubmission:!0,editors:[{id:"313341",title:"Ph.D.",name:"Yaroslava",surname:"Robles-Bykbaev",slug:"yaroslava-robles-bykbaev",fullName:"Yaroslava Robles-Bykbaev"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},onlineFirstChapters:{paginationCount:20,paginationItems:[{id:"82526",title:"Deep Multiagent Reinforcement Learning Methods Addressing the Scalability Challenge",doi:"10.5772/intechopen.105627",signatures:"Theocharis Kravaris and George A. 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The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. 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He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"117248",title:"Dr.",name:"Andrew",middleName:null,surname:"Macnab",slug:"andrew-macnab",fullName:"Andrew Macnab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. 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\r\n\tIn general, the harsher the environmental conditions in an ecosystem, the lower the biodiversity. Changes in the environment caused by human activity accelerate the impoverishment of biodiversity.
\r\n
\r\n\tBiodiversity refers to “the variability of living organisms from any source, including terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; it includes diversity within each species, between species, and that of ecosystems”.
\r\n
\r\n\tBiodiversity provides food security and constitutes a gene pool for biotechnology, especially in the field of agriculture and medicine, and promotes the development of ecotourism.
\r\n
\r\n\tCurrently, biologists admit that we are witnessing the first phases of the seventh mass extinction caused by human intervention. It is estimated that the current rate of extinction is between a hundred and a thousand times faster than it was when man first appeared. The disappearance of species is caused not only by an accelerated rate of extinction, but also by a decrease in the rate of emergence of new species as human activities degrade the natural environment. The conservation of biological diversity is "a common concern of humanity" and an integral part of the development process. Its objectives are “the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits resulting from the use of genetic resources”.
\r\n
\r\n\tThe following are the main causes of biodiversity loss:
\r\n
\r\n\t• The destruction of natural habitats to expand urban and agricultural areas and to obtain timber, minerals and other natural resources.
\r\n
\r\n\t• The introduction of alien species into a habitat, whether intentionally or unintentionally which has an impact on the fauna and flora of the area, and as a result, they are reduced or become extinct.
\r\n
\r\n\t• Pollution from industrial and agricultural products, which devastate the fauna and flora, especially those in fresh water.
\r\n
\r\n\t• Global warming, which is seen as a threat to biological diversity, and will become increasingly important in the future.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/40.jpg",hasOnlineFirst:!0,hasPublishedBooks:!1,annualVolume:11968,editor:{id:"209149",title:"Prof.",name:"Salustiano",middleName:null,surname:"Mato",slug:"salustiano-mato",fullName:"Salustiano Mato",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRLREQA4/Profile_Picture_2022-03-31T10:23:50.png",biography:"Salustiano Mato de la Iglesia (Santiago de Compostela, 1960) is a doctor in biology from the University of Santiago and a Professor of zoology at the Department of Ecology and Animal Biology at the University of Vigo. He has developed his research activity in the fields of fauna and soil ecology, and in the treatment of organic waste, having been the founder and principal investigator of the Environmental Biotechnology Group of the University of Vigo.\r\nHis research activity in the field of Environmental Biotechnology has been focused on the development of novel organic waste treatment systems through composting. The result of this line of work are three invention patents and various scientific and technical publications in prestigious international journals.",institutionString:null,institution:{name:"University of Vigo",institutionURL:null,country:{name:"Spain"}}},editorTwo:{id:"60498",title:"Prof.",name:"Josefina",middleName:null,surname:"Garrido",slug:"josefina-garrido",fullName:"Josefina Garrido",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRj1VQAS/Profile_Picture_2022-03-31T10:06:51.jpg",biography:"Josefina Garrido González (Paradela de Abeleda, Ourense 1959), is a doctor in biology from the University of León and a Professor of Zoology at the Department of Ecology and Animal Biology at the University of Vigo. She has focused her research activity on the taxonomy, fauna and ecology of aquatic beetles, in addition to other lines of research such as the conservation of biodiversity in freshwater ecosystems; conservation of protected areas (Red Natura 2000) and assessment of the effectiveness of wetlands as priority areas for the conservation of aquatic invertebrates; studies of water quality in freshwater ecosystems through biological indicators and physicochemical parameters; surveillance and research of vector arthropods and invasive alien species.",institutionString:null,institution:{name:"University of Vigo",institutionURL:null,country:{name:"Spain"}}},editorThree:{id:"464288",title:"Dr.",name:"Francisco",middleName:null,surname:"Ramil",slug:"francisco-ramil",fullName:"Francisco Ramil",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003RI7lHQAT/Profile_Picture_2022-03-31T10:15:35.png",biography:"Fran Ramil Blanco (Porto de Espasante, A Coruña, 1960), is a doctor in biology from the University of Santiago de Compostela and a Professor of Zoology at the Department of Ecology and Animal Biology at the University of Vigo. His research activity is linked to the taxonomy, fauna and ecology of marine benthic invertebrates and especially the Cnidarian group. Since 2004, he has been part of the EcoAfrik project, aimed at the study, protection and conservation of biodiversity and benthic habitats in West Africa. He also participated in the study of vulnerable marine ecosystems associated with seamounts in the South Atlantic and is involved in training young African researchers in the field of marine research.",institutionString:null,institution:{name:"University of Vigo",institutionURL:null,country:{name:"Spain"}}},series:{id:"25",title:"Environmental Sciences",doi:"10.5772/intechopen.100362",issn:"2754-6713"},editorialBoard:[{id:"220987",title:"Dr.",name:"António",middleName:"Onofre",surname:"Soares",slug:"antonio-soares",fullName:"António Soares",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNtzQAG/Profile_Picture_1644499672340",institutionString:null,institution:{name:"University of the Azores",institutionURL:null,country:{name:"Portugal"}}},{id:"276688",title:"Prof.",name:"Mohammed Latif",middleName:null,surname:"Khan",slug:"mohammed-latif-khan",fullName:"Mohammed Latif Khan",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcCZQA0/Profile_Picture_2022-07-15T15:04:17.jpg",institutionString:"Dr. Harisngh Gour Central University, India",institution:null}]},onlineFirstChapters:{paginationCount:1,paginationItems:[{id:"82526",title:"Deep Multiagent Reinforcement Learning Methods Addressing the Scalability Challenge",doi:"10.5772/intechopen.105627",signatures:"Theocharis Kravaris and George A. 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