Search results for: clinical staff

Authors: Zuzana Chaloupková, Zdeňka Marková, Václav Ranc, Radek Zbořil

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Prostate cancer is now one of the most serious oncological diseases in men with an incidence higher than that of all other solid tumors combined. Diagnosis of prostate cancer usually involves detection of related genes or detection of marker proteins, such as PSA. One of the new potential markers is PSMA (prostate specific membrane antigen). PSMA is a unique membrane bound glycoprotein, which is considerably overexpressed on prostate cancer as well as neovasculature of most of the solid tumors. Commonly applied methods for a detection of proteins include techniques based on immunochemical approaches, including ELISA and RIA. Magnetically assisted surface enhanced Raman spectroscopy (MA-SERS) can be considered as an interesting alternative to generally accepted approaches. This work describes a utilization of MA-SERS in a detection of PSMA in human blood. This analytical platform is based on magnetic nanocomposites Fe3O4@Ag, functionalized by a low-molecular selector labeled as JB303. The system allows isolating the marker from the complex sample using application of magnetic force. Detection of PSMA is than performed by SERS effect given by a presence of silver nanoparticles. This system allowed us to analyze PSMA in clinical samples with limits of detection lower than 1 ng/mL.

Keywords: diagnosis, cancer, PSMA, MA-SERS, Ag nanoparticles

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Authors: R. M. Noah, N. M. Nasir, M. R. Jais, M. S. S. Wahab, M. H. Abdullah, A. S. S. Raj

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Infectious diseases are getting more difficult to treat due to the resistant strains of bacteria. Current generations of antibiotics are most likely ineffective against multi-drug resistant strains bacteria. Thus, there is an urgent need in search of natural antibiotics in particular from medicinal plants. One of the common medicinal plants, Melaleuca cajuputi, has been reported to possess antibacterial properties. The study was conducted to evaluate and justify the presence of antibacterial activity of Melaleuca cajuputi essential oil (EO) against the multi-drug resistant bacteria. Clinical isolates obtained from the teaching hospital were re-assessed to confirm the exact identity of the bacteria to be tested, namely methicillin-resistant staphylococcus aureus (MRSA), carbapenem-resistant enterobacteriaceae (CRE), and extended-spectrum beta-lactamases producer (ESBLs). A well diffusion method was done to observe the inhibition zones of the essential oil against the bacteria. Minimum inhibitory concentration (MIC) was determined using the microdilution method in 96-well flat microplate. The absorbance was measured using a microplate reader. Minimum bactericidal concentration (MBC) was performed using the agar medium method. The zones of inhibition produced by the EO against MRSA, CRE, and ESBL were comparable to that of generic antibiotics used, gentamicin and augmentin. The MIC and MBC results highlighted the antimicrobial efficacy of the EO. The outcome of this study indicated that the EO of Melaleuca cajuputi had antibacterial activity on the multi-drug resistant bacteria. This finding was eventually substantiated by electron microscopy work.

Keywords: melaleuca cajuputi, antibacterial, resistant bacteria, essential oil

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Authors: Dawn Tsang

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This paper aims at synthesizing the difficulties in cognitive processes faced by translation majors in mainland China. The purpose is to develop possible solutions and innovation in terms of translation pedagogy, curriculum reform, and syllabus design. This research will base its analysis on students’ instant feedback and interview after training in translation and interpreting courses, and translation faculty’s teaching experiences. This research will take our translation majors as the starting point, who will be one of the focus groups. At present, our Applied Translation Studies Programme is offering translation courses in the following areas: practical translation and interpreting, translation theories, culture and translation, and internship. It is a four-year translation programme, and our students would start their introductory courses since Semester 1 of Year 1. The medium of instruction of our College is solely in English. In general, our students’ competency in English is strong. Yet in translation and especially interpreting classes, no matter it is students’ first attempt or students who have taken university English courses, students find class practices very challenging, if not mission impossible. Their biggest learning problem seems to be weakening cognitive processes in terms of lack of intercultural competence, incomprehension of English language and foreign cultures, inadequate aptitude and slow reaction, and inapt to utilize one’s vocabulary bank etc. This being so, the research questions include: (1) What specific and common cognitive difficulties are students facing while learning translation and interpreting? (2) How to deal with such difficulties, and what implications can be drawn on curriculum reform and syllabus design in translation? (3) How significant should cognitive study be placed on translation curriculum, i.e., the proportion of cognitive study in translation/interpreting courses and in translation major curriculum? and (4) What can we as translation educators do to maximize teaching and learning effectiveness by incorporating the latest development of cognitive study?. We have collected translation students’ instant feedback and conduct interviews with both students and teaching staff, in order to draw parallels as well as distinguishing from our own current teaching practices at United International College (UIC). We have collected 500 questionnaires for now. The main learning difficulties include: poor vocabulary bank, lack of listening and reading comprehension skills in terms of not fully understanding the subtext, aptitude in translation and interpreting etc. This being so, we propose to reform and revitalize translation curriculum and syllabi to address to these difficulties. The aim is to maximize teaching effectiveness in translation by addressing the above-mentioned questions with a special focus on cognitive difficulties faced by translation majors.

Keywords: cognitive difficulties, teaching and learning effectiveness, translation curriculum reform, translation pedagogy

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Hassan Abo-Salem, Huang Xiaolin

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Background and Purpose: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantarflexor muscle tone by Modified Ashworth Scale. Results: Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05). Conclusions: Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and walking speed in chronic stroke patients.

Keywords: mirror therapy, stroke, MAS, walking speed

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Authors: Chao Hsing Yeh, Wei Chun Lin

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Background: Current management of aromatase inhibitor-induced arthralgia (AIA) in postmenopausal breast cancer survivors (PBCS) has limited effect. Method: In this prospective randomized clinical trial (RCT), a 4-week APA treatment was used to manage AIA. Twenty PBCS participated. After baseline data was collected, participants were waited for a month before they receive APA at a convenient time once a week for 4 weeks. Blood samples from participants in both groups were collected at baseline and after 4 weeks of treatment. The primary outcomes included: pain intensity, pain interference, stiffness, and physical function. Results: After the 4-week APA treatment, the pro-inflammatory cytokines and chemokines display a trend of mean percentage reduction (i.e., -22% in IL-1α, -4% in IL-1β, -1% in IL-2, -3% in IL-6, -19% in IL-12, -9% in Eotaxin, and -2% in MCP-1). The anti-inflammatory cytokine IL-10 and IL-13 (i.e., 5% in IL-10 and 29% in IL-13) increased from pre- to post-APA treatment. Significant positive correlation of percentage mean change was observed between symptom severity and eotaxin (ρ = 0.56; p < 0.01) & MCP-1 (ρ = 0.65; p < 0.01). Interference and chemokines (eotaxin & MIP-1) also shows positive correlation (ρ = 0.48; p < 0.01 & ρ = 0.39; p < 0.05). Another positive correlation was found between worst pain and chemokines (eotaxin, ρ = 0.48; p < 0.01 & MIP-1, ρ = 0.39; p < 0.05). Additionally, interference also shows positive correlation among IL-1α (ρ = 0.36; p < 0.05) and IL-β (ρ = 0.33; p < 0.05). Conclusion: These findings suggest that APA intervention may inhibit inflammation of AIA patients and chemokine could be one of the key factors of AIA symptom improvement.

Keywords: acupressure, cytokine, pain management, breast cancer survivors

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Authors: Kuan-Han Lin, Kuan-Yin Lin, Ka-Chun Siu

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The purpose of this systematic review was to determine the impact of post-traumatic stress disorders (PTSD) symptom or depressive symptoms on return to work (RTW) after occupational injury. The original articles of clinical trials and observational studies from PubMed, MEDLINE, and PsycINFO between January 1980 and November 2016 were retrieved. Two reviewers evaluated the abstracts identified by the search criteria for full-text review. To be included in the final analysis, studies were required to use either intervention or observational study design to examine the association between psychiatric symptoms and RTW. A modified checklist designed by Downs & Black and Crombie was used to assess the methodological quality of included study. A total of 58 articles were identified from the electronic databases after duplicate removed. Seven studies fulfilled the inclusion criteria and were critically reviewed. The rates of RTW in the included studies were reported to be 6% to 63.6% among workers after occupational injuries. This review found that post-traumatic stress symptom and depressive symptoms were negatively associated with RTW. Although the impact of psychiatric symptoms on RTW after occupational injury remains poorly understood, this review brought up the important information that injured workers with psychiatric symptoms had poor RTW outcome. Future work should address the effective management of psychiatric factors affecting RTW among workers.

Keywords: depressive symptom, occupational injury, post-traumatic stress disorder, return to work

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Authors: Mudassar Iqbal, Riaz Hussain, Khalid Mehmood, Farah Ali, Fazal Mahmood, Abdul Ghaffar

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Corynebacterium pseudotuberculosis is an important cause of caseous lymphadenitis (CL), a complex, chronic devastating and destructive disease of small ruminants. In present study, postmortem examination of Chinkara deer (n=25) was conducted in year 2014. Pus samples suggestive of CL were collected from the superficial lymph nodes, liver, spleen and lungs during necropsy and subjected to standard microbiological procedures for isolation and molecular analysis of bacterial pathogens. Pus samples collected from carcasses (25) presenting clinical lesions of C. pseudotuberculosis infection was identified in 19 (76%) carcasses on the basis of culture characteristics. The frequency of C. pseudotuberculosis bacterium was higher in older animals as compared to young animals. Grossly, multiple tubercles of variable size having caseous material were observed in liver, lungs, spleen and lymph nodes. Histopathologically, tissue sections from all the visceral organs were extensively plugged with abscess. In present study specific prolineiminopeptidase (PIP) gene of the C. pseudotuberculosis was amplified by the Polymerase chain reaction technique (PCR) in 17(25) cases. The efficient and reliable molecular analysis along with necropsy findings in present study can be used as valuable approach for diagnosis of caseous lymphadenitis in small ruminants.

Keywords: Chinkara deer, Corynebacterium pseudotuberculosis, Caseous lymphadenitis, PCR

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Authors: Chia-Feng Lu, Yuh-Jen Wang, Shin Teng, Yu-Te Wu, Sui-Hing Yan

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Brain functional networks based on resting-state EEG data were compared between patients with mild Alzheimer’s disease (mAD) and matched patients with amnestic subtype of mild cognitive impairment (aMCI). We integrated the time–frequency cross mutual information (TFCMI) method to estimate the EEG functional connectivity between cortical regions and the network analysis based on graph theory to further investigate the alterations of functional networks in mAD compared with aMCI group. We aimed at investigating the changes of network integrity, local clustering, information processing efficiency, and fault tolerance in mAD brain networks for different frequency bands based on several topological properties, including degree, strength, clustering coefficient, shortest path length, and efficiency. Results showed that the disruptions of network integrity and reductions of network efficiency in mAD characterized by lower degree, decreased clustering coefficient, higher shortest path length, and reduced global and local efficiencies in the delta, theta, beta2, and gamma bands were evident. The significant changes in network organization can be used in assisting discrimination of mAD from aMCI in clinical.

Keywords: EEG, functional connectivity, graph theory, TFCMI

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Authors: Peter Clutterbuck, Terry Rowlands, Owen Seamons

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In this paper we describe one critical research program within a complex, ongoing multi-year project (2010 to 2014 inclusive) with the overall goal to improve the learning outcomes for first year undergraduate commerce/business students within an Information Systems (IS) subject with very large enrolment. The single research program described in this paper is the analysis of student attitudes and decision making in relation to the availability of formative assessment feedback via Web-based real time conferencing and document exchange software (Adobe Connect). The formative assessment feedback between teaching staff and students is in respect of an authentic problem-based, team-completed assignment. The analysis of student attitudes and decision making is investigated via both qualitative (firstly) and quantitative (secondly) application of the Theory of Planned Behavior (TPB) with a two statistically-significant and separate trial samples of the enrolled students. The initial qualitative TPB investigation revealed that perceived self-efficacy, improved time-management, and lecturer-student relationship building were the major factors in shaping an overall favorable student attitude to online feedback, whilst some students expressed valid concerns with perceived control limitations identified within the online feedback protocols. The subsequent quantitative TPB investigation then confirmed that attitude towards usage, subjective norms surrounding usage, and perceived behavioral control of usage were all significant in shaping student intention to use the online feedback protocol, with these three variables explaining 63 percent of the variance in the behavioral intention to use the online feedback protocol. The identification in this research of perceived behavioral control as a significant determinant in student usage of a specific technology component within a virtual learning environment (VLE) suggests that VLEs could now be viewed not as a single, atomic entity, but as a spectrum of technology offerings ranging from the mature and simple (e.g., email, Web downloads) to the cutting-edge and challenging (e.g., Web conferencing and real-time document exchange). That is, that all VLEs should not be considered the same. The results of this research suggest that tertiary students have the technological sophistication to assess a VLE in this more selective manner.

Keywords: formative assessment feedback, virtual learning environment, theory of planned behavior, perceived behavioral control

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Authors: Rinat Gabbay-Benziv, Merav Ben-Natan, Ariel Roguin, Benyamine Abbou, Anna Ofir, Adi Klein, Dikla Dahan-Shriki, Mordechai Hallak, Boris Kessel, Mickey Dudkiewicz

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Introduction: Over recent decades, technology has become integral to healthcare, with electronic health records and advanced medical equipment now standard. However, this reliance has made healthcare systems increasingly vulnerable to ransomware attacks. On October 13, 2021, Hillel Yaffe Medical Center experienced a severe ransomware attack that disrupted all IT systems, including electronic health records, laboratory services, and staff communications. The attack, carried out by the group DeepBlueMagic, utilized advanced encryption to lock the hospital's systems and demanded a ransom. This incident caused significant operational and patient care challenges, particularly impacting the obstetrics department. Objective: The objective is to describe the challenges facing the obstetric division following a cyberattack and discuss ways of preparing for and overcoming another one. Methods: A retrospective descriptive study was conducted in a mid-sized medical center. Division activities, including the number of deliveries, cesarean sections, emergency room visits, admissions, maternal-fetal medicine department occupancy, and ambulatory encounters, from 2 weeks before the attack to 8 weeks following it (a total of 11 weeks), were compared with the retrospective period in 2019 (pre-COVID-19). In addition, we present the challenges and adaptation measures taken at the division and hospital levels leading up to the resumption of full division activity. Results: On the day of the cyberattack, critical decisions were made. The media announced the event, calling on patients not to come to our hospital. Also, all elective activities other than cesarean deliveries were stopped. The number of deliveries, admissions, and both emergency room and ambulatory clinic visits decreased by 5%–10% overall for 11 weeks, reflecting the decrease in division activity. Nevertheless, in all stations, there were sufficient activities and adaptation measures to ensure patient safety, decision-making, and workflow of patients were accounted for. Conclusions: The risk of ransomware cyberattacks is growing. Healthcare systems at all levels should recognize this threat and have protocols for dealing with them once they occur.

Keywords: ransomware attack, healthcare cybersecurity, obstetrics challenges, IT system disruption

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Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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Authors: Jie Huo, Jonathan Wu

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Segmentation of anatomical structures in medical images is essential for scientific inquiry into the complex relationships between biological structure and clinical diagnosis, treatment and assessment. As a method of incorporating the prior knowledge and the anatomical structure similarity between a target image and atlases, multi-atlas segmentation has been successfully applied in segmenting a variety of medical images, including the brain, cardiac, and abdominal images. The basic idea of multi-atlas segmentation is to transfer the labels in atlases to the coordinate of the target image by matching the target patch to the atlas patch in the neighborhood. However, this technique is limited by the pairwise registration between target image and atlases. In this paper, a novel multi-atlas segmentation approach is proposed by introducing a dynamic energy model. First, the target is mapped to each atlas image by minimizing the dynamic energy function, then the segmentation of target image is generated by weighted fusion based on the energy. The method is tested on MICCAI 2012 Multi-Atlas Labeling Challenge dataset which includes 20 target images and 15 atlases images. The paper also analyzes the influence of different parameters of the dynamic energy model on the segmentation accuracy and measures the dice coefficient by using different feature terms with the energy model. The highest mean dice coefficient obtained with the proposed method is 0.861, which is competitive compared with the recently published method.

Keywords: brain MRI segmentation, dynamic energy model, multi-atlas segmentation, energy minimization

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Authors: Fariha Akhter Chowdhury, Mohammad Nurul Islam, Anamika Saha, Sabrina Mahboob, Abu Syed Md. Mosaddek, Md. Omar Faruque, Most. Fahmida Begum, Rajib Bhattacharjee

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Urinary tract infection (UTI) is one of the most common infectious diseases in Bangladesh where Escherichia coli is the prevalent organism and responsible for most of the infections. Lipopolysaccharide (LPS) is known to act as a major virulence factor of E. coli. The present study aimed to purify, extract and visualize LPS of E. coli clinical isolates from urine samples of patients with UTI. The E. coli strain was isolated from the urine samples of 10 patients with UTI and then the antibiotic sensitivity pattern of the isolates was determined. The purification of LPS was carried out using the hot aqueous-phenol method and separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, which was directly stained using the modified silver staining method and Coomassie blue. The silver-stained gel demonstrated both smooth and rough type LPS by showing trail-like band patterns with the presence and lacking O-antigen region, respectively. Coomassie blue staining showed no band assuring the absence of any contaminating protein. Our successful extraction of purified LPS from E. coli isolates of UTI patients’ urine samples can be an important step to understand the UTI disease conditions.

Keywords: Escherichia coli, electrophoresis, polyacrylamide gel, silver staining, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE)

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Authors: Prachi Choudhary, Jai Gopal Sharma

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Microbial cultures determine the type of organism, its abundance in the tested sample, or both. It is one of the primary diagnostic methods of microbiology. It is used to determine the cause of infectious disease by letting the agent multiply in a predetermined medium. Different bacteria produce colonies that may be very distinct from the bacterial species that produced them. To culture any pathogen or microorganism, we should first know about the types of media used in microbiology for culturing. Sometimes sub culturing is also done in various microorganisms if some mixed growth is seen in culture. Nearly 3 types of culture media based on consistency – solid, semi-solid, and liquid (broth) media; are further explained in the report. Then, The Five I's approach is a method for locating, growing, observing, and characterizing microorganisms, including inoculation and incubation. Isolation, inspection, and identification. For identification of bacteria, we have to culture the sample like urine, sputum, blood, etc., on suitable media; there are different methods of culturing the bacteria or microbe like pour plate method, streak plate method, swabbing by needle, pipetting, inoculation by loop, spreading by spreader, etc. After this, we see the bacterial growth after incubation of 24 hours, then according to the growth of bacteria antibiotics susceptibility test is conducted; this is done for sensitive antibiotics or resistance to that bacteria, and also for knowing the name of bacteria. Various methods like the dilution method, disk diffusion method, E test, etc., do antibiotics susceptibility tests. After that, various medicines are provided to the patients according to antibiotic sensitivity and resistance.

Keywords: inoculation, incubation, isolation, antibiotics suspectibility test, characterizing

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Authors: Suvorov Vasyl, Filipchuk Viktor

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Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).

Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy

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Authors: Stefanos Karanasios, Charkleia Koutri, Maria Moutzouri, Sofia A. Xergia, Vasiliki Sakellari, George Gioftsos

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The precise calculation of arterial occlusive pressure (AOP) is a critical step to accurately prescribe individualized pressures during blood flow restriction training (BFRT). AOP is usually measured in a supine position before training; however, previous reports suggested a significant influence in lower limb AOP across different body positions. The aim of the study was to investigate the effect of three different body positions on upper limb AOP and the reliability of the method for its standardization in clinical practice. Forty-two healthy participants (Mean age: 28.1, SD: ±7.7) underwent measurements of upper limb AOP in supine, seated, and standing positions by three blinded raters. A cuff with a manual pump and a pocket doppler ultrasound were used. A significantly higher upper limb AOP was found in seated compared with supine position (p < 0.031) and in supine compared with standing position (p < 0.031) by all raters. An excellent intraclass correlation coefficient (0.858- 0.984, p < 0.001) was found in all positions. Upper limb AOP is strongly dependent on body position changes. The appropriate measurement position should be selected to accurately calculate AOP before BFRT. The excellent inter-rater reliability and repeatability of the method suggest reliable and consistent results across repeated measurements.

Keywords: Kaatsu training, blood flow restriction training, arterial occlusion, reliability

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Authors: Syue-Wen Lin

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Objective:This article reviews the care experience of a 40-year-old male patient who underwent a thoracoscopic right lower lobectomy following a COVID-19 infection. His complex medical history included multiple metastases (lungs, liver, spleen, and left kidney) and lung damage from COVID-19, which complicated the weaning process from mechanical ventilation. The care involved managing cancer treatment, postoperative pain, wound care, and palliative care. Methods:Nursing care was provided from August 16 to August 17, 2024. Challenges included difficulty with sputum clearance, which exacerbated the patient's anxiety and fear of reintubation. Pain management strategies combined analgesic drugs, non-drug methods, essential oil massages with family members, and playing the patient’s favorite music to reduce pain and anxiety. Progressive rehabilitation began with stabilizing vital signs, followed by assistance with sitting on the edge of the bed and walking within the ward. Strict sterile procedures and advanced wound care technology were used for daily dressing changes, with meticulous documentation of wound conditions and appropriate dressing selection. Holistic cancer care and palliative measures were integrated to address the patient’s physical and psychological needs. Results:The interdisciplinary care team developed a comprehensive plan addressing both physical and psychological aspects. Respiratory therapy, lung expansion exercises, and a high-frequency chest wall oscillation vest facilitated sputum expulsion and assisted in weaning from mechanical ventilation. The integration of cancer care, pain management, wound care, and palliative care led to improved quality of life and recovery. The collaborative approach between nursing staff and family ensured that the patient received compassionate and effective care. Conclusion: The complex interplay of emergency surgery, COVID-19, and advanced cancer required a multifaceted care strategy. The care team’s approach, combining critical care with tailored cancer and palliative care, effectively improved the patient’s quality of life and facilitated recovery. The comprehensive care plan, developed with family collaboration, provided both high-quality medical care and compassionate support for the terminally ill patient.

Keywords: multiple metastases, testicular cancer, palliative care, nursing experience

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Authors: Zahra Emami, Mohammad Ebrahim Khamseh, Nahid Hashemi Madani, Iman Kermani

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The aim of the study was to map scientific research on adrenal gland diseases in the Middle East countries through the Web of Science database using scientometric analysis. Data were analyzed with Excel software; and HistCite was used for mapping of the scientific texts. In this study, from a total of 268 retrieved records, 1125 authors from 328 institutions published their texts in 138 journals. Among 17 Middle East countries, Turkey ranked first with 164 documents (61.19%), Israel ranked second with 47 documents (15.53%) and Iran came in the third place with 26 documents. Most of the publications (185 documents, 69.2%) were articles. Among the universities of the Middle East, Istanbul University had the highest science production rate (9.7%). The Journal of Clinical Endocrinology & Metabolism had the highest TGCS (243 citations). In the scientific mapping, 7 clusters were formed based on TLCS (Total Local Citation Score) & TGCS (Total Global Citation Score). considering the study results, establishment of scientific connections and collaboration with other countries and use of publications on adrenal gland diseases from high ranking universities can help in the development of this field and promote the medical practice in this regard. Moreover, investigation of the formed clusters in relation to Congenital Hyperplasia and puberty related disorders can be research priorities for investigators.

Keywords: mapping, scientific research, adrenal gland diseases, scientometric

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Authors: Gehan A. Hegazy, Hesham N. Mustafa, Sally A. El Awdan, Marawan AbdelBaset

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Doxorubicin (DOX) is a chemotherapeutic agent used for the treatment of different cancers and its clinical usage is hindered by the oxidative injury-related cardiotoxicity. This work aims to declare if the harmful effects of DOX on the heart can be alleviated with the use of Coenzyme Q10 (CoQ10) or L-carnitine. The study was performed on seventy-two female Wistar albino rats divided into six groups, 12 animals each: Control group; DOX group (10 mg/kg); CoQ10 group (200 mg/kg); L-carnitine group (100 mg/kg); DOX + CoQ10 group; DOX + L-carnitine group. CoQ10 and L-carnitine treatment orally started five days before a single dose of 10 mg/kg DOX that injected intraperitoneally (IP) then the treatment continued for ten days. At the end of the study, serum biochemical parameters of cardiac damage, oxidative stress indices, and histopathological changes were investigated. CoQ10 or L-carnitine showed noticeable effects in improving cardiac functions evidenced reducing serum enzymes as serum interleukin-1 beta (IL-1), tumor necrosis factor alpha (TNF-), leptin, lactate dehydrogenase (LDH), Cardiotrophin-1, Troponin-I and Troponin-T. Also, alleviate oxidative stress, decrease of cardiac Malondialdehyde (MDA), Nitric oxide (NO) and restoring cardiac reduced glutathione levels to normal levels. Both corrected the cardiac alterations histologically and ultrastructurally. With visible improvements in -SMA, vimentin and eNOS immunohistochemical markers. CoQ10 or L-carnitine supplementation improves the functional and structural integrity of the myocardium.

Keywords: CoQ10, doxorubicin, L-Carnitine, cardiotoxicity

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Authors: Blanche Aguida, Marootpong Pooam, Nathalie Jourdan, Margaret Ahmad

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COVID-19-related morbidity is associated with exaggerated inflammation and cytokine production in the lungs, leading to acute respiratory failure. The cellular mechanisms underlying these so-called ‘cytokine storms’ are regulated through the Toll-like receptor 4 (TLR4) signaling pathway and by reactive oxygen species (ROS). Both light (photobiomodulation) and magnetic fields (e.g., pulsed electromagnetic field) stimulation are non-invasive therapies known to confer anti-inflammatory effects and regulate ROS signaling pathways. Here we show that daily exposure to two 10-minute intervals of moderate-intensity infra-red light significantly lowered the inflammatory response induced via the TLR4 receptor signaling pathway in human cell cultures. Anti-inflammatory effects were likewise achieved by electromagnetic field exposure of cells to daily 10-minute intervals of either pulsed electromagnetic fields (PEMF) or to low-level static magnetic fields. Because current illumination and electromagnetic field therapies have no known side effects and are already approved for some medical uses, we have here developed protocols for verification in clinical trials of COVID 19 infection. These treatments are affordable, simple to implement, and may help to resolve the acute respiratory distress of COVID 19 patients both in the home and in the hospital.

Keywords: COVID 19, electromagnetic fields therapy, inflammation, photobiomodulation therapy

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Authors: Maria Magdy Danial Riad

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Background: In the United Kingdom (UK), pharmacists' roles have expanded considerably in recent decades to encompass clinical practice through more direct patient care. However, dispensing and compounding remain core activities for pharmacists. A lack of marketed preparations for species-specific animal use results in veterinary pharmacy practice compounding, retaining its prominence. Current participation by pharmacists to support this sphere of practice would appear to be minimal. Objectives: This study was undertaken to determine the opinions and views toward the practice of veterinary pharmacy by a cross-sectional group of pharmacists. Methods: Research data were collected via a self-administered survey questionnaire distributed at the 2012 annual conference of the Royal Pharmaceutical Society. Sampling was purposive, with a random distribution of the questionnaire to pharmacists during the conference sessions. Key findings: Interaction by pharmacists with veterinary pharmacies is currently minimal, primarily due to a lack of knowledge of veterinary medicines. Respondents revealed a lack of veterinary pharmacy courses during their undergraduate studies. This has led to situations where some veterinary prescriptions are dispensed without adequate checks being performed by the pharmacist. Pharmacists, on occasion, do not dispense veterinary prescriptions presented to them due to insufficient knowledge of veterinary medicines and/or a lack of consultable reference sources. The effect on practice is that pharmacists do not always participate as fully as would seem logical. Conclusions: Pharmacists' participation in veterinary pharmacy is limited by a lack of knowledge of veterinary medicines, mostly resulting from inadequate tuition on veterinary pharmacy during their initial education.

Keywords: veterinary pharmacy, veterinary medicines, pharmacy education, pharmacists continuing professional development

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Authors: Wan-Yu Liu, Tiffany April Lin, Yu-Chieh Tang, Yi-Lin Wang, Chieh-Hui Li

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As the national income in Taiwan has been raised, the life style of the public has also been changed, so that the tourism industry gradually moves from a service industry to an experience economy. The Lihpaoland is one of the most popular theme parks in Taiwan. However, the related works on performance of service quality of the park have been lacking since its re-operation in 2012. Therefore, this study investigates the quality of software/hardware facilities and services of the Lihpaoland, and aims to achieve the following three goals: 1) analyzing how various sample data of tourists leads to different results for service quality of LihpaoLand; 2) analyzing how tourists respond to the service tangibility, service reliability, service responsiveness, service guarantee, and service empathy of LihpaoLand; 3) according to the theoretical and empirical results, proposing how to improve the overall facilities and services of LihpaoLand, and hoping to provide suggestions to the LihpaoLand or other related businesses to make decision. The survey was conducted on the tourists to the LihpaoLand using convenience sampling, and 400 questionnaires were collected successfully. Analysis results show that tourists paid much attention to maintenance of amusement facilities and safety of the park, and were satisfied with them, which are great advantages of the park. However, transportation around the LihpaoLand was inadequate, and the price of the Fullon hotel (which is the hotel closest to the LihpaoLand) were not accepted by tourists – more promotion events are recommended. Additionally, the shows are not diversified, and should be improved with the highest priority. Tourists did not pay attention to service personnel’s clothing and the ticket price, but they were not satisfied with them. Hence, this study recommends to design more distinctive costumes and conduct ticket promotions. Accordingly, the suggestions made in this study for LihpaoLand are stated as follows: 1) Diversified amusement facilities should be provided to satisfy the needs at different ages. 2) Cheep but tasty catering and more distinctive souvenirs should be offered. 3) Diversified propaganda schemes should be strengthened to increase number of tourists. 4) Quality and professional of the service staff should be enhanced to acquire public praise and tourists revisiting. 5) Ticket promotions in peak seasons, low seasons, and special events should be conducted. 6) Proper traffic flows should be planned and combined with technologies to reduce waiting time of tourists. 7) The features of theme landscape in LihpaoLand should be strengthened to increase willingness of the tourists with special preferences to visit the park. 8) Ticket discounts or premier points card promotions should be adopted to reward the tourists with high loyalty.

Keywords: service quality, customers’ satisfaction, theme park, Taiwan

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Authors: Fouzia Perveen, Rumana Qureshi

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The presently studied twelve anticancer drugs are the cytotoxic agents which inhibit the replication of DNA and activity of enzymes involved in DNA replication namely topoisomerase-II, polymerase and helicase and have shown remarkable anticancer activity in clinical trials. In this study, we performed molecular docking studies of twelve antitumor drugs against DNA and DNA enzymes in the presence and absence of ascorbic acid (AA) and developed the quantitative structure-activity relationship (QSAR) model for anticancer activity screening. A number of electronic and steric descriptors were calculated using MOE software package. QSAR was established showing a correlation of binding strength with various physicochemical descriptors. Out of these twelve, eight cytotoxic drugs were tested on Non-Small Cell Lung Cancer cell lines (H-157 and H-1299) in the absence and presence of ascorbic acid and experimental IC50 values were calculated. From the docking studies, binding constants were calculated indicating the strength of drug-DNA and drug-enzyme complex formation and it was correlated to the IC50 values (both experimental and theoretical). These results can offer useful references for directing the molecular design of DNA enzyme inhibitor with improved anticancer activity.

Keywords: ascorbic acid, binding constant, cytotoxic agents, cell culture, DNA, DNA enzymes, molecular docking

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Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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Authors: Sarim Ahmad

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The Single Cell Gel Electrophoresis Assay (SCGE, known as comet assay) is a potential, uncomplicated, sensitive and state-of-the-art technique for quantitating DNA damage at individual cell level and repair from in vivo and in vitro samples of eukaryotic cells and some prokaryotic cells, being popular in its widespread use in various areas including human biomonitoring, genotoxicology, ecological monitoring and as a tool for research into DNA damage or repair in different cell types in response to a range of DNA damaging agents, cancer risk and therapy. The method involves the encapsulation of cells in a low-melting-point agarose suspension, lysis of the cells in neutral or alkaline (pH > 13) conditions, and electrophoresis of the suspended lysed cells, resulting in structures resembling comets as observed by fluorescence microscopy; the intensity of the comet tail relative to the head reflects the number of DNA breaks. The likely basis for this is that loops containing a break lose their supercoiling and become free to extend towards the anode. This is followed by visual analysis with staining of DNA and calculating fluorescence to determine the extent of DNA damage. This can be performed by manual scoring or automatically by imaging software. The assay can, therefore, predict an individual’s tumor sensitivity to radiation and various chemotherapeutic drugs and further assess the oxidative stress within tumors and to detect the extent of DNA damage in various cancerous and precancerous lesions of oral cavity.

Keywords: comet assay, single cell gel electrophoresis, DNA damage, early detection test

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Authors: Akbar Darouie, Mamak Joulaie

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In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Daoud, Leila Keskes, Tarek Rebai

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Introduction: Recurrent pregnancy loss (RPL) defined as two or more pregnancy losses, is a serious clinical problem. Methylene-tetrahydro-folate-reductase (MTHFR) polymorphisms, commonly the variant C677T is recognized as an inherited thrombophilia which might affect embryonic development and pregnancy success and cause pregnancy complications as RPL. Material and Methods DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of the C677T MTHFR polymorphism among 70 patients (35 couples) with more than 2 fetal losses. Aims and Objective: The aim of this study is to determine the frequency of MTHFR C677T among Tunisian couples with RPL and to critically analyze the available literature on the importance of MTHFR polymorphism testing in the management of RPL. Result and comments: No C677T mutation was detected in the carriers of RPL. This result would be related to sample size and to different criteria (number of abortion), - The association between MTHFR polymorphisms and pregnancy complications has been reported but with controversial results. - A lack of evidence for MTHFR polymorphism testing previously recommended by ACMG (American College of Medical medicine). Our study highlights the importance of screening of MTHFR polymorphism since the real impact of such thrombotic molecular defect on the pregnancy outcome is evident. - Folic supplementation of these patients during pregnancy can prevent such complications and lead to a successful pregnancy outcome.

Keywords: methylenetetrahydrofolate reductase, C677T, recurrent pregnancy loss, genetic testing

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Authors: Ayman Hegab

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Increasing evidence supports the use of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) for the treatment of knee osteoarthritis, which effectively promotes cartilage repair. This study aimed to determine whether injection of PRP+HA following arthrocentesis reduces pain and improves maximum incisal opening. This was a single-blind, prospective, randomized control study. The patients were selected based on the Hegab classification: Group I: patients treated with arthrocentesis followed by a single PRP injection; Group II (Control): patients treated with arthrocentesis followed by a single HA injection; and Group III: patients treated with arthrocentesis followed by a single PRP+HA combination injection. The primary predictor variable was the medication used for injection. The primary outcome variables were the maximum voluntary mouth opening and pain index scores. The secondary outcome variable was joint sounds. All outcome variables were assessed and compared among the three groups at baseline and at 1-, 3-, 6-, and 12-month intervals. Other variables, including patients’ age and sex, were evaluated in relation to the patient outcomes. Injecting PRP+HA showed statistically significant improvement in the primary and secondary treatment outcomes over PRP or HA injection throughout the study period (P<0.005). Injection of PRP+HA following arthrocentesis had significant long-term clinical efficacy regarding pain relief that was considered the main concern of both the patient and clinician.

Keywords: TMJ, HA, PRP, osteoarthritis

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Authors: Leili Iranirad, Mohammad Saleh Sadeghi, Seyed Fakhreddin Hejazi, Negar Vakili Razlighi

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Objective: Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an unknown acute kidney injury (AKI) occurring after exposure to contrast media (CM). Contrast agents are most often used for diagnostic procedures or therapeutic angiographic interventions. Recently, Na/K citrate as a urine alkalinization has been evaluated for the prevention of CIN. We conducted this experiment to evaluate the efficiency of Na/K citrate on CIN in high-risk patients treated with cardiac catheterization. Methods: A prospective randomized clinical trial was conducted on 400 patients having moderate to high-risk factors for CIN treated with elective percutaneous coronary intervention (PCI) and were assigned randomly to the control group or the Na/K citrate group. The Na/K citrate group (n=200) received 5 g Na/K citrate solution, which was diluted in 200 mL water two h before and four hours after the first administration and intravenous hydration for two h prior to and six h after the procedure, while the control group (n=200) only received intravenous hydration. Serum creatinine (SCr) was calculated prior to the contrast exposure and after 48 h. CIN was described as a 25% increase in creatinine of serum (SCr) or >0.5 mg/dl 48 h after contrast administration. Results: CIN was observed in 33 patients (16.5%) in the control group and in 6 patients (3%) in the Na/K citrate group. A significant variation was recorded in the CIN incidence between the two groups 48 h after the radiocontrast agent administration (p < 0.001). Conclusion: Our results show that Na/K citrate is useful and substantially reduces the incidence of CIN.

Keywords: contrast media, citrate, PCI

Procedia PDF Downloads 108