Search results for: patients' rights

Authors: Sherif Sabri, Nael Samir, Mohamed Ali, Ahmed ElSakhawy

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Introduction: There is growing evidence to support the hypothesis that serum matrix metalloproteinase -9 in could be an early predictor of mortality in septic patients. Aim of the work: Study the relationship of matrix metalloproteinase 9 in patients with SIRS in comparison to septic patients in day 0 and day 2. Patients and Methods: This is a prospective observational study conducted on 40 adult critically ill patients staying more than 24 hours in ICU either surgical or medical department, El Fayoum General Hospital in the period from November 2014 to March 2015. Patients met at least two of the criteria for severe inflammatory response syndrome (SIRS). Diagnostic criteria include several clinical and laboratory findings of sepsis induced tissue hypoperfusion or organ dysfunction. Samples were grouped as drawn either at admission, or at day 2 after admission. Results: Patients were divided into two groups: The non-sepsis (SIRS) group, which included 15 (37.5%) patients with no later evidence of sepsis were enrolled as controls. The Sepsis group, which included 25 patients diagnosed to have SIRS with later evidence of sepsis with positive culture. Exploring serum level of MMP-9 in non-survivors and survivors, there was significant increase in non-survivors if compared to survivors at admission p-value 0.001 (mean value in survivors 4.4mg/dl±4.1mg/dl at admission versus mean value in non-survivors 11.9mg/dl±5.8mg/dl) and after two days of admission was also significant increase p-value 0.001 (mean value in survivors 10.9mg/dl ±9.4mg/dl versus mean value in non-survivors 22.6mg/dl±10.4). Conclusion: MMP-9 levels in septic patients have a beneficial role in ICU for high-risk stratification as it is an independent marker of mortality in severe sepsis.

Keywords: matrix metalloproteinase (MMP-9), sepsis, septic shock, systemic inflamatory response syndrome

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Authors: Marco Khalaf Ayad Milhaail

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In thinking about the role of legal rules and their impact on social ethics and social structures, scholars have explored many issues related to gender, power, and ideology. First, it provides a framework for defining feminist legal studies through an overview of the field's evolution in terms of equality, rights, and justice. Secondly, it encourages those interested in equality, rights, and justice regarding women's issues to participate in international comparative law research. Third, we must emphasize that those seeking solutions to disability and discrimination must be aware of the need to confront the so-called undermining of culture. Therefore, an effective way for women to solve this problem is to rely heavily on international law, which establishes basic legal principles such as gender equality, rights, and justice and can help create a domestic environment. Woman has gained many advantages by adopting the law of Divorce in the Islamic Sharea. Any Egyptian woman can get divorce by letting her rightful rights and wealth to her husband in return for her freedom.

Keywords: stability, harsh environments, techniques, thermal, properties, materials, applications, brittleness, fragility, disadvantages, bank, branches, profitability, setting prediction, effective target, measurement, evaluation, performance, commercial, business, profitability, sustainability, financial, system, banks

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Authors: Ayyoub Jamali, Jennie Edlund, Alena Kozlová

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This paper evaluates the monitoring, prevention, and enforcing mechanisms of the core values of international organisations (IOs) in a comparative human rights perspective. The IOs in focus are the European Union, the Council of Europe, the African Union, and the Organization of American States. The paper will take the founding treaties of these IOs and their relevant protocols as a starting point to identify the values and the mechanisms used for their implementation. It will explore the scope of violations, the procedures in place and evaluate what type of response to those breaches seems to work best in terms of achieving its declared objectives. The study will identify and compare the weaknesses and strengths of each mechanism used by the IOs and recognize common challenges and means, thereby drawing inter-organizational comparisons. Consequently, the findings of this paper can be used among the IOs to improve their system and thus enhance their effectiveness.

Keywords: international organizations, core values, human rights, enforcement mechanism, compliance

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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Authors: Maide Yesilyurt, Saide Faydalı

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Patients experience pain at different intensities in postoperative. The diagnosis of the pain, the assessment and the success of the treatment and care make the measurement of this finding compulsory. The aim of the study is to determine the evaluation differences numeric pain scales. The descriptive study was conducted with 360 patients with in postoperative. The data were obtained from questionnaires related to six numeric pain scales most preferred in clinical use, and a face-to-face interview technique was used by the researcher. Regarding to numeric pain scale, questions include forth positive and one negative statement. In evaluating the data; chi-square and Pearson correlation tests were used. For the study, the patients’ informed consents, the institution and the ethics committee received permission. In this study, patients' ages are between 18-80, 95.8% of the patients were not informed about pain assessment. Patients evaluated the 5-item numeric scale as the easy, can be answered quickly, accurate, and appropriate for clinical use and the 101 items numeric scale as complex than other scales. Regarding to numeric pain scales with positive statements between age, marital status, educational status, previous surgery, having chronic disease and getting information about pain assessment significant difference has been detected. All numeric pain scales are correlated to each other. As a result, it was determined that as the items in the numerical scales decreased, the patients were able to perceive the scales better, and the items in the scales increased, the patients were in trouble to understand.

Keywords: numeric pain scales, nurse, pain assessment, patient

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Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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Authors: F. Ece Cetin, H. Nezih Ozdemir, Emre Kumral

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Ischemic stroke of the precuneal cortex (PC) alone is extremely rare. This study aims to evaluate the clinical, neurocognitive, and behavioural characteristics of isolated PC infarcts. We assessed neuropsychological and behavioral findings in 12 patients with isolated PC infarct among 3800 patients with ischemic stroke. To determine the most frequently affected brain locus in patients, we first overlapped the ischemic area of patients with specific cognitive disorders and patients without specific cognitive disorders. Secondly, we compared both overlap maps using the 'subtraction plot' function of MRIcroGL. Patients showed various types of cognitive disorders. All patients experienced more than one category of cognitive disorder, except for two patients with only one cognitive disorder. Lesion topographical analysis showed that damage within the anterior precuneal region might lead to consciousness disorders (25%), self-processing impairment (42%), visuospatial disorders (58%), and lesions in the posterior precuneal region caused episodic and semantic memory impairment (33%). The whole precuneus is involved in at least one body awareness disorder. The cause of the stroke was cardioembolism in 5 patients (42%), large artery disease in 3 (25%), and unknown in 4 (33%). This study showed a wide variety of neuropsychological and behavioural disorders in patients with precuneal infarct. Future studies are needed to achieve a proper definition of the function of the precuneus in relation to the extended cortical areas. Precuneal cortex region infarcts have been found to predict a source of embolism from the large arteries or heart.

Keywords: cognition, pericallosal artery, precuneal cortex, ischemic stroke

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Authors: Junhong Li, Danni Cheng, Yaxin Luo, Xiaowei Yi, Ke Qiu, Wendu Pang, Minzi Mao, Yufang Rao, Yao Song, Jianjun Ren, Yu Zhao

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Background: The number of multiple cancer patients was increasing, and the impact of prior cancer history on salivary gland cancer patients remains unclear. Methods: Clinical, demographic and pathological information on salivary gland cancer patients were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2017, and the characteristics and prognosis between patients with a prior cancer and those without prior caner were compared. Univariate and multivariate cox proportional regression models were used for the analysis of prognosis. A risk score model was established to exam the impact of treatment on patients with a prior cancer in different risk groups. Results: A total of 9098 salivary gland cancer patients were identified, and 1635 of them had a prior cancer history. Salivary gland cancer patients with prior cancer had worse survival compared with those without a prior cancer (p<0.001). Patients with a different type of first cancer had a distinct prognosis (p<0.001), and longer latent time was associated with better survival (p=0.006) in the univariate model, although both became nonsignificant in the multivariate model. Salivary gland cancer patients with a prior cancer were divided into low-risk (n= 321), intermediate-risk (n=223), and high-risk (n=62) groups and the results showed that patients at high risk could benefit from surgery, radiation therapy, and chemotherapy, and those at intermediate risk could benefit from surgery. Conclusion: Prior cancer history had an adverse impact on the survival of salivary gland cancer patients, and individualized treatment should be seriously considered for them.

Keywords: prior cancer history, prognosis, salivary gland cancer, SEER

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Authors: Benghezel Hichem

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Thyroid dysfunction in hemodialysis subjects is represented mainly by hypothyroidism. The objective of our work is to determine the thyroid profile of our hemodialysis patients and to highlight the prevalence of different thyroid disorders. Methods: This is a retrospective study performed on a mono centric 2 months (February and March 2013) on 42 hemodialysis patients (11 male and 31 female). We made the dosage of thyroid hormones Thyrotropin (TSH) ((free thyroxin ) FT4 and free Triodothyronin ) FT3) by chemiluminescence immunoassay method on cobas 6000 Roche Diagnostics. The results: The prevalence of biological hypothyroidism was 18% (7% with a high TSH isolated and a mean +/- SD 9.44 +/- 6.29, 5% with high TSH, and with low FT4 a mean +/- SD is 8.18 +/- 0.53 for TSH and 9.69 +/- 0.22 for FT4, One patient with a high TSH, and low FT4, FT3. 4% of patients with a low T3 syndrome with a mean +/- SD of 3.93 +/- 0,3 for FT3), we notice that 5% of patients with hyperthyroidism TSH collapsed and mean +/- SD of TSH is 0.017 +/- 0,001. Conclusion: The biological Hypothyroidism is a common endocrine disorder in chronic hemodialysis.

Keywords: hypothyroidism, hemodialysis, thyréostimulin, free thyroxin, triodothyronin

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: To analyze hematological changes in patients of oral cancer with history of smokable and chewable tobacco use, and to compare them with healthy controls. Study Design: Descriptive type of study survey. Setting: This study was conducted at the Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro. Study Period: One year July, 2013 to July, 2014. Subject and Methods: Histopathologically confirmed hundred cases of oral cancer with the history of smokable and non-smokable tobacco were selected to analyze the hematological variation. Inclusion Criteria: Histopathologically diagnosed patients of oral squamous cell carcinoma, with history of smokable and non-smokable tobacco. Exclusion Criteria: Patient with any systemic medically compromising problem, terminally ill patients, radio or chemotherapeutically treated patients, patients with metastasis to lungs or any distant metastasis, patients with the history of more than one well-defined etiological factor involved. Results: There were 73% patients of oral cancer reported with anemic. Significantly lower values of Hb, platelet, and higher mean values of ESR, TLC, and were observed in both groups of oral cancer patients; tobacco smokers and tobacco chewers as compared to non-smokers healthy controls. There was more decline in the level of haemoglobin and incline in the level of ESR observed in tobacco chewer oral cancer patients as compared to tobacco smokers patients, while TLC was more observed in smokers. Conclusion: Oral cancer patients with a history of chewable/smokable tobacco have likely worse hematological profile, which increases the anesthetic and surgical challenges for maxillofacial surgeons, which have a significant impact on treatment planning as well.

Keywords: oral cancer, hematological variations, tobacco, smokers

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Authors: A. Kamel Abd Elaziz Mohamed, B. Sameh Kamal el Maraghi

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Introduction: Adaptive support ventilation (ASV) is an improved closed-loop ventilation mode that provides both pressure-controlled ventilation and PSV according to the patient’s needs. Aim of the work: To compare the short-term effects of Adaptive support ventilation (ASV), with conventional Pressure support ventilation (PSV) in weaning of intubated COPD patients. Patients and methods: Fifty patients admitted in the intensive care with acute exacerbation of COPD and needing intubation were included in the study. All patients were initially ventilated with control/assist control mode, in a stepwise manner and were receiving standard medical therapy. Patients were randomized into two groups to receive either ASV or PSV. Results: Out of fifty patients included in the study forty one patients in both studied groups were weaned successfully according to their ABG data and weaning indices. APACHE II score showed no significant difference in both groups. There were statistically significant differences between the groups in term of, duration of mechanical ventilation, weaning hours and length of ICU stay being shorter in (group 1) weaned by ASV. Re-intubation and mortality rate were higher in (group 11) weaned by conventional PSV, however the differences were not significant. Conclusion: ASV can provide automated weaning and achieve shorter weaning time for COPD patients hence leading to reduction in the total duration of MV, length of stay, and hospital costs.

Keywords: COPD patients, ASV, PSV, mechanical ventilation (MV)

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Authors: Ramona Georgeta Biholar

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Gender-based violence against women plagues societies around the world. The work to eliminate it is an ongoing battle. At the international level, Article 5 (a) CEDAW establishes an agenda for social and cultural transformation: it imposes on States parties to CEDAW an obligation to modify sex roles and stereotypical social and cultural patterns of conduct. Also, it provides for the protection of women from violence stemming from such gender norms. Yet, the lived realities of women are frequently disconnected from this agenda. Nonetheless, it is the reality of the local that is crucial for the articulation, implementation and realization of women’s rights in general, and for the elimination of gender-based violence against women in particular. In this paper we discuss the transformation of sex roles and gender stereotyping with a view to realize women’s right to be free from gender-based violence. This paper is anchored in qualitative data collection undertaken in Jamaica and socio-legal research. Based on this research, 1) We explain the process of vernacularisation as a strategy that enables women’s human rights to hit the ground and benefit rights holders, and 2) We present a synergistic model for the implementation of Article 5 (a) CEDAW so that women’s right to be free from gender-based violence can be realized in a concrete national jurisdiction. This model is grounded in context-based demands and recommendations for social and cultural transformation as a remedy for the incidence of gender-based violence against women. Moreover, the synergistic model offers directions that have a general application for the implementation of CEDAW and Article 5 (a) CEDAW in particular, with a view to realize women’s right to be free from gender-based violence. The model is thus not only a conceptual tool of analysis, but also a prescriptive tool for action. It contributes to the work of both academics and practitioners, such as Governmental officials, and national and local civil society representatives. Overall, this paper contributes to understanding the process necessary to bridge that gap between women’s human rights norms and women’s life realities of discrimination and violence.

Keywords: CEDAW, gender-based violence against women, international human rights law, women’s rights implementation, the Caribbean

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Authors: Michael Augustus Akagbor

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Same-sex relationships have always existed in Ghana. In coastal towns such as James Town in the heart of the country’s capital, persons who were sexually different and attracted to members of their own sex were able to live their lives openly as queer persons without any fear for their lives. Since 2006, this idyllic existence has been under attack, with LGBTQ+ communities suffering violence and discrimination. This paper highlights the lived experiences of the LGBTIQ+ community in Ghana against the backdrop of the anti-gay bill - The Promotion of Proper Human Sexual Rights and Ghanaian Family Values Bill, 2021 (now renamed the Human Sexual Rights and Family Values Bill, 2021), currently before Parliament, introduced by eight members of Parliament as a Private Members’ Bill, and its implications for the LGBTQ+ community. The paper makes recommendations to key stakeholders on strategies to counter the cultural and religious arguments/strategies and activism of the anti-LGBTQ+ movement in Ghana. It relied on secondary data from a variety of sources, including the Bill before Parliament, media reports, and baseline surveys and studies conducted by LGBTQ organizations and other Civil Society Organizations (CSOs) in Ghana and elsewhere.

Keywords: sexual rights, promotion, family values, lgbtq+, ghana, discrimination

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Authors: Kim Rod

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People whose chronic pain limits their independence are especially likely to become anxious and depressed. Mindfulness training has shown promise for stress-related disorders. Methods: Chronic pain patients who complained of anxiety and depression and who scored higher than moderate in Hamilton Depression Rating Scale (HDRS) and Hospital Anxiety and Depression Scale (HADS) as well as moderate in Quality of Life Scale (QOLS) were observed for eight weeks, three days a week for an hour of Mindfulness Meditation training with an hour daily home Mindfulness Meditation practice. Pain was evaluated on study entry and completion, and patients were given the Patients’ Global Impression of Change (PGIC) to score at the end of the training program. Results: Forty-seven patients (47) completed the Mindfulness Meditation Training program. Over the year-long observation, patients demonstrated noticeable improvement in depression, anxiety, pain, and global impression of change. Conclusion: Chronic pain patients who suffer with anxiety and depression may benefit from incorporating Mindfulness Meditation into their treatment plans.

Keywords: mindfulness, meditation, depression, anxiety, chronic pain

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Authors: Rahul Magazine, Shobitha Rao

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The aim of this study was to study the prescribing pattern of drugs in patients with ARDS (Acute Respiratory Distress Syndrome) managed at a tertiary care hospital. This observational study was conducted at Kasturba Hospital, Karnataka, India. Data of patients admitted from January 2010 to December 2012 was collected. A total of 150 patients of ARDS were included. Data included patients’ age, gender, clinical disorders precipitating ARDS, and prescribing pattern of drugs. The mean age of the study population was 42.92±13.91 years. 48% of patients were less than 40 years of age. Infection was the cause of ARDS in 81.3% of subjects. Antibiotics were prescribed in all the subjects and beta-lactams were prescribed in 97.3%. 41.3% were prescribed corticosteroids, 39.3% diuretics and 89.3% intravenous fluids. Infection was the commonest etiology for ARDS, and beta-lactams were the commonest antibiotics prescribed. Corticosteroids and diuretics were prescribed in a significant number of patients. Most of the patients received intravenous fluids.

Keywords: acute respiratory syndrome, beta lactams, corticosteroids, Acute Respiratory Distress Syndrome (ARDS)

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.

Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease

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Authors: Shagufta Jahangir, Raisa Jahangir, Nadeemullah

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In many societies sports is considered inappropriate for women. It traditionally associated with mascunity. The proposed study aims at undertaking a critical situation analysis of sports women in Pakistan from a gender perspective by examining various aspects of sports women by gender including wrong social values, unstable economical position, wrong religious perspective and the role of media towards women in sports, while sports can provide a channel for informing women about their social and legal rights as well as their health issues, productive health and others. A major concern of the study is to identify the basic causes which depriving Pakistani women from sports. The Human Rights Commission of Pakistan and the Joint Action Committee for People’s Rights organized a symbolic mini marathon on 21 May 2005 in Pakistan to challenge arbitrary curbs on women’s public participation in sport and to highlight rising violence against women. Historically, sport has engaged the perception of gender-hierarchy in order to reproduce the ideology of male superiority, a notion which is often translated into ‘usual superiority’ within the superior communal order. However, it is argued here that we are presently in a state of communal instability with esteem to women's participation in sport.

Keywords: mascunity, gender, productive health, inappropriate, rights

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Authors: Zeynep Üskül Engin

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Looking upon the world’s history, one can easily understand that the most drastic and evil comes to the human from his own kind. Human, proving that Hobbs was actually right, finally have agreed on taking some necessary measures after the destructive effects of the great World Wars. Surely after this, human rights have been more commonly mentioned in written form and now the priority of the values and goals of a democratic society is to protect its individuals. Due to this fact, the right of living is found to be valuable and all the existing forms of torture, anti-human and humiliating activities have been banned. Turkey, having signed the international papers of human rights, has aimed for eliminating torture through changing its laws and regulations to a certain extent. Monitoring Turkey’s experience, it is likely to say that during certain periods of time systematic torture has been applied. The urge to enter the European Union and verdicts against Turkey, have led to considerable progress in human rights. Besides, changes in law and the comprehensive training for the police, judges, medical and prison staff have resulted in positive improvement related to this issue. Certainly, this current legal update does not completely mean the total elimination of the practice of torture; however, in the commitment of this crime, the ones who have committed are standing a trial and facing severe punishments. In this article, Turkey, with a notorious reputation in international arena is going to be examined through its policy towards torture and defects in practice.

Keywords: torture, human rights, impunity of torture, sociology

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Authors: Farnaz Dehkhoda

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This study was conducted to compare the effectiveness of active and receptive music-therapy on anxiety in cancer patients undergoing chemotherapy or radiotherapy. 184 young adult patients, who were diagnosed with early stage cancer and were undergoing treatment, were divided into three groups. Two groups received music therapy as a parallel treatment and the third group was control group. In active music-therapy, a music specialist helped the patients to play guitar and sing. In the receptive music-therapy, patients preferred pre-recorded music played by MP3 player. The level of anxiety was measured by the Beck Anxiety Inventory as pre-test and post-test. ANCOVA revealed that both types of music-therapy reduced anxiety level of patients and the active music-therapy intervention found to be more effective. The results suggest that music-therapy can be applied as an intervention method contemporary with cancer medical treatment, for improving quality of life in cancer patients by reducing their anxiety.

Keywords: Anxiety, Cancer, Chemotherapy, Music-therapy

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Authors: Lauren Dixon, David Galvani

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Objective: Sharing devastating news with patients is often considered the most difficult task of doctors. This study aimed to explore patients’ perceptions of receiving bad news including which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the SPIKES model for breaking bad news. 20 patients receiving treatment for a haematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised their consultation. ‘Poor’ was more commonly rated by women and participants aged 45-64. The main differences between the ‘excellent’ and ‘poor’ consultations include the doctor’s sensitivity and checking the patients’ understanding. Only 35% of patients were asked their existing knowledge and 85% of consultations failed to discuss the impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing literature. The commended aspects include consultation set-up and information given. Areas patients felt needed improvement include doctors determining the patient’s existing knowledge and exploring how the diagnosis will affect the patient’s life. With a poorer prognosis, doctors should work on conveying appropriate hope. The study was limited by a small sample size and potential recall bias.

Keywords: cancer, diagnosis, haematology, patients

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Authors: Chaliya Wamaloon, Malee Chaisaena, Nusara Prasertsri

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Informal caregivers providing home-based palliative and end-of-life (EOL) care to people with advanced cancer is needed, however, there has not been develop caregiver skills for the EOL in cancer patients. The aim of this research was to study the model development of caregiver skills for the EOL in cancer patients. Mixed methods research was conducted in 3 phases. All subjects were in Ubon Rathchathani Cancer Hospital including 30 EOL cancer patient caregivers, 30 EOL cancer patients, and 111 health care professionals who provided care for the EOL cancer patients and 30 EOL target participants who had been trained to be cancer patient caregivers. The research tools were questionnaires, semi structured interviews, and caregiver skills questionnaires. Data were analyzed by using percentage, mean, standard deviation, pair t-test, and content analysis. The result from this study showed the model development of caregiver skills for cancer patients consisted of 9 domains skills: 1. monitoring, 2. interpreting, 3. making decisions, 4. taking action, 5. making adjustments, 6. providing hands-on care, 7. accessing resources, 8. working together with the ill patients, and 9. navigating the healthcare system. The model composed of skills development curriculum for cancer patient caregivers, Manual of palliative care for caregivers, diary of health care records for cancer patients, and the evaluation model of development of caregiver skills for EOL cancer patients. The results of the evaluation in the development model of caregiver skills for EOL cancer patients showed that the caregivers were satisfied with the model of development for caregiver skills at a high level. The comparison of the caregiver skills before and after obtaining the development of caregivers skills revealed that it improved at a statistically significant level (p < 0.05).

Keywords: caregiver, caregiver skills, cancer patients, end of life

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Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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Authors: Dara Kutsyk, Olga Bondarenko, Mariya Sorochka

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In 21-century type 2 diabetes (T2D) has become a global health and social problem in the whole world. The goal of treatment for patients with T2D is to prevent complications of diabetes - macrovascular diseases (heart disease, stroke, and peripheral vascular disease) and microvascular diseases (retinopathy, neuropathy and nephropathy). Nitric oxide (NO) plays an important role in maintaining vascular homeostasis. Loss of NO function is one of the earliest indicators of disease and its progression especially in patients with T2D. Aim: To compare NO level between patients with well and bad controlled glycemia in T2D. Methods: The study included 32 patients with T2D. The diagnosis of T2D was confirmed due to International Diabetes Federation (IDF) criteria 2015. Patients were divided into two groups: with well controlled glycaemia (HbA1c < 7%) and bad controlled glycaemia (HbA1c > 7%). The control group consists of 15 healthy subjects. Results: NO level in patients with T2D is significantly higher (27,2 ±3,1 µmol), compared to controls (18,86±0,9 µmol; p < 0,001). A significant difference in NO level was found between patients with bad controlled glycaemia (25,9±2,2 µmol) and well controlled glycaemia (28,7 ± 3,0 µmol; p<0,01). The study showed a moderate negative correlation between NO level and HbA1c (-0,399; р< 0,05). Conclusions: Production of NO is impaired in patients with T2D, especially with badly controlled glycaemia. With the increase in HbAc serum NO decreases. This can be the main target for prevention vascular complication in T2D.

Keywords: type 2 diabetes, glycated hemoglobin, nitric oxide, Diabetes mellitus

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Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

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This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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Authors: Priyanka Joshi

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The paper traces the evolving relationship between women, public spaces, and citizenship and dissent by analyzing acts of dissent led by women. The paper outlines this relationship in the context of the protests held in Shaheen Bagh, Delhi against the Citizenship Amendment Act (CAA), National Registry of Citizens (NRC), and National Population Register (NPR) in 2019. Additionally, the paper aims to explore how the multiple identities of the protestors in Shaheen Bagh affected the nature, implications, and responses to the protests. To do so, the paper will analyze three key areas in relationship with women, namely, public spaces, citizenship, and dissent. In doing so, it will examine the gendered access to public spaces and its implications on the realization of one’s citizenship rights. Moreover, it will explore the historical notions of citizenship, its contemporary understanding, the exclusionary nature of citizenship, and the conflict between community rights and individual rights with respect to women’s rights. In context of dissent, it will evaluate the understanding of dissent and trace the difference in the experience of dissent based on gender by reviewing social movements led and maintained by women. This paper will utilize secondary data to explore the questions it poses. This includes a study of books and journal articles in conjunction with media reports concerning gender, public spaces, citizenship, and dissent. It will apply an intersectional lens in its analysis.

Keywords: citizenship, dissent, public spaces, Shaheen Bagh, women

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Authors: George Hikah Benson

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The promotion of lesbian, gay, bisexual, transgender, queer and Intersex (LGBTQIs) rights within the continent of Africa in general and Ghana, in particular, has for some time now, met the fiercest of resistance; premised mainly on socio-cultural-religious factors. This phenomenon contrasts with notions of countries of the Global North where persons within the context of their fundamental freedoms and rights have the right to sexual choices and preferences. A Private Member’s Bill was introduced to the Ghanaian Parliament in 2021, seeking to criminalize the promotion and advocacy of LGBTQIs related activities. This paper in assessing public views on the matter also seeks to ascertain the security implications regarding the passage of the law at the community level. The study also evaluates LGBTQIs rights vis-a-vis the provisions of Chapter 5 of the 1992 Ghana Constitution and global legal jurisprudence on fundamental human rights. To that end, the study adopted a mixed design approach (quantitative and qualitative) to gather data from 1,550 respondents from all ‘walks of life, across all sixteen regions of Ghana. The main findings are that first, over 85% of Ghanaians abhor the practices of LGBTQIs in keeping with the societal, cultural and religious beliefs of Ghanaians, and will go any length to prevent its survival in the country. Further, the time is not ripe for the acceptance of LGBTQ rights in Ghana as the activities will disrupt family values and poison the existing peace that Ghanaians are currently enjoying. However, it is generally believed that when the bill is passed into law, Ghana’s international image will be dented, and 60% of participants and respondents will be unmoved. Against this hostile, intolerant backdrop regarding LGBTQIs rights in the country and in many other African countries, the study foremost recommends that such a law, when passed, should come with a ‘human face’ that will not just seek to be punitive of LGBTQIs persons but corrective. Additionally, the law should be one that offers them support in line with their rights as Ghanaian and African citizens. Moreover, religious and traditional bodies should endeavor to engage LGBTQIs persons in a friendlier, corrective and loving manner rather than in the current hostile environment that society exposes them to.

Keywords: Ghanaian parliament, LGBTQIs rights, perceptions, socio-culture-religious

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Authors: Gassem Alfaleh

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In Strict liability, a person can be held liable for any harm resulting from certain actions or activities without any mistake. The liability is strict because a person can be liable when he or she commits any harm with or without his intention. The duty owed is the duty to avoid causing the plaintiff any harm. However, “strict liability is imposed at the International level by two types of treaties, namely those limited to giving internal effect to treaty provisions and those that impose responsibilities on states. The basic principle of strict liability is that there is a liability on the operator or the state (when the act concerned is attributable to the state) for damage inflicted without there being a need to prove unlawful behavior”. In international human rights law, strict liability can exist when a defendant is in legal jeopardy by virtue of an internationally wrongful act, without any accompanying intent or mental state. When the defendant engages in an abnormally dangerous activity against the environment, he will be held liable for any harm it causes, even if he was not at fault. The paper will focus on these activities under international human rights law. First, the paper will define important terms in the first section of the paper. Second, it will focus on state and non-state actors in terms of strict liability. Then, the paper will cover three major areas in which states should be liable for hazardous activities: (1) nuclear energy, (2) maritime pollution, (3) Space Law, and (4) other hazardous activities which damage the environment.

Keywords: human rights, law, legal, absolute

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Authors: Ibtisam Al-Zaru

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Background: Worldwide, depression among coronary artery disease (CAD) patients is considered a serious problem that may cause many complications and negative consequences; particularly serious being increased mortality and morbidity rate. Studying depression among CAD patients in Jordan has not been investigated thoroughly and thus a need for further studies has been a priority. Aims: To assess depression in non-hospitalized Jordanian patients with CAD; to describe the relationship between socio-demographic data, health related factors, and depression; and to examine the best predictors of depression in non-hospitalized Jordanian patients with CAD. Method: A cross-sectional-descriptive design was used to collect data from 174 non-hospitalized Jordanian patients diagnosed with CAD in outpatients’ cardiac clinics, using a self- administered questionnaires and Cardiac Depression Scale. Results: 53.4% of CAD patients reported mild/moderate, and severe depressive symptoms. Significant relationships between depressive symptoms and some demo-clinical characteristics (i.e. being female gender; having of chronic disease and surgical history; being physically inactive, and perceived their sexual activity, physical and psychological as poor). The preceding factors are also found to be statistically significant predictors for depression among this patients’ group. Conclusion: Jordanian patients with CAD had various levels of severity regarding their depressive symptoms. Therefore, health care providers need to introduce depression assessment and treatment in cardiac rehabilitation to control depression and its impact on the patient. Consequently, such control will reduce co-morbidity, mortality, complications and health costs among CAD patients and enhance the quality of their lives.

Keywords: coronary artery disease, predictors, depression, prevalence

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Authors: Hateem Zafar Kayani, Nageen Hussain

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The main aim is to analyze the mutations of DNASE I gene in diabetic patients. A total of 120 diabetes patients and 120 controls were sampled. The total number of male diabetic patients included in the study was 79 (66%) while female patients were 41 (34%) in number. Exon 8 of the DNASE I gene was amplified by using thermo cycler. The possible band of interest was located at 165 base pairs. Two samples showed similar missense mutations at 127th position of exon 8 which replaced amino acid Arginine (Arg) to Glutamine (Gln). All controls showed no mutations. The association of diabetes with different levels of blood pressure and body mass index (BMI) were found to be significant.

Keywords: deoxyribonuclease I, polymerase chain reaction, insulin-dependent diabetes mellitus, non-insulin dependent diabetes mellitus

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Authors: Nan Wu, Peng Liu

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As a morphological element reflecting the land property rights structure, the plot pattern plays a crucial role in shaping the form and quality of the built environment. Therefore, it is one of the core control elements of urban regeneration. As China's urban development mode is shifting from growth-based development to urban regeneration, it is urgent to explore a more refined way for the planning control of the plot pattern, which further promotes the optimization of urban form and land property structure. European and American countries such as Germany and the United States began to deal with the planning control of plot patterns in urban regeneration earlier and established relatively mature methods and mechanisms. Therefore, this paper summarizes two typical scenarios of plot pattern regeneration in old cities in China: the first one is "limited scale plot pattern rezoning", which mainly deals with the regeneration scenario of tearing down the old and building the new, and the focus of its control is to establish an adaptive plot pattern rezoning methodology and mechanism; The second is "localized parcel regeneration under the existing property rights," which mainly deals with the renewal scenario of alteration and addition, and its control focuses on the establishment of control rules for individual plot regeneration. For the two typical plot pattern regeneration scenarios, Germany (Berlin) and the United States (New York) are selected as two international cases with reference significance, and the framework of plot pattern form and property rights control elements of urban regeneration is established from four latitudes, namely, the overall operation mode, form control methods, property rights control methods, and effective implementation prerequisites, so as to compare and analyze the plot pattern control methods of the two countries under different land systems and regeneration backgrounds. Among them, the German construction planning system has formed a more complete technical methodology for block-scale rezoning, and together with the overall urban design, it has created a practical example in the critical redevelopment of the inner city of Berlin. In the United States (New York), the zoning method establishes fine zoning regulations and rules for adjusting development rights based on the morphological indicators plots so as to realize effective control over the regeneration of local plots under the existing property rights pattern. On the basis of summarizing the international experience, we put forward the proposal of plot pattern and property rights control for the organic regeneration of old cities in China.

Keywords: plot pattern, urban regeneration, urban morphology, property rights, regulatory planning

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