Search results for: skin and soft tissue infection

Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Roshan Kamal Topno, Maneesh Kumar, Manas Ranjan Dikhit, Krishna Pandey, Major Madhukar, Vidhya Nand Rabidas, Vahab Ali, Ganesh Chandra Sahoo, Bhawana, Devendra Prasad Yadav, Rishikesh Kumar, Pradeep Das

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A diagnostic marker for asymptomatic subject becomes a crucial need for advocating early prophylactic majors to control protozoal infection. The main issue in epidemiological affected regions is the presence of an asymptomatic individual that might potentially convert to a symptomatic visceral leishmaniasis (VL). The epidemiological study has been conducted at highly VL endemic Moriyama village in Patna district, Bihar, India that covers total population of 1540 individuals. Here, 1104(74.02%) people had been randomly screened and only 46 (4.17%) asymptomatic individuals were found sero-positive by the rK39 test. After taking signed informed consent form, blood samples were collected from 46 asymptomatic subjects for further hematological and immunological tests. Total leukocyte count, hemoglobin (gm%), neutrophil, lymphocyte, platelet count and interleukin-10 (IL-10) had been included as diagnostic markers. Interestingly only 5 (10.86%) individuals showed their asymptomatic conversion into symptomatic VL patients during quarterly surveillance. In overall analysis only two markers are suggestive for disease conversion that is hemoglobin (gm%) and IL-10. In all the infected patients, both the mean decrease in hemoglobin and mean increase of IL-10 was 19.23% from its normal value. The results might suggest that hematological and immunological changes would become helpful for early diagnosis of asymptomatic to symptomatic VL conversion.

Keywords: asymptomatic, epidemiological, symptomatic visceral leishmaniasis, hemoglobin (gm%), interleukin-10, diagnosis

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Authors: Monthon Tangjitmungman

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Numerous diseases have been linked to oxidative stress, in which a disproportion of free radicals in the body leads to tissue or cell damage. Polyphenols are the most abundant antioxidants found in plants, and they are highly effective at scavenging oxidative free radicals. Due to the presence of phenolic compounds in Caesalpinia sappan has been discovered to have antioxidant activity. It has several health benefits, the most important of which is preventing cardiovascular and cancer diseases. This study aimed to determine the phenolic content and antioxidant activity of C. sappan extract using a variety of antioxidant assays. The extract of C. sappan was made using a mixture of solvents (ethyl alcohol: water in ratio 8:2). The total phenolic content of C. sappan extract was determined and expressed as gallic acid equivalents using the Folin-Cioucalteu method (GAE). The antioxidant activity of C. sappan extract was assessed using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay and the ABTS radical scavenging capacity assay. An association was found between antioxidant activity and total phenol content. The antioxidant activity of C. sappan extract was also determined by DPPH and ABTS assays. The IC50 values for C. sappan extract from DPPH and ABTS assays were 54.48 μg/mL ± 0.545 and 25.46 μg/mL ± 0.790, respectively, in the DPPH assay. In the DPPH assay, vitamin C was used as a positive control, whereas Trolox was used as a positive control in the ABTS assay. In conclusion, C. sappan extract contains a high level of total phenolics and exhibits significant antioxidant activity. Nevertheless, more research should be done on the antioxidant activity, such as SOD and ROS scavenging assays and in vivo experiments, to determine whether the compound has antioxidant activity.

Keywords: ABTS assay, antioxidant activity, Caesalpinia sappan, DPPH assays, total phenolic content

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Authors: S. Amirhossein Tabatabaei, Abdulghader A. Aldaeef, Mohammad T. Rayhani

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As the permafrost continues to melt in the northern regions due to global warming, a soil-water mixture is left behind with drastically lower strength; a phenomenon that directly impacts the resilience of existing structures and infrastructure systems. The frozen soil-structure interaction, which in ice-poor soils is controlled by both interface shear and ice-bonding, changes its nature into a sole frictional state. Adfreeze, the controlling mechanism in frozen soil-structure interaction, diminishes as the ground temperature approaches zero. The main purpose of this paper is to capture the altered behaviour of frozen interface with respect to rising temperature, especially near melting states. A series of pull-out tests are conducted on model piles inside a cold room to study how the strength parameters are influenced by the phase change in ice-poor soils. Steel model piles, embedded in artificially frozen cohesionless soil, are subjected to both sustained pull-out forces and constant rates of displacement to observe the creep behaviour and acquire load-deformation curves, respectively. Temperature, as the main variable of interest, is increased from a lower limit of -10°C up to the point of melting. During different stages of the temperature rise, both skin deformations and temperatures are recorded at various depths along the pile shaft. Significant reduction of pullout capacity and accelerated creep behaviour is found to be the primary consequences of rising temperature. By investigating the different pull-out capacities and deformations measured during step-wise temperature change, characteristics of the transition from frozen to unfrozen soil-structure interaction are studied.

Keywords: Adfreeze, frozen soil-structure interface, ice-poor soils, pull-out capacity, warming permafrost

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Authors: Abdullah Abdu Qaseem Shamsan

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Background: Gliomas represent the most frequent, heterogeneous group of tumors arising from glial cells, characterized by difficult monitoring, poor prognosis, and fatality. Tissue biopsy is an established procedure for tumor cell sampling that aids diagnosis, tumor grading, and prediction of prognosis. We studied and compared the levels of liquid biopsy markers in patients with different grades of glioma. Also, it tried to establish the potential association between glioma and specific blood groups antigen. Result: 78 patients were identified, among whom maximum percentage with glioblastoma possessed blood group O+ (53.8%). The second highest frequency had blood group A+ (20.4%), followed by B+ (9.0%) and A- (5.1%), and least with O-. Liquid biopsy biomarkers comprised of ALT, LDH, lymphocytes, Urea, Alkaline phosphatase, AST Neutrophils, and CRP. The levels of all the components increased significantly with the severity of glioma, with maximum levels seen in glioblastoma (grade IV), followed by grade III and grade II respectively. Conclusion: Gliomas possess significant clinical challenges due to their progression with heterogeneous nature and aggressive behavior. Liquid biopsy is a non-invasive approach which aids to establish the status of the patient and determine the tumor grade, therefore may show diagnostic and prognostic utility. Additionally, our study provides evidence to demonstrate the role of ABO blood group antigens in the development of glioma. However, future clinical research on liquid biopsy will improve the sensitivity and specificity of these tests and validate their clinical usefulness to guide treatment approaches.

Keywords: GBM: glioblastoma multiforme, CT: computed tomography, MRI: magnetic resonance imaging, ctRNA: circulating tumor RNA

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Authors: K. B. M. Islam, Syeeda Shiraj-Um-Mahmuda, Afroj Jahan, A. A. Bhuiyan

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In Bangladesh, the use of imported probiotics in poultry is gradually being increased. But surprisingly, no probiotic bacteria have been isolated yet in Bangladesh despite the existence of scavenging native poultry as potential source that is seemingly more resistant to GIT infection as well as other diseases. Therefore, the study was undertaken to isolate, identify and characterize the potential probiotic Lactobacillus and Bifidobacteria strains from Bangladeshi indigenous poultry, and to evaluate their suitability to use in poultry industry. Crop and cecal samples from 61 healthy indigenous birds were used to isolate potential probiotics strains following conventional cultural methods. A total of 216 isolates were identified following physical, biochemical and molecular methods that belonged to the genus Lactobacillus and Bifidobacteria. An auto-aggregation test was performed for 180 and 136 isolated lactobacilli and bifidobacteria strains, respectively. Twelve lactobacilli isolates and 7 bifidobacteria isolates were selected because of their convenient aggregation. In vitro tests including antibacterial activity, resistance to low pH, hemolytic activities etc. were performed for evaluation of probiotic potential of each strain. Under the in vitro conditions and with respects to the probiotic traits, three lactobacilli; LS16, LS45, LS133 and two bifidobacteria, BS21 and BS90 were found to be potential probiotic strains. Thus, they are proposed to be evaluated for their in vivo probiotic properties. If the proposed strains are found suitable as the probiotics to be used in commercial poultry industry, it is expected that the local probiotics would be more beneficial and would save the huge amount of money that Bangladesh spends every year for the importation of such materials from abroad.

Keywords: Bangladeshi poultry, gut microbiota, lactic acid bacteria, scavenging chicken, GIT health

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Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

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The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

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Authors: Jung Park, Anca Mazare, Klaus Von Der Mark, Patrik Schmuki

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In clinical application of TiO2 implants on tooth and hip replacement, migration, adhesion and differentiation of neighboring mesenchymal stem cells onto implant surfaces are critical steps for successful bone regeneration. In a recent decade, accumulated attention has been paid on nanoscale electrochemical surface modifications on TiO2 layer for improving bone-TiO2 surface integration. We generated, on titanium surfaces, self-assembled layers of vertically oriented TiO2 nanotubes with defined diameters between 15 and 100 nm and here we show that mesenchymal stem cells finely sense TiO2 nanotubular geometry and quickly decide their cell fate either to differentiation into osteoblasts or to programmed cell death (apoptosis) on TiO2 nanotube layers. These cell fate decisions are critically dependent on nanotube size differences (15-100nm in diameters) of TiO2 nanotubes sensing by integrin clustering. We further demonstrate that nanoscale topography-sensing is feasible not only in mesenchymal stem cells but rather seems as generalized nanoscale microenvironment-cell interaction mechanism in several cell types composing bone tissue network including osteoblasts, osteoclast, endothelial cells and hematopoietic stem cells. Additionally we discuss the synergistic effect of simultaneous stimulation by nanotube-bound growth factor and nanoscale topographic cues on enhanced bone regeneration.

Keywords: TiO2 nanotube, stem cell fate decision, nano-scale microenvironment, bone regeneration

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Authors: Sauradipta Ganguly, Akhato Sumi, Sanjeet Kumar Hom, Ajan T. Lotha

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Populus deltoides is a hardwood used predominantly for the manufacturing of plywood, matchsticks, and paper in India and hence has a higher economical significance. Wood-decaying fungi cause serious damage to Populus deltoides products, as the wood itself is perishable and vulnerable to decaying agents, decreasing their aesthetical value which in return results in significant monetary loss for the wood industries concerned. The aim of the study was to determine the antifungal activity of Cedrus deodara oil against three primary wood-decaying fungi namely white-rot fungi (Trametes versicolor), brown-rot fungi (Oligoporus placentus) and soft-rot fungi (Xylaria acuminata) on Populus deltoides samples under optimum laboratory conditions. The susceptibility of Populus deltoides samples on the fungal attack and the ability of deodar oil to control colonization of the wood rotting fungi on the samples were assessed. Three concentrations of deodar oil were considered for the study as treating solutions, i.e., 4%, 5%, and 6%. The Populus deltoides samples were treated with treating solutions, and the ability of the same to prevent a fungal attack on the samples were assessed using accelerated test in the laboratory at Biochemical Oxygen Demand incubator at temperature (25 ± 2°C) and relative humidity 70 ± 4%. Efficacy test and statistical analysis of deodar oil against Trametes versicolor, Oligoporus placentus, and Xylariaacuminataon P. deltoides samples exhibited light, minor and negligible mycelia growth at 4 %, 5% and 6% concentrations of deodar oil, respectively. Whereas, moderate to heavy attack was observed on the surface of the control samples. Statistical analysis further established that the treatments were statistically significant and had significantly inhibited fungal growth of all the three fungus spp by almost 3 to 5 times.

Keywords: populus deltoides, Trametes versicolor, Oligoporus placentus, Xylaria acuminata, Deodar oil, treatment

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Authors: Mohammed Ghazwani, Shyma Ali Alshahrani, Zahra Abdu Yousef, Taif Torki Asiri, Ghofran Abdur Rahman, Asma Ali Alshahrani, Umme Hani

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Background and introduction: Piroxicam is a nonsteroidal anti-inflammatory drug characterized by low solubility-high permeability used to reduce pain, swelling, and joint stiffness from arthritis. Hydrotropes are a class of compounds that normally increase the aqueous solubility of insoluble solutes. Aim: The objective of the present research study was to formulate and optimize Piroxicam hydrotropic starch gel using sodium salicylate, sodium benzoate as hydrotropic salts, and potato starch for topical application. Materials and methods: The prepared Piroxicam hydrotropic starch gel was characterized for various physicochemical parameters like drug content estimation, pH, tube extrudability, and spreadability; all the prepared formulations were subjected to in-vitro diffusion studies for six hours in 100 ml phosphate buffer (pH 7.4) and determined gel strength. Results: All formulations were found to be white opaque in appearance and have good homogeneity. The pH of formulations was found to be between 6.9-7.9. Drug content ranged from 96.8%-99.4.5%. Spreadability plays an important role in patient compliance and helps in the uniform application of gel to the skin as gels should spread easily; F4 showed a spreadability of 2.4cm highest among all other formulations. In in vitro diffusion studies, extrudability and gel strength were good with F4 in comparison with other formulations; hence F4 was selected as the optimized formulation. Conclusion: Isolated potato starch was successfully employed to prepare the gel. Hydrotropic salt sodium salicylate increased the solubility of Piroxicam and resulted in a stable gel, whereas the gel prepared using sodium benzoate changed its color after one week of preparation from white to light yellowish. Hydrotropic potato starch gel proposed a suitable vehicle for the topical delivery of Piroxicam.

Keywords: Piroxicam, potato starch, hydrotropic salts, hydrotropic starch gel

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Authors: Dileep Kumar Verma, Sunil Kumar Lal

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Influenza still remains one of the most challenging diseases posing significant threat to public health causing seasonal epidemics and pandemics. Influenza A Virus (IAV) surface protein hemagglutinin is known to play an important role in viral attachment to the host sialic acid receptors and concentrate in lipid rafts for efficient viral fusion. Selective nature of Influenza A virus to utilize rafts micro-domain for efficient virus assembly and budding has been explored in depth. However, the detailed mechanism of IAV binding to host cell membrane and entry into the host remains elusive. In the present study we investigated the role of lipid rafts in early life cycle events of IAV. Role of host lipid rafts was studied using raft disruption method by extraction of cholesterol by Methyl-β-Cyclodextrin. Using GM1, a well-known lipid raft marker, we were able to observe co-localization of IAV on lipid rafts on the host cell membrane. This experiment suggests a direct involvement of lipid rafts in the initiation of the IAV life cycle. Upon disruption of lipid rafts by Methyl-b-cyclodextrin, we observed a significant reduction in IAV binding on the host cell surface indicating a significant decrease in virus attachment to coherent membrane rafts. Our results provide proof that host lipid rafts and their constituents play an important role in the adsorption of IAV. This study opens a new avenues in IAV virus-host interactions to combat infection at a very early steps of the viral lifecycle.

Keywords: lipid raft, adsorption, cholesterol, methyl-β-cyclodextrin, GM1

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Authors: Harison Masih, Jyotsna Kiran Peter, Sundara Singh, Geetha Singh

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The present investigation deals with diversity of dermatophytes and keratinophilic fungi from different tourist spots such as Agra Fort, Akbar tomb, It-Mat-Ud-Daulah, Mariam tomb, Radha Swami Bagh, and Taj Mahal of Agra City. These fungi are medically important which causes various infections and diseases in humans and animals. The main reservoir of these pathogens are the keratinous substances that increases due to birds and animal activities in the vicinity of monuments, where thousands (5413266) annual visitors from all over the world are visiting. The soil samples were subjected to isolate the pathogenic fungi through bait technique (buffalo skin, chicken feathers, human hair and goat tail hair). Baits were spread over the soil samples and incubated at room temperature for 30-35 days and pure culture isolates were maintained in SDA medium, stored at 4°C. Highest number of visitors were (3906453) from Taj Mahal, minimum 10785 at Mariam tomb annually, the total 271 isolates were encountered from soil samples out of these 18 genera and 38 species were found in different season. Highest incidence was 4.79% frequency shown by Chrysosporium keratinophilum while least 738% frequency occurrence by Trichophyton simii in soil samples. From the present study it was concluded that the incidence of pathogenic fungal isolates were the common in tourists soil that are etiological agents of superficial mycosis. Thus, both human and animal activity seemed to play an important role in occurrence and distribution of keratinophilic and related dermatophytes at various tourist places of Agra city.

Keywords: dermatophytic fungal diversity, bait technique, visitors at tourist spots, human and animal activities, soil samples

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Authors: Jiayi Pan, Le Qin, Shichan Zhang

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Following the worldwide growing interest in the sharing economy, especially in China, innovations within the field are rapidly emerging. It is, therefore, appropriate to address the under-investigated sustainability issues related to the development of shared mobility. In 2019, Shanghai Jiao Tong University (SJTU) introduced one of the first on-campus Time-sharing Electric Cars (TEC) that counts now about 4000 users. The increasing popularity of this original initiative highlights the necessity to assess its sustainability and find ways to extend the performance and availability of this new transport option. This study used an online questionnaire survey on TEC usage and experience to collect answers among students and university staff. The study also conducted interviews with TEC’s team in order to better understand its motivations and operating model. Data analysis underscores that TEC’s usage frequency is positively associated with a lower carbon footprint, showing that this scheme contributes to improving the environmental sustainability of transportation on campus. This study also demonstrates that TEC provides a convenient solution to those not owning a car in situations where soft mobility cannot satisfy their needs, this contributing to a globally positive assessment of TEC in the social domains of sustainability. As SJTU’s TEC project belongs to the non-profit sector and aims at serving current research, its economical sustainability is not among the main preoccupations, and TEC, along with similar projects, could greatly benefit from this study’s findings to better evaluate the overall benefits and develop operation on a larger scale. This study suggests various ways to further improve the TEC users’ experience and enhance its promotion. This research believably provides meaningful insights on the position of shared transportation within transport mode choice and how to assess the overall sustainability of such innovations.

Keywords: shared mobility, sharing economy, sustainability assessment, sustainable transportation, urban electric transportation

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Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

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Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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Authors: Esraa Elaraby, Dania Abu Zahra, Ghidaa Maswadah, Osama Amira, Mohamed Alshoura, Nihar Dash

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Background: Human being uses salon for a variety of purposes, from trimming of hair and shaving to a range of beauty treatments such as manicure and pedicure. Salon activities involve use of several instruments including scissors, scalpels and razors, materials such as soaps, solutions, creams and gels on human skin and body. Besides, salon customers also use chair, bed and many other common shared utensils and appliances. These salons related activities create a suitable environment for the transmission of several diseases and pathogens including hepatitis B and C, scabies, tuberculosis, staphylococcus and MRSA etc. The transmission of these pathogens can be prevented by maintenance of adequate hygiene and standard preventive measures. Aim: To assess the customer’s level of knowledge about salon-acquired infections and practices taken to prevent their transmission. Methods: A cross-sectional study was conducted among 500 participants across the Emirates. Moreover, self-administered questionnaires (in English and Arabic) were distributed through convenience sampling methods between February and April 2017. Results: The study included 500 participants of which 250 were females. The mean age of the study population was 33 years (SD=4.77). The participants were from several nationalities including 325 Arabs (Non-GCC) (66.2%), 108 Non-Arabs (22%), and 59 Arabs (GCC) (11.8%). The majority of the participants 421 (84.4%) had required knowledge about salon-associated infections with a mean knowledge score of 6/10 (60%). However, when it comes down to preventive practices, only 73 of the 500 participants (14.6%) did carry their own equipment. Thus, there was insufficient correlation between the level of knowledge and preventive practices (p=0.139) of salon-associated infections. Conclusion: People’s knowledge about the salon-associated infections among UAE residents was good, but only a small number practically took the required preventative measures towards this issue. Therefore, a public awareness program is recommended to enhance the deficiencies in knowledge and practices to prevent salon-acquired infections among the users. Up to our knowledge, this is the first study of this kind in the UAE targeting the salon customers about this important issue.

Keywords: awareness, knowledge, practices, salon-associated infections

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Authors: Akim Borbuev, Francisco de León

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Economic and population growth in densely-populated urban areas introduce major challenges to distribution system operators, planers, and designers. To supply added loads, utilities are frequently forced to invest in new distribution feeders. However, this is becoming increasingly more challenging due to space limitations and rising installation costs in urban settings. This paper proposes the conversion of critical alternating current (ac) distribution feeders into direct current (dc) feeders to increase the power transfer capacity by a factor as high as four. Current trends suggest that the return of dc transmission, distribution, and utilization are inevitable. Since a total system-level transformation to dc operation is not possible in a short period of time due to the needed huge investments and utility unreadiness, this paper recommends that feeders that are expected to exceed their limits in near future are converted to dc. The increase in power transfer capacity is achieved through several key differences between ac and dc power transmission systems. First, it is shown that underground cables can be operated at higher dc voltage than the ac voltage for the same dielectric stress in the insulation. Second, cable sheath losses, due to induced voltages yielding circulation currents, that can be as high as phase conductor losses under ac operation, are not present under dc. Finally, skin and proximity effects in conductors and sheaths do not exist in dc cables. The paper demonstrates that in addition to the increased power transfer capacity utilities substituting ac feeders by dc feeders could benefit from significant lower costs and reduced losses. Installing dc feeders is less expensive than installing new ac feeders even when new trenches are not needed. Case studies using the IEEE 342-Node Low Voltage Networked Test System quantify the technical and economic benefits of dc feeders.

Keywords: DC power systems, distribution feeders, distribution networks, power transfer capacity

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Authors: Yaya Gao, Bing Zhong, Yafeng Liu, Fei Chen

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Aim: The purpose of this study was to explore the difference between acellular dermal matrix (ADM) combined with anterolateral thigh (ALT) flap and ALT flap alone. Methods: HSCC patients were treated and divided into group A (ALT) and group B (ALT+ADM) between January 2014 and December 2018. We compared and analyzed the intraoperative information and postoperative outcomes of the patients. Results: There were 21 and 17 patients in group A and group B, respectively. The operation time, blood loss, defect size and anastomotic vessel selection showed no significant difference between two groups. The postoperative complications, including wound bleeding (n=0 vs. 1, p=0.459), wound dehiscence (n=0 vs. 1, p=0.459), wound infection (n=5vs.3, p=0.709), pharyngeal fistula (n=5vs.4, p=1.000) and hypoproteinemia (n=11 vs. 12, p=0.326) were comparable between the groups. Dysphagia at 6 months (number of liquid diets=0vs. 0; number of partial tube feedings=1vs. 1; number of total tube feedings=1vs. 0, p=0.655) also showed no significant differences. However, significant differences was observed in dysphagia at 12 months (number of liquid diets=0vs. 0; number of partial tube feedings=3 vs. 1; number of total tube feedings=10vs. 1, p=0.006). Conclusion: For HSCC patients, the use of the ALT flap combined ADM, compared to ALT treatment, showed better swallowing function at 12 months. The ALT flap combined ADM may serve as a safe and feasible alternative for selected HSCC patients.

Keywords: hypopharyngeal squamous cell carcinoma, anterolateral thigh free flap, acellular dermal matrix, reconstruction, dysphagia

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Authors: Saud S. AL Oud

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Soil contamination can have dire consequences, such as loss of ecosystem and agricultural productivity, diminished food chain quality, tainted water resources, economic loss, and human and animal illness. In recent years, attention has focused on the development of in situ immobilization methods that are generally less expensive and disruptive to the natural landscape, hydrology, and ecosystems than are conventional excavation treatments, and disposal methods. Soft, inexpensive, and efficient agents were used in the present research to immobilize Pb in polluted sandy soil. Five agents, either naturally occurring or chemically prepared, were used for this purpose. These agents include; iron ore (72% Fe2O3), cement, a mixture of calcite and shale rich in aluminum (CASH), and two chemically prepared amorphous materials of Al- and Fe-gel. These agents were selected due to their ability to specifically adsorb heavy metals onto their surface OH functional groups, which provide permanent immobilization of metal pollutants and reduce the fraction that is potentially mobile or bioavailable. The efficiency of these agents in immobilizing Pb were examined in a laboratory experiment, in which two rates (0.5 and 1.0 %) of tested agents were added to the polluted soils containing total contents of Pb ranging from 17.4-49.8 mg/kg. The results show that all immobilizing agents were succeed in minimizing the mobile form of Pb as extracted by 0.5 N HNO3. The extracted Pb decreased with increasing addition rate of immobilizing agents. At addition rate of 0.5%, HNO3 extractable-Pb varied widely depending on the agents type and were found to represent 21-67% of the initial values. All agents were able to reduce mobile Pb to levels lower than that (2.0 mg/kg) reported for non polluted soil, particularly for soils had initials of mobile Pb less than 10 mg/kg. Both iron oxide and CASH had the highest efficiency in immobilizing Pb, followed by cement, then amorphous materials of Fe and Al hydroxides.

Keywords: soil, synthetic chemical, lead, immobilization, polluted

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Authors: Kanchan Yadav, Ai-Chuan Chou, Rajesh Kumar Ulaganathan, Hua-De Gao, Hsien-Ming Lee, Chien-Yuan Pan, Yit-Tsong Chen

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Optogenetics is an innovative technology now widely adopted by researchers in different fields of the biological sciences. However, due to the weak tissue penetration capability of the short wavelengths used to activate light-sensitive proteins, an invasive light guide has been used in animal studies for photoexcitation of target tissues. Upconverting nanoparticles (UCNPs), which transform near-infrared (NIR) light to short-wavelength emissions, can help address this issue. To improve optogenetic performance, we enhance the target selectivity for optogenetic controls by specifically conjugating the UCNPs with light-sensitive proteins at a molecular level, which shortens the distance as well as enhances the efficiency of energy transfer. We tagged V5 and Lumio epitopes to the extracellular N-terminal of channelrhodopsin-2 with an mCherry conjugated at the intracellular C-terminal (VL-ChR2m) and then bound NeutrAvidin-functionalized UCNPs (NAv-UCNPs) to the VL-ChR2m via a biotinylated antibody against V5 (bV5-Ab). We observed an apparent energy transfer from the excited UCNP (donor) to the bound VL-ChR2m (receptor) by measuring emission-intensity changes at the donor-receptor complex. The successful patch-clamp electrophysiological test and an intracellular Ca2+ elevation observed in the designed UCNP-ChR2 system under optogenetic manipulation confirmed the practical employment of UCNP-assisted NIR-optogenetic functionality. This work represents a significant step toward improving therapeutic optogenetics.

Keywords: Channelrhodopsin-2, near infrared, optogenetics, upconverting nanoparticles

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Authors: Samira Ghasempourkazemi

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In terms of the COVID-19 pandemic, lots of mutations in the urban system, which have systemic impacts, have clearly appeared. COVID-19 not only had a direct impact on health but also caused significant losses to other departments, including the economy, education, tourism, environment and the construction industry. Therefore, the pandemic caused a disruption in the whole urban system. Particularly, today’s large urban areas are not designed in order to be compatible during a pandemic. Hence, cities are more vulnerable to infectious disease threats according to the population density, built environment and socioeconomic aspects. Considering the direct relationship between population and rate of infection, higher rates are given to those individuals located in areas with high-density populations. Population density can be a factor that seems to have a strong impact on the spread of infectious diseases. Thus, the preliminary hypothesis can be related to a densely populated areas which become hotspots for the rapid spread of the pandemic due to high levels of interaction. In addition, some other indicators can be effective in this condition, such as age range, education and socio-economy. To figure out the measure of infectious disease risk in densely populated areas in Istanbul is an objective of this study. Besides, this study intends to figure out Vulnerability Index in the case of COVID-19. In order to achieve the proper result, the considered method can be Analytic Hierarchy Process (AHP) by involving the mentioned variables. In the end, the study represents the COVID Vulnerability of densely populated areas in a metro city and the gaps that need to be identified and plugged for the pandemic-resilience city of tomorrow.

Keywords: infectious disease, COVID-19, urban system, densely populated area

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Authors: R. Tajau, R. Rohani, M. S. Alias, N. H. Mudri, K. A. Abdul Halim, M. H. Harun, N. Mat Isa, R. Che Ismail, S. Muhammad Faisal, M. Talib, M. R. Mohamed Zin

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Bio-based polymeric materials are increasingly used for a variety of applications, including surface coating, drug delivery systems, and tissue engineering. These polymeric materials are ideal for the aforementioned applications because they are derived from natural resources, non-toxic, low-cost, biocompatible, and biodegradable, and have promising thermal and mechanical properties. The nature of hydrocarbon chains, carbon double bonds, and ester bonds allows various sources of oil (edible), such as soy, sunflower, olive, and oil palm, to fine-tune their particular structures in the development of innovative materials. Palm oil can be the most eminent raw material used for manufacturing new and advanced natural polymeric materials involving radiation techniques, such as coating resins, nanoparticles, scaffold, nanotubes, nanocomposites, and lithography for different branches of the industry in countries where oil palm is abundant. The radiation technique is among the most versatile, cost-effective, simple, and effective methods. Crosslinking, reversible addition-fragmentation chain transfer (RAFT), polymerisation, grafting, and degradation are among the radiation mechanisms. Exposure to gamma, EB, UV, or laser irradiation, which are commonly used in the development of polymeric materials, is used in these mechanisms. Therefore, this review focuses on current radiation processing technologies for the development of various radiation-curable bio-based polymeric materials with a promising future in biomedical and industrial applications. The key focus of this review is on radiation curable palm oil-based products, which have been published frequently in recent studies.

Keywords: palm oil, radiation processing, surface coatings, VOC

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Authors: Fikri Turk, Sahika Pinar Akyer, Mevci Ozdemir, Mehmet Bulent Ozdemir, Ilgaz Akdogan

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The complications such as bleeding, thrombosis and air embolism depend on injuries emissary veins is often encountered in surgery. Detailed descriptions of the mastoid foramen, occipital foramen, parietal foramen, posterior condylar canal and foramen vesalius are lacking in the literature. For this reason, the purpose of our study was to explore and represent the morphology and morphometry of these emissary foramina in order to prevent complications and to guide for surgeons. The present study was made on 60 dry human skull in the laboratories of Pamukkale University, Faculty of Medicine Department of Anatomy. After taken photograph of emissary foramens by Canon 650D professional camera, the evaluation and measurement’s these foramens made with Matlab program by computer. The overall prevalence of mastoid foramen was 90.52%, occipital foramen was 72.52%, parietal foramen was 42.85%, posterior condylar canal was 91.25% and foramen vesalius was 78.26%. The mean diameter of the mastoid foramen was 1.81±0.76 mm, occipital foramen was 1.20±0.25 mm, parietal foramen was 1.49±0.46 mm, posterior condylar canal was 2.83±1.33 mm and foramen vesalius was 1.74±0.60 mm. Distances between emissary foramina and fixed bony landmarks were measured. Emissary veins are important in clinic practice and surgical procedures because they act a route of spread of exracranial infection to the intracranial structures and these veins may be a significant bleeding during surgery of the skull and they can be source of thrombosis and air embolism. The detailed anatomical knowledge of these veins and foraminas may help to prevent complications and to guide for surgeons.

Keywords: emissary foramina, mastoid foramen, occipital foramen, parietal foramen, posterior condylar canal, foramen vesalius, morphology, morphometry

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Authors: Sahar Essa, Hussain A. Safar, Raj Raghupathy

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Human cytomegalovirus (CMV) continues to be a source of severe complications in immunologically immature and immunocompromised hosts. Effective CMV vaccines that help diminish CMV disease in transplant patients and avoid congenital infection are of great importance. Though the exact roles of defense mechanisms are unidentified, viral-specific antibodies and cytokine responses are known to be involved in controlling CMV infections. CMV envelope glycoprotein B (UL55/gB), matrix proteins (UL83/pp65, UL99/pp28, UL32/pp150), and assembly protein UL80a/pp38 are known to be targets of antiviral immune responses. We immunized mice intraperitoneally with these five CMV-related proteins (commercial) for their ability to induce specific antibody responses (in-house immunoassay) and cytokine production (commercial assay) in a mouse model. We observed a significant CMV-antigen-specific antibody response to pp38 and pp65 (E/C ˃2.0, p˂0.001). Mice immunized with pp38 had significantly higher concentrations of GM-CSF, IFN-α, IL-2 IL-4, IL-5, and IL-17A (p˂0.05). Mice immunized with pp65 showed significantly higher concentrations of GM-CSF, IFN-γ, IL-2 IL-4, IL-10, IL-12, IL-17A, and TNF-α. Th1 to Th2 cytokines ratios revealed a Th1 cytokine bias in mice immunized with pp38, pp65, pp150, and gB. We suggest that stimulation with multiple CMV-related proteins, which include pp38, pp65, and gB antigens, will allow both humoral and cellular immune responses to be efficiently activated, thus serving as appropriate CMV antigens for future vaccines.

Keywords: cytomegalovirus, UL99/pp28, UL80a/pp38, UL83/pp65, UL32/pp150, UL55/gB, CMV-antigen-specific antibody, CMV antigen-specific cytokine responses

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Authors: Monika Szymańska-Czerwińska, Agnieszka Jodełko, Krzysztof Niemczuk

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Q fever (coxiellosis) is an infectious disease of animals and humans causes by C. burnetii and widely distributed throughout the world. Cattle and small ruminants are commonly known as shedders of C. burnetii. The aims of this study were the evaluation of seroprevalence and shedding of C. burnetii in cattle. Genotypes of the pathogen present in the tested specimens were also identified using MLVA (Multiple Locus Variable-Number Tandem Repeat Analysis) and MST (multispacer sequence typing) methods. Sampling was conducted in different regions of Poland in 2018-2021. In total, 2180 bovine serum samples from 801 cattle herds were tested by ELISA (enzyme-linked immunosorbent assay). 489 specimens from 157 cattle herds such as: individual milk samples (n=407), bulk tank milk (n=58), vaginal swabs (n=20), placenta (n=3) and feces (n=1) were subjected to C. burnetii specific qPCR. The qPCR (IS1111 transposon-like repetitive region) was performed using Adiavet COX RealTime PCR kit. Genotypic characterization of the strains was conducted utilizing MLVA and MST methods. MLVA was performed using 6 variable loci. The overall herd-level seroprevalence of C. burnetii infection was 36.74% (801/2180). Shedders were detected in 29.3% (46/157) cattle herds in all tested regions. ST 61 sequence type was identified in 10 out of 18 genotyped strains. Interestingly one strain represents sequence type which has never been recorded previously. MLVA method identified three previously known genotypes: most common was J but also I and BE were recognized. Moreover, a one genotype has never been described previously. Seroprevalence and shedding of C. burnetii in cattle is common and strains are genetically diverse.

Keywords: Coxiella burnetii, cattle, MST, MLVA, Q fever

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Authors: Mustafa Taskin, Ozgur Demir, M. Mert Serveren

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The precise study of the impact of underwater explosions on structures is of great importance in the design and engineering calculations of floating structures, especially those used for military purposes, as well as power generation facilities such as offshore platforms that can become a target in case of war. Considering that ship and submarine structures are mostly curved surfaces, it is extremely important and interesting to examine the destructive effects of underwater explosions on curvilinear surfaces. In this study, geometric nonlinear dynamic analysis of cylindrical composite sandwich shells subjected to instantaneous pressure load is performed. The instantaneous pressure load is defined as an underwater explosion and the effects of the liquid medium are taken into account. There are equations in the literature for pressure due to underwater explosions, but these equations have been obtained for flat plates. For this reason, the instantaneous pressure load equations are arranged to be suitable for curvilinear structures before proceeding with the analyses. Fluid-solid interaction is defined by using Taylor's Plate Theory. The lower and upper layers of the cylindrical composite sandwich shell are modeled as composite laminate and the middle layer consists of soft core. The geometric nonlinear dynamic equations of the shell are obtained by Hamilton's principle, taken into account the von Kàrmàn theory of large displacements. Then, time dependent geometric nonlinear equations of motion are solved with the help of generalized differential quadrature method (GDQM) and dynamic behavior of cylindrical composite sandwich shells exposed to underwater explosion is investigated. An algorithm that can work parametrically for the solution has been developed within the scope of the study.

Keywords: cylindrical composite sandwich shells, generalized differential quadrature method, geometric nonlinear dynamic analysis, underwater explosion

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Authors: Jae-Il Jeong, Hoon-Jae Park, Jung-Woo Cho, Yang-Gon Kim, Jin-Young Park, Joo-Young Oh, Si-Geun Choi, Seock-Sam Kim, Young Tae Cho, Chan Gyu Kim, Jong-Hyoung Kim

Abstract:

Bearing component has strongly required to decrease vibration and wear to achieve high durability and life time. In the industry field, bearing durability is improved by surface treatment on the bearing surface by centrifugal casting or gravity casting production method. However, this manufacturing method has caused problems such as long processing time, defect rate, and health harmful effect. To solve this problem, there is a laser cladding deposition treatment, which provides fast processing and food adhesion. Therefore, optimum conditions of white metal laser deposition should be studied to minimize bearing contact axis wear using laser cladding techniques. In this study, we deposit a soft white metal layer on SCM440, which is mainly used for shaft and bolt. On laser deposition process, the laser power and powder feed rate and laser head speed factors are controlled to find out the optimal conditions. We also measure hardness using micro Vickers, analyze FE-SEM (Field Emission Scanning Electron Microscope) and EDS (Energy Dispersive Spectroscopy) to study the mechanical properties and surface characteristics with various parameters change. Furthermore, this paper suggests the optimum condition of laser cladding deposition to apply in industrial fields. This work was supported by the Industrial Innovation Project of the Korea Evaluation Institute of Industrial Technology (KEIT) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (Research no. 10051653).

Keywords: laser deposition, bearing, white metal, mechanical properties

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Authors: Manal Suleiman, George Abu-Aqil, Uraib Sharaha, Klaris Riesenberg, Itshak Lapidot, Ahmad Salman, Mahmoud Huleihel

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Klebsiella pneumoniae is one of the most aggressive multidrug-resistant bacteria associated with human infections resulting in high mortality and morbidity. Thus, for an effective treatment, it is important to diagnose both the species of infecting bacteria and their susceptibility to antibiotics. Current used methods for diagnosing the bacterial susceptibility to antibiotics are time-consuming (about 24h following the first culture). Thus, there is a clear need for rapid methods to determine the bacterial susceptibility to antibiotics. Infrared spectroscopy is a well-known method that is known as sensitive and simple which is able to detect minor biomolecular changes in biological samples associated with developing abnormalities. The main goal of this study is to evaluate the potential of infrared spectroscopy in tandem with Random Forest and XGBoost machine learning algorithms to diagnose the susceptibility of Klebsiella pneumoniae to antibiotics within approximately 20 minutes following the first culture. In this study, 1190 Klebsiella pneumoniae isolates were obtained from different patients with urinary tract infections. The isolates were measured by the infrared spectrometer, and the spectra were analyzed by machine learning algorithms Random Forest and XGBoost to determine their susceptibility regarding nine specific antibiotics. Our results confirm that it was possible to classify the isolates into sensitive and resistant to specific antibiotics with a success rate range of 80%-85% for the different tested antibiotics. These results prove the promising potential of infrared spectroscopy as a powerful diagnostic method for determining the Klebsiella pneumoniae susceptibility to antibiotics.

Keywords: urinary tract infection (UTI), Klebsiella pneumoniae, bacterial susceptibility, infrared spectroscopy, machine learning

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Authors: I Putu Yuda Hananta, Inke Kusumastuti

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The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex

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