Search results for: attachment-based family therapy
Commenced in January 2007
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Edition: International
Paper Count: 4972

Search results for: attachment-based family therapy

1552 Characteristic and Prevalence of Cleft Lip and Palate Patient in Bandung Cleft Lip and Palate Center: A Descriptive Study

Authors: Kusmayadi Ita Nursita, Sundoro Ali

Abstract:

Cleft lip and palate are one of the most common congenital abnormalities in the face. It could happen to anyone, but mostly affect Asian population including Indonesia. Factors that influence the occurrence of cleft lip and palate vary from genetic to environmental factors. Children with cleft lip and palate will often have various problems such as airway disorders, eating disorders, speech and language developmental disorders, hearing disorders and psycho-social disorders, one of which is caused by appearance disorders. During his life, the child will experience multidisciplinary surgery and non-surgical treatment and can be accompanied by a psychological and financial burden on himself and his family. In Indonesia, there are no detailed scientific data on the prevalence and characteristic of cleft lip and palate patients. It was mainly caused by the absence of a national level organization, differences in geographical location, and the absence of national guidelines. This study aimed to describe the characteristic and prevalence of cleft lip and palate patients in Bandung Cleft Lip and Palate Center from 1 January 2016 to 31 December 2017. A total of 560 patients were included in the study. The highest percentage of cases are left unilateral cleft lip and palate with higher number of female patient and labioplasty as the most often surgical procedure to be conducted in Bandung Cleft Lip and Palate Center. In order to improve quality of life in patients with cleft lip and palate, early recognition and early treatment based on actual comprehensive data should be conducted. The data from Bandung Cleft Lip and Palate Center as one of the largest center of cleft lip and palate in West Java Indonesia hopefully could provide a big step of further comprehensive data collection in Indonesia and for the better overall management of cleft lip and palate in the future.

Keywords: cleft lip, cleft palate, characteristic, prevalence

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1551 Novel Recombinant Betasatellite Associated with Vein Thickening Symptoms on Okra Plants in Saudi Arabia

Authors: Adel M. Zakri, Mohammed A. Al-Saleh, Judith. K. Brown, Ali M. Idris

Abstract:

Betasatellites are small circular single stranded DNA molecules found associated with begomoviruses on field symptomatic plants. Their genome size is about half that of the helper begomovirus, ranging between 1.3 and 1.4 kb. The helper begomoviruses are usually members of the family Geminiviridae. Okra leaves showing vein thickening were collected from okra plants growing in Jazan, Saudi Arabia. Total DNA was extracted from leaves and used as a template to amplify circular DNA using rolling circle amplification (RCA) technology. Products were digested with PstI to linearize the helper viral genome(s), and associated DNA satellite(s), yielding a 2.8kbp and 1.4kbp fragment, respectively. The linearized fragments were cloned into the pGEM-5Zf (+) vector and subjected to DNA sequencing. The 2.8 kb fragment was identified as Cotton leaf curl Gezira virus genome, at 2780bp, an isolate closely related to strains reported previously from Saudi Arabia. A clone obtained from the 1.4 kb fragments he 1.4kb was blasted to GeneBank database found to be a betasatellite. The genome of betasatellite was 1357-bp in size. It was found to be a recombinant containing one fragment (877-bp) that shared 91% nt identity with Cotton leaf curl Gezira betasatellite [KM279620], and a smaller fragment [133--bp) that shared 86% nt identity with Tomato leaf curl Sudan virus [JX483708]. This satellite is thus a recombinant between a malvaceous-infecting satellite and a solanaceous-infecting begomovirus.

Keywords: begomovirus, betasatellites, cotton leaf curl Gezira virus, okra plants

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1550 The Influence of Culture on Manifestations of Animus

Authors: Anahit Khananyan

Abstract:

The results of the long-term Jungian analysis with female clients from Eastern and Asian countries, which belong to collectivist cultures, are summarised in the article. The goal of the paper is to describe the cultural complex, which was found by the author in the analysis of women of collectivistic culture. It was named “the repression of Animus”. Generally, C.G.Jung himself and the Post-Jungians studied conditions caused by the possession by Animus. The conditions and cases of the repressed Animus, depending on the type of culture and cultural complexes, as we know, were not widely disseminated. C.G. Jung discovered and recognized the Animus as the second component of a pair of opposites of the psyche of women – femininity and Animus. In the way of individuation, an awareness of manifestations of Animus plays an important role: understanding the differences between negative and positive Animus as well as the Animus and the Shadow, then standing the tension of the presence of a pair of opposites - femininity and Animus, acceptance of the tension of them, finding the balance between them and reconciliation of this opposites. All of the above are steps towards the realization of the Animus, its release Animua, and the healing of the psyche. In the paper, the author will share her experience of analyzing the women of different collectivist cultures and her experience of recognizing the repressed Animus during the analysis. Also, she will describe some peculiarities of upbringing and cultural traditions, which reflected the cultural complex of repression of Animus. This complex is manifested in the traditions of girls' upbringing in accordance with which an image of a woman with overly developed femininity and an absence or underdeveloped Animus is idealized and encouraged as well as an evaluating attitude towards females who have to correspond to this image and fulfill the role prescribed in this way in the family and society.

Keywords: analysis, cultural complex, animus, manifestation, culture

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1549 Depression and Associated Factors among Adolescent Females in Riyadh, Kingdom of Saudi Arabia: A Cross‑Sectional Study

Authors: Hafsa Raheel

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Background: Adolescents who suffer from depression early in life, have an increase in suicidal tendency, anxiety, conduct disorders, substance abuse, and continue to be depressed, later on in life. This study was conducted to identify the prevalence and correlates of depression among adolescent girls in Riyadh city in order to carry out early intervention. Methods: A cross‑sectional, school‑based survey was conducted among 1028 adolescent girls aged 15–19 years in secondary schools of Riyadh city. Riyadh was divided into clusters and within each cluster, both public and private schools were enrolled. From the selected schools students from grade 10–12 were surveyed. Survey was conducted using a structured questionnaire including the beck depression inventory‑II, and questions exploring the correlates of depression. Results: About 30% of participants were found to be depressed. Depression was more prevalent among female adolescents whose household income was inferior to 12,000 Saudi Riyal/month (odds ratio [OR] 2.17, confidence interval [CI] 0.97–6.84), did not have a good relationship with peers and family members (OR 4.63, CI 2.56–8.41), lived with single parent or alone (OR 1.77, CI 0.97–3.23), had been emotionally abused (OR 3.45, CI 2.56–8.41), and those who had been subjected to physical violence at least once (OR 3.34, CI 1.89–5.91). Conclusions: Strategies need to be developed to identify early signs and symptoms of depression among Saudi female adolescents. Training can be given to groups of students to help their peers, and also to the teachers to identify, and help students identify early signs of depression and provide them with better‑coping strategies to combat progression of depression and anxiety among such adolescents.

Keywords: adolescents, depression, Saudi Arabia, mental health

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1548 Effects of Boron Compounds in Rabbits Fed High Protein and Energy Diet: A Metabolomic and Transcriptomic Approach

Authors: Nuri Başpınar, Abdullah Başoğlu, Özgür Özdemir, Çağlayan Özel, FundaTerzi, Özgür Yaman

Abstract:

Current research is targeting new molecular mechanisms that underlie non-alcoholic fatty liver disease (NAFLD) and associated metabolic disorders like nonalcoholic steatohepatitis (NASH). Forty New Zealand White rabbits have been used and fed a high protein (HP) and energy diet based on grains and containing 11.76 MJ/kg. Boron added to 3 experimental groups’ drinking waters (30 mg boron/L) as boron compounds. Biochemical analysis including boron levels, and nuclear magnetic resonance (NMR) based metabolomics evaluation, and mRNA expression of peroxisome proliferator-activated receptor (PPAR) family were performed. LDL-cholesterol concentrations alone were decreased in all the experimental groups. Boron levels in serum and feces were increased. Content of acetate was in about 2x higher for anhydrous borax group, at least 3x higher for boric acid group. PPARα mRNA expression was significantly decreased in boric acid group. Anhydrous borax attenuated mRNA levels of PPARα, which was further suppressed by boric acid. Boron supplementation decreased the degenerative alterations in hepatocytes. Except borax group other boron groups did not have a pronounced change in tubular epithels of kidney. In conclusion, high protein and energy diet leads hepatocytes’ degenerative changes which can be prevented by boron supplementation. Boric acid seems to precede in this effectiveness.

Keywords: high protein and energy diet, boron, metabolomics, transcriptomic

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1547 Polycystic Ovary Syndrome - Clinical Profile of Women Attending NPFDB Subfertility Clinic

Authors: Komathy Thiagarajan, Mohd. Azizuddin Mohd. Yussof, Hasnoorina Husin, Noor Azreena Abd Aziz, Faezah Shekh Abdullah, Abdul Wahaf Abdul Wahid

Abstract:

Polycystic Ovary Syndrome (PCOS) presents with a plethora of clinical features owing to the multifaceted underlying pathophysiology. This study was conducted to determine the clinical features unique to the sub fertile women attending the Sub fertility Clinic of the National Population and Family Development Board (NPFDB) so that a more holistic approach can be adopted to further enhance the pregnancy outcome in those women. This was a case-control study conducted over a span of three years (from January 2014 until December 2016), whereby women who fulfilled the Rotterdam Criteria 2004 were classified as PCOS (n=79) and women who did not fulfill the Rotterdam Criteria were classified as controls (n=88). The mean age of the women was 30.1 years and the mean duration of marriage was 3.93 years. The majority of women suffered from primary sub fertility (82.6%). The median age was lower among PCOS women (29.0 years) compared to the controls (30.0 years), p<0.05. The majority of PCOS women (43.0%) were obese (BMI > 30 kg/m2) compared to only 19.3% who were obese in the control group, p<0.05. Hypertension was present in 59.5% of PCOS women and only in 36.4% of the control group, p<0.05. There were significantly more women who presented with hirsutism in PCOS group (27.8%) as compared to the control group (5.7%), p<0.05. The findings of this study elucidate that the clinical features of significance among sub fertile women suffering from PCOS, if detected early, are amenable to lifestyle modifications and timely interventions can potentially improve the fertility outcomes in this group of women.

Keywords: clinical features, fertility, lifestyle modification, PCOS

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1546 Combinational Therapeutic Targeting of BRD4 and CDK7 Synergistically Induces Anticancer Effects in Hepatocellular Carcinoma

Authors: Xinxiu Li, Chuqian Zheng, Yanyan Qian, Hong Fan

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Objectives: In hepatocellular carcinoma (HCC), oncogenes are continuously and robustly transcribed due to aberrant expression of essential components of the trans-acting super-enhancers (SE) complex. Preclinical and clinical trials are now being conducted on small-molecule inhibitors that target core-transcriptional components, including as transcriptional bromodomain protein 4 (BRD4) and cyclin-dependent kinase 7 (CDK7), in a number of malignant tumors. This study aims to explore whether co-overexpression of BRD4 and CDK7 is a potential marker of worse prognosis and a combined therapeutic target in HCC. Methods: The expression pattern of BRD4 and CDK7 and their correlation with prognosis in HCC were analyzed by RNA sequencing data and survival data of HCC patients from TCGA and GEO datasets. The protein levels of BRD4 and CDK7 were determined by immunohistochemistry (IHC), and survival data of patients were analyzed using the Kaplan-Meier method. The mRNA expression levels of genes in HCC cell lines were evaluated by quantitative PCR (q-PCR). CCK-8 and colony formation assays were conducted to assess cell proliferation of HCC upon treatment with BRD4 inhibitor JQ1 or/and CDK7 inhibitor THZ1. Results: It was shown that BRD4 and CDK7 were often overexpressed in HCCs and were associated with poor prognosis of HCC by analyzing the TCGA and GEO datasets. BRD4 or CDK7 overexpression was related to a lower survival rate. It's interesting to note that co-overexpression of CDK7 and BRD4 was a worse prognostic factor in HCC. Treatment with JQ1 or THZ1 alone had an inhibitory effect on cell proliferation; however, when JQ1 and THZ1 were combined, there was a more notable suppression of cell growth. At the same time, the combined use of JQ1 and THZ1 synergistically suppresses the expression of HCC driver genes. Conclusion: Our research revealed that BRD4 and CDK7 coupled can be a useful biomarker in HCC prognosis and the combination of JQ1 and THZ1 can be a promising therapeutic therapy against HCC.

Keywords: BRD4, CDK7, cell proliferation, combined inhibition

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1545 The Proportion of and Factors Associated With Thyroid Dysfunction among Individuals Referred To A Tertiary Care Facility in Kabul, Afghanistan

Authors: Mohammad Naeem Lakanwall

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Background:The thyroid gland, located just below the vocal cord on each side of and anterior to the trachea, is one of the main endocrine glands. Its normal weight is 15 to 20 grams in adults. The thyroid secretes two most important hormones, thyroxine and triiodothyronine, usually called T4 and T3, respectively. These hormones greatly increase the metabolic rate of the body. In addition to T3 and T4, the thyroid gland secrets calcitonin as well which is a significant hormone for calcium metabolism. Objective: The aim of this study is to estimate the proportion of and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Material and Methods: An analytical cross-sectional study design was conducted from July to Sep 2018. Blood samples were obtained, serum TSH levels were measured, and the patients were divided into three diagnostic categories according to their serum TSH concentrations. 1) Hypothyroidism 2) Hyperthyroidism 3) Normal thyroid Results: A total of 127 individuals were part of the sample for the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction and the majority of the female participants, (85%) were not pregnant in the last two years. Furthermore, 98% of participants, were non-smokers. Conclusion: The findings of the current study showed a high prevalence of thyroid dysfunctions in individuals coming to FMIC for thyroid functions tests. The findings also indicated that aging and smoking are the factors associated with thyroid dysfunctions. Further studies are needed to find out the prevalence of and factors associated with thyroid dysfunctions.

Keywords: Afghanistan, Kabul, hypothyroidism, hyperthyroidism, triiodothyronine, thyroxine

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1544 Chemical Composition, in vitro Antioxidant Activity and Gas Chromatography–Mass Spectrometry Analysis of Essential Oil and Extracts of Ruta chalpensis aerial Parts Growing in Tunisian Sahara

Authors: Samir Falhi, Neji Gharsallah, Adel Kadri

Abstract:

Ruta chalpensis L. is a medicinal plant in the family of Rutaceae, has been used as an important traditional in the Mediterranean basin in the treatment of many diseases. The current study was devoted to investigate and evaluate the chemical composition, total phenolic, flavonoid and tannin contents, and in vitro antioxidant activities of ethyl acetate, ethanol and hydroalcoholic extracts and essential oil from the aerial parts of Ruta chalpensis from Tunisian Sahara. Total phenolic, flavonoid and tannin contents of extracts ranged from 40.39 ± 1.87 to 75.13 ± 1.22 mg of GAE/g, from 22.62 ± 1.55 to 27.51 ± 1.04 mg of QE/g, and from 5.56 ± 1.32 to 10.89 ± 1.10 mg of CE/g respectively. Results showed that the highest antioxidant activities was determined for ethanol extract with IC50 value of 26.23 ± 0.91 µg/mL for 2,2-diphenyl-1-picrylhydrazyl assay, and for hydroalcoholic extract with EC50 value of 412.95±6.57 µg/mL and 105.52±2.45 mg of α-tocopherol/g for ferric reducing antioxidant power and total antioxidant capacity assays, respectively. Furthermore, Gas Chromatography–Mass Spectrometry (GC-MS) analysis of essential oil led to identification of 20 compounds representing 98.96 % of the total composition. The major components of essential oil were 2-undecanone (39.13%), 2-nonanone (25.04), 1-nonene (13.81), and α-limonene (7.72). Spectral data of Fourier-transform infrared spectroscopy analysis (FT-IR) of extracts revealed the presence of functional groups such as C= O, C─O, ─OH, and C─H, which confirmed its richness on polyphenols and biological active functional groups. These results showed that Ruta chalpensis could be a potential natural source of antioxidants that can be used in food and nutraceutical applications.

Keywords: antioxidant, FT-IR analysis, GC-MS analysis, phytochemicals contents, Ruta chalpensis

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1543 Empowering Women through the Fishermen of Functional Skills for City Gorontalo Indonesia

Authors: Abdul Rahmat

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Community-based education in the economic empowerment of the family is an attempt to accelerate human development index (HDI) Dumbo Kingdom District of Gorontalo economics (purchasing power) program developed in this activity is the manufacture of functional skills shredded fish, fish balls, fish nuggets, chips anchovies, and corn sticks fish. The target audience of this activity is fishing se mothers subdistrict Dumbo Kingdom include Talumolo Village, Village Botu, Kampung Bugis Village, Village North and Sub Leato South Leato that each village is represented by 20 participants so totaling 100 participants. Time activities beginning in October s/d November 2014 held once a week on every Saturday at 9.00 s/d 13:00/14:00. From the results of the learning process of testing the skills of functional skills of making shredded fish, fish balls, fish nuggets, chips anchovies, fish and corn sticks residents have additional knowledge and experience are: 1) Order the concept include: nutrient content, processing food with fish raw materials , variations in taste, packaging, pricing and marketing sales. 2) Products made: in accordance with the wishes of the residents learned that estimated Eligible selling, product packaging logo creation, preparation and realization of the establishment of Business Study Group (KBU) and pioneered the marketing network with restaurant, store / shop staple food vendors that are around CLC.

Keywords: community development, functional skills, gender, HDI

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1542 Reasons for Adhesion of Membership: A Case Study of Brazilian Soccer Team

Authors: Alexandre Olkoski, Marcelo Curth

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Football in Brazil is considered a passion, being the most popular sport in the country, both by the consumer public and by the means of communication that divulge it individually, when compared with other sports modalities. In the last two decades, the soccer teams have given greater importance to the management, since they understood that the same should be managed as a company, but with peculiarities related to the business. In this sense, Brazilian soccer clubs started to make bigger investments for the adhesion of fans in their social frames, allowing a greater need of understanding about the profile of this group of fans/clients. Thus, this work aims to understand the reasons that cause the fans to join the club and identify variables present in the process of intention to join the club. For that, a qualitative exploratory research was conducted, in which thirty-one membership of a soccer club from southern Brazil were interviewed. Based on the interviews, five categories were classified as emotional aspects (passion and love), cognitive aspects (easy access to the stadium and promotional values in tickets), external influences (family and friends), situational aspects (club moment) and aspects related to the event (engagement by modality). As results found in the analysis, it can be highlighted that the motivation of the majority of the respondents to become a member of the analyzed club, is related to the emotional aspects, such as passion and love. Thus, it is perceived that sport, in the case of soccer, generates in the involved ones (fans and leaders) different manifestations, suggesting that the management of this type of business has great complexity and should not be observed only by the spectrum of the club like a business.

Keywords: consumer behavior, marketing, membership, soccer

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1541 A Novel Method for Isolation of Kaempferol and Quercetin from Podophyllum Hexandrum Rhizome

Authors: S. B. Bhandare, K. S. Laddha

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Podphyllum hexandrum belonging to family berberidaceae has gained attention in phytochemical and pharmacological research as it shows excellent anticancer activity and has been used in treatment of skin diseases, sunburns and radioprotection. Chemically it contains lignans and flavonoids such as kaempferol, quercetin and their glycosides. Objective: To isolate and identify Kaempferol and Quercetin from Podophyllum rhizome. Method: The powdered rhizome of Podophyllum hexandrum was subjected to soxhlet extraction with methanol. This methanolic extract is used to obtain podophyllin. Podohyllin was extracted with ethyl acetate and this extract was then concentrated and subjected to column chromatography to obtain purified kaempferol and quercetin. Result: Isolated kaempferol, quercetin were light yellow and dark yellow in colour respectively. TLC of the isolated compounds was performed using chloroform: methanol (9:1) which showed single band on silica plate at Rf 0.6 and 0.4 for kaempferol and quercetin. UV spectrometric studies showed UV maxima (methanol) at 259, 360 nm and 260, 370 nm which are identical with standard kaempferol and quercetin respectively. Both IR spectra exhibited prominent absorption bands for free phenolic OH at 3277 and 3296.2 cm-1 and for conjugated C=O at 1597 and 1659.7 cm-1 respectively. The mass spectrum of kaempferol and quercetin showed (M+1) peak at m/z 287 and 303.09 respectively. 1H NMR analysis of both isolated compounds exhibited typical four-peak pattern of two doublets at δ 6.86 and δ 8.01 which was assigned to H-3’,5’ and H-2’,6’ respectively. Absence of signals less than δ 6.81 in the 1H NMR spectrum supported the aromatic nature of compound. Kaempferol and Quercetin showed 98.1% and 97% purity by HPLC at UV 370 nm. Conclusion: Easy and simple method for isolation of Kaempferol and Quercetin was developed and their structures were confirmed by UV, IR, NMR and mass studies. Method has shown good reproducibility, yield and purity.

Keywords: flavonoids, kaempferol, podophyllum rhizome, quercetin

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1540 Data Mining Model for Predicting the Status of HIV Patients during Drug Regimen Change

Authors: Ermias A. Tegegn, Million Meshesha

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Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major cause of death for most African countries. Ethiopia is one of the seriously affected countries in sub Saharan Africa. Previously in Ethiopia, having HIV/AIDS was almost equivalent to a death sentence. With the introduction of Antiretroviral Therapy (ART), HIV/AIDS has become chronic, but manageable disease. The study focused on a data mining technique to predict future living status of HIV/AIDS patients at the time of drug regimen change when the patients become toxic to the currently taking ART drug combination. The data is taken from University of Gondar Hospital ART program database. Hybrid methodology is followed to explore the application of data mining on ART program dataset. Data cleaning, handling missing values and data transformation were used for preprocessing the data. WEKA 3.7.9 data mining tools, classification algorithms, and expertise are utilized as means to address the research problem. By using four different classification algorithms, (i.e., J48 Classifier, PART rule induction, Naïve Bayes and Neural network) and by adjusting their parameters thirty-two models were built on the pre-processed University of Gondar ART program dataset. The performances of the models were evaluated using the standard metrics of accuracy, precision, recall, and F-measure. The most effective model to predict the status of HIV patients with drug regimen substitution is pruned J48 decision tree with a classification accuracy of 98.01%. This study extracts interesting attributes such as Ever taking Cotrim, Ever taking TbRx, CD4 count, Age, Weight, and Gender so as to predict the status of drug regimen substitution. The outcome of this study can be used as an assistant tool for the clinician to help them make more appropriate drug regimen substitution. Future research directions are forwarded to come up with an applicable system in the area of the study.

Keywords: HIV drug regimen, data mining, hybrid methodology, predictive model

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1539 The Study of Spray Drying Process for Skimmed Coconut Milk

Authors: Jaruwan Duangchuen, Siwalak Pathaveerat

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Coconut (Cocos nucifera) belongs to the family Arecaceae. Coconut juice and meat are consumed as food and dessert in several regions of the world. Coconut juice contains low proteins, and arginine is the main amino acid content. Coconut meat is the endosperm of coconut that has nutritional value. It composes of carbohydrate, protein and fat. The objective of this study is utilization of by-products from the virgin coconut oil extraction process by using the skimmed coconut milk as a powder. The skimmed coconut milk was separated from the coconut milk in virgin coconut oil extraction process that consists approximately of protein 6.4%, carbohydrate 7.2%, dietary fiber 0.27 %, sugar 6.27%, fat 3.6 % and moisture content of 86.93%. This skimmed coconut milk can be made to powder for value - added product by using spray drying. The factors effect to the yield and properties of dry skimmed coconut milk in spraying process are inlet, outlet air temperature and the maltodextrin concentration. The percentage of maltodextrin content (15, 20%), outlet air temperature (80 ºC, 85 ºC, 90 ºC) and inlet air temperature (190 ºC, 200 ºC, 210 ºC) were conducted to the skimmed coconut milk spray drying process. The spray dryer was kept air flow rate (0.2698 m3 /s). The result that shown 2.22 -3.23% of moisture content, solubility, bulk density (0.4-0.67g/mL), solubility, wettability (4.04 -19.25 min) for solubility in the water, color, particle size were analyzed for the powder samples. The maximum yield (18.00%) of spray dried coconut milk powder was obtained at 210 °C of temperature, 80°C of outlet temperature and 20% maltodextrin for 27.27 second for drying time. For the amino analysis shown that the high amino acids are Glutamine (16.28%), Arginine (10.32%) and Glycerin (9.59%) by using HPLP method (UV detector).

Keywords: skimmed coconut milk, spray drying, virgin coconut oil process (VCO), maltodextrin

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1538 Galtung’s Violence Triangle: We Need to Be Thinking Upside Down

Authors: Michael Fusi Ligaliga

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Peace and Conflict Studies (PACS), despite being a new pedagogical discipline, is a growing interdisciplinary academic field that has expanded its presence from the traditional lens of war, conflict, and violence to addressing various social issues impacting society. Family and domestic violence (FDV) has seldom been explored through the PACS lens despite some studies showing that “on average, nearly 20 people per minute are physically abused by an intimate partner in the United States. Over one year, this equates to more than 10 million women and men.” In the Pacific, FDV rates are some of the highest in the world. The friction caused by cultural practices reinforcing patriarchy and male impunity, compounded by historical colonial experiences, as well as the impact of Christianity on the Pacific region, creates a complex social landscape when thinking about and addressing FDV in the Pacific. This paper seeks to re-examine Johan Galtung’s violence triangle (GVT) theory and its application to understanding FDV in the Pacific. Galtung argues that there are three forms of violence – direct, structural, and cultural. Direct violence (DV) is behaviors that threaten life itself or diminishes the ability of a person to meet his or her basic needs. This form of violence is visible because it is manifested in behaviors such as killing, maiming, sexual assault, etc. Structural violence (SV) exists when people do not get equal access to goods and services (health, education, justice) that enable them to reach their full potential. When ideologies embedded in cultural norms and practices are used to justify and advocate acts of violence by shifting the moral parameters from being wrong to right or acceptable, this, according to Galtung, is referred to as Cultural violence (CV).

Keywords: direct violence, cultural violence, structural violence, indigenous peacebuilding, samoa

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1537 Surgical Treatment Tumors and Cysts of the Pancreas in Children

Authors: Trunov V.O., Ryabov A. B., Poddubny I.V

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Introduction: cystic and solid pancreatic tumors have a relevant and disruptive position in many positions. The results of the treatment of children with tumors and pancreatic cysts aged 3 to 17 years for the period from 2008 to 2019 on the basis of the Morozov State Children's Clinical Hospital in Moscow were analyzed. The total number of children with solid tumors was 17, and 31 with cysts. In all children, the diagnosis was made on the basis of ultrasound, followed by CT and MRI. In most patients with solid tumors, they were located in the area of the pancreas tail - 58%, in the body area - 14%, in the area of the pancreatic head - 28%. In patients with pancreatic cysts, the distribution of patients by topography was as follows: head of the pancreas - 10%, body of the pancreas - 16%, tail of the pancreas - 68%, total cystic transformation of the Wirsung duct - 6%. In pancreatic cysts, the method of surgical treatment was based on the results of MRCP, the level of amylase in the contents of the cyst, and the localization of the cyst. Thus, pathogenetically substantiated treatment included: excision of cysts, internal drainage on an isolated loop according to Ru, the formation of pancreatojejunoanastomosis in a child with the total cystic transformation of the Wirsung duct. In patients with solid pancreatic lesions, pancretoduodenalresection, central resection of the pancreas, and distal resection from laparotomy and laparoscopic access were performed. In the postoperative period, in order to prevent pancreatitis, all children underwent antisecretory therapy, parenteral nutrition, and drainage of the omental bursa. Results: hospital stay ranged from 7 to 12 days. The duration of postoperative fermentemia in patients with solid formations lasted from 3 to 6 days. In all cases, according to the histological examination, a pseudopapillary tumor of the pancreas was revealed. In the group of children with pancreatic cysts, fermentemia was observed from 2 to 4 days, recurrence of cysts in the long term was detected in 3 children (10%). Conclusions: the treatment of cystic and solid pancreatic neoplasms is a difficult task in connection with the anatomical and functional features of the organ.

Keywords: pancreas, tumors, cysts, resection, laparoscopy, children

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1536 Border Between the Violation of Dental Ethics and the Occurrence of Dental Malpractice

Authors: Saimir Heta, Rialda Xhizdari, Kers Kapaj, Ilma Robo

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Background: The interests of both individuals involved, both the dentist with his professionalism, and the patient who claims and expects the proper professional dental service, are determined in cases of dental malpractice. The latter is a phenomenon that is also wearing the "cloak" of bilateral manipulations, which in themselves require strong legal control to regulate the relations between the involved parties. The two individuals are involved both individually and even professionally and emotionally, with support in the "ultimate" interests of the two people, which in the case of conflicts or grievances, which as a result are transported to the family or society of the affected individual. Main text: The reason for malpractice is the most difficult part to find and then to interpret. It can be professional in the view of "so much I know how to do, so much done", or in the view of the impossibility of individual health conditions to achieve high professional expectations. But, the reason can also be individual with the intention of doing bad without reason or with the source of an unhealthy mind and the source of malicious thinking. The professional himself is a human being and as such may be under the effect of individual treatments or vices, therefore causing misuse, a case that must be distinguished from intentional misuse and which must be judged for the results or damages caused by the professional based on criminal law. Conclusions: Malpractice in some cases may be unavoidable, beyond the good intention of the dental intervention, which should be well understood by both parties involved in this relationship. Malpractice is not necessarily related only to difficult clinical cases, but sometimes also appears as a random deviation of a dental treatment with a welldefined professional protocol. The legal support in the interpretation of malpractice cases should be much more specific according to previous cases, this practice specifically, perhaps also according to different religious states.

Keywords: dental ethics, malpractice, professional dental service, legal support

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1535 Effects of Achillea millefolium L. Extract on Rat Spermatogenesis

Authors: Nasrin Takzaree, Gholamreza Hassanzadeh, Abbas Hadjiakhoondi, Mohammadreza Rouini

Abstract:

Introduction: Today herbal medicine are extensively used for various therapeutic reasons. Whereas Achillea millefolium L. comprises different chemical compounds it is used in classic and modern medicine for different purposes. Concerning the family planning as a principle matter, the idea of using specific herbal medicine is of great importance. Purpose: To investigate the effects of Achillea millefolium L. extract on fertility power and spermatogenesis process in male mature Wistar rats and the anti-fertility effects of this extract in male genital system. Material and methods: In this study 32 male mature Wistar rats were randomly divided in to 4 experimental groups. 1st experimental group included 8 rats receiving Achillea millefolium extract at the dose of 200 mg/kg intraperitoneally. Second and third groups received the extract the same at the doses of 400 and 800 mg/kg respectively. 4th group was considered as control group in which the parenteral distilled water was administered. after 20 days, rats were sacrificed and the spermatogenesis process was histologically examined. Results: In experimental groups receiving high doses of extract comparing with control group, thickness in seminiferous tubules basal membrane, decrease in germinal epithelium cells, congestion in testicular tissue, disarrangement in germinal epithelium cells as well as decrease in cellular condense were observed (p<0.001). Conclusion: Findings suggest that alcoholic extract of Achillea millefolium at high concentrations lead to the structural alterations and changes in spermatogenesis in testicular tissue.

Keywords: spermatogenesis, alcoholic extract of Achillea millefolium L., testis, Wistar rat

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1534 The Impact of Nutritional Education for Peritoneal Dialysis Patients in Mongolia

Authors: Sanchir Erdenebayar, Namuuntsetseg Oyunbaatar

Abstract:

Objectives: Peritoneal dialysis treatment is one of the important forms of kidney replacement therapy, and it has recently developed instantly in Mongolia for the past five years. Currently, more than 120 patients undergo peritoneal dialysis nationwide. These patients lack nutritional education, which predisposes them to protein deficiency and further impairs their quality of life. However, there is no study which is conducted among those about their dietary in Mongolia. Therefore, integrated nutrition information and educating them about dietary patterns to follow are urgently needed for PD patients. Methods: A cross-sectional study was carried out on 45 patients aged between 18 and 60 years who were undergoing CAPD at the biggest Medvic dialysis center in Ulaanbaatar. The knowledge of nutrition and food intake is assessed by interview based on a validated questionnaire prepared from KDIGO guidelines, semi-FFQ and a 24-hour dietary recall method. In addition, a biochemical blood test that includes total protein, albumin, calcium, phosphorus, potassium, and hemoglobin is used for an assessment of the patient’s current nutritional status. Results: Knowledge of nutritional status for CAPD was great, with 21.4% of patients and 78.65% having poor nutrition knowledge. The rate of mild to moderate malnutrition was 48.8% among research participants. Serum albumin was 38.4 ± 4.7 g/L, and total protein was 67.3±7.5g/l. Patients met 62.5± 26.5% of their daily intake nutritional requirement for calories and 72±40% of their nutritional requirement for protein. All patients’ energy intake was significantly /1328±304kcal/ lower than the energy requirement (2124±378kcal). Only 14.2% met the recommended dietary protein intake recommended to them of greater than 1.2 g/kg. Conclusions: As was established before, nutritional education has a vital positive impact on the health and nutritional status of peritoneal dialysis patients. The results of this study show that nutritional education programs are not enough adequate in peritoneal dialysis patients. There is a crucial priority to establish nutritional educational programs and guidelines for PD patients in Mongolia.

Keywords: renal diet, peritoneal dialysis, nutrition education, CKD diet

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1533 Feeding Habitat of Parrot (Ringed Necked Parakeet) in District Mirpurkhas Sindh Pakistan

Authors: Aisha Liaquat Ali, Ghulam Sarwar Gachal, Muhammad Yusuf Sheikh

Abstract:

The parrot (Rose Ringed) commonly known as tota, belongs to the order ‘psiitaciformes’ and family ‘Psittacidea’, Four species of parakeet inhabits tropical and subtropical regions of Pakistan mostly adopted parks in cities deciduous woodlands, light secondary jungles, semidesert, and scrubland and in orchards and cultivated farmlands. They are mostly feed on citrus fruits, guava, mango, green unripen seed and almond nuts as well as bud and flowers etc. the core aim of the present study was to investigate the Feeding Habitat of Parrot (Ringed Necked Parakeet) in District Mirpurkhas Sindh Pakistan. Sampling was obtained from various adjoining areas of District Mirpurkhas by Non-Random Method, which was conducted from June to Nov 2017. During the present study, a total no: of 84 specimens were collected from different localities of City Mirpurkhas (42.8%) were male ♂ and (57.1%) were female ♀. Maximum population density of Psittaculla Krameri Borealis (50.0%) was collected from Guava (Psidium Guajava) Orchards, Mango (Mangifera Indica) orchard (41.6%), chekoo (Manilkara Zapota) orchard (5.9%) and the Minimum No: of Psittaculla krameri Borealis (2.3%) collected Date (Phoenix Dactylifera) orchard. It was observed that Psittaculla krameri Borealis were highly consumed Guava (Psidium Guajava) and the minimum consume food was Date (Phoenix Dactylifera).

Keywords: district Mirpur Khas Sindh Pakistan, feeding, habitat, parrot (ringed necked parakeet)

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1532 Antibacterial Activity of Methanol Extract of Punica Granatum Linn. (Punnicaceae) Fruit Peel Against Selected Bacterial Species

Authors: Afzan Mahmad, Santibuana Abd Rahman, Gouri Kumar Dash, Mohd. Syafiq Bin Abdullah

Abstract:

Antibacterial activity of the methanol extract of fruit peel of Punica granatum Linn (Family: Punicaceae) was evaluated against two Gram positive and two Gram negative bacteria. The Gram positive bacteria included Staphylococcus aureus, Streptococcus pneumoniae and the Gram negative organisms included Escherichia coli and Pseudomonas aeruginosa respectively. The culture media used for antibacterial assay was Mueller Hinton agar for the growth of S. aureus, E. coli, and P. aeruginosa. The media used for the growth of S. pneumoniae was Mueller Hinton blood agar. The antibacterial assay was performed through Disc diffusion technique. The methanol extract was tested at three different concentrations (50, 100 and 200 mg/ml). Standard antibiotic discs containing vancomycin (30 μg) for S. pneumoniae, penicillin (10 units) for S. aureus, ceftriaxone (30 μg) for E. coli and ciprofloxacin (5 μg) for P. aeruginosa were used for the activity comparison. The results of the study revealed that the extract possesses antibacterial activity against S. aureus, S. pneumoniae and P. aeruginosa at all tested concentrations. The maximum zone of inhibition of 19 mm of the extract at 200 mg/ml was observed against S. pneumoniae. However, no zone of inhibition was observed against E. coli at the tested concentrations of the extract. Based on the results obtained in this study, it may be concluded that the fruit peel of P. granatum possess broad spectrum of antibacterial activity against a number bacteria.

Keywords: Punica granatum Linn., methanol extract, antibacterial, zone of inhibition

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1531 Impact of a Home-Based Health Intervention on Older Adults at Risk of Chronic Diseases: A Study Protocol

Authors: Elaine Wong Yee-Sing

Abstract:

Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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1530 Adsorptive Membrane for Hemodialysis: Potential, Future Prospection and Limitation of MOF as Nanofillers

Authors: Musawira Iftikhar

Abstract:

The field of membrane materials is the most dynamic due to the constantly evolving requirements advancement of materials, to address challenges such as biocompatibility, protein-bound uremic toxins, blood coagulation, auto-immune responses, oxidative stress, and poor clearance of uremic toxins. Hemodialysis is a membrane filtration processes that is currently necessary for daily living of the patients with ESRD. Tens of millions of people with ESRD have benefited from hemodialysis over the past 60–70 years, both in terms of safeguarding life and a longer lifespan. Beyond challenges associated with the efficiency and separative properties of the membranes, ensuring hemocompatibility, or the safe circulation of blood outside the body for four hours every two days, remains a persistent challenge. This review explores the ongoing field of metal–Organic Frameworks (MOFs) and their applications in hemodialysis, offering a comprehensive examination of various MOFs employed to address challenges inherent in traditional hemodialysis methodologies. this This review included includes the experimental work done with various MOFs as a filler such as UiO-66, HKUST-1, MIL-101, and ZIF-8, which together lead to improved adsorption capacities for a range of uremic toxins and proteins. Furthermore, this review highlights how effectively MOF-based hemodialysis membranes remove a variety of uremic toxins, including p-cresol, urea, creatinine, and indoxyl sulfate and potential filler choices for the future. Future research efforts should focus on refining synthesis techniques, enhancing toxin selectivity, and investigating the long-term durability of MOF-based membranes. With these considerations, MOFs emerge as transformative materials in the quest to develop advanced and efficient hemodialysis technologies, holding the promise to significantly enhance patient outcomes and redefine the landscape of renal therapy.

Keywords: membrane, hemodailysis, metal organic frameworks, seperation, protein adsorbtion

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1529 Effect of Insulin versus Green Tea on the Parotid Gland of Streptozotocin Induced Diabetic Rats

Authors: H. El-Messiry, M. El-Zainy, D. Ghazy

Abstract:

Diabetes is a metabolic disease that results in a variety of oral health complications. Green tea is a natural antioxidant proved to have powerful effects against diabetes. The aim of this study was to compare between the effect of insulin and green tea on the Parotid gland of streptozotocin induced diabetic Albino rats by using light and transmission electron microscopy. Forty male Albino rats were divided into control group and diabetic groups. The diabetic group received a single injection of 40 mg/kg of streptozotocin intra-peritoneal under anesthesia and was further subdivided into three subgroups: The diabetic untreated subgroup which was untreated for two weeks, the insulin treated subgroup which has received insulin subcutaneously in a daily dose of 5 IU/kg body weight/day for two weeks and a green tea treated subgroup received a daily dose of 1 ml/ 100 gm body weight intragastrically for two weeks. Rats were terminated and parotid glands were dissected and processed for light and transmission electron microscopic examination. Histological examination of the diabetic untreated subgroup revealed acinar cells with pyknotic and hyperchromatic nuclei with cytoplasmic vacuolations. Ultrastructurally, acinar cells showed nuclear pleomorphism, dilated rough endoplasmic reticulum and swollen mitochondria with damaged cristae. Inflammatory cell infiltration was detected both histologically and ultrastructurally. Ducts showed signs of degeneration with loss of their normal outline and stagnated secretion within the lumen. However, insulin and green tea treated subgroups showed minimal degenerative damage and were almost similar to the control with minimal changes. Treatment of the parotid gland of the streptozotocin induced diabetic rats with GT was closely comparable to the traditional insulin therapy in reducing signs of histological and ultrastructural damage.

Keywords: diabetes, green tea, insulin, parotid

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1528 Detonalization of Punjabi: Towards a Loss of Linguistic Indigeneity

Authors: Sukhvinder Singh

Abstract:

Punjabi language is related to the languages of New Indo-Aryan group that, in turn, is related to the branch of Indo-European language family. Punjabi language covers the areas of Western part (that is in Pakistan) and Eastern part (the Punjab state, Haryana, Delhi Himachal and J&K) and abroad (particularly Canada, USA, U.K. and Arab Emirates), where it is spoken widely. Besides India and Pakistan, Punjabi is the third language spoken in Canada after English, French having more than one hundred millions speakers worldwide. It is the fourth language spoken in Canada after English, French, and Chinese. It is also being taught as second language in most of the community school of British Columbia. The total number of Punjabi speakers is more than one hundred millions including India, Pakistan and abroad. Punjabi has a long tradition of linguistic tradition. A large number of scholars have studied Punjabi at different linguistic levels. Various studies are devoted to its special phonological characteristics, especially the tone, which has now started disappearing in favour of aspiration, a rare example of a language change in progress in its reversal direction. This process of language change in progress in reversal is dealt with in this paper a change towards a loss of linguistic indigeneity. The tone being a distinctive linguistic feature of Punjabi language is getting lost due to the increasing influence of Hindi and English particularly in the speech Urban Punjabi and Punjabi settled abroad. In this paper, an attempt has been made to discuss the sociolinguistics and sociology of Punjabi language and Punjab to trace the initiation and progression of this change towards a loss of Linguistic Indigeneity.

Keywords: language change in reversal, reaspiration, detonalization, new Indo-Aryan group

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1527 Cultural Analysis of Dowry System with Relation to Women Prestige in District Swabi

Authors: Ullah Aman

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The practice of giving dowry was meant to assist a newly-wed couple to start their life together with ease; however, now it has turned into a commercial transaction in which monetary considerations receive priority over the personal merits of the bride. The present study was designed to explore the causes and consequences of dowry system and to measure the association between dowry and women prestige in district Swabi. A sample size of 378 household (female) Respondents was randomly selected through proportional allocation method. The data was interpreted into frequency and percentages while to measure the relationship between Dowry system and Women Prestige, Chi-Square statistic was applied. Result indicated that majority of the 316(83.6%) respondents stated that Family members are in favor of high dowry because high dowry is today’s women need which is disclosed by 302(79.9%) of the sample size. In addition to this, most 320(84.7%) of the respondents has opined that low dowry leads to broken families in the society. Moreover, a strong association (p=0.000) was determined between high dowry and women prestige. Similarly, a strong significant relation was found (p=0.000) between women prestige and low dowry mortifying women prestige in our society. The study concluded that dowry, deeply rooted in the society is an immorality which must be strictly banned in the country. It is a herculean task to completely eliminate dowry system from the nation but slowly and gradually efforts are being made in this direction. Dowry is a sure cause of promoting intense conflicts between the families, quarrels and inculcates greed in the society. Government and the builders of the social fabric should strictly work on it, banning this system for each and every class in Pakistan. Moreover, for curbing this mal practice we must put effort to bring social awareness to the society are some of the recommendation.

Keywords: Dowry, women, prestige, causes,

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1526 Design of an Active Compression System for Treating Vascular Disease Using a Series of Silicone Based Inflatable Mini Bladders

Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

Abstract:

Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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1525 Islamic Perspective on Autism Spectrum Disorder: Lived Experience of Muslim Families of Children with Autism Spectrum Disorder in a City in the UK

Authors: Hawa Khan

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Autism is a complex disorder related to abnormalities in the development of brain structure and neurological function and a new phenomenon which is epidemically on the increase. The Muslim community, with its profound commitment to the all-encompassing Islamic precedence, views all phenomena in the light of religious imperatives. How autism is understood and treated in these communities is key to successful inclusive services. Moreover, parents mentioned their Islamic faith as a coping mechanism for the challenges they faced while caring for their child. This study utilises interpretative phenomenology analysis as a methodology that seeks to interpret the meaning the participants make of their experiences, which extends descriptive analysis. Semi-structured interviews were conducted with 5 family units that included fathers, mothers, grandparents, and siblings. In the preliminary stage, this study found families give high importance of accessible Islamic education for their child and questioning the accountability of the child who might not be able to follow the Islamic way of life entirely or understand the concept of Allah. Moreover, the families expressed their beliefs in traditional and religious treatment as an effective way to treat and cure autism. This poses a major barrier between families seeking support and professionals providing services. Consequentially, it can also result in a low uptake of mainstream services from the Muslim community. Exploring the lived experiences of parents from the Muslim community and how ASD is conceptualised in this community could have implications for improved and effective home, community, and service collaboration.

Keywords: autism spectrum disorder, Islamic education, religious beliefs, mainstream services

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1524 Knowledge, Attitude and Practices Regarding Advance Directives among Resident Physicians in Vicente Sotto Memorial Medical Center

Authors: Marica Pidor-Quingco, Francis Cabatingan

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Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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1523 Coronary Artery Calcium Score and Statin Treatment Effect on Myocardial Infarction and Major Adverse Cardiovascular Event of Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis

Authors: Yusra Pintaningrum, Ilma Fahira Basyir, Sony Hilal Wicaksono, Vito A. Damay

Abstract:

Background: Coronary artery calcium (CAC) scores play an important role in improving prognostic accuracy and can be selectively used to guide the allocation of statin therapy for atherosclerotic cardiovascular disease outcomes and potentially associated with the occurrence of MACE (Major Adverse Cardiovascular Event) and MI (Myocardial Infarction). Objective: This systematic review and meta-analysis aim to analyze the findings of a study about CAC Score and statin treatment effect on MI and MACE risk. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “coronary artery calcium” AND “statin” AND “cardiovascular disease” Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on 11 studies included with a total of 1055 participants, we performed a meta-analysis and found that individuals with CAC score > 0 increased risk ratio of MI 8.48 (RR = 9.48: 95% CI: 6.22 – 14.45) times and MACE 2.48 (RR = 3.48: 95% CI: 2.98 – 4.05) times higher than CAC score 0 individual. Statin compared against non-statin treatment showed a statistically insignificant overall effect on the risk of MI (P = 0.81) and MACE (P = 0.89) in an individual with elevated CAC score 1 – 100 (P = 0.65) and > 100 (P = 0.11). Conclusions: This study found that an elevated CAC scores individual has a higher risk of MI and MACE than a non-elevated CAC score individual. There is no significant effect of statin compared against non-statin treatment to reduce MI and MACE in elevated CAC score individuals of 1 – 100 or > 100.

Keywords: coronary artery calcium, statin, cardiovascular disease, myocardial infarction, MACE

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