Search results for: significant factors

Authors: Suleman Maliha, Suleman Sidra

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Obstructive sleep apnea (OSA) is a sleep disorder that can result in behavioral and psychomotor impairments in children. The classical treatment modalities for OSA have been continuous positive airway pressure and adenotonsillectomy. However, orthodontic intervention through rapid maxillary expansion (RME) has also been commonly used to manage skeletal transverse maxillary discrepancies. Aim and objectives: The aim of this study is to determine the efficacy of rapid maxillary expansion in paediatric patients with obstructive sleep apnea by assessing pre and post-treatment mean apnea-hypopnea index (AHI) and oxygen saturations. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, and CINAHL databases. Articles published from 2012 onwards were selected. The inclusion criteria consisted of patients aged 18 years and under with no systemic disease, adenotonsillar surgery, or hypertrophy who are undergoing RME with AHI measurements before and after treatment. In total, six suitable papers were identified. Results: Three studies assessed patients pre and post-RME at 12 months. The first study consisted of 15 patients with an average age of 7.5 years. Following treatment, they found that RME resulted in both higher oxygen saturations (+ 5.3%) and improved AHI (- 4.2 events). The second study assessed 11 patients aged 5–8 years and also noted improvements, with mean AHI reduction from 6.1 to 2.4 and oxygen saturations increasing from 93.1% to 96.8%. The third study reviewed 14 patients aged 6–9 years and similarly found an AHI reduction from 5.7 to 4.4 and an oxygen saturation increase from 89.8% to 95.5%. All modifications noted in these studies were statistically significant. A long-term study reviewed 23 patients aged 6–12 years post-RME treatment on an annual basis for 12 years. They found that the mean AHI reduced from 12.2 to 0.4, with improved oxygen saturations from 78.9% to 95.1%. Another study assessed 19 patients aged 9-12 years at two months into RME and four months post-treatment. Improvements were also noted at both stages, with an overall reduction of the mean AHI from 16.3 to 0.8 and an overall increase in oxygen saturations from 77.9% to 95.4%. The final study assessed 26 children aged 7-11 years on completion of individual treatment and found an AHI reduction from 6.9 to 5.3. However, the oxygen saturation remained stagnant at 96.0%, but this was not clinically significant. Conclusion: Overall, the current evidence suggests that RME is a promising treatment option for paediatric patients with OSA. It can provide efficient and conservative treatment; however, early diagnosis is crucial. As there are various factors that could be contributing to OSA, it is important that each case is treated on its individual merits. Going forward, there is a need for more randomized control trials with larger cohorts being studied. Research into the long-term effects of RME and potential relapse amongst cases would also be useful.

Keywords: orthodontics, sleep apnea, maxillary expansion, review

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Authors: Saradiya Mukherjee

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Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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Authors: V. Mathad, S. Shivprasad, P. Shivsharannappa, M. K. Patil

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Introduction: Non-communicable diseases are emerging diseases in India. Government of India launched National Programme for Prevention and Control of Cardiovascular Diseases, Cancer and Stroke (NPCDCS) during the year 2008. The aim of the programme was to reduce the burden of non communicable diseases by health promotion and prompt treatment. Objective: The present study was intended to assess the impact of National Program for prevention and control of Cardiovascular Diseases, Diabetes, Cancer and Stroke Programme on biochemical and physiological factors influencing Type 2 diabetes in Kalaburagi District. Material and Method: NCD Clinic was established at District Hospital during April 2016. All the patients attending District Hospital Kalaburagi above the age of 30 years are screened for Non Communicable Diseases under NPCDCS Programme. A total sample of 7447 patients attending NCD Clinic situated at Kalaburagi district was assessed in this study. Pre structured and pretested schedule seeking information was obtained from all the patients by the counselor working under NPCDCS programme. All the Patients attending District Hospital were screened for Diabetes using Glucometer at NCD clinic. The suspected cases were further confirmed through Biochemical investigations like Fasting Blood glucose, HBA1c, Urine Glucose, Kidney Function test. SPSS 20 version was used for analysis of data. Chi square test, P values and odds ratio was used to study the association of factors. Results: A Total of 7447 patients attended NCD clinic during the year 2017-18 were analyzed, Diabetes was seen among 3028 individuals were as comorbidities along with Hypertension was seen among 757 individuals. The mean age of the population was 50 ± 2.84. 3440(46.2%) were males whereas Female constituted 4007(53.8%) of population. The incidence and prevalence of Diabetes being 8.6 and 12.8 respectively. Diabetes was more commonly seen during the age group of 40 to 69 years. Diabetes was significantly associated with Age group 40 to 69 years, obesity and female gender (p < 0.05). The risk of developing Hypertension and comorbidity conditions of hypertension and Diabetes was 1.224 and 1.305 times higher among males, whereas the risk of diabetes was 1.127 higher among females as compared to males. Conclusion: The screening for NCD has significantly increased after launching of NPCDCS programme. NCD was significantly associated with obesity, female gender, increased age as well as comorbid conditions like hypertension and tuberculosis.

Keywords: non-communicable diseases, NPCDCS programme, type 2 Diabetes, physiological factors

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Authors: Parvin Mirmiran, Zahra Bahadoran, Sahar Mirzae, Fereidoun Azizi

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Background and aim: Lifestyle factors, especially dietary intakes play an important role in metabolism of lipids and lipoproteins. In this study, we assessed the association between dietary factors and 3-year changes of serum triglycerides (TG), HDL-C and the atherogenic index of plasma among Iranian adults. This longitudinal study was conducted on 1938 subjects, aged 19-70 years, who participated in the Tehran Lipid and Glucose Study. Demographics, anthropometrics and biochemical measurements including serum TG were assessed at baseline (2006-2008) and after a 3-year follow-up (2009-2011). Dietary data were collected by using a 168-food item, validated semi-quantitative food frequency questionnaire at baseline. The risk of hypertriglyceridemia in the quartiles of dietary factors was evaluated using logistic regression models with adjustment for age, gender, body mass index, smoking, physical activity and energy intakes. Results: Mean age of the participants at baseline was 41.0±13.0 y. Mean TG and HDL-C at baseline was 143±86 and 42.2±10.0 mg/dl, respectively. Three-year change of serum TG were inversely related energy intake from phytochemical rich foods, whole grains, and legumes (P<0.05). Higher intakes compared to lower ones of dietary fiber and phytochemical-rich foods had similar impact on decreased risk of hyper-triglyceridemia (OR=0.58, 95% CI=0.34-1.00). Higher- compared to lower-dietary sodium to potassium ratios (Na/K ratio) increased the risk of hypertriglyceridemia by 63% (OR=0.1.63, 95% CI= 0.34-1.00). Conclusion: Findings showed that higher intakes of fiber and phytochemical rich foods especially whole grain and legumes could have protective effects against lipid disorders; in contrast higher sodium to potassium ratio had undesirable effect on triglycerides.

Keywords: lipid disorders, hypertriglyceridemia, diet, food science

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Authors: Neusa Fernanda Torres, Buyisile Chibi, Lyn E. Middleton, Vernon P. Solomon, Tivani P. Mashamba-Thompson

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Background: Self-medication with antibiotics (SMA) is a global concern, with a higher incidence in low and middle-income countries (LMICs). Despite intense world-wide efforts to control and promote the rational use of antibiotics, continuing practices of SMA systematically exposes individuals and communities to the risk of antibiotic resistance and other undesirable antibiotic side effects. Moreover, it increases the health systems costs of acquiring more powerful antibiotics to treat the resistant infection. This review thus maps evidence on the factors influencing self-medication with antibiotics in these settings. Methods: The search strategy for this review involved electronic databases including PubMed, Web of Knowledge, Science Direct, EBSCOhost (PubMed, CINAHL with Full Text, Health Source - Consumer Edition, MEDLINE), Google Scholar, BioMed Central and World Health Organization library, using the search terms:’ Self-Medication’, ‘antibiotics’, ‘factors’ and ‘reasons’. Our search included studies published from 2007 to 2017. Thematic analysis was performed to identify the patterns of evidence on SMA in LMICs. The mixed method quality appraisal tool (MMAT) version 2011 was employed to assess the quality of the included primary studies. Results: Fifteen studies met the inclusion criteria. Studies included population from the rural (46,4%), urban (33,6%) and combined (20%) settings, of the following LMICs: Guatemala (2 studies), India (2), Indonesia (2), Kenya (1), Laos (1), Nepal (1), Nigeria (2), Pakistan (2), Sri Lanka (1), and Yemen (1). The total sample size of all 15 included studies was 7676 participants. The findings of the review show a high prevalence of SMA ranging from 8,1% to 93%. Accessibility, affordability, conditions of health facilities (long waiting, quality of services and workers) as long well as poor health-seeking behavior and lack of information are factors that influence SMA in LMICs. Antibiotics such as amoxicillin, metronidazole, amoxicillin/clavulanic, ampicillin, ciprofloxacin, azithromycin, penicillin, and tetracycline, were the most frequently used for SMA. The major sources of antibiotics included pharmacies, drug stores, leftover drugs, family/friends and old prescription. Sore throat, common cold, cough with mucus, headache, toothache, flu-like symptoms, pain relief, fever, running nose, toothache, upper respiratory tract infections, urinary symptoms, urinary tract infection were the common disease symptoms managed with SMA. Conclusion: Although the information on factors influencing SMA in LMICs is unevenly distributed, the available information revealed the existence of research evidence on antibiotic self-medication in some countries of LMICs. SMA practices are influenced by social-cultural determinants of health and frequently associated with poor dispensing and prescribing practices, deficient health-seeking behavior and consequently with inappropriate drug use. Therefore, there is still a need to conduct further studies (qualitative, quantitative and randomized control trial) on factors and reasons for SMA to correctly address the public health problem in LMICs.

Keywords: antibiotics, factors, reasons, self-medication, low and middle-income countries (LMICs)

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Authors: Bundit Pungnirund

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This research aimed to study the relationship between marketing mix attitudes, motivation of buying decision and tendency of consumer decision making in buying the condominiums in Thailand. This study employed by survey and quantitative research. The questionnaire was used to collect the data from 400 sampled of customers who interested in buying condominium in Bangkok. The descriptive statistics and Pearson’s correlation coefficient analysis were used to analyze data. The research found that marketing mixed factors in terms of product and price were related to buying decision making tendency in terms of price and room size. Marketing mixed factors in terms of price, place and promotion were related to buying decision making tendency in term of word of mouth. Consumers’ buying motivation in terms of social acceptance, self-esteemed and self-actualization were related to buying decision making tendency in term of room size. In addition, motivation in self-esteemed was related to buying decision making tendency within a year.

Keywords: condominium, marketing mix, motivation, tendency of consumer decision making

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Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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Authors: Soufiane Fal, Abderahim Aasfar, Ali Ouhssain, Hasnae Choukri, Abelaziz Smouni, Hicham El Arroussi

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Heavy metals contamination is a major environmental concern around the world. It has a harmful impact on plant productivity and poses a serious risk to humans and animals health. In the present study, the effect of Microalgae Crude Extract (MCE) on tomato growth and nutrients uptake exposed to 2 mM Pb2+ and Cd2+ was investigated. In results, 2 mM Pb2+ and Cd2+ showed a significant reduction of tomatobiomass and perturbation in nutrients absorption. Moreover, MCE application in tomato plant exposed to Pb2+ and Cd2+ showed a significant enhancement of biomass compared to tomato plants under Pb2+ and Cd2+. On the other hand, MCE application favoured heavy metals accumulation in root and inhibited their translocation to shoot as phytostabilisation mechanism. Tomato plants showed biochemical responses to Pb2+ and Cd2+ stress with elevation of scavenging enzymes and molecules such as POD, CAT, SOD, Proline, and polyphenols, etc. In addition, the treatment by MCE showed a significant reduction level of the majority of these parameters. Furthermore, the metabolomic analysis revealed a significant change in important metabolites. Pb2+ and Cd2+ showed decrease in SFA and increase of UFA, VLFA, alkanes, alkenes, sterols, which known accumulated as tolerance and resistance mechanism to heavy metal (H.M) stress. However, MCE treatment showed the inverse of these response to return tomato plants to normal state and enhanced tolerance and resistance to heavy metal stress. In the present study, we emphasized that MCE can alleviate H.M stress, enhance tomato plant growth nutrients absorption and improve biochemical responses.

Keywords: microalgae crude extract, heavy metal stress, nutrient uptake, metabolomic analysis, solanum lycopersicum (Tomato), phytostabilisation

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Authors: T. Prommi, P. Thamsenanupap

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The influence of physicochemical water quality parameters on the abundance and diversity of caddisfly larvae was studied in seven sampling stations in Mae Tao and Mae Ku watersheds, Mae Sot District, Tak Province, northern Thailand. The streams: MK2 and MK8 as reference site, and impacted streams (MT1-MT5) were sampled bi-monthly during July 2011 to May 2012. A total of 4,584 individual of caddisfly larvae belonging to 10 family and 17 genera were found. The larvae of family Hydropsychidae were the most abundance, followed by Philopotamidae, Odontoceridae, and Leptoceridae, respectively. The genus Cheumatopsyche, Hydropsyche, and Chimarra were the most abundance genera in this study. Results of CCA ordination showed the total dissolved solids, sulfate, water temperature, dissolved oxygen and pH were the most important physicochemical factors to affect distribution of caddisflies communities. Changes in the caddisfly fauna may indicate changes in physicochemical factors owing to agricultural pollution, urbanization, or other human activities. Results revealed that the order Trichoptera, identified to species or genus, can be potentially used to assess environmental water quality status in freshwater ecosystems.

Keywords: Caddisfly larvae, environmental variables, diversity, streams

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Authors: G .D. B. N. Kulasaooriya, H. B. S. Ariyarathne, I. Abeygunawardene, A. A. J. Rafarathne, B. V. Perera

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Elephant is the largest resident of the wild and has small surface to volume ratio as well as less number of sweat glands which cause challenges to the thermoregulation of this mammal. However, this megaherbivore has adopted specialised meachanisms to maintain its thermal balance through behavioral adaptations, ear flapping and well anastomosed arterioles and venules of the ear. Nevertheless, little is known on the involvement of the skin in the process of thermoregulation. The present study was undertaken to monitor the water evaporation rate from the skin of unrestrained wild elephant calves throughout the day and to understand its importance in the thermoregulation. Seven baby elephants housed in the elephant transit home, Udawalawe were used. Ambient temparature, relative humidity (RH) and radiation heat load was monitored throughout the day of the study period. Similarly, surface temparature of the skin was taken at six points including lateral ear pinna, lateral body and the rump during the same period. The skin water evaporation was also measured from the same sites using cobolt chloride method. The surface are of the skin was determined by assigning geometrical shapes to each body part. The results showed that the ambient temperature gradually increased with the day reaching maximum around 3.00 pm. The relative humidity was lowest early in the morning. The radiation heat load did not show any significant change in the study period. The skin temperature was different among lateral ear pinna, lateral body and the rump where the highest temperature was on the rump and the lowest on the lateral ear pinna. The skin temperature gradually increase with increasing ambient temperature but there was not a strong correlation (R2 =53.53) between these two. The skin temperature had strong correlation with RH (p<0.05 R2 =70.84% ) but a significant relationship was not considered since the radiation heat load was not varying in large scale. The skin evaporative water loss had a weak negative correlation with ambient temperature (correlation coefficient= -0.01) whereas strong positive correlation with RH (correlation coefficient= 25.275 ) and no corelation with radiation heat load. It also appeared that skin water loss increases as the skin temperature increased. In the present study, it was observed that on average, skin of the baby elephant looses 403 g/m2/h of water. Based on these observations it can be concluded that a large volume of water is evaporated from the skin of baby elephants and evaporative heat loss may be contributing significantly to the thermoregulation. However, further investigation on the influence of environmental factors on evaporative heat loss has to be conducted to understand the thermoregulatory mechanisms of the baby elephant.

Keywords: thermoregulation, behavioral adaptations, evaporation, elephant

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Authors: Bishnu Prasad Devkota

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Peoples` perception is reflected in their attitudes and presumably their behavior towards wildlife conservation. The success of wildlife conservation initiatives in the mountains of Nepal is heavily dependent on local people. Therefore, Nepal has emphasized the involvement of local people in wildlife conservation, especially in the mountainous region. Local peoples` perception towards snow leopard conservation in six mountainous protected area of Nepal was carried out conducting 300 household surveys and 90 face to face key informant interviews. The average livestock holding was 27.74 animals per household with depredation rate of 10.6 % per household per annum. Livestock was the source of 32.74% of the total mean annual income of each household. In average, the economic loss per household per annum due to livestock depredation was US $ 490. There was significant difference in people´s perception towards snow leopard conservation in protected areas of mountainous region of Nepal. These differences were due to economic, educational and cultural factors. 54.4% local people showed preference for snow leopard conservation. The perception of local people toward snow leopard was significantly difference by the economic status of local people. Involvement of local people in conservation activities had positive impact towards wildlife conservation in the mountain region of Nepal. Timely introducing incentive programs can be a supportive way for sustaining the conservation of snow leopards in the Nepalese Himalayas.

Keywords: economic loss, livestock depredation, local people, perception, snow leopard

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Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

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Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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Authors: Faride Hashemiannejad, Shima Oloomi

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Imagination is one of the important elements of creative thinking which as a skill needs attention by the educational system. Although most students learn reading, writing, and arithmetic skills well, they lack high level thinking skills like creative thinking. Therefore, in the information age and in the beginning of entry to knowledge-based society, the educational system needs to think over its goals and mission, and concentrate on creativity-based curriculum. From among curriculum elements-goals, content, method and evaluation “method” is a major domain whose reform can pave the way for fostering imagination and creativity. The purpose of this study was examining the relationship between creativity development and curriculum. Research questions were: (1) is there a relationship between the cognitive-emotional structure of the classroom and creativity development? (2) Is there a relationship between the environmental-social structure of the classroom and creativity development? (3) Is there a relationship between the thinking structure of the classroom and creativity development? (4) Is there a relationship between the physical structure of the classroom and creativity development? (5) Is there a relationship between the instructional structure of the classroom and creativity development? Method: This research is a applied research and the research method is Correlational research. Participants: The total number of participants in this study included 894 students from High school through 11th grade from seven schools of seven zones in Mashad city. Sampling Plan: Sampling was selected based on Random Multi State. Measurement: The dependent measure in this study was: (a) the Test of Creative Thinking, (b) The researcher-made questionnaire includes five fragments, cognitive, emotional structure, environmental social structure, thinking structure, physical structure, and instructional structure. The Results Show: There was significant relationship between the cognitive-emotional structure of the classroom and student’s creativity development (sig=0.139). There was significant relationship between the environmental-social structure of the classroom and student’s creativity development (sig=0.006). There was significant relationship between the thinking structure of the classroom and student’s creativity development (sig=0.004). There was not significant relationship between the physical structure of the classroom and student’s creativity development (sig=0.215). There was significant relationship between the instructional structure of the classroom and student’s creativity development (sig=0.003). These findings denote if students feel secure, calm and confident, they can experience creative learning. Also the quality of coping with students’ questions, imaginations and risks can influence on their creativity development.

Keywords: imagination, creativity, curriculum, bioinformatics, biomedicine

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Authors: Mojdeh Chelemal Dezfoul Nejad, Masomeh Moradi, Mehrzad Mesbah, Mehran Javaheri Babouli

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This study was conducted in order to characterize the different levels of dietary vitamin C on some of biochemical parameters of Barbuas grypus. For this purpose 300 Barbuas grypus were divided into 15 groups. five levels of vitamin C (0, 200 ,400,800,1600 mg kg-1 diet) and their combination were used to prepare five experimental diets. The fish were fed 3% of their wet b.wt. per day for a 60 days period. Blood samples were obtained from six fish of each tank at the end of experiment. The results reveal that fish fed diets containing 1600 mg kg^-1 vitamin C had the significant decreased in the mean amount of cholesterol, glucose and triglyceride (p<0.05). Also, there was no significant difference in the mean amount of total protein with the different diets designed for this experiment (p>0.05).

Keywords: Barbuas, grypus, vitamin C, biochemical parameters

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Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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Authors: Coppa Federica, Iannello Giulia, Pennisi Stefania, Giuffrida Graziella, Lo Faro Riccardo, Cartelli Simone, Ferruggia Greta, Brundo Maria Violetta

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In recent years, a new field of basic research has emerged: the biology and physiology of extracellular vesicles and their application in diagnostics and therapy. In particular, exosomes attract the scientific community as nanovesicles of endosomal origin, which can be secreted by a variety of cells and are found in all biological fluids. Exosomes have recently gained attention also in the cosmetic field: in fact they are used in creams, serums and masks for topical use, proving to have a series of therapeutic and anti-aging benefits. To date, the orally administration of exosomes is the subject of attention because it represents a non-invasive and efficient method for delivering bioactive molecules into the intestine. We decided to focus our research on the creation of a food supplement that contains various bioactive factors, vitamins and a new technology called AMPLEX PLUS, containing a mixture of 20 different biologically active factors (GF20) and exosomes isolated and purified from bovine colostrum. We have demonstrated in vitro that this new supplement acts on telomerase, slowing down cell aging.

Keywords: AMPLEX PLUS, colostrum, exosomes, telomerase

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Authors: Julie Ann L. Gadin, Andrearose C. Igano, Carl Joseph S. Ignacio, Christopher C. Bacungan

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Corn production has become an important and pervasive industry in the Visayas for many years. Its role as a substitute commodity to rice heightens demand for health-particular consumers. Unfortunately, the corn industry is confronted with several challenges, such as weak institutions. Considering these issues, the paper examined the factors that influence corn production in the three administrative regions in the Visayas, namely, Western Visayas, Central Visayas, and Eastern Visayas. The data used was retrieved from a variety of publicly available data sources such as the Philippine Statistics Authority, the Department of Agriculture, the Philippine Crop Insurance Corporation, and the International Disaster Database. Utilizing a dataset from 2002 to 2019, the indicators were tested using three multiple linear regression (MLR) models. Results showed that the land area harvested (p=0.02), and the value of corn production (p=0.00) are statistically significant variables that influence corn production in the Visayas. Given these findings, it is suggested that the policy of forest conversion and sustainable land management should be effective in enabling farmworkers to obtain land to grow corn crops, especially in rural regions. Furthermore, the Biofuels Act of 2006, the Livestock Industry Restructuring and Rationalization Act, and supported policy, Senate Bill No. 225, or an Act Establishing the Philippine Corn Research Institute and Appropriating Funds, should be enforced inclusively in order to improve the demand for the corn-allied industries which may lead to an increase in the value and volume of corn production in the Visayas.

Keywords: corn, industry, production, MLR, Visayas

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Authors: Andrej Pilipović, Branislav Kovačević, Marina Milović, Lazar Kesić, Saša Pekeč, Leopold Poljaković-Pajnik, Saša Orlović

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The effect of landfills on the environment reflects in the dispersion of the contaminants on surrounding soils by the groundwater plume. Such negative effect can be mitigated with the establishment of vegetative buffers surrounding landfills. The “TreeRemEnergy” project funded by the Science Fund of Republic of Serbia – Green program focuses on development of phytobuffers for landfill phytoremediation with the use of Short Rotation Woody Crops (SRWC) plantations that can be further used for the biomass for energy. One of the goals of the project is to select most appropriate poplar (Populus sp.) and willow (Salix sp.) clones through phytorecurrent selection that involves testing of various breeding traits. Physiological parameters serve as a significant contribution to the breeding process aimed to early detection of potential candidates. This study involved testing of the effect of the landfill soils on the photosynthetic processes of the selected poplar and willow candidates. For this purpose, measurements of the gas exchange, chlorophyll content and chlorophyll fluorescence were measured on the tested plants. Obtained results showed that there were differences in the influence of the controlled sources of variation on examined physiological parameters. The effect of clone was significant in all parameters, while the effect of the substrate was not statistically significant in any of measured parameters. However, the effect of interaction Clone×Substrate was significant in intercellular CO2 concentration(ci), stomatal conductance (gs) and transpiration rate (E), suggesting that water regime of the tested clones showed different response to the tested soils. Some clones showed more “generalist” behavior (380, 107/65/9, and PE19/66), while “specialist” behavior was recorded in clones PE4/68, S1-8, and 79/64/2. On the other hand, there was no significant effect of the tested substrate on the pigments content measured with SPAD meter. Results of this study allowed us to narrow the group of clones for further trails in field conditions.

Keywords: clones, net photosynthesis, WUE, transpiration, stomatal conductance, SPAD

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Authors: Muhammad Afzal Malik

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Traditional Learning & Distance based learning are the two systems prevailing in Pakistan. These systems affect the level of education standard. The purpose of this study was to compare the traditional classroom learning and distance learning in Pakistan: (a) To explore the effectiveness of the traditional to Distance learning in Pakistan; (b) To identify the factors that affect traditional and distance learning. This review found that, on average, students in traditional classroom conditions performed better than those receiving education in and distance learning. The difference between student outcomes for traditional Classroom and distance learning classes —measured as the difference between treatment and control means, divided by the pooled standard deviation— was larger in those studies contrasting conditions that blended elements of online and face-to-face instruction with conditions taught entirely face-to-face. This research was conducted to highlight the impact of distance learning education system on education standard. The education standards were institutional support, course development, learning process, student support, faculty support, evaluation and assessment. A well developed questionnaire was administered and distributed among 26 faculty members of GCET, H-9 and Virtual University of Pakistan from each. Data was analyzed through correlation and regression analysis. Results confirmed that there is a significant relationship and impact of DLE system on education standards. This will also provide baseline for future research. It will add value to the existing body of knowledge.

Keywords: distance learning education, higher education, education standards, student performance

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Authors: Mehdi Modabberifar, Milad Roodi, Ehsan Souri

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In recent years, honeycomb fiber reinforced plastic (FRP) sandwich panels have been increasingly used in various industries. Low weight, low price, and high mechanical strength are the benefits of these structures. However, their mechanical properties and behavior have not been fully explored. The objective of this study is to conduct a combined numerical-statistical investigation of honeycomb FRP sandwich beams subject to torsion load. In this paper, the effect of geometric parameters of the sandwich panel on the maximum shear strain in both face and core and angle of torsion in a honeycomb FRP sandwich structures in torsion is investigated. The effect of Parameters including core thickness, face skin thickness, cell shape, cell size, and cell thickness on mechanical behavior of the structure were numerically investigated. Main effects of factors were considered in this paper and regression equations were derived. Taguchi method was employed as experimental design and an optimum parameter combination for the maximum structure stiffness has been obtained. The results showed that cell size and face skin thickness have the most significant impacts on torsion angle, maximum shear strain in face and core.

Keywords: finite element, honeycomb FRP sandwich panel, torsion, civil engineering

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Authors: Fabian Flintoff

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The nature of the workforce has changed radically over the last 50 years in terms of a wide range of factors, including its education levels, gender composition, and the status of workers. Despite extensive changes to the structure of the workforce, lawmakers and judges have shown a reluctance to reshape employment law. In particular, employment laws have not kept pace with the extensive use of flexible forms of employment, whether part-time, casual or agency employees. This paper focuses on recent attempts at legislative change in the state/provincial and federal jurisdictions in both Australia and Canada. Australian and Canadian employment laws share a common heritage and many similarities. However, there are significant differences in the way in which employment-based disputes are resolved. The Australian component of the paper considers the changes made by the Federal conservative Coalition government in 2021. The paper also reviews the proposals for change to regulating the gig economy made by the Canadian Federal government in the 2021 budget and the idea of a rebuttable presumption in favor of an employment relationship over a contract for services. The paper suggests that there are considerable institutional impediments to achieving pragmatic law reform that balances the interests of workers and employers. It concludes that there are strong interests in the legal and labor law community for continuing the status quo, despite the fact that it may negatively impact the most marginalized members of the workforce in Australia, Canada, and other jurisdictions.

Keywords: employment law, flexible employment, labor law, legislative reform

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Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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Authors: Krasimir Ivanov, Dimitar Dimitrov, Tatyana Tabakova, Stefka Kirkova, Anna Stoilova, Violina Angelova

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It has been suggested that nicotine, CO and tar in mainstream smoke are the most important substances and have been judged as the most harmful compounds, responsible for the health hazards of smoking. As nicotine is extremely important for smoking qualities of cigarettes and the tar yield in the tobacco smoke is significantly reduced due to the use of filters with various content and design, the main efforts of cigarettes researchers and manufacturers are related to the search of opportunities for CO content reduction. Highly active ceria supported gold catalyst was prepared by the deposition-precipitation method, and the possibilities for CO oxidation in the synthetic gaseous mixture were evaluated using continuous flow equipment with fixed bed glass reactor at atmospheric pressure. The efficiently of the catalyst in CO oxidation in the real cigarette smoke was examined by a single port, puf-by-puff smoking machine. Quality assessment of smoking using cigarette holder containing catalyst was carried out. It was established that the catalytic activity toward CO oxidation in cigarette smoke rapidly decreases from 70% for the first cigarette to nearly zero for the twentieth cigarette. The present study shows that there are two critical factors which do not permit the successful use of catalysts to reduce the CO content in the mainstream cigarette smoke: (i) significant influence of the processes of adsorption and oxidation on the main characteristics of tobacco products and (ii) rapid deactivation of the catalyst due to the covering of the catalyst’s grains with condensate.

Keywords: cigarette smoke, CO oxidation, gold catalyst, mainstream

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Authors: Muhammad Nouman, Salim Gul, Karim Ullah

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Partnership has been understood as the essence of Islamic banking. However, in practice, the non-partnership paradigm dominates the operations of Islamic banks. Islamic banks adopt partnership contracts for the scheme of deposits, especially for term deposit accounts. However, they do not adopt partnership contracts (i.e., Musharakah and Mudarabah) as the main financing scheme. In practice, non-partnership contracts including Murabahah and Ijara are widely used for financing. Many authors have provided different explanations for the less utilization of the partnership contracts as a scheme of financing. However, the typology of constraints remains missing. The extant literature remains scattered, with diverse studies focused on different dimensions of the issue. Therefore, there is no unified understanding of the constraints in the application of the partnership contracts. This paper aims to highlight the major factors hindering the application of partnership contracts, and produce a coherent view by synthesizing different explanations provided in several studies conducted around the globe. The present study employs insights form the extant literature using a systematic review and provides academia, practitioners, and policy makers with a holistic framework to name and make sense of what is making partnership contracts a less attractive option for Islamic banks. A total of 84 relevant publications including 11 books, 14 chapters of edited books, 48 journal articles, 8 conference papers and 3 IMF working papers were selected using a systematic procedure. Analysis of these selected publications followed three steps: i) In the first step of analysis the constraints explicitly appearing in the literature set of 84 articles were extracted, ii) In the second step 27 factors hindering the application of partnership contracts were identified from the constraints extracted in the first step with the overlapping items either eliminated or combined, iii) In the last step the factors identified in the second step were classified into three distinct categories. Our intention was to develop the typology of constraints by connecting the rather abstract concepts into the broader sets of constraints for better conceptualization and policy implications. Our framework highlights that there are mainly three facets of lower preference for partnership contracts of financing. First, there are several factors in the contemporary business settings, prevailing social setting, and the bank’s internal environment that underpin uncertainty in the success of partnership contracts of financing. Second, partnership contracts have lower demand i.e., entrepreneurs prefer to use non-partnership contracts for financing their ventures due to the inherent restraining characteristics of the partnership contracts. Finally, there are certain factors in the regulatory framework that restraint the extensive utilization of partnership contracts of financing by Islamic banks. The present study contributes to the Islamic banking literature in many ways. It provides clarification to the heavily criticized operations of Islamic banks, integrates the scattered literature, and provides a holistic framework for better conceptualization of the key constraints in the application of the partnership contracts and policy implications. Moreover, it demonstrates an application of systematic review in Islamic banking research.

Keywords: Islamic banking, Islamic finance, Mudarabah, Musharakah, partnership, systematic review

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Authors: Lucy Lugo Mawang

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Educational Psychologists have highlighted the significance of creativity in education. Likewise, a fundamental objective of music education concern the development of students’ musical creativity potential. The purpose of this study was to determine the relationship between motivation strategies and musical creativity, and establish the prediction equation of musical creativity. The study used purposive sampling and census to select 201 fourth-form music students (139 females/ 62 males), mainly from public secondary schools in Kenya. The mean age of participants was 17.24 years (SD = .78). Framed upon self- determination theory and the dichotomous model of achievement motivation, the study adopted an ex post facto research design. A self-report measure, the Achievement Goal Questionnaire-Revised (AGQ-R) was used in data collection for the independent variable. Musical creativity was based on a creative music composition task and measured by the Consensual Musical Creativity Assessment Scale (CMCAS). Data collected in two separate sessions within an interval of one month. The questionnaire was administered in the first session, lasting approximately 20 minutes. The second session was for notation of participants’ creative composition. The results indicated a positive correlation r(199) = .39, p ˂ .01 between musical creativity and intrinsic music motivation. Conversely, negative correlation r(199) = -.19, p < .01 was observed between musical creativity and extrinsic music motivation. The equation for predicting musical creativity from music motivation strategies was significant F(2, 198) = 20.8, p < .01, with R2 = .17. Motivation strategies accounted for approximately (17%) of the variance in participants’ musical creativity. Intrinsic music motivation had the highest significant predictive value (β = .38, p ˂ .01) on musical creativity. In the exploratory analysis, a significant mean difference t(118) = 4.59, p ˂ .01 in musical creativity for intrinsic and extrinsic music motivation was observed in favour of intrinsically motivated participants. Further, a significant gender difference t(93.47) = 4.31, p ˂ .01 in musical creativity was observed, with male participants scoring higher than females. However, there was no significant difference in participants’ musical creativity based on age. The study recommended that music educators should strive to enhance intrinsic music motivation among students. Specifically, schools should create conducive environments and have interventions for the development of intrinsic music motivation since it is the most facilitative motivation strategy in predicting musical creativity.

Keywords: extrinsic music motivation, intrinsic music motivation, musical creativity, music composition

Procedia PDF Downloads 139

Authors: Preethi Sudarshanie Dassanayake, R. A. Sudath Weerasiri

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Objective: The objective of this study were to find out highest expectation and perception,highest gap between perception and expectation of service quality, and to find out such gaps between perception and expectation with regard to service quality dimensions were whether statistically significant. Methodology: This study carried out at the Out Patient Department (OPD) of the Veterinary Teaching Hospital (VTH), University of Peradeniya. Modified version of SERVQUAL with 22-pairs of items regarding expectation and perception of service quality in dimensions of tangible, reliability, responsiveness, assurance and empathy were included in Part 1 and the Part 2 of the questionnaire consisted of questions regarding socio-demographic factors. Sample size was 200 and sampling procedure was Systematic Random Sampling. Customers above 18 years of age, able to read, write and understand Sinhala or English language, visits more than twice in last six months and who willing to respond were selected. Findings: The analysis revealed customers expectations of service higher than the perceived for all 22- items of the SERVQUAL. This high expectation suggests that there is sufficient room for further improvement of service quality in all five dimensions. Originality/Value of the Paper: This study gave a new insight for poorly researched area of veterinary health service quality in Sri Lankan context. It provides hospital administrators and policy makers to develop strategies for further improvement of service quality according to customers' view.

Keywords: expectation, perception, service quality, SERVQUAL, veterinary health care

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Authors: Berhanu Keno Terfa

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Flash floods are among the most dangerous natural disasters that pose a significant threat to human existence. They occur frequently and can cause extensive damage to homes, infrastructure, and ecosystems while also claiming lives. Although flash floods can happen anywhere in the world, their impact is particularly severe in developing countries due to limited financial resources, inadequate drainage systems, substandard housing options, lack of early warning systems, and insufficient preparedness. To address these challenges, a comprehensive study has been undertaken to analyze and map flood inundation using Geographic Information System (GIS) techniques by considering various factors that contribute to flash flood resilience and developing effective mitigation strategies. Key factors considered in the analysis include slope, drainage density, elevation, Curve Number, rainfall patterns, land-use/cover classes, and soil data. These variables were computed using ArcGIS software platforms, and data from the Sentinel-2 satellite image (with a 10-meter resolution) were utilized for land-use/cover classification. Additionally, slope, elevation, and drainage density data were generated from the 12.5-meter resolution of the ALOS Palsar DEM, while other relevant data were obtained from the Ethiopian Meteorological Institute. By integrating and regularizing the collected data through GIS and employing the analytic hierarchy process (AHP) technique, the study successfully delineated flash flood hazard zones (FFHs) and generated a suitable land map for urban agriculture. The FFH model identified four levels of risk in Bishoftu City: very high (2106.4 ha), high (10464.4 ha), moderate (1444.44 ha), and low (0.52 ha), accounting for 15.02%, 74.7%, 10.1%, and 0.004% of the total area, respectively. The results underscore the vulnerability of many residential areas in Bishoftu City, particularly the central areas that have been previously developed. Accurate spatial representation of flood-prone areas and potential agricultural zones is crucial for designing effective flood mitigation and agricultural production plans. The findings of this study emphasize the importance of flood risk mapping in raising public awareness, demonstrating vulnerability, strengthening financial resilience, protecting the environment, and informing policy decisions. Given the susceptibility of Bishoftu City to flash floods, it is recommended that the municipality prioritize urban agriculture adaptation, proper settlement planning, and drainage network design.

Keywords: remote sensing, flush flood hazards, Bishoftu, GIS.

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Authors: D. Vidhyaprakash, A. Elango

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In real-time applications, wheeled mobile robots are increasingly used and operated in extreme and diverse conditions traversing challenging surfaces such as a pitted, uneven terrain, natural flat, smooth terrain, as well as wet and dry surfaces. In order to accomplish such tasks, it is critical that the motion control functions without wheel slip and odometry error during the navigation of the two-wheeled mobile robot (WMR). Wheel slip and odometry error are disrupting factors on overall WMR performance in the form of deviation from desired trajectory, navigation, travel time and budgeted energy consumption. The wheeled mobile robot’s ability to operate at peak performance on various work surfaces without wheel slippage and odometry error is directly connected to four main parameters, which are the range of payload distribution, speed, wheel diameter, and wheel width. This paper analyses the effects of those parameters on overall performance and is concerned with determining the ideal range of parameters for optimum performance.

Keywords: wheeled mobile robot, terrain, wheel slippage, odometryerror, trajectory

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Authors: Burcu Akyildiz, Cigdem Kadaifci, Y. Ilker Topcu, Burc Ulengin

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In today’s business environment, companies should make strategic decisions to gain sustainable competitive advantage. Order selection is a crucial issue among these decisions especially for steel production industry. When the companies allocate a high proportion of their design and production capacities to their ongoing projects, determining which customer order should be chosen among the potential orders without exceeding the remaining capacity is the major critical problem. In this study, it is aimed to identify and prioritize the evaluation factors for the customer order selection problem. Conjoint analysis is used to examine the importance level of each factor which is determined as the potential profit rate per unit of time, the compatibility of potential order with available capacity, the level of potential future order with higher profit, customer credit of future business opportunity, and the negotiability level of production schedule for the order.

Keywords: conjoint analysis, order prioritization, profit management, structural steel firm

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Authors: Hanan Azzam1, Nashwa Abousamra1, Amany Mansour1, Yaser Abd El-dayem2, , Solafa Elsharawy1

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Background: Inherited thrombophilias are a heterogenous group of conditions which have been implicated in a variety of pregnancy complications. More recently, deficiency of protein Z (PZ) has been liked to pregnancy complications, including preterm delivery. Aim: We designed this study to evaluate the association of inherited thrombophilias including [Protein C (PC), Protein S (PS), Anti thrombin III (ATIII) deficiency and activated protein C (APC) resistance] and protein Z deficiency with a variety of pregnancy complications. Patients and Methods: 60 women with different pregnancy complications, including 20 patients with preeclampsia, 20 patients with intrauterine growth resistance (IUGR), and 20 patients with intrauterine fetal death (IUFD), in addition to 30 healthy pregnant women were recruited for the present study. PC and free PS antigen, ATIII activity, modified functional APC-resistance, and PZ levels were determined. Results: There was no significant association between inherited thrombophilias and complicated pregnancies as regards PC deficiency (p=1.0), AT III and PS deficiency (p=0.312), and APC-resistance (P=0.083). PZ was significantly associated with complicated pregnancies (p=0.012). Patients with protein Z levels below 1.5 µg/ml were considered deficient. Accordingly, we demonstrated protein Z deficiency in 30% of complicated pregnancies (RR 6.0, 95% CI 1.29-27.90;p=0.022), 20% of preeclampsia (RR 3.5, 95% CI 0.57 – 21.28; P = 0.174), 40% of IUGR (RR 9.3 95% CI 1.72-50.61; P = 0.010) and 30% of IUFD (RR 6, 95% CI 1.07 – 33.64; P = 0.042). Conclusions: These findings indicate the absence of association of inherited thrombophilias, including PC, PS, AT III deficiency, and APC resistance with pregnancy complications. However, PZ deficiency is associated with increased risk of pregnancy complications, especially intrauterine growth restriction and intrauterine fetal death.

Keywords: protein C, protein S, thrombophelia, pregnancy, protein Z

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