Search results for: oral symptoms

Authors: Khalid Mohammed Idrees

Abstract:

Endodontic treatment aims to reverse the disease process and thereby eliminate the associated signs of symptoms. When the treatment itself appears to initiate the onset of pain and /or swelling (endodontic flare-up), the result can be distressing to both the patient and the operator. Patient might even consider postoperative symptoms as a bench mark against which the clinician’s skills are measured. Obviously the treatment with the lowest prevalence of postoperative pain is usually the treatment of choice as long as effectiveness and cost are not compromised. Knowledge of the cause and mechanism behind intra appointment flare-up is of utmost importance for the clinician to properly prevent or manage this undesirable condition. This review lecture will discuss the causative factors of flare-up with special attention to the microorganism role, various modalities of preventive measures would be discussed. Those measures are based on scientific evidence combined with the long clinical experience of the lecturer.

Keywords: endodontic flare-up, causative factors, inflammatory mediators, preventive measures

Procedia PDF Downloads 109

Authors: Dharshini Selvarajah, Nicula Lui, Karen Kong

Abstract:

Background: Uterine fibroids are a common benign gynaecologic neoplasm in reproductive-aged women. Fibroids may become symptomatic in a vast majority of nulliparous women. Their diagnosis and management is often coordinated between gyneacologists, radiologists and urologists depending on the anatomical location, growth, size and the fibroids sarcomatous evolvement. Some patients may develop obstructive uropathy symptoms, either uni or bilateral secondary urethral obstruction causing hydronephrosis. Uterine artery emoblisation (UAE) has previously shown to effectively resolve symptoms as well as relieve urethral obstruction and resolve the hydronephrosis. UAE has now established itself as an organ preserving and minimally invasive procedure in the management of symptomatic uterine fibroids. It is a safe and effective alternative to hysterectomy for resolving fibroid related pressure symptoms. The case presented examines the clinical manifestations and impact of uterine fibroids on the urinary tract system. The therapeutic options to relieve the urological symptoms as well as preserve fertility are explored and presented. Case: The case is a 29-year-old Nepalese female admitted to hospital with recurrent urosepsis with multiresistant organisms. This was on a background of an enlarged uterus (measuring 17cm x11cm) with multiple subserosal, intramural and exophytic fibroids- causing external ureteric compression. She had bilateral ureteric stents insitu and required bilateral right and left nephrostomies during repeated episodes of urosepsis and bilateral ureteric obstruction. The left nephrostomy was removed a month prior to admission and her most recent CT KUB demonstrated hypofunctioning ureteric stents with bilateral hydronephrosis. Options of hysterectomy versus uterine artery emoblisation (UAE) were extensively explored. The patient was keen to preserve fertility. Risks associated with UAE such as expulsion of the submucosal component of the fibroids and the possibilities of sepsis in the setting of ongoing ureteric colonisation were particularly high. The patient opted to trial UAE even though the risks of recurrent hospital admissions with urosepsis were going to be particularly high. In the event, the uterus fails to shrink adequately enough to relieve the obstructed ureters a hysterectomy would inevitably be required in future. Day 3 post UAE the patient developed fevers, was hypotensive and tachycardic post-receiving prophylactic meropenem and fluconazole pre emoblisation. She was noted to have a CRP of 293 with the most recent urine culture during this time growing Candida albicans. The patient was recommenced on oral fluconazole and IV meropenem, with good effect. Her repeat renal tract ultrasound post-UAE showed ongoing marked left hydronephrosis relatively unchanged from the scan one month prior to the procedure, however the right-sided hydronephrosis had resolved. The patient was discharged on a 2-week course of antibiotics. The patient will have a repeat renal tract ultrasound and MRI of the ureters to re-evaluate the degree of hydronephrosis and progress- this was unavailable at the time of abstract submission and will be presented at the conference. Conclusion: Fibroids are a common benign tumour of the uterus and can frequently impact the lower urinary system resulting in significant uropathy. They often enlarge and compress the urinary bladder, urethra and lower end of the ureters. The effectiveness of UAE as a fertility preserving option is described.

Keywords: Uterine leiomyomas and urological complications, uterine artery embolisation for fibroids, Uterine fibroids and complications, Management of uterine fibroids

Procedia PDF Downloads 195

Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

Abstract:

Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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Authors: I. C. Orabueze, A. A. Amudalat, S. A. Adesegun, A. A. Usman

Abstract:

Dental and associated oral diseases are increasingly affecting a considerable portion of the population and are considered some of the major causes of tooth loss, discomfort, mouth odor and loss of confidence. This study focused on the ethnobotanical survey of medicinal plants used in oral therapy and evaluation of the antimicrobial activities of methanolic extracts of two selected plants from the survey for their efficacy against dental microorganisms. The ethnobotanical survey was carried out in six herbal markets in Lagos State, Nigeria by oral interviewing and information obtained from an old family manually complied herbal medication book. Methanolic extracts of Olax subscorpioidea (stem bark) and Bridelia ferruginea (stem bark) were assayed for their antimicrobial activities against clinical oral isolates (Aspergillus fumigatus, Candida albicans, Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa). In vitro microbial technique (agar well diffusion method and minimum inhibitory concentration (MIC) assay) were employed for the assay. Chlorhexidine gluconate was used as the reference drug for comparison with the extract results. And the preliminary phytochemical screening of the constituents of the plants were done. The ethnobotanical survey produced plants (28) of diverse family. Different parts of plants (seed, fruit, leaf, root, bark) were mentioned but 60% mentioned were either the stem or the bark. O. subscorpioidea showed considerable antifungal activity with zone of inhibition ranging from 2.650 – 2.000 cm against Aspergillus fumigatus but no such encouraging inhibitory activity was observed in the other assayed organisms. B. ferruginea showed antibacterial sensitivity against Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa with zone of inhibitions ranging from 3.400 - 2.500, 2.250 - 1.600, 2.700 - 1.950, 2.225 – 1.525 cm respectively. The minimum inhibitory concentration of O. subscorpioidea against Aspergillus fumigatus was 51.2 mg ml-1 while that of B. ferruginea against Streptococcus spp was 0.1mg ml-1 and for Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa were 25.6 mg ml-1. A phytochemical analysis reveals the presence of alkaloids, saponins, cardiac glycoside, tannins, phenols and terpenoids in both plants, with steroids only in B. ferruginea. No toxicity was observed among mice given the two methanolic extracts (1000 mg Kg-1) after 21 days. The barks of both plants exhibited antimicrobial properties against periodontal diseases causing organisms assayed, thus up-holding their folkloric use in oral disorder management. Further research could be done viewing these extracts as combination therapy, checking for possible synergistic value in toothpaste and oral rinse formulations for reducing oral bacterial flora and fungi load.

Keywords: antimicrobial activities, Bridelia ferruginea, dental disinfection, methanolic extract, Olax subscorpioidea, ethnobotanical survey

Procedia PDF Downloads 219

Authors: Dharshini Selvarajah, Karen Kong

Abstract:

Background: Uterine fibroids are a common benign gynaecologic neoplasm in reproductive-aged women. Fibroids may become symptomatic in a vast majority of nulliparous women. Their diagnosis and management are often coordinated between gyneacologists, radiologists and urologists depending on the anatomical location, growth, size and the fibroids' sarcomatous evolvement. Some patients may develop obstructive uropathy symptoms, either uni or bilateral secondary urethral obstruction causing hydronephrosis. Uterine artery embolization (UAE) has previously been shown to effectively resolve symptoms as well as relieve urethral obstruction and resolve hydronephrosis. UAE has now established itself as an organ-preserving and minimally invasive procedure in the management of symptomatic uterine fibroids. It is a safe and effective alternative to hysterectomy for resolving fibroid-related pressure symptoms. The case presented examines the clinical manifestations and impact of uterine fibroids on the urinary tract system. The therapeutic options to relieve the urological symptoms as well as preserve fertility are explored and presented. Case: The case is a 29-year-old Nepalese female admitted to the hospital with recurrent urosepsis with multiresistant organisms. This was on a background of an enlarged uterus (measuring 17cm x11cm) with multiple subserosal, intramural and exophytic fibroids- causing external ureteric compression. She had bilateral ureteric stents in situ and required bilateral right and left nephrostomies during repeated episodes of urosepsis and bilateral ureteric obstruction. The left nephrostomy was removed a month prior to admission, and her most recent CT KUB demonstrated hypofunctioning ureteric stents with bilateral hydronephrosis. Options of hysterectomy versus uterine artery embolization (UAE) were extensively explored. The patient was keen to preserve fertility. Risks associated with UAE, such as the expulsion of the submucosal component of the fibroids and the possibilities of sepsis in the setting of ongoing ureteric colonisation were particularly high. The patient opted to trial UAE even though the risks of recurrent hospital admissions with urosepsis were going to be particularly high. In the event, the uterus fails to shrink adequately enough to relieve the obstructed ureters, a hysterectomy would inevitably be required in the future. Day 3 post-UAE the patient developed fevers, was hypotensive and tachycardic post-receiving prophylactic meropenem and fluconazole pre emoblisation. She was noted to have a CRP of 293 with the most recent urine culture during this time growing Candida albicans. The patient was recommenced on oral fluconazole and IV meropenum, with good effect. Her repeat renal tract ultrasound post-UAE showed ongoing marked left hydronephrosis relatively unchanged from the scan one month prior to the procedure; however, the right-sided hydronephrosis had resolved. The patient was discharged on a 2-week course of antibiotics. The patient will have a repeat renal tract ultrasound and MRI of the ureters to re-evaluate the degree of hydronephrosis and progress- this was unavailable at the time of abstract submission and will be presented at the conference. Conclusion: Fibroids are a common benign tumor of the uterus and can frequently impact the lower urinary system resulting in significant uropathy. They often enlarge and compress the urinary bladder, urethra and lower end of the ureters. The effectiveness of the UAE as a fertility-preserving option is described.

Keywords: uterine artery embolisation for fibroids, urological complications from fibroids, uropathy of fibroids, obstructive fibroid management

Procedia PDF Downloads 185

Authors: Jolien Rijlaarsdam, Charlotte A. M. Cecil, J. Marieke Buil, Pol A. C. Van Lier, Edward D. Barker

Abstract:

Although there is mounting evidence that the experience of being bullied associates with both internalizing and externalizing symptoms, it is not known yet whether the identified associations are specific to these symptoms or shared between them. The primary focus of this study is to assess the prospective associations of bullying exposure with both general and specific (i.e., internalizing, externalizing) factors of psychopathology. This study included data from 6,210 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Child bullying was measured by self-report at ages 8 and 10 years. Child psychopathology symptoms were assessed by parent-interview, using the Development and Well-being Assessment (DAWBA) at ages 7 and 13 years. Bullying exposure is significantly associated with the general psychopathology factor in early adolescence. In particular, chronically victimized youth exposed to multiple forms of bullying (i.e., both overt and relational) showed the highest levels of general psychopathology. Bullying exposure is also associated with both internalizing and externalizing factors from the correlated-factors model. However, the effect estimates for these factors decreased considerably in size and dropped to insignificant for the internalizing factor after extracting the shared variance that belongs to the general factor of psychopathology. In an integrative longitudinal model, higher levels of general psychopathology at age seven are associated with bullying exposure at age eight, which, in turn, is associated with general psychopathology at age 13 through its two-year continuity. Findings suggest that exposure to bullying is a risk factor for a more general vulnerability to psychopathology through mutually influencing relationships.

Keywords: bullying exposure, externalizing, general psychopathology, internalizing, longitudinal

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Authors: Christopher Leung, Guillermo Becerril-Martinez

Abstract:

Amyloidosis is a rare systemic disease where abnormal proteins invade various organs and impede their function. Occasionally, they can manifest in a solidary organ such as the heart, lung, and nervous systems; rarely do they manifest in the gallbladder. Diagnosis often requires biopsy of the affected area and histopathology shows deposition of abnormally folded globular proteins called amyloid proteins. This case presents a 69-year-old male with a 3-month history of RUQ pain, diarrhea and non-specific symptoms of tiredness, etc. On imaging, both his US and CT abdomen showed gallbladder wall thickening and pericholecystic fluid, which may represent acute cholecystitis with hypodense lesions around the gallbladder, possibly representing liver abscesses. Given his symptoms of abdominal pain and imaging findings, this gentleman eventually had a laparoscopic cholecystectomy showing a gangrenous gallbladder with a mass on the liver bed. On histopathology, it showed amorphous hyaline eosinophilic material, which Congo-stained confirmed amyloidosis. Amyloidosis explained his non-specific symptoms, he avoided further biopsy, and he was commenced immediately on Lenalidomide. Involvement of the gallbladder is extremely rare, with less than 30 cases around the world. Half of the cases are reported as primary amyloidosis. This case adds to the current literature regarding primary gallbladder amyloidosis. Importantly, this case highlights how laparoscopic cholecystectomy can help with the diagnosis of gallbladder amyloidosis.

Keywords: amyloidosis, cholecystitis, gangrenous cholecystitis, gallbladder, systemic amyloidosis

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Authors: Saimir Cenameri, Arjana Tereziu, Kastriot Dallaku

Abstract:

Introduction: Intra-uterine death is a common problem in obstetrical practice, and can lead to complications if left to resolve spontaneously. The cervix is unprepared, making inducing of labor difficult. Misoprostol is a synthetic prostaglandin E1 analogue, inexpensive, and is presented valid thanks to its ability to bring about changes in the cervix that lead to the induction of uterine contractions. Misoprostol is quickly absorbed when taken orally, resulting in high initial peak serum concentrations compared with the vaginal route. The vaginal misoprostol peak serum concentration is not as high and demonstrates a more gradual serum concentration decline. This is associated with many benefits for the patient; fast induction of labor; smaller doses; and fewer side effects (dose-depended). Mostly it has been used the regime of 50 μg/4 hour, with a high percentage of success and limited side effects. Objective: Evaluation of the efficiency of the use of oral and vaginal misoprostol in inducing labor, and comparing it with its use not by a previously defined protocol. Methods: Participants in this study included patients at U.H.O.G. 'Koco Gliozheni', Tirana from April 2004-July 2006, presenting with an indication for inducing labor in the third trimester for pregnancy termination. A total of 37 patients were randomly admitted for birth inducing activity, according to protocol (26), oral or vaginal protocol (10 vs. 16), and a control group (11), not subject to the protocol, was created. Oral or vaginal misoprostol was administered at a dose of 50 μg/4 h, while the fourth group participants were treated individually by the members of the medical staff. The main result of interest was the time between induction of labor to birth. Kruskal-Wallis test was used to compare the average age, parity, women weight, gestational age, Bishop's score, the size of the uterus and weight of the fetus between the four groups in the study. The Fisher exact test was used to compare day-stay and causes in the four groups. Mann-Whitney test was used to compare the time of the expulsion and the number of doses between oral and vaginal group. For all statistical tests used, the value of P ≤ 0.05 was considered statistically significant. Results: The four groups were comparable with regard to woman age and weight, parity, abortion indication, Bishop's score, fetal weight and the gestational age. There was significant difference in the percentage of deliveries within 24 hours. The average time from induction to birth per route (vaginal, oral, according to protocol and not according to the protocol) was respectively; 10.43h; 21.10h; 15.77h, 21.57h. There was no difference in maternal complications in groups. Conclusions: Use of vaginal misoprostol for inducing labor in the third trimester for termination of pregnancy appears to be more effective than the oral route, and even more to uses not according to the protocols approved before, where complications are greater and unjustified.

Keywords: inducing labor, misoprostol, pregnancy termination, third trimester

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Authors: Folajimi Oladimeji Shorunke

Abstract:

Background: As of October 9, 2023, diphtheria has been noted to be re-emerging in four African countries: Algeria, Guinea, Niger, and Nigeria. 14,587 cases with a case fatality rate of 4.1% have been reported across these regions, with Nigeria alone responsible for over 90% of the cases. In Taraba State Nigeria, the index case of Diphtheria was reported on epidemic week 34, August 24, 2023 with 75 confirmed cases found 3 months after the index case and a case fatality of 1.3%. it described the distribution, trend and common symptoms found during the Outbreak. Methods: The Taraba State Diphtheria Outbreak line list on the Surveillance Outbreak Response Management & Analysis System (SORMAS) for all its 16 local government areas (LGAs) was analyzed using descriptive statistics (graphs, chats and maps) for the period between 24th August to 25th November 2023. Primary data was collected through the use of case investigation forms and variables like Age, gender, date of disease onset, LGA of residence, and symptoms exhibited were collected. Naso-pharyngeal and oro-pharyngeal samples were also collected for Laboratory confirmation. The most common diphtheria symptoms during the outbreak were also highlighted. Results: A total of 75 Diphtheria cases were diagnosed in 10 of the 16 LGAs in Taraba State between 24th August to 25th November 2023, 72% of the cases were female, with the age range 0-9 years having the highest proportion of 34 (45.3%), the number of positive diagnosis reduces with age among cases. The Northern part of the State had the highest proportion of cases, 68 (90.7%), with Ardo-Kola LGA having the highest 28 (29%). The remaining 9.2% of cases is shared among the middle belt and southern part of the State. The Epi-curve took the characteristic shape of a propagated infection with peaks at the 37th, 39th and 45th epidemic weeks. The most common symptoms found in cases were fever 71 (94.7%), pharyngitis 65( 86.7%), tonsillitis 60 (80%), and laryngitis 53 (71%). Conclusions: The number of confirmed cases of Diphtheria in Taraba State, Nigeria between 24th August to 25th November 2023 is 75. The condition is higher among females than male and mostly affected children between ages 0-9 with the northern part of the state most affected. The most common symptoms exhibited by cases include fever, pharyngitis, tonsillitis and laryngitis.

Keywords: diphtheria outbreak, taraba nigeria, descriptive epidemiology, trend

Procedia PDF Downloads 35

Authors: Heba A. Hazzah, Ragwa M. Farid, Maha M. A. Nasra, Mennatallah Zakria, Magda A. El Massik, Ossama Y. Abdallah

Abstract:

Introduction: Curcumin (Cur) is a polyphenol derived from the herbal remedy and dietary spice turmeric. It possesses diverse anti-inflammatory and anti-cancer properties following oral or topical administration. The buccal delivery of curcumin can be useful for both systemic and local disease treatments such as gingivitis, periodontal diseases, oral carcinomas, and precancerous oral lesions. Despite of its high activity, it suffers a limited application due to its low oral bioavailability, poor aqueous solubility, and instability. Aim: Preparation and characterization of curcumin solid lipid nanoparticles with a high loading capacity into a mucoadhesive gel for buccal application. Methodology: Curcumin was formulated as nanoparticles using different lipids, namely Gelucire 39/01, Gelucire 50/13, Precirol, Compritol, and Polaxomer 407 as a surfactant. The SLN were dispersed in a mucoadhesive gel matrix to be applied to the buccal mucosa. All formulations were evaluated for their content, entrapment efficiency, particle size, in vitro drug dialysis, ex vivo mucoadhesion test, and ex vivo permeation study using chicken buccal mucosa. Clinical evaluation was conducted on 15 cases suffering oral erythroplakia and erosive lichen planus. Results: The results showed high entrapment efficiency reaching almost 90 % using Gelucire 50, the loaded gel with Cur-SLN showed good adhesion property and 25 minutes in vivo residence time. In addition to stability enhancement for the Cur powder. All formulae did not show any drug permeated however, a significant amount of Cur was retained within the mucosal tissue. Pain and lesion sizes were significantly reduced upon topical treatment. Complete healing was observed after 6 weeks of treatment. Conclusion: These results open a room for the pharmaceutical technology to optimize the use of this golden magical powder to get the best out of it. In addition, the lack of local anti-inflammatory compounds with reduced side effects intensifies the importance of studying natural products for this purpose.

Keywords: curcumin, erythroplakia, mucoadhesive, pain, solid lipid nanoparticles

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Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

Abstract:

Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of anti-aging. They have been given one intravenous infusion of UC-MSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: chronic inflammatory diseases, intravenous infusion, stem cell therapy, umbilical cord blood derived mesenchymal stem cells (UC-MSCs)

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Authors: Katalin Gocze, Vanda A Nemes, Charlotte Briest

Abstract:

Introduction: Premenstrual syndrome (PMS) is a psychoneuroendocrinological disorder adversely affecting life-quality for over 80% of hormonally active women. PMS has a negative impact on women’s daily life in terms of work, interpersonal relationships and leisure time activities. The aim of our study was to evaluate the effects of a yoga intervention focusing on the female pelvic area. Materials and methods: 34 women (ages 18-40) with PMS (Premenstrual Syndrome Screening Tool) and no previous experience in yoga were recruited and randomly assigned to either the yoga or the control group. The intervention consisted of 90’ yoga sessions twice a week and a daily 15’ self-practice module with carefully chosen yogic exercises addressing the reproductive organs by toning the pelvic floor and opening the hips as well as relieving stress and improving concentration. Severity of symptoms of PMS was assessed at the beginning and after the 8-week-long intervention. Pre- and post-program data collection included physical and psychological parameters and the evaluation of ACOQ PMS questionnaire and daily symptom diary. Results: Age and educational background were similar in the control and intervention group with an overall mean age of 29.11±4.78 years. PSST scores significantly improved in the yoga group (p=0.002), while difference in the control group’s pre and post-program values were non-significant (p=0.38). Perception and tolerance of anxiety and stress was significantly better after the intervention (p=0.008). As for changes in physical symptoms distinct improvement was registered for breast tenderness (p=0.028) and for meteorism (p=0.015). Discussion: Yoga’s success originates from the synergic positive effects of stress relief and regular physical activity. Benefits (both mental and physical) of strategically planned, focused yoga practice are apparent even after shorter time periods and can help women with PMS manage or eliminate symptoms in order to improve their life-quality.

Keywords: life-quality, physical symptoms, premenstrual syndrome, psychological impact, yoga

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Authors: Mai M. Farid, Ximeng Yang, Tomoharu Kuboyama, Yuna Inada, Chihiro Tohda

Abstract:

Intro: Trigonella foenum-graecum (Fenugreek), from Fabaceae family is a well-known plant traditionally used as food and medicine. Many pharmacological effects of Trigonella foenum- graecum seeds extract (TF extract) were evaluated such as anti-diabetic, anti-tumor and anti-dementia effects using in vivo models. Regarding the anti-dementia effects of TF extract, diabetic rats, aluminum chloride-induced amnesia rats and scopolamine-injected mice were used previously for evaluation, which are not well established as Alzheimer’s disease models. In addition, those previous studies, active constituents in TF extract for memory function were not identified. Method: This study aimed to clarify the effect of TF extract on Alzheimer’s disease model, 5XFAD mouse that overexpresses mutated APP and PS1 genes and determine the major active constituent in the brain after oral intake of TF extract. Results: Trigonelline was detected in the cerebral cortex of 5XFAD mice after 24 hours of oral administration of TF extract by LC-MS/MS. Oral administration of TF extract for 17 days improved object location memory in 5XFAD mice. Conclusion: These results suggest that TF extract and its active constituents could be an expected therapeutic candidate for Alzheimer’s disease.

Keywords: Alzheimer's disease, LC-MS/MS, memory recovery, Trigonella foenum-graecum Seeds, 5XFAD mice

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Authors: Asha Manoharan, Sooraj A. O, Anju K. G

Abstract:

Enlarged vestibular aqueduct (EVA) refers to the presence of congenital sensorineural hearing loss with an enlarged vestibular aqueduct. The Audiological symptoms of EVA are fluctuating and progressive in nature and the diagnosis of EVAS can be confirmed only with radiological evaluation. Hence it is difficult to differentiate EVA from conditions like Meniere’s disease, semi-circular dehiscence, etc based on audiological findings alone. EVA in adults is easy to identify due to distinct vestibular symptoms. In children, EVA can remain either unidentified or misdiagnosed until the vestibular symptoms are evident. Motor developmental delay, especially the ones involving a change of body alignment, has been reported in the pediatric population with EVA. So, it should be made mandatory to recommend radiological evaluation in young children with fluctuating hearing loss reporting with motor developmental delay. This single case study of a baby with Enlarged Vestibular Aqueduct (EVA) primarily aimed to address the following: a) Challenges while diagnosing young patients with EVA and fluctuating hearing loss, b) Importance of radiological evaluation in audiological diagnosis in the pediatric population, c) Need for regular monitoring of hearing, hearing aid performance, and cochlear implant mapping closely for potential fluctuations in such populations, d) Importance of reviewing developmental, language milestones in very young children with fluctuating hearing loss.

Keywords: enlarged vestibular aqueduct (EVA), motor delay, radiological evaluation, fluctuating hearing loss, cochlear implant

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Authors: Ilma Robo, Saimir Heta, Vera Ostreni, Elsaida Agrushi, Eduart Kapaj

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Introduction: Cyclic hormonal fluctuations are known from literature to have a clinically visible effects on gingival tissue reactions, to the diagnosed processes of gingival inflammation. Materials and methods: At a total of 47 female patients, ad-hock presented at the University Clinic, were recorded data on effect of hormonal oscillations at periodontal treatment protocol. Oral examination was performed on soft tissue of gingiva and the oral mucous membrane, always respecting the air-drying procedure and then checking with free eye differences in oral mucosal relief. After the patients were informed about the study protocol, the purpose of the study and the ongoing procedure, verbal consensus was required. Results: The study was conducted in a total of 47 patients, out of which 13 patients were under the gingivitis classification, and 24 patients under the periodontal classification. Patients included in the study are divided by age, cycle week respectively 1,2,3 and 4.The younger age of female patients is more prone to the appearance of gingivitis, which is further aggravated by the effects of sexual hormones and the effect of the controlled or non-regulated fluctuations of the latter. Conclusions: The healing process is more fuel-intensive in the absence of high hormone levels, as they are these pro-inflammatory hormones, both in or near the ho Younger women are more open to volunteering in studies that record individual and study data that may last in time.

Keywords: gingiva, hormonal oscillations, female patients, mucosa, periodontal non-surgical treatment

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Authors: Annisa Siu, Ping Zou

Abstract:

Background: Existent literature addressing Asian American children and adolescents reveals that this population is experiencing rates of depression comparable to those of European American and other ethnic minority youths. Within the last decade, increased attention has been given to Asian American adolescent mental health. Methods: 44 articles were extracted from Pubmed, PsycINFO, EMBASE, and Proquest CINAHL. Data were subject to thematic analyses and categorized into factors under individual, familial, and community levels. Results: Of all the individual factors, age and gender were the most supported in their relationship with depressive symptoms. Likewise, living situations, parent-child relations, peer relations, and broader environmental factors were strongly evidenced. The remaining psychosocial factors faced contrary evidence or were insubstantially addressed in the empirical literature. Discussion: The identified psychosocial factors within this study offer a starting point for future research to examine what factors should be included in formal or informal methods of screening/consultations. Clinicians should aim to understand the cultural influences specific to Asian American adolescents, particularly the central role that family relations may have on their depressive symptoms. Conclusion: Low awareness of culturally linked expressions of psychological distress can lead to misdiagnosis or under-diagnosis of depression in Asian American youth. Further evidence is needed to clarify the relationship of psychosocial factors linked to Asian American adolescent depressive symptoms.

Keywords: adolescent, Asian American, depression, psychosocial factors

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Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore

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Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.

Keywords: dental caries, life course, Bahrain, school outcomes

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Authors: Rachel M. Edelstein, John D. Van Horn, Karen M. Schmidt, Sydney N. Cushing

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As a consequence of sports-related concussions, female athletes have been documented as reporting more symptoms than their male counterparts, in addition to incurring longer periods of recovery. However, the role of sex and its potential influence on symptom reporting and recovery outcomes in concussion management has not been completely explored. The present aims to investigate the relationship between female concussion symptom severity and the presence of assessment bias. The Sport Concussion Assessment Tool 3 (SCAT3), collected by the NCAA and DoD CARE Consortium, was quantified at five different time points post-concussion. N= 1,258 NCAA athletes, n= 473 female (soccer, rugby, lacrosse, ice hockey) and n=785 male athletes (football, rugby, lacrosse, ice hockey). A polytomous Item Response Theory (IRT) Graded Response Model (GRM) was used to assess the relationship between sex and symptom reporting. Differential Item Functioning (DIF) and Differential Group Functioning (DGF) were used to examine potential group-level bias. Interactions for DIF were utilized to explore the impact of sex on symptom reporting among NCAA male and female athletes throughout and after their concussion recovery. DIF was significantly detected after B-H corrections displayed in limited items; however, one symptom, “Pressure in Head” (-0.29, p=0.04 vs -0.20, p =0.04), was statistically significant at both < 6 hours and 24-48 hours. Thus, implies that at < 6 hours, males were 29% less likely to indicate “Pressure in the Head” compared to female athletes and 20% less likely at 24-48 hours. Overall, the DGF suggested significant group differences, suggesting that male athletes might be at a higher risk for returning to play prematurely (logits = -0.38, p < 0.001). However, after analyzing the SCAT 3, a clinically relevant trend was discovered. Twelve out of the twenty-two symptoms suggest higher difficulty in female athletes within three or more of the five-time points. These symptoms include Balance Problems, Blurry Vision, Confusion, Dizziness, Don’t Feel Right, Feel in Fog, Feel Slow Down, Low Energy, Neck Pain, Sensitivity to Light, Sensitivity to Noise, Trouble Falling Asleep. Despite a lack of statistical significance, this tendency is contrary to current literature stating that males may be unclear on symptoms, but females may be more honest in reporting symptoms. Further research, which includes possible modifying socioecological factors, is needed to determine whether females may consistently experience more symptoms and require longer recovery times or if, parsimoniously, males tend to present their symptoms and readiness for play differently than females. Such research will help to improve the validity of current assumptions concerning male as compared to female head injuries and optimize individualized treatments for sports-related head injuries.

Keywords: female athlete, sports-related concussion, item response theory, concussion assessment

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Authors: Mami Miyasaka, Kaichi Yanaoka

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Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity; symptoms often manifest during childhood. In children with ADHD, the development of inhibitory processes is impaired. Inhibitory control allows people to avoid processing unnecessary stimuli and to behave appropriately in various situations; thus, people with ADHD require interventions to improve inhibitory control. Positive or negative reinforcements (i.e., reward or punishment) help improve the performance of children with such difficulties. However, in order to optimize impact, reward and punishment must be presented immediately following the relevant behavior. In regular elementary school classrooms, such supports are uncommon; hence, an alternative practical intervention method is required. One potential intervention involves setting goals to keep children motivated to perform tasks. This study examined whether goal setting improved inhibitory performances, especially for children with severe ADHD-related symptoms. We also focused on giving feedback on children's task performances. We expected that giving children feedback would help them set reasonable goals and monitor their performance. Feedback can be especially effective for children with severe ADHD-related symptoms because they have difficulty monitoring their own performance, perceiving their errors, and correcting their behavior. Our prediction was that goal setting by itself would be effective for children with mild ADHD-related symptoms, and goal setting based on feedback would be effective for children with severe ADHD-related symptoms. Japanese elementary school children and their parents were the sample for this study. Children performed two kinds of go/no-go tasks, and parents completed a checklist about their children's ADHD symptoms, the ADHD Rating Scale-IV, and the Conners 3rd edition. The go/no-go task is a cognitive task to measure inhibitory performance. Children were asked to press a key on the keyboard when a particular symbol appeared on the screen (go stimulus) and to refrain from doing so when another symbol was displayed (no-go stimulus). Errors obtained in response to a no-go stimulus indicated inhibitory impairment. To examine the effect of goal-setting on inhibitory control, 37 children (Mage = 9.49 ± 0.51) were required to set a performance goal, and 34 children (Mage = 9.44 ± 0.50) were not. Further, to manipulate the presence of feedback, in one go/no-go task, no information about children’s scores was provided; however, scores were revealed for the other type of go/no-go tasks. The results revealed a significant interaction between goal setting and feedback. However, three-way interaction between ADHD-related inattention, feedback, and goal setting was not significant. These results indicated that goal setting was effective for improving the performance of the go/no-go task only with feedback, regardless of ADHD severity. Furthermore, we found an interaction between ADHD-related inattention and feedback, indicating that informing inattentive children of their scores made them unexpectedly more impulsive. Taken together, giving feedback was, unexpectedly, too demanding for children with severe ADHD-related symptoms, but the combination of goal setting with feedback was effective for improving their inhibitory control. We discuss effective interventions for children with ADHD from the perspective of goal setting and feedback. This work was supported by the 14th Hakuho Research Grant for Child Education of the Hakuho Foundation.

Keywords: attention deficit disorder with hyperactivity, feedback, goal-setting, go/no-go task, inhibitory control

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Authors: Preethy Mary Donald, Renjith George

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Oral tori are localized non-neoplastic protuberances of maxilla and mandible. Torus palatinus (TP) is found on the midline of the roof of mouth existing as single growth or in clusters. Torus mandibularis(TM) is located on the lingual aspect of the mandible commonly between canine and premolar region. Etiology of their presence was not clear and was found to be multifactorial. Their variations in relation to age, gender, ethnicity and also the characteristics of TP and TM have become the interest of multiple studies. The objectives of this study were to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) among patients who have visited outpatient department, Faculty of Dentistry, Melaka Manipal Medical College. 108 patients were examined for the presence of oral tori at the outpatient department, Faculty of Dentistry, Melaka-Manipal Medical College. Factors such as age, gender, ethnicity of the patients and size, shape, location of the oral tori were studied. For TP, Malays (62.96%) have been found to have the highest prevalence than Chinese (43.3%) and Indians (35.71%). For TM, Chinese (7.46%) had predominated compared to Malays (7.41%) and Indians (0%). There is no significant association between occurrence of TP and TM with age, gender and ethnicity. For Torus palatinus, the most common size was Grade 1(1-3mm), most common location was molar region, and the most common shape was spindle. For Torus mandibularis, the most frequent location was canine premolar region and exists in unilateral single or bilateral single fashion. The overall prevalence rates were 47.2% for TP and 6.48% for TM. However, there is no significant association between occurrence of TP and TM with age, gender and ethnicity. The results showed variations in clinical characteristics and support the findings that occurrence of tori is a dynamic phenomenon which is multifactorial owing to the environmental factors such as stress from occlusion and dietary habits. It could be due to the genetic make-up of the individual.

Keywords: torus palatinus, torus mandibularis, age, gender

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Authors: Genevieve Jorolan-Quintero

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The recording as well as the preservation of indigenous literature is an important task as it deals with a significant heritage of pre-colonial culture. The beliefs and traditions of a people are reflected in their oral narratives, such as the folk epic, which must be written down to insure their preservation. The epic poem for instance, known as dawot among the Mandaya, one of the indigenous communities in the southern region of the Philippines, narrates the customs, the ways of life, and the adventures of an ancient people. Nabayra, an expert on Philippine folkloric studies, stresses that still extant after centuries of unknown origin, the dawot was handed down to the magdadawot (bard) by word of mouth, forming the greatest bulk of Mandaya oral tradition. Unhampered by modern means of communication to distract her/him, the magdadawot has a sharp memory of the intricacies of the ancient art of chanting the panayday (verses) of the epic poem. The dawot has several hullubaton (episodes), each of which takes several nights to chant . The language used in these oral traditions is archaic Mandaya, no longer spoken or clearly understood by the present generation. There is urgency to the task of recording and writing down what remain of the epic poem since the singers and storytellers who have retained the memory and the skill of chanting and narrating the dawot and other forms of oral tradition in their original forms are getting fewer. The few who are gifted and skilled to transmit these ancient arts and wisdom are old and dying. Unlike the other Philippine epics (i.e. the Darangen, the Ulahingan, the Hinilawod, etc.), the Mandaya epic is yet to be recognized and given its rightful place among the recorded epics in Philippine Folk Literature. The general aim of this study was to put together and preserve an intangible heritage, the Mandaya hullubaton (episodes of the dawot), in order to preserve and promote appreciation for the oral traditions and cultural legacy of the Mandaya. It was able to record, transcribe, and translate four hullubaton of the folk epic into two languages, Visayan and English to insure understanding of their contents and significance among non-Mandaya audiences. Evident in the contents of the episodes are the cultural practices, ideals, life values, and traditions of the ancient Mandaya. While the conquests and adventures of the Mandaya heroes Lumungtad, Dilam, and Gambong highlight heroic virtues, the role of the Mandaya matriarch in family affairs is likewise stressed. The recording and the translation of the hullubaton and the dawot into commonly spoken languages will not only promote knowledge and understanding about their culture, but will also stimulate in the members of this cultural community a sense of pride for their literature and culture. Knowledge about indigenous cultural system and philosophy derived from their oral literature will serve as a springboard to further comparative researches dealing with indigenous mores and belief systems among the different tribes in the Philippines, in Asia, in Africa, and other countries in the world.

Keywords: Dawot, epic poem, Mandaya, Philippine folk literature

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Authors: Rojith K. Balakrishnan

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Plasmablastic lymphoma (PBL) is an uncommon, recently described B-cell derived lymphoma that is most commonly seen in patients with Human Immunodeficiency Virus (HIV) infection. Here we report a case of PBL in a 35 year old man with HIV who presented with multiple subcutaneous swellings all over the body and oral mucosal lesions.The biopsy report was suggestive of Diffuse Large B Cell Lymphoma. Immunohistochemistry was done which showed, lymphoma cells, positive for MUM1, CD 138, and VS 38. The proliferation index (MIB) was 95%. Final report was consistent with the diagnosis of Plasmablastic Lymphoma. The lesion completely regressed after treatment with systemic chemotherapy. Up to date, only a few cases of plasmablastic lymphoma have been reported from India. Increased frequency of this lymphoma in HIV patients and rarity of the tumour, along with rapid response of the same to chemotherapy, make this case a unique one. Hence the knowledge about this new entity is important for clinicians who deal with HIV patients.

Keywords: human immunodeficiency virus (HIV), oral cavity lesion, plasmablastic lymphoma, subcutaneous swelling

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Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

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Authors: Tatjana Stefanovic Stanojevic, Milica Tosic Radev, Aleksandra Bogdanovic

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Depression is considered to be a leading cause of death and disability in the female population, and that is the reason why understanding the dynamics of the onset of depressive symptomatology is important. A review of the literature indicates the relationship between depressive symptoms and insecure attachment patterns, but very few studies have examined the mechanism underlying this relation. The aim of the study was to examine the pathway from the preoccupied attachment pattern to depressive symptomatology, as well as to test the mediation effect of mentalization, social anxiety and rumination in this relationship using a serial mediation model. The research was carried out on a geographical cluster sample from the general population of Serbia included within the project ‘Indicators and models of family and work roles harmonization’ funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia. This research was carried out on a subsample of 791 working-age female adults from 37 urban and rural locations distributed through 20 administrative districts of Serbia. The respondents filled in a battery of instruments, including Relationship Questionnaire - Clinical Version (RQ - CV), The Mentalization Scale (MentS), Scale of Social Anxiety (SA), Patient Ruminative Thought Style Questionnaire (RTSQ), Health Questionnaire (PHQ-9). The results confirm our assumption that the total indirect effect of the preoccupied attachment pattern to depressive symptoms is significant across all mediators separately. More importantly, this effect is still present in a model with a sequential mediator relationship, where social anxiety, rumination, and mentalization were perceived as serial mediators of a relationship between preoccupied attachment and depressive symptoms (estimated indirect effect=0.004, boot-strapped 95% CI=0.002 to 0.007). Our findings suggest that there is a significant specific indirect effect of the preoccupied attachment pattern to depressive symptoms, occurring through mentalization, social anxiety and rumination, indicating that preoccupied attachment cause decrease of a self related mentalization, which in turn causes increasing of social anxiety and rumination, concluding in depressive symptoms as a final consequence. The finding that the path from the preoccupied attachment pattern to depressive symptoms is typical in women is understandable from the perspective of both evolutionary and culturally conditioned gender differences. The practical implications of the study are reflected in the recommendations for the prevention and forehand psychotherapy response among preoccupied women with depressive symptomatology. Treatment of this specific group of depressed patients should be focused on strengthening mentalization, learning to accept and to understand herself better, reducing anxiety in situations where mistakes are visible to others, and replacing the rumination strategy with more constructive coping strategies.

Keywords: preoccupied attachment, depression, serial mediation model, mentalization, rumination

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Authors: Naheed Khan

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A non-experimental study was conducted to evaluate the prevalence of anxiety and depression in middle-class women in Karachi, a metropolitan city of Pakistan. The Aga Khan University Anxiety and Depression Scale (AKUADS) was self -administered by a sample of 50 housewives and 50 professional women between the ages of 24 and 54 years. All the participants were at least graduates, married, had children, and were living in joint family systems. Results showed a 48% prevalence of anxiety and depression in housewives as compared to 34% in professional women. The data showed significant difference in mean of total scores on AKUADS and the calculated t-value of 1.957 with a df = 98 and α = 0.05. Two variables, that is, profession and a higher level of education were significantly related to the outcome. Hence acquiring higher education and taking up a job, even a part time one, may alleviate the symptoms of anxiety and depression in housewives. Other factors responsible for the relief of such symptoms, such as quality of relationship with husbands, may be investigated for both categories of women.

Keywords: anxiety, depression, housewives, professional women

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Authors: Kaarunya Sampathkumar, Say Chye Joachim Loo

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Oral delivery is regarded as the facile method for the administration of active pharmaceutical ingredients (API) and drug carriers. In an initiative towards sustainable nanotechnology, an oral nano-delivery system has been developed that is made entirely of food-based materials and can also act as a site-specific delivery device depending on the stimulus encountered in different parts of the gastrointestinal tract (GIT). The delivery system has been fabricated from food grade polysaccharide materials like chitosan and starch through electrospraying technique without the use of any organic solvents. A nutraceutical extracted from an Indian medicinal plant, has been loaded into the nano carrier to test its efficacy in encapsulation and stimuli based release of the active ingredient. The release kinetics of the nutraceutical from the carrier was evaluated in simulated gastric, intestinal and colonic fluid and was found to be triggered both by the enzymes and the pH in each part of the intestinal tract depending on the polysaccharide being used. The toxicity of the nanoparticles on the intestinal epithelial cells was tested and found to be relatively safe for up to 24 hours at a concentration of 0.2 mg/mL with cellular uptake also being observed. The developed nano carrier thus serves as a promising delivery vehicle for targeted delivery to different parts of the GIT with the inherent conditions of the GIT itself acting as the stimulus. In addition, being fabricated from food grade materials, the carrier could be potentially used for the targeted delivery of nutrients through functional foods.

Keywords: bioavailability, chitosan, delivery systems, encapsulation

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Authors: Mohammed Khalid Mahmood, Delphine Tardivo, Romain Lan

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Dental caries is one of the most common diseases in the world, affecting billions of people and significantly lowering the quality of life. Malnutrition, on the other hand, is defined as inadequate, imbalanced, or excessive consumption of macronutrients, micronutrients, or both, which is characterized as an abnormal physiological condition. Oral health is impacted by malnutrition, and malnutrition can result from poor oral health. The objective of this paper was to study the association of serum Vitamin D level and body mass index as representatives of malnutrition at micro and macro levels, respectively, on dental caries. Results showed that: 1. The majority of the population studied (70%) are Vitamin D deficient. 2. Having a normal and even a sufficient level of serum Vitamin D and having a normal body mass index increase the chances of children being caries-free and having a lower caries index.

Keywords: children, dental Caries, malnutrition, vitamin D

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Authors: M. Siedlikowski, F. Rauch, A. Tsimicalis

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Osteogenesis Imperfecta (OI) is a genetic disorder of childhood onset that causes frequent fractures after minimal physical stress. To date, OI research has focused on medically- and surgically-oriented outcomes with little attention on the perspective of the affected child. It is a challenge to elicit the child’s voice in health care, in other words, their own perspective on their symptoms, but software development offers a way forward. Sisom (Norwegian acronym derived from ‘Si det som det er’ meaning ‘Tell it as it is’) is an award-winning, rigorously tested, interactive, computerized tool that helps children with chronic illnesses express their symptoms to their clinicians. The successful Sisom software tool, that addresses the child directly, has not yet been adapted to attend to symptoms unique to children with OI. The purpose of this study was to develop a Sisom paper prototype for children with OI by seeking the perspectives of end users, particularly, children with OI and clinicians. Our descriptive qualitative study was conducted at Shriners Hospitals for Children® – Canada, which follows the largest cohort of children with OI in North America. Purposive sampling was used to recruit 12 children with OI over three cycles. Nine clinicians oversaw the development process, which involved determining the relevance of current Sisom symptoms, vignettes, and avatars, as well as generating new Sisom OI components. Data, including field notes, transcribed audio-recordings, and drawings, were deductively analyzed using content analysis techniques. Guided by the following framework, data pertaining to symptoms, vignettes, and avatars were coded into five categories: a) Relevant; b) Irrelevant; c) To modify; d) To add; e) Unsure. Overall, 70.8% of Sisom symptoms were deemed relevant for inclusion, with 49.4% directly incorporated, and 21.3% incorporated with changes to syntax, and/or vignette, and/or location. Three additions were made to the ‘Avatar’ island. This allowed children to celebrate their uniqueness: ‘Makes you feel like you’re not like everybody else.’ One new island, ‘About Me’, was added to capture children’s worldviews. One new sub-island, ‘Getting Around’, was added to reflect accessibility issues. These issues were related to the children’s independence, their social lives, as well as the perceptions of others. In being consulted as experts throughout the co-creation of the Sisom OI paper prototype, children coded the Sisom symptoms and provided sound rationales for their chosen codes. In rationalizing their codes, all children shared personal stories about themselves and their relationships, insights about their OI, and an understanding of the strengths and challenges they experience on a day-to-day basis. The child’s perspective on their health is a basic right, and allowing it to be heard is the next frontier in the care of children with genetic diseases. Sisom OI, a methodological breakthrough within OI research, will offer clinicians an innovative and child-centered approach to capture this neglected perspective. It will provide a tool for the delivery of health care in the center that established the worldwide standard of care for children with OI.

Keywords: child health, interactive computerized communication tool, participatory approach, symptom management

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Authors: Rasha Ahmadi

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In December 2019, a coronavirus, currently identified as SARS-CoV-2, produced a series of acute atypical respiratory illnesses in Wuhan, Hubei Province, China. The sickness induced by this virus was named COVID-19. The virus is transmittable between humans and has caused pandemics worldwide. The number of death tolls continues to climb and a huge number of countries have been obliged to perform social isolation and lockdown. Lack of focused therapy continues to be a problem. Epidemiological research showed that senior patients were more susceptible to severe diseases, whereas children tend to have milder symptoms. In this study, we focus on other possible side effects of COVID-19 and more detailed treatment strategies. Using bioinformatics analysis, we first isolated the gene expression profile of patients with severe COVID-19 from the GEO database. Patients' blood samples were used in the GSE183071 dataset. We then categorized the genes with high and low expression. In the next step, we uploaded the genes separately to the Enrichr database and evaluated our data for signs and symptoms as well as related medication regimens. The results showed that 138 genes with high expression and 108 genes with low expression were observed differentially in the severe COVID-19 VS control group. Symptoms and diseases such as embolism and thrombosis of the abdominal aorta, ankylosing spondylitis, suicidal ideation or attempt, regional enteritis were observed in genes with high expression and in genes with low expression of acute and subacute forms of ischemic heart, CNS infection and poliomyelitis, synovitis and tenosynovitis. Following the detection of diseases and possible signs and symptoms, Carmustine, Bithionol, Leflunomide were evaluated more significantly for high-expression genes and Chlorambucil, Ifosfamide, Hydroxyurea, Bisphenol for low-expression genes. In general, examining the different and invisible aspects of COVID-19 and identifying possible treatments can help us significantly in the emergency and hospitalization of patients.

Keywords: phenotypes, drug regimens, gene expression profiles, bioinformatics analysis, severe COVID-19

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Authors: Zahra Ebrahimi, Abbas Moradan

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This study investigated the effect of applying different layers of activity for different Iranian intermediate EFL learner’s oral proficiency and two of its components (fluency and accura-cy) for the beneficial use of films within speaking classes. For this purpose, thirty Iranian EFL intermediate learners were selected based on availability sampling, they were divided into one experimental group and one control group, each consisting of 15 participants, who were proved to be homogeneous based on the results obtained from IELTS oral proficien-cy test prior to the treatment. Experimental Group received the treatment which was apply-ing different layers of speaking tasks according to learners’ level of fluency and accuracy. Control group received ordinal treatment of speaking classrooms. The materials for this study consisted of 11 English movies for each session, voice-recorder device, and IELTS oral proficiency tests as well as two interviews based on Ur’s oral scale for measuring fluen-cy and accuracy. The treatment was run for 12 sessions in six weeks. At the end of the treatment, all the students both in experimental and control group were given a post-test interview based on Ur’s scale. To compare and contrast the amount of progress of the learners in different groups the results of the pre-test and post-test of speaking were analysed by using T-tests. Moreover, Multivariate analysis of variance was also used to check the hypotheses. Results showed that application of different layers of activity with regard to students’ level, led to a significantly superior performance in experimental group. Thus, this study verified the positive effect of implementation of different layers of activity and tasks to achieve progress in speaking skill. It can also help to create a less stressful at-mosphere of learning in which all the students will be given specific time to speak and lead them to be autonomous learners.

Keywords: differentiated instruction, learners’ style, multiple intelligence, speaking skill, task-based activities

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