Search results for: inferior alveolar nerve

Authors: M. P. S. Tomar, Himanshu R. Joshi, P. Jagapathi Ramayya, Rakhi Vaish, A. B. Shrivastav

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The morphology of an organ system varies according to the feeding habit, habitat and nature of their life-style. This phenomenon is called adaptation. During evolution these morphological changes make the system species specific so the study on the differential characteristics of them makes the understanding regarding the morpho-physiological adaptation easier. Hence the present study was conducted on esophagus of pariah kite, median egret, goshawk, dove and duck. Esophagus in all birds was comprised of four layers viz. Tunica mucosa, Tunica submucosa, Tunica muscularis and Tunica adventitia. The mucosa of esophagus showed longitudinal folds thus the lumen was irregular. The epithelium was stratified squamous in all birds but in Median egret the cells were large and vacuolated. Among these species very thick epithelium was observed in goshawk and duck but keratinization was highest in dove. The stratum spongiosum was 7-8 layers thick in both Pariah kite and Goshawk. In all birds, the glands were alveolar mucous secreting type. In Median egret and Pariah kite, these were round or oval in shape and with or without lumen depending upon the functional status whereas in Goshawk the shape of the glands varied from spherical / oval to triangular with openings towards the lumen according to the functional activity and in dove these glands were oval in shape. The glands were numerous in number in egret while one or two in each fold in goshawk and less numerous in other three species. The core of the mucosal folds was occupied by the lamina propria and showed large number of collagen fibers and cellular infiltration in pariah kite, egret and dove where as in goshawk and duck, collagen and reticular fibers were fewer and cellular infiltration was lesser. Lamina muscularis was very thick in all species and it was comprised of longitudinally arranged smooth muscle fibers. In Median egret, it was in wavy pattern. Tunica submucosa was very thin in all species. Tunica muscularis was mostly comprised of circular smooth muscle bundles in all species but the longitudinal bundles were very few in number and not continuous. The tunica adventitia was comprised of loose connective tissue fibers containing collagen and elastic fibers with numerous small blood vessels in all species. Further, it was observed that the structure of esophagus in birds varies according to their feeding habits.

Keywords: dove, duck, egret, esophagus, goshawk, kite

Procedia PDF Downloads 438

Authors: Chen ChihYu, Tang Wen Tzu, Chen Kuang Hui

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Aim —To compare the dismount skill between Taiwanese and elite international gymnastics in parallel bars following the 2017-2020 code of points. Methods—The gymnasts who advanced to the parallel bars event finals of these four competitions including World Championships, Universiade, the National Games of Taiwan, and the National Intercollegiate Athletic Games of Taiwan both 2017 and 2019 were selected in this study. The dismount skill of parallel bars was analyzed, and the average difficulty score was compared by one-way ANOVA. Descriptive statistics were applied to present the type of dismount skill and the difficulty of each gymnast in these four competitions. The data from World Championships and Universiade were combined as the international group (INT), and data of Taiwanese National Games and National Intercollegiate Athletic Games were also combined as the national group (NAT). The differences between INT and NAT were analyzed by the Chi-square test. The statistical significance of this study was set at α= 0.05. Results— i) There was a significant difference in the mean parallel bars dismount skill in these four competitions analyzed by one-way ANOVA. Both dismount scores of World Championships and Universiade were significantly higher than in Taiwanese National Games and National Intercollegiate Athletic Games (0.58±0.08 & 0.56±0.08 > 0.42±0.06 & 40±0.06, p < 0.05). ii) Most of the gymnasts in World Championships and Universiade selected the 0.6-point skill as the parallel bars dismount element, and for the Taiwanese National Games and the National Intercollegiate Athletic Games, most of the gymnasts performed the 0.4-point dismount skill. iii) The result of the Chi-square test has shown that there was a significant difference in the selection of parallel bars dismount skill. The INT group used the E or E+ difficulty element as the dismount skill, and the NAT group selected the D or D- difficulty element. Conclusion— The level of parallel bars dismount in Taiwanese gymnastics is inferior to elite international gymnastics. It is suggested that Taiwanese gymnastics must try to practice the F difficulty dismount (double salto forward tucked with half twist) in the future.

Keywords: Artistic Gymnastics World Championships, dismount, difficulty score, element

Procedia PDF Downloads 142

Authors: Jaruwan Chutrtong, Tanakwan Bussabun

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Study production of tempeh inoculums powder by freeze-drying comparison with dry at 50°C and the sun bask for developing efficient tempeh inoculums for tempeh producing. Rhizopus oligosporus in PDA slant cultures was incubated at 30°C for 3-5 days until spores and mycelium. Preparation spores suspension with sterilized water and then count the number of started spores. Fill spores suspension in Rice flour and soy flour, mixed with water (in the ratio 10: 7), which is steamed and sterilized at 121°C 15min. Incubated at room temperature for 4 days, count number of spores. Then take the progressive infection and full spore dough to dry at 50°C, sun bask, and lyophilize. Grind to powder. Then pack in plastic bags, stored at 5°C. To investigate quality of inoculums which use different methods, tempeh was fermented every 4 weeks for 24 weeks of the experiment. The result found that rice flour is not suitable to use as raw material in the production of powdered spores. Fungi can growth rarely. Less number of spores and requires more time than soy flour. For drying method, lyophilization is the least possible time. Samples from this method are very hard and very dark and harder to grind than other methods. Drying at 50°C takes longer time than lyophilization but can also set time use for drying. Character of the dry samples is hard solid and brown color, but can be grinded easier. The sun drying takes the longest time, can’t determine the exact time. When the spore powder was used to fermented tempeh immediately, product has similar characters as which use spores that was fresh prepared. The tempeh has normal quality. When spore powder stored at low temperature, tempeh from storage spore in weeks 4, 8 and 12 is still normal. Time spending in production was close to the production of fresh spores. After storage spores for 16 and 20 weeks, tempeh is still normal but growth and sporulation were take longer time than usual (about 6 hours). At 24 week storage, fungal growth is not good, made tempeh looks inferior to normal color, also smell and texture.

Keywords: freez drying, preparation, spores powder, tempeh

Procedia PDF Downloads 202

Authors: Syeda Sahra, Abdullah Jahangir, Rachelle Hamadi, Ahmad Jahangir, Allison Glaser

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Background: Antimicrobial resistance is on the rise. The use of redundant and inappropriate antibiotics is contributing to recurrent infections and resistance. Newer antibiotics with more robust coverage for gram-negative bacteria are in great demand for complicated urinary tract infections (cUTIs), complicated intra-abdominal infections (cIAIs), hospital-acquired bacterial pneumonia (H.A.B.P.), and ventilator-associated bacterial pneumonia (V.A.B.P.). Objective: We performed this meta-analysis to evaluate the efficacy and safety profile of a new antibiotic, Imipenem/cilastatin/relebactam, compared to other broad-spectrum antibiotics for complicated infections. Search Strategy: We conducted a systemic review search on PubMed, Embase, and Central Cochrane Registry. Selection Criteria: We included randomized clinical trials (R.C.T.s) with the standard of care as comparator arm with Imipenem/cilastatin/relebactam as intervention arm. Analysis: For continuous variables, the mean difference was used. For discrete variables, we used the odds ratio. For effect sizes, we used a confidence interval of 95%. A p-value of less than 0.05 was used for statistical significance. Analysis was done using a random-effects model irrespective of heterogeneity. Heterogeneity was evaluated using the I2 statistic. Results: The authors observed similar efficacy at clinical and microbiologic response levels on early follow-up and late follow-up compared to the established standard of care. The incidence of drug-related adverse events, serious adverse events, and drug discontinuation due to adverse events were comparable across both groups. Conclusion: Imipenem/cilastatin/relebactam has a non-inferior safety and efficacy profile compared to peer antibiotics to treat severe bacterial infections (cUTIs, cIAIs, H.A.B.P., V.A.B.P.).

Keywords: bacterial pneumonia, complicated intra-abdominal infections, complicated urinary tract infection, Imipenem, cilastatin, relebactam

Procedia PDF Downloads 206

Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

Procedia PDF Downloads 27

Authors: Sarkawt M. Hama, Paul S. Monks, Rebecca L. Cordell

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Within the Joaquin project, ultrafine particles (UFP) are continuously measured at one urban background site in Leicester. The main aims are to examine the temporal and seasonal variations in UFP number concentration and size distribution in an urban environment, and to try to assess the added value of continuous UFP measurements. In addition, relations of UFP with more commonly monitored pollutants such as black carbon (BC), nitrogen oxides (NOX), particulate matter (PM2.5), and the lung deposited surface area(LDSA) were evaluated. The effects of meteorological conditions, particularly wind speed and direction, and also temperature on the observed distribution of ultrafine particles will be detailed. The study presents the results from an experimental investigation into the particle number concentration size distribution of UFP, BC, and NOX with measurements taken at the Automatic Urban and Rural Network (AURN) monitoring site in Leicester. The monitoring was performed as part of the EU project JOAQUIN (Joint Air Quality Initiative) supported by the INTERREG IVB NWE program. The total number concentrations (TNC) were measured by a water-based condensation particle counter (W-CPC) (TSI model 3783), the particle number concentrations (PNC) and size distributions were measured by an ultrafine particle monitor (UFP TSI model 3031), the BC by MAAP (Thermo-5012), the NOX by NO-NO2-NOx monitor (Thermos Scientific 42i), and a Nanoparticle Surface Area Monitor (NSAM, TSI 3550) was used to measure the LDSA (reported as μm2 cm−3) corresponding to the alveolar region of the lung between November 2013 and November 2015. The average concentrations of particle number concentrations were observed in summer with lower absolute values of PNC than in winter might be related mainly to particles directly emitted by traffic and to the more favorable conditions of atmospheric dispersion. Results showed a traffic-related diurnal variation of UFP, BC, NOX and LDSA with clear morning and evening rush hour peaks on weekdays, only an evening peak at the weekends. Correlation coefficients were calculated between UFP and other pollutants (BC and NOX). The highest correlation between them was found in winter months. Overall, the results support the notion that local traffic emissions were a major contributor of the atmospheric particles pollution and a clear seasonal pattern was found, with higher values during the cold season.

Keywords: size distribution, traffic emissions, UFP, urban area

Procedia PDF Downloads 330

Authors: Pechpailin Kortnoi, Tanitnun Paprad

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Background: Myasthenia gravis (MG) is an autoimmune disorder characterized by impaired neuromuscular transmission due to antibodies against nicotinic receptors, leading to muscle weakness, ptosis, and respiratory issues. The incidence of MG has risen globally, emphasizing the need for effective diagnostics. Objective: This study evaluates the validity of a combined bedside test (the ice pack test and fatigability test) for diagnosing juvenile myasthenia gravis (JMG) in pediatric patients with ptosis. Methods: This cross-sectional study, conducted from January 2012 to May 2024 at King Chulalongkorn Memorial Hospital, Thailand, included pediatric patients (1 month to 18 years) with ptosis undergoing ice pack and fatigability tests. Data included demographics, clinical findings, and test results. Diagnostic efficacy was assessed using sensitivity, specificity, accuracy, PPV, NPV, Fagan Nomogram, Kappa Statistics, and McNemar’s Chi-Square. Results: Of 43 identified patients, 32 were included, with 47% male and a mean age of 7 years. The combined bedside test had high sensitivity (92.8%) and accuracy (87.5%) but moderate specificity (50%). It significantly outperformed the ice pack test (P = 0.0005), which showed low sensitivity (42.8%) and accuracy (43.8%). The fatigability test had 82% sensitivity and 92% PPV. Confirmatory tests (AChR-Ab, MuSK-Ab, neostigmine, repetitive nerve stimulation) supported most diagnoses. Conclusions: The combined bedside test, with high sensitivity (92.8%) and accuracy (87.5%), is an effective screening tool for juvenile myasthenia gravis, outperforming the ice pack test. Integrating it into clinical practice may improve diagnosis and enable timely treatment. The fatigability test (82% sensitivity) is also useful as an adjunct screening tool.

Keywords: myasthenia gravis (MG), the ice pack test, the fatigability test, the combined bedside test

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Authors: Amin Akbari, Dongcai Wang, Huiru Li, Xiaoping Du, Jie Chen

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The effect of vibrational force (VF) on accelerating orthodontic tooth movement depends on the level of delivered stimulation to the tooth in terms of peak load (PL), which requires contacts between the tooth and the VF device. A personalized device ensures the contacts, but the resulting PL distribution on the teeth is unknown. Furthermore, it is unclear whether the PL on particular teeth can be adjusted to the prescribed values. The objective of this study was to investigate the efficacy of apersonalized VF device in controlling the level of stimulation on two teeth, the mandibular canines and 2nd molars. A 3-D finite element (FE) model of human dentition, including teeth, PDL, and alveolar bone, was created from the cone beam computed tomography images of an anonymous subject. The VF was applied to the teeth through a VFdevice consisting of a mouthpiece with engraved tooth profile of the subject and a VF source that applied 0.3 N force with the frequency of 30 Hz. The dentition and mouthpiece were meshed using 10-node tetrahedral elements. Interface elements were created at the interfaces between the teeth and the mouthpiece. The upper and lower teeth bite on the mouthpiece to receive the vibration. The depth of engraved individual tooth profile could be adjusted, which was accomplished by adding a layer of material as an interference or removing a layer of material as a clearance to change the PL on the tooth. The interference increases the PL while the clearance decreases it. Fivemouthpiece design cases were simulated, which included a mouthpiece without interference/clearance; the mouthpieces with bilateral interferences on both mandibular canines and 2nd molars with magnitudes of 0.1, 0.15, and 0.2-mm, respectively; and mouthpiece with bilateral 0.3-mm clearances on the four teeth. Then, the force distributions on the entire dentition were compared corresponding to these adjustments. The PL distribution on the teeth is uneven when there is no interference or clearance. Among all teeth, the anterior segment receives the highest level of PL. Adding 0.1, 0.15, and 0.2-mm interferences to the canines and 2nd molars bilaterally leads to increase of the PL on the canines by 10, 62, and 73 percent and on the 2nd molar by 14, 55, and 87 percent, respectively. Adding clearances to the canines and 2nd molars by removing the contactsbetween these teeth and the mouthpiece results in zero PL on them. Moreover, introducing interference to mandibular canines and 2nd molarsredistributes the PL on the entireteeth. The share of the PL on the anterior teeth are reduced. The use of the personalized mouthpiece ensures contactsof the teeth to the mouthpiece so that all teeth can be stimulated. However, the PL distribution is uneven. Adding interference between a tooth and the mouthpiece increases the PL while introducing clearance decreases the PL. As a result, the PL is redistributed. This study confirms that the level of VF stimulation on the individual tooth can be adjusted to a prescribed value.

Keywords: finite element method, orthodontic treatment, stress analysis, tooth movement, vibrational force

Procedia PDF Downloads 224

Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage

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Background: Three nociceptive thresholds of thermal, electrical, and mechanical thresholds commonly use to evaluate the local anesthesia in many species, for instance, cow, horse, cat, dog, rabbit, and so on. Due to the lack of investigations to evaluate and/or validate such those nociceptive thresholds, our plan was the comparison of two-foot local anesthesia methods of Intravenous Regional Anesthesia (IVRA) and our modified four-point Nerve Block Anesthesia (NBA). Materials and Methods: Eight healthy nonpregnant nondairy Holstein Frisian cows in a cross-over study design were selected for this study. All cows divided into two different groups to receive two local anesthesia techniques of IVRA and our modified four-point NBA. Three thermal, electrical, and mechanical force and pinpricks were applied to evaluate the quality of local anesthesia methods before and after local anesthesia application. Results: The statistical evaluation demonstrated that our four-point NBA has a qualification to select as a standard foot local anesthesia. However, the recorded results of our study revealed no significant difference between two groups of local anesthesia techniques of IVRA and modified four-point NBA related to quality and duration of anesthesia stimulated by electrical, mechanical and thermal nociceptive stimuli. Conclusion and discussion: All three nociceptive threshold stimuli of electrical, mechanical and heat nociceptive thresholds can be applied to measure and evaluate the efficacy of foot local anesthesia of dairy cows. However, our study revealed no superiority of those three nociceptive methods to evaluate the duration and quality of bovine foot local anesthesia methods. Veterinarians to investigate the duration and quality of their selected anesthesia method can use any of those heat, mechanical, and electrical methods.

Keywords: mechanical, thermal, electrical threshold, IVRA, NBA, hind limb, dairy cow

Procedia PDF Downloads 245

Authors: Mohammed H. Karim, Bestoon M. Faraj

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Introduction: instrument separation is a common challenge in the endodontic field. Various techniques and technologies have been developed to improve the retrieval success rate. This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardised access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused a minor change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: dynamic navigation system, separated instruments retrieval, trephine burs and extractor system, three-dimensional video microscope

Procedia PDF Downloads 98

Authors: I. Wardana Ketut, I. Suparwa Nyoman

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This study investigated the form and characteristic of speech sound produced by three Balinese subjects who have recovered from aphasia as well as intervened their language impairment on side of linguistic and neuronal aspects of views. The failure of judging the speech sound was caused by impairment of motor cortex that indicated there were lesions in left hemispheric language zone. Sound articulation phenomena were in the forms of phonemes deletion, replacement or assimilation in individual words and meaning building for anomic aphasia. Therefore, the Balinese sound patterns were stimulated by showing pictures to the subjects and recorded to recognize what individual consonants or vowels they unclearly produced and to find out how the sound disorder occurred. The physiology of sound production by subject’s speech organs could not only show the accuracy of articulation but also any level of severity the lesion they suffered from. The subjects’ speech sounds were investigated, classified and analyzed to know how poor the lingual units were and observed to clarify weaknesses of sound characters occurred either for place or manner of articulation. Many fricative and stopped consonants were replaced by glottal or palatal sounds because the cranial nerve, such as facial, trigeminal, and hypoglossal underwent impairment after the stroke. The phonological intervention was applied through a technique called phonemic articulation drill and the examination was conducted to know any change has been obtained. The finding informed that some weak articulation turned into clearer sound and simple meaning of language has been conveyed. The hierarchy of functional parts of brain played important role of language formulation and processing. From this finding, it can be clearly emphasized that this study supports the role of right hemisphere in recovery from aphasia is associated with functional brain reorganization.

Keywords: aphasia, intervention, phonology, stroke

Procedia PDF Downloads 196

Authors: Ochuko K. Overen, Golden Makaka, Edson L. Meyer, Sampson Mamphweli

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Low-cost housing provided for people with small incomes in South Africa are characterized by poor thermal performance. This is due to inferior craftsmanship with no regard to energy efficient design during the building process. On average, South African households spend 14% of their total monthly income on energy needs, in particular space heating; which is higher than the international benchmark of 10% for energy poverty. Adopting energy efficient passive solar design strategies and superior thermal building materials can create a stable thermal comfort environment indoors. Thereby, reducing energy consumption for space heating. The aim of this study is to analyse the thermal behaviour of a low-cost house integrated with passive solar design features. A low-cost passive solar house with superstructure fly ash brick walls was designed and constructed in Somerset East, South Africa. Indoor and outdoor meteorological parameters of the house were monitored for a period of one year. The ASTM E741-11 Standard was adopted to perform ventilation test in the house. In summer, the house was found to be thermally comfortable for 66% of the period monitored, while for winter it was about 79%. The ventilation heat flow rate of the windows and doors were found to be 140 J/s and 68 J/s, respectively. Air leakage through cracks and openings in the building envelope was 0.16 m3/m2h with a corresponding ventilation heat flow rate of 24 J/s. The indoor carbon dioxide concentration monitored overnight was found to be 0.248%, which is less than the maximum range limit of 0.500%. The prediction percentage dissatisfaction of the house shows that 86% of the occupants will express the thermal satisfaction of the indoor environment. With a good operation of the house, it can create a well-ventilated, thermal comfortable and nature luminous indoor environment for the occupants. Incorporating passive solar design in low-cost housing can be one of the long and immediate solutions to the energy crisis facing South Africa.

Keywords: energy efficiency, low-cost housing, passive solar design, rural development, thermal comfort

Procedia PDF Downloads 261

Authors: Naim Izet Kajtazi

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Context: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Process: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a six-month history of headaches, blurred vision, and vomiting presented to our clinic three days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of a third ventricle colloid cyst and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventricular CC excision under neuronavigation through a right frontal craniotomy. Twelve days post-operatively, the patient developed further headaches, followed by a generalized tonic-clonic seizure that led to no postictal neurological deficits. Nonetheless, computed tomography venography of the brain revealed extensive thrombosis of the superior sagittal sinus, inferior sagittal sinus, right sigmoid sinus, and right internal jugular vein. A newly diagnosed CVT was treated with intravenous heparin. The patient was discharged with warfarin, which was discontinued after 12 months. Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Outcome: Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Relevance: A preoperative venous study should be performed in all cases to gain a better understanding of the venous anatomy. We advocate meticulous microsurgical techniques to protect the venous system surrounding the foramen of Monro and reduce the amount of retraction during surgery.

Keywords: CVT, seizures, third ventricle colloid cyst, MRI of brain

Procedia PDF Downloads 72

Authors: Akash Soogumbur

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Tourniquets are commonly used in orthopaedic surgery to provide hemostasis during procedures on the upper and lower limbs. However, there is a risk of complications associated with tourniquet use, such as nerve damage, skin necrosis, and compartment syndrome. The British Orthopaedic Association (BOAST) guidelines recommend the use of tourniquets at a pressure of 300 mmHg or less for a maximum of 2 hours. Research Aim: The aim of this study was to evaluate the effectiveness of a tourniquet checklist in improving compliance with the BOAST guidelines. Methodology: This was a retrospective study of all orthopaedic procedures performed at a single institution over a 12-month period. The study population included patients who had a tourniquet applied during surgery. Data were collected from the patients' medical records, including the duration of tourniquet use, the pressure used, and the method of exsanguination. Findings: The results showed that the use of the tourniquet checklist significantly improved compliance with the BOAST guidelines. Prior to the introduction of the checklist, compliance with the guidelines was 83% for the duration of tourniquet use and 73% for pressure used. After the introduction of the checklist, compliance increased to 100% for both duration of tourniquet use and pressure used. Theoretical Importance: The findings of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use. Data Collection: Data were collected from the patients' medical records. The data included the following information: Patient demographics, procedure performed, duration of tourniquet use, pressure used, method of exsanguination. Analysis Procedures: The data were analyzed using descriptive statistics. The compliance with the BOAST guidelines was calculated as the percentage of patients who met the guidelines for the duration of tourniquet use and pressure used. Question Addressed: The question addressed by this study was whether the use of a tourniquet checklist could improve compliance with the BOAST guidelines. Conclusion: The results of this study suggest that the use of a tourniquet checklist can be an effective way to improve compliance with the BOAST guidelines. This is important because it can help to reduce the risk of complications associated with tourniquet use.

Keywords: tourniquet, pressure, duration, complications, surgery

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Authors: Stanisław Fic, Danuta Barnat-Hunek, Przemysław Brzyski

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The aim of the study was to evaluate the possibility of applying modified lime binder together with natural flax fibers and straw to the production of wall blocks to the usage in energy-efficient construction industry and the development of proposals for technological solutions. The following laboratory tests were performed: the analysis of the physical characteristics of the tested materials (bulk density, total porosity, and thermal conductivity), compressive strength, a water droplet absorption test, water absorption of samples, diffusion of water vapor, and analysis of the structure by using SEM. In addition, the process of surface hydrophobisation was analyzed. In the paper, there was examined the effectiveness of two formulations differing in the degree of hydrolytic polycondensation, viscosity and concentration, as these are the factors that determine the final impregnation effect. Four composites, differing in composition, were executed. Composites, as a result of the presence of flax straw and fibers showed low bulk density in the range from 0.44 to 1.29 kg/m3 and thermal conductivity between 0.13 W/mK and 0.22 W/mK. Compressive strength changed in the range from 0,45 MPa to 0,65 MPa. The analysis of results allowed observing the relationship between the formulas and the physical properties of the composites. The results of the effectiveness of hydrophobisation of composites after 2 days showed a decrease in water absorption. Depending on the formulation, after 2 days, the water absorption ratio WH of composites was from 15 to 92% (effectiveness of hydrophobization was suitably from 8 to 85%). In practice, preparations based on organic solvents often cause sealing of surface, hindering the diffusion of water vapor from materials but studies have shown good water vapor permeability by the hydrophobic silicone coating. The conducted pilot study demonstrated the possibility of applying flax composites. The article shows that the reduction of CO2 which is produced in the building process can be affected by using natural materials for the building components whose quality is not inferior as compared to the materials which are commonly used.

Keywords: ecological construction, flax fibers, hydrophobisation, lime

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Authors: Kai-Yao Huang, Tzong-Yi Lee, Pin-Hao Ho, Tzu-Hao Chang, Cheng-Wei Chang

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Background: Human cytomegalovirus (HCMV) infects much people around the world, and there were many researches mention that many diseases were caused by HCMV. To understand the mechanism of HCMV lead to diseases during infection. We observe a microRNA (miRNA) – miRNA interaction between HCMV and host during infection. We found HCMV miRNA sequence component complementary with host miRNA precursors, and we also found that the host miRNA abundances were decrease in HCMV infection. Hence, we focus on the host miRNA which may target by the other HCMV miRNA to find theirs target mRNAs expression and analysis these mRNAs affect what kind of signaling pathway. Interestingly, we found the affected mRNA play an important role in some diseases related pathways, and these diseases had been annotated by HCMV infection. Results: From our analysis procedure, we found 464 human miRNAs might be targeted by 26 HCMV miRNAs and there were 291 human miRNAs shows the concordant decrease trend during HCMV infection. For case study, we found hcmv-miR-US22-5p may regulate hsa-mir-877 and we analysis the KEGG pathway which built by hsa-mir-877 validate target mRNA. Additionally, through survey KEGG Disease database found that these mRNA co-regulate some disease related pathway for instance cancer, nerve disease. However, there were studies annotated that HCMV infection casuse cancer and Alzheimer. Conclusions: This work supply a different scenario of miRNA target interactions(MTIs). In previous study assume miRNA only target to other mRNA. Here we wonder there is possibility that miRNAs might regulate non-mRNA targets, like other miRNAs. In this study, we not only consider the sequence similarity with HCMV miRNAs and human miRNA precursors but also the expression trend of these miRNAs. Then we analysis the human miRNAs validate target mRNAs and its associated KEGG pathway. Finally, we survey related works to validate our investigation.

Keywords: human cytomegalovirus, HCMV, microRNA, miRNA

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Authors: Claudia Pisano

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The Italian shockumentary Mondo cane (1962), directed by Gualtiero Jacopetti, Paolo Cavara, and Franco Prosperi, has often been criticized for its supposed racist and colonialist stances. Several critics consider it a film that proclaims, without explicitly mentioning it, the superiority of the white Euro-American individual over the people who do not belong to white-western societies. This paper proposes a different interpretation of the way in which Mondo cane engages with the discourse of race. Through an analysis of crucial scenes and of the relationship between images and voice-over, and through a comparison between the representation of non-white societies in Mondo cane and in some popular Italian newsreels of the 50s-60s, such as 'La Settimana Incom' and 'Mondo Libero,' the paper argues that Mondo cane debunks the western-white superiority that, according to some critics, the film would promote. The continuous and rapid alternance of scenes set in the western world, for example in Europe or in the United States, and scenes set in exotic countries inhabited by non-white peoples highlights the commonalities between these far-away realities, rather than pointing out the superiority of the white-western one. In addition, the subtle irony employed by the voice-over distances Mondo cane from the newsreels that it much resembles for its documentary style. Mondo cane’s treatment and representation of race is analyzed in the light of the work of Australian Aboriginal anthropologist Aileen Moreton-Robinson, which is based on key concepts such as whiteness and whiteness invisibility. Whiteness is defined as the invisible and omnipresent norm based on which everything that does not belong to the white world is labeled as an odd and inferior 'other.' To overcome racial discrimination, it is necessary to make whiteness visible; that is to say, to deprive it of that aura of normalcy and unquestionable righteousness that surrounds it. This essay argues that Mondo cane participates in the process of making whiteness visible through the confrontation of the white people with the visible 'other'. Because the film shows that the common features on which this confrontation is based are violence and bestiality, the paper suggests that the film does not support the idea of the white world being superior to the non-white; on the contrary, it underlines that the entire world is characterized by the same shocking savagery.

Keywords: irony, race, shockumentary, whiteness, whiteness invisibility

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Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

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Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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Authors: Syed Hadi Hasan, Devendra Kumar Singh, Viyaj Kumar

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Cr (VI) is a known toxic heavy metal and has been considered as a priority pollutant in water. The effluent of various industries including electroplating, anodizing baths, leather tanning, steel industries and chromium based catalyst are the major source of Cr (VI) contamination in the aquatic environment. Cr (VI) show high mobility in the environment and can easily penetrate cell membrane of the living tissues to exert noxious effects. The Cr (VI) contamination in drinking water causes various hazardous health effects to the human health such as cancer, skin and stomach irritation or ulceration, dermatitis, damage to liver, kidney circulation and nerve tissue damage. Herein, an attempt has been done to develop an efficient adsorbent for the removal of Cr (VI) from water. For this purpose nanosorbent composed of polyvinyl alcohol functionalized graphene oxide (GO/PVA) was prepared. Thus, obtained GO/PVA was characterized through FTIR, XRD, SEM, and Raman Spectroscopy. As prepared nanosorbent of GO/PVA was utilized for the removal Cr (VI) in batch mode experiment. The process variables such as contact time, initial Cr (VI) concentration, pH, and temperature were optimized. The maximum 99.8 % removal of Cr (VI) was achieved at initial Cr (VI) concentration 60 mg/L, pH 2, temperature 35 °C and equilibrium was achieved within 50 min. The two widely used isotherm models viz. Langmuir and Freundlich were analyzed using linear correlation coefficient (R2) and it was found that Langmuir model gives best fit with high value of R2 for the data of present adsorption system which indicate the monolayer adsorption of Cr (VI) on the GO/PVA. Kinetic studies were also conducted using pseudo-first order and pseudo-second order models and it was observed that chemosorptive pseudo-second order model described the kinetics of current adsorption system in better way with high value of correlation coefficient. Thermodynamic studies were also conducted and results showed that the adsorption was spontaneous and endothermic in nature.

Keywords: adsorption, GO/PVA, isotherm, kinetics, nanosorbent, thermodynamics

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Authors: K. A. Gladkova, N. P. Babushkina, E. Y. Bragina

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Purpose: Tuberculosis (TB), caused by Mycobacterium tuberculosis, is one of the major public health problems worldwide. It is clear that the immune response to M. tuberculosis infection is a relationship between inflammatory and anti-inflammatory responses in which Tumour Necrosis Factor-α (TNF-α) plays key roles as a pro-inflammatory cytokine. TNF-α involved in various cell immune responses via binding to its two types of membrane-bound receptors, TNFRSF1A and TNFRSF1B. Importantly, some variants of the TNFRSF1B gene have been considered as possible markers of host susceptibility to TB. However, the possible impact of such TNF-α and its receptor genes polymorphism on TB cases in Tomsk is missing. Thus, the purpose of our study was to investigate polymorphism of TNF-α (rs1800629) and its receptor TNFRSF1B (rs652625 and rs525891) genes in population of Tomsk and to evaluate their possible association with the development of pulmonary TB. Materials and Methods: The population distribution features of genes polymorphisms were investigated and made case-control study based on group of people from Tomsk. Human blood was collected during routine patients examination at Tomsk Regional TB Dispensary. Altogether, 234 TB-positive patients (80 women, 154 men, average age is 28 years old) and 205 health-controls (153 women, 52 men, average age is 47 years old) were investigated. DNA was extracted from blood plasma by phenol-chloroform method. Genotyping was carried out by a single-nucleotide-specific real-time PCR assay. Results: First, interpopulational comparison was carried out between healthy individuals from Tomsk and available data from the 1000 Genomes project. It was found that polymorphism rs1800629 region demonstrated that Tomsk population was significantly different from Japanese (P = 0.0007), but it was similar with the following Europeans subpopulations: Italians (P = 0.052), Finns (P = 0.124) and British (P = 0.910). Polymorphism rs525891 clear demonstrated that group from Tomsk was significantly different from population of South Africa (P = 0.019). However, rs652625 demonstrated significant differences from Asian population: Chinese (P = 0.03) and Japanese (P = 0.004). Next, we have compared healthy individuals versus patients with TB. It was detected that no association between rs1800629, rs652625 polymorphisms, and positive TB cases. Importantly, AT genotype of polymorphism rs525891 was significantly associated with resistance to TB (odds ratio (OR) = 0.61; 95% confidence interval (CI): 0.41-0.9; P < 0.05). Conclusion: To the best of our knowledge, the polymorphism of TNFRSF1B (rs525891) was associated with TB, while genotype AT is protective [OR = 0.61] in Tomsk population. In contrast, no significant correlation was detected between polymorphism TNF-α (rs1800629) and TNFRSF1B (rs652625) genes and alveolar TB cases among population of Tomsk. In conclusion, our data expands the molecular particularities associated with TB. The study was supported by the grant of the Russia for Basic Research #15-04-05852.

Keywords: polymorphism, tuberculosis, TNF-α, TNFRSF1B gene

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Authors: Preetham Shankapal, Jill King, Kori Murray, Corby Martin, Paula Giselman, Jason Hicks, Owen Carmicheal

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Activation of reward and satiety networks in the brain while processing palatable food cues, as well as functional connectivity during rest has been studied using functional Magnetic Resonance Imaging of the brain in various obesity phenotypes. However, functional connectivity within the reward and satiety network during food cue processing is understudied. 14 obese individuals underwent two fMRI scans during viewing of Macronutrient Picture System images. Each scan included two blocks of images of High Sugar/High Fat (HSHF), High Carbohydrate/High Fat (HCHF), Low Sugar/Low Fat (LSLF) and also non-food images. Seed voxels within seven food reward relevant ROIs: Insula, putamen and cingulate, precentral, parahippocampal, medial frontal and superior temporal gyri were isolated based on a prior meta-analysis. Beta series correlation for task-related functional connectivity between these seed voxels and the rest of the brain was computed. Voxel-level differences in functional connectivity were calculated between: first and the second scan; individuals who saw novel (N=7) vs. Repeated (N=7) images in the second scan; and between the HC/HF, HSHF blocks vs LSLF and non-food blocks. Computations and analysis showed that during food image viewing, reward network ROIs showed significant functional connectivity with each other and with other regions responsible for attentional and motor control, including inferior parietal lobe and precentral gyrus. These functional connectivity values were heightened among individuals who viewed novel HS/HF images in the second scan. In the second scan session, functional connectivity was reduced within the reward network but increased within attention, memory and recognition regions, suggesting habituation to reward properties and increased recollection of previously viewed images. In conclusion it can be inferred that Functional Connectivity within reward network and between reward and other brain regions, varies by important experimental conditions during food photography viewing, including habituation to shown foods.

Keywords: fMRI, functional connectivity, task-based, beta series correlation

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Authors: Debora Caetano Dahas

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In ‘Ethics’ and in ‘A Political Treatise’ Spinoza presents his very influential take on natural law and the principles that guide his philosophical work and observations. Spinoza’s ideas about rationalization, God, and ethical behavior are undeniably relevant to many debates in the field of legal theory. In addition, it is important to note that Spinoza's takes on body, mind, and imagination played an important role in building a certain way of understanding the female figure in western societies and of their differences in regards to the male figure. It is important to emphasize that the constant and insistent presentation of women as inferior and irrational beings corroborates the institutionalization of discriminatory public policies and practices legitimized by the legal system that cooperates with the aggravation of gender inequalities. Therefore, his arguments in relation to women and their nature have been highly criticized, especially by feminist theorists during the second half of the 21st century. The questioning of this traditional philosophy –often phallocentric– and its way of describing women as irrational and less capable than men, as well as the attempt to reformulate postulates and concepts, takes place in such a way as to create a deconstruction of classical concepts. Some of the arguments developed by Spinoza, however, can serve as a basis for elucidating in what way and to what extent the social and political construction of the feminine identity served as a basis for gender inequality. Thus, based on to the observations elaborated by Moira Gantes, the present research addresses the relationship between Spinoza and the feminist demands in the juridical and political spheres, elaborating arguments that corroborate the convergence between his philosophy and feminist critical theory. Finally, this research aims to discuss how the feminists' critics of Spinoza’s writings have deconstructed and rehabilitated his principles and, in doing so, can further help to illustrate the importance of his philosophy –and, consequently, of his notes on Natural Law– in understanding gender equality as a vital part of the effective implementation of democratic debate and inclusive political participation and representation. In doing so, philosophical and legal arguments based on the feminist re-reading of Spinoza’s principles are presented and then used to explain the controversial political reform in Brazil, especially in regards to the applicability of the legislative act known as Law n. 9.504/1997 which establishes that at least 30% of legislative seats must be occupied by women.

Keywords: natural law, feminism, politics, gender equality

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Authors: Elif Erdem, Nalan Kaya, Gonca Ozan, Durrin Ozlem Dabak, Enver Ozan

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This study was carried out to determine the histological and biochemical changes in the lungs of the rat pups exposed to tobacco smoke during pregnancy period and to investigate the protective effects of alpha lipoic acid, which is administered during pregnancy, on these changes. In our study, 24 six-week old Spraque-Dawley female rats weighing 160 ± 10 g were used (n:7). Rats were randomly divided into four equal groups: group I (control), group II (tobacco smoke), group III (tobacco smoke + alpha lipoic acid) and group IV (alpha lipoic acid). Rats in the group II, group III were exposed to tobacco smoke twice a day for one hour starting from eight weeks before mating and during pregnancy. In addition to tobacco smoke, 20 mg/kg of alpha lipoic acid was administered via oral gavage to the rats in the group III. Only alpha lipoic acid was administered to the rats in the group IV. Once after the delivery, all administrations were stopped. On the 7 and 21th days, the seven pups of all groups were decapitated. A portion of the lung was taken and stained with HE, PAS and Masson. In addition to immunohistochemical staining of surfactant protein A, vascular endothelial growth factor, caspase-3, TUNEL method was also used to determine apoptosis. Biochemical analyzes were performed with some part of the lung tissue specimens. In the histological evaluations performed under light microscopy, inflammatory cell increase, hemorrhagic areas, edema, interalveolar septal thickening, alveolar numbers decrease, degeneration of some bronchi and bronchial epithelium, epithelial cells that were fallen into the lumen and hyaline membrane formation were observed in tobacco smoke group. These findings were ameliorated in tobacco smoke + ALA group. Hyaline membrane formation was not detected in this group. The TUNEL positive cell numbers a significant increase was detected in the tobacco smoke group, whereas a significant decrease was detected in the tobacco smoke + ALA group. In terms of the immunoreactivity of both SP-A and VEGF, a significant decrease was observed in the tobacco smoke group, and a significant increase was observed in the tobacco smoke + ALA group. Regarding the immunoreactivity of caspase-3, there was a significant increase in the group of tobacco smoke and a significant decrease in the group of tobacco smoke + ALA. The malondialdehyde levels were determined to be significantly increased in the tobacco smoke group, and a significant decreased in the tobacco smoke + ALA. Glutathione and superoxide dismutase enzyme activities showed a significant decrease in the group of tobacco smoke and a significant increase in the tobacco smoke + ALA group. In conclusion, we suggest that the exposure to tobacco smoke during pregnancy leads to morphological, histopathological and functional changes on lung development by causing oxidative damage in lung tissues of neonatal rats and the maternal use of alpha lipoic acid can provide a protective effect on the neonatal lung development against this oxidative stress originating from tobacco smoke.

Keywords: alpha lipoic acid, lung, neonate, tobacco smoke, pregnancy

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage

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Background: Nowadays, bovine limb interventions, especially any claw surgeries, raises selection of the most qualified and appropriate local anesthesia technique applicable for any superficial or deep interventions of the limbs. Currently, two local anesthesia methods of Intravenous Regional Anesthesia (IVRA), as well as Nerve Blocks, have been routine to apply. However, the lack of studies investigating the quality and duration as well as quantity and onset of full (complete) local anesthesia, is noticeable. Therefore, the aim of our study was comparing the onset and quality of both IVRA and our modified NBA at the hind limb of dairy cows. For this abstract, only the onset of full local anesthesia would be consider. Materials and Methods: For that reason, we used six healthy non pregnant non lactating Holestein Frisian cows in a cross-over study design. Those cows divided into two groups to receive IVRA and our modified four-point NBA. For IVRA, 20 ml procaine without epinephrine was injected into the vein digitalis dorsalis communis III and for our modified four-point NBA, 10-15 ml procaine without epinephrine preneurally to the nerves, superficial and deep peroneal as well as lateral and medial branches of metatarsal nerves. For pain stimulation, electrical stimulator Grass S48 was applied. Results: The results of electrical stimuli revealed the faster onset of full local anesthesia (p < 0.05) by application of our modified NBA in comparison to IVRA about 10 minutes. Conclusion and discussion: Despite of available references showing faster onset of foot local anesthesia of IVRA, our study demonstrated that our modified four point NBA not only can be well known as a standard foot local anesthesia method applicable to desensitize the hind limb of dairy cows, but also, selection of this modified validated local anesthesia method can lead to have a faster start of complete desensitization of distal hind limb that is remarkable in any bovine limb interventions under time constraint.

Keywords: IVRA, four point NBA, dairy cow, hind limb, full onset

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Authors: A. Kherraf, M. Bouziane, L. Azzouzi, R. Habbal

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Introduction: Hypocalcaemia is a rare cause of heart failure. We report the clinical case of a young patient with reversible dilated cardiomyopathy secondary to hypocalcaemia in the context of hyperparathyroidism. Clinical case: We report the clinical case of a 23-year-old patient with a history of thyroidectomy for papillary thyroid carcinoma 3 years previously, who presented to the emergency room with a progressive onset dyspnea and edema of the lower limbs. Clinical examination showed hypotension at 90/70 mmHg, tachycardia at 102 bpm, and edema of the lower limbs. The ECG showed a regular sinus rhythm with a prolonged corrected QT interval to 520ms. The chest x-ray showed cardiomegaly. Echocardiography revealed dilated cardiomyopathy with biventricular dysfunction and a left ventricular ejection fraction of 45%, as well as moderate mitral insufficiency by restriction of the posterior mitral leaflet, moderate tricuspid insufficiency, and a dilated inferior vena cava with a pulmonary arterial pressure estimated at 46 mmHg. Blood tests revealed severe hypocalcemia at 38 mg / l with normal albumin and thyroxine levels, as well as hyperphosphatemia and increased TSH. The patient received calcium intake and vitamin D supplementation and was treated with beta blockers, ACE inhibitors, and diuretics with good progress and progressive normalization of cardiac function. Discussion: The cardiovascular manifestations of hypocalcaemia usually appear with deeply low serum calcium levels. This can lead to hypotension, arrhythmias, ventricular fibrillation, prolonged QT interval, or even heart failure. Heart failure is a rare and serious complication of hypocalcemia but most often characterized by complete normalization of myocardial function after treatment. The etiology of the hypocalcaemia, in this case, was probably related to accidental parathyroid removal during thyroidectomy. This is why careful monitoring of calcium levels is recommended after surgery. Conclusion: Hypocalcemic heart failure is rare but reversible heart disease. Systematic monitoring of serum calcium should be performed in all patients after thyroid surgery to avoid any complications related to hypoparathyroidism.

Keywords: hypocalcemia, heart failure, thyroid surgery, hypoparathyroidism

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Authors: M. Varmaziar

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Magnesium (Mg) is an essential mineral that plays a crucial role in the human body. Certain types of foods, including nuts, grains, fruits, vegetables, and whole grains, are rich sources of magnesium. Mg serves as an essential cofactor for numerous enzymatic reactions, including energy metabolism, cellular growth, glycolysis, and protein synthesis. The Mg-ATP complex serves as an energy source and is vital for many physiological functions, including nerve conduction, muscle contraction, and blood pressure regulation. Despite the vital role of magnesium in energy metabolism, maintaining adequate magnesium intake is often overlooked among the general population and athletes. The aim of this study was to investigate the effect of magnesium supplementation on the physical activities of field athletes. Field athletes were divided into two groups: those who consumed magnesium supplements and those who received a placebo. These two groups received either 500 mg of magnesium oxide or a placebo daily for 8 weeks. At the beginning and end of the study, athletes completed ISI questionnaires and physical activity assessments. Nutritional analyses were performed using N4 software, and statistical analyses were conducted using SPSS19 software. The results of this study revealed a significant difference between the two study groups. Athletes who received magnesium supplements experienced less fatigue related to field athletic activities and muscle soreness. In contrast, athletes who received the placebo reported more significant fatigue and muscle soreness. A concerning finding in these results is that the performance of athletic activities may be at risk with low magnesium levels. Therefore, magnesium is essential for maintaining health and plays a crucial role in athletic performance. Consuming a variety of magnesium-rich foods ensures that individuals receive an adequate amount of this essential nutrient in their diet. The consumption of these foods improves performance parameters in athletic exercises.

Keywords: athletic performance, effect, field athletes, magnesium supplement

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