Search results for: non-pharmacological treatment methods

Authors: Ayoola Idowu Olasebikan

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The global community has become increasingly dependent on various kinds of technologies out of which Information and Communication Technologies (ICTs) appear to be the most prominent. ICTs have become multipurpose tools which have had a revolutionary impact on how we see the world and how we live in it. Yoruba is the most widely spoken African language outside Africa but it remains one of the badly spoken language in the world as a result of its outdated teaching method in the African schools which prevented its standard version from being spoken and written. This paper conducts a critical review of the traditional methods of teaching Yoruba language. It then examines the possibility of leveraging on ICTs for improved methods of teaching Yoruba language to achieve global standard and spread. It identified key ICT platforms that can be deployed for the teaching of Yoruba language and the constraints facing each of them. The paper concludes that Information and Communication Technologies appear to provide veritable opportunity for paradigm shift in the methods of teaching Yoruba Language. It also opines that Yoruba language has the potential to transform economic fortune of Africa for sustainable development provided its teaching is taken beyond the brick and mortar classroom to the virtual classroom/global information super highway called internet or any other ICTs medium. It recommends that students and teachers of Yoruba language should be encouraged to acquire basic skills in computer and internet technology in order to enhance their ability to develop and retrieve electronic Yoruba language teaching materials.

Keywords: Africa, ICT, teaching method, Yoruba language

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Authors: Bakytzhan Bimbetov, Abay Zhangabilov, Saule Aitbaeva, Galymzhan Meirambekov

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Mare’s milk (saumal) contains in total about 40 biological components necessary for the human body. The most significant among them are amino acids, fats, carbohydrates, enzymes (lysozyme, amylase), more minerals and vitamins which are well balanced with each other. In Kazakhstan, Company "Eurasia Invest Ltd.” produces a freeze-dried saumal in form of powder by the use of modern German innovative technology by means of evaporating at low temperature (-35°C) with an appropriate pasteurization. Research of freeze-dried biomilk for the qualitative content showed that main ingredients of freshly drown milk are being preserved. We are currently studying medical and dietary properties of freeze-dried mare's milk for diseases of the digestive system, including for nonalcoholic steatohepatitis (NASH) and liver cirrhosis (LC) viral etiology. The studied group consisted of 14 patients with NASH, and 7 patients with LC viral etiology of Class A severity degree as per Child-Pugh. Patients took freeze-dried saumal, preliminary dissolved in boiled warm water (24 g. powder per 200 ml water) 3-4 times a day for a month in conjunction with basic therapy. The results were compared to a control group (11 patients with NASH and LC) who received only basic therapy without mare’s milk. Results of preliminary research showed an improvement of subjective and objective conditions of all patients, but more significant improvement of clinical symptoms and syndromes were observed in the treatment group compared to the control one. Patients with NASH significantly over time compared to the beginning of therapy decreased asthenic and dyspeptic syndromes (p<0,01). Hepatomegaly, identified on the basis of ultrasound prior to treatment was observed in 92,8±2,4% of patients, and after combination therapy hepatomegaly the rate decreased by 14,3%, amounting to 78,5±2,8%. Patients with LC also noted the improvement of asthenic (p<0,01) and dyspeptic (p<0,05) syndromes and hemorrhagic syndrome (nosebleeds and bleeding gums when brushing your teeth, p<0,05), and jaundice. Laboratory study also showed improvement in the research group, but more significant changes were observed in the experimental group. Group of patients with NASH showed a significant improvement of index in cytolysis in conjunction with a combination therapy (p<0,05). In the control group, these indicators were also improved, but they were not statistically reliable (p>0,05). Markers of liver failure were additionally studied during the study of laboratory parameters in patients with liver cirrhosis, in particular, bilirubin, albumin and prothrombin index (PTI). Combined therapy with the use of basic treatment and mare's milk showed a significant improvement in cytolysis and bilirubin (p<0,05). In our opinion, a very important and interesting fact is that, in conjunction with basic therapy, the use of mare's milk revealed an improvement of liver function in the form of normalized PTI and albumin in patients with liver cirrhosis viral etiology. Results of this work have shown therapeutic efficiency of the use of mare's milk in complex treatment of patients with liver disease and require further in-depth study.

Keywords: liver cirrhosis, non-alcohol steatohepatitis, saumal, mare’s milk

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Authors: O. Delage, H. Bencherif, T. Portafaix, A. Bourdier

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The main purpose of time series analysis is to learn about the dynamics behind some time ordered measurement data. Two approaches are used in the literature to get a better knowledge of the dynamics contained in observation data sequences. The first of these approaches concerns time series decomposition, which is an important analysis step allowing patterns and behaviors to be extracted as components providing insight into the mechanisms producing the time series. As in many cases, time series are short, noisy, and non-stationary. To provide components which are physically meaningful, methods such as Empirical Mode Decomposition (EMD), Empirical Wavelet Transform (EWT) or, more recently, Empirical Adaptive Wavelet Decomposition (EAWD) have been proposed. The second approach is to reconstruct the dynamics underlying the time series as a trajectory in state space by mapping a time series into a set of Rᵐ lag vectors by using the method of delays (MOD). Takens has proved that the trajectory obtained with the MOD technic is equivalent to the trajectory representing the dynamics behind the original time series. This work introduces the singular spectrum decomposition (SSD), which is a new adaptive method for decomposing non-linear and non-stationary time series in narrow-banded components. This method takes its origin from singular spectrum analysis (SSA), a nonparametric spectral estimation method used for the analysis and prediction of time series. As the first step of SSD is to constitute a trajectory matrix by embedding a one-dimensional time series into a set of lagged vectors, SSD can also be seen as a reconstruction method like MOD. We will first give a brief overview of the existing decomposition methods (EMD-EWT-EAWD). The SSD method will then be described in detail and applied to experimental time series of observations resulting from total columns of ozone measurements. The results obtained will be compared with those provided by the previously mentioned decomposition methods. We will also compare the reconstruction qualities of the observed dynamics obtained from the SSD and MOD methods.

Keywords: time series analysis, adaptive time series decomposition, wavelet, phase space reconstruction, singular spectrum analysis

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Authors: Zhuang He, Andrei Kotousov

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All current experimental methods for determination of stress intensity factors are based on the assumption that the state of stress near the crack tip is plane stress. Therefore, these methods rely on strain and displacement measurements made outside the near crack tip region affected by the three-dimensional effects or by process zone. In this paper, we develop and validate an experimental procedure for the evaluation of stress intensity factors from the measurements of the out-of-plane displacements in the surface area controlled by 3D effects. The evaluation of stress intensity factors is possible when the process zone is sufficiently small, and the displacement field generated by the 3D effects is fully encapsulated by K-dominance region.

Keywords: digital image correlation, stress intensity factors, three-dimensional effects, transverse displacement

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Authors: Amir Mirzaei

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The powertrain system is one of the most basic and essential components in a machine. The occurrence of motion is practically impossible without the presence of this system. When power is generated by the engine, it is transmitted by the powertrain system to the wheels, which are the last parts of the system. Powertrain system has different components according to the type of use and design. When the force generated by the engine reaches to the wheels, the amount of frictional force between the tire and the ground determines the amount of traction and non-slip or the amount of slip. At various levels, such as icy, muddy, and snow-covered ground, the amount of friction coefficient between the tire and the ground decreases dramatically and considerably, which in turn increases the amount of force loss and the vehicle traction decreases drastically. This condition is caused by the phenomenon of slipping, which, in addition to the waste of energy produced, causes the premature wear of driving tires. It also causes the temperature of the transmission oil to rise too much, as a result, causes a reduction in the quality and become dirty to oil and also reduces the useful life of the clutches disk and plates inside the transmission. this issue is much more important in road construction and mining machinery than passenger vehicles and is always one of the most important and significant issues in the design discussion, in order to overcome. One of these methods is the automatic spin regulator system which is abbreviated as ASR. The importance of this method and its structure and function have solved one of the biggest challenges of the powertrain system in the field of construction and mining machinery. That this research is examined.

Keywords: automatic spin regulator, ASR, methods of reducing slipping, methods of preventing the reduction of the useful life of clutches disk and plate, methods of preventing the premature dirtiness of transmission oil, method of preventing the reduction of the useful life of tires

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Authors: Bal Deep Sharma, Suresh Ray Yadav

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Local soils are often chosen due to their widespread availability and low cost. However, these soils typically have poor durability, which can lead to significant limitations in their use for construction. To address this issue, various soil stabilization techniques have been developed and used over the years. This study investigates the viability of employing the mineral polymerization (MIP) technique to stabilize black soils, intending to enhance their suitability for construction applications. This technique involves the microstructural transformation of certain clay minerals into solid and stable compounds exhibiting characteristics similar to hydroxy sodalite, feldspathoid, or zeolite. This transformation occurs through the action of an alkaline reactant at atmospheric pressure and low temperature. The soil sample was characterized using grain size distribution, Atterberg limit test, organic content test, and pH-value tests. The unconfined compressive strength of the soil specimens, prepared with varying percentages of sodium hydroxide as an additive and sand as a filler by weight, was determined at the optimum moisture content. The unconfined compressive strength of the specimens was tested under three different conditions: dry, wet, and cycling. The maximum unconfined compressive strengths were 77.568 kg/cm², 38.85 kg/cm², and 56.3 kg/cm² for the dry, wet, and cycling specimens, respectively, while the unconfined compressive strength of the untreated soil was 7.38 kg/cm². The minimum unconfined compressive strength of the wet and cycling specimens was greater than that of the untreated soil. Based on these findings, it can be concluded that these soils can be effectively used as construction material after treatment with sodium hydroxide.

Keywords: soil stabilization technique, soft soil treatment, sodium hydroxide, unconfined compressive strength

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Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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Authors: Aleksandra Chałupnik, Zuzanna Chilimoniuk, Joanna Borowik, Aleksandra Borkowska, Anna Torres

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Background: Precocious puberty is the occurrence of secondary sexual characteristics in girls before the age of 8. The diverse etiology of premature puberty is crucial to determine whether it is true precocious puberty, depending on the activation of the hypothalamic-pituitary-gonadal axis, or pseudo-precocious, which is independent of the activation of this axis. Whatever the cause, premature action of the sex hormones leads to the common symptoms of various forms of puberty. These include the development of sexual characteristics, acne, acceleration of growth rate and acceleration of skeletal maturation. Due to the possible genetic basis of the disorders, an interdisciplinary search for the cause is needed. Case report: The case report concerns a patient of a pediatric gynecology clinic who, at the age of two years, developed advanced thelarhe (M3) and started recurrent vaginal bleeding. In August 2019, gonadotropin suppression initially and after LHRH stimulation and high estradiol levels were reported at the Endocrinology Department. Imaging examinations showed a cyst in the right ovary projection. The bone age was six years. The entire clinical picture indicated pseudo- (peripheral) precocious in the course of ovarian autonomic cyst. In the follow-up ultrasound performed in September, the image of the cyst was stationary and normalization of estradiol levels and clinical symptoms was noted. In December 2019, cyst regression and normal gonadotropin and estradiol concentrations were found. In June 2020, white mucus tinged with blood on the underwear, without any other disturbing symptoms, was observed for several days. Two consecutive USG examinations carried out in the same month confirmed the change in the right ovary, the diameter of which was 25 mm with a very high level of estradiol. Germinal tumor markers were normal. On the Tanner scale, the patient scored M2P1. The labia and hymen had puberty features. The correct vaginal entrance was visible. Another active vaginal bleeding occurred in the first week of July 2020. The considered laparoscopic treatment was abandoned due to the lack of oncological indications. Treatment with Tamoxifen was recommended in July 2020. In the initiating period of treatment, no maturation progression, and even reduction of symptoms, no acceleration of growth and a marked reduction in the size of the cysts were noted. There was no bleeding. After the size of the cyst and hormonal activity increased again, the treatment was changed to Anastrozole, the effect of which led to a reduction in the size of the cyst. Conclusions: The entire clinical picture indicates alleged (peripheral) puberty. Premature puberty in girls, which is manifested as enlarged mammary glands with high levels of estrogens secreted by autonomic ovarian cysts and prepubertal levels of gonadotropins, may indicate McCune-Albright syndrome. Vaginal bleeding may also occur in this syndrome. Cancellation of surgical treatment of the cyst made it impossible to perform a molecular test that would allow to confirm the diagnosis. Taking into account the fact that cysts are often one of the first symptoms of McCune-Albrigt syndrome, it is important to remember about multidisciplinary care for the patient and careful search for skin and bone changes or other hormonal disorders.

Keywords: McCune Albrigth's syndrome, ovarian cyst, pediatric gynaecology, precocious puberty

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Authors: Abdullahi Ibrahim

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The culture of Clarias gariepinus for fish production is becoming increasingly essential as the fish is contributing to the food abundance and nutritional benefit to family health, income generation, and employment opportunities. The effect of feeding frequency was investigated over a period of ten (10) weeks; the experiment was conducted to monitor survival rates, growth performance, and feeding behavior of juvenile catfish. The experimental fish were randomly assigned to five treatment groups; (i.e., with different feeding frequency intervals) of 100 fish each. Each treatment was replicated twice with 50 fish per replicate. All the groups were fed with floating fish feed (blue crown®). The five treatments (feeding frequency) were T1- once a day feeding of night hours only, T2- twice a day feeding time of morning and night hours, T3- trice a day feeding time of morning, evening and night hours, T-4 four times a day feeding of morning, afternoon, evening, and night hours, T-5 five times a day feeding at four hours interval. There were significant differences (p > 0.05) among treatments. Feed intake and weight gain improved significantly (p < 0.05) in T-4 and T-3. The best of the feeding time on weight gain, survival rate, and feed conversion ratio were obtained at three times a day feeding (T-3) compared to other treatments, especially those fed once and five times feeding a regiment. This might be attributed to the high level of dissolve oxygen and less stress. Feeding fish three times a day is therefore recommended for efficient catfish production to maximize profits as the feed represents more than 50% of aquaculture inputs, particularly in intensive farming systems.

Keywords: catfish, floating fish feed, dissolve oxygen, juvenile

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Authors: M. Dezvarei, S. Morovati

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In recent years, increasing usage of electrical energy provides a widespread field for investigating new methods to produce clean electricity with high reliability and cost management. Fuel cells are new clean generations to make electricity and thermal energy together with high performance and no environmental pollution. According to the expansion of fuel cell usage in different industrial networks, the identification and optimization of its parameters is really significant. This paper presents optimization of a proton exchange membrane fuel cell (PEMFC) parameters based on modified particle swarm optimization with real valued mutation (RVM) and clonal algorithms. Mathematical equations of this type of fuel cell are presented as the main model structure in the optimization process. Optimized parameters based on clonal and RVM algorithms are compared with the desired values in the presence and absence of measurement noise. This paper shows that these methods can improve the performance of traditional optimization methods. Simulation results are employed to analyze and compare the performance of these methodologies in order to optimize the proton exchange membrane fuel cell parameters.

Keywords: clonal algorithm, proton exchange membrane fuel cell (PEMFC), particle swarm optimization (PSO), real-valued mutation (RVM)

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Authors: Warren Jared, Bekker Jeremy, Salazar Guy, Jackman Katelyn, Linford Lauren

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Introduction: Positive Psychology research has burgeoned in the past 20 years; however, relatively few evidence-based resources to cultivate positive psychology skills are widely available to the general public. The positive psychology resources at www.mybestself101.org were developed to assist individuals in cultivating well-being using a variety of techniques, including gratitude, purpose, mindfulness, self-compassion, savoring, personal growth, and supportive relationships. These resources are empirically based and are built to be accessible to a broad audience. Key Objectives: This presentation highlights results from two recent randomized intervention studies of specific MBS101 learning modules. A key objective of this research is to empirically assess the efficacy and usability of these online resources. Another objective of this research is to encourage the broad dissemination of online positive psychology resources; thus, recommendations for further research and dissemination will be discussed. Methods: In both interventions, we recruited adult participants using social media advertisements. The participants completed several well-being and positive psychology construct-specific measures (savoring and self-compassion measures) at baseline and post-intervention. Participants in the experimental condition were also given a feedback questionnaire to gather qualitative data on how participants viewed the modules. Participants in the self-compassion study were randomly split between an experimental group, who received the treatment, and a control group, who were placed on a waitlist. There was no control group for the savoring study. Participants were instructed to read content on the module and practice savoring or self-compassion strategies listed in the module for a minimum of twenty minutes a day for 21 days. The intervention was semi-structured, as participants were free to choose which module activities they would complete from a menu of research-based strategies. Participants tracked which activities they completed and how long they spent on the modules each day. Results: In the savoring study, participants increased in savoring ability as indicated by multiple measures. In addition, participants increased in well-being from pre- to post-treatment. In the self-compassion study, repeated measures mixed model analyses revealed that compared to waitlist controls, participants who used the MBS101 self-compassion module experienced significant improvements in self-compassion, well-being, and body image with effect sizes ranging from medium to large. Attrition was 10.5% for the self-compassion study and 71% for the savoring study. Overall, participants indicated that the modules were generally helpful, and they particularly appreciated the specific strategy menus. Participants requested more structured course activities, more interactive content, and more practice activities overall. Recommendations: Mybestself101.org is an applied positive psychology research program that shows promise as a model for effectively disseminating evidence-based positive psychology resources that are both engaging and easily accessible. Considerable research is still needed, both to test the efficacy and usability of the modules currently available and to improve them based on participant feedback. Feedback received from participants in the randomized controlled trial led to the development of an expanded, 30-day online course called The Gift of Self-Compassion and an online mindfulness course currently in development called Mindfulness For Humans.

Keywords: positive psychology, intervention, online resources, self-compassion, dissemination, online curriculum

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Authors: Yang Zhuo

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This study explores the integration of MIDI technology as one of the important digital technologies in music teaching, from the perspective of teaching practice, into the process of cultivating students' teaching skills. At the same time, the framework elements of the learning environment for music education students are divided into four aspects: digital technology supported learning space, new knowledge learning, teaching methods, and teaching evaluation. In teaching activities, more attention should be paid to students' subjectivity and interaction between them so as to enhance their emotional experience in teaching practice simulation. In the process of independent exploration and cooperative interaction, problems should be discovered and solved, and basic knowledge of music and teaching methods should be exercised in practice.

Keywords: music education, educational technology, MIDI, teacher training

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Authors: Amberkar Mohanbabu Vittalrao, Avin, Meena Kumari Kamalkishore, Padmanabha Udupa, Vinaykumar Bavimane, Honnegouda

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Objective: To evaluate the hepato-protective activity of Tinospora cordiofolia (Tc) against paracetamol induced hepatic damage in rats. Methods: The plant stem (test drug) was procured locally, shade dried, powdered and extracted with water. Silymarin was used as standard hepatoprotective drugs and 2% gum acacia as a control (vehicle) against paracetamol (PCT) induced hepatotoxicity. Results and Discussion: The hepato-protective activity of aqueous stem extract was assessed by paracetamol induced hepatotoxicity preventive model in rats. Alteration in the levels of biochemical markers of hepatic damage like AST, ALT, ALP and lipid peroxides were tested in both paracetamol treated and untreated groups. Paracetamol (3g/kg) had enhanced the AST, ALT, ALP and the lipid peroxides in the serum. Treatment of silymarin and aqueous stem extract of Tc (200 and 400mg/kg) extract showed significant hepatoprotective activity by altering biochemical marker levels to the near normal. Preliminary phytochemical tests were done. Aqueous Tc extract showed presence of phenolic compound and flavonoids. Our findings suggested that Tc extract possessed hepatoprotective activity in a dose dependent manner. Conclusions: Tc was found to possess significant hepatoprotective property when treated with PCT. This was evident by decreasing the liver enzymes significantly when treated with PCT as compared to PCT only treated group (P < 0.05). Hence Tinospora cardiofolia could be a good, promising, preventive agent against PCT induced hepatotoxicity.

Keywords: Tinospora cardiofolia, hepatoprotection, paracetamol, silymarin

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Authors: Kaveh Azadeh, Saeid Fazelifar

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The main purpose of the present study was to examine the effect of 12 weeks (3 days/week) concurrent training followed by 4 weeks detraining on insulin resistance in obese boys without dietary intervention. Methods: 24 obese children boys (body mass index> 28, age= 11- 13year old) voluntarily participated in the study. Biochemical factors, body composition, and functional physical fitness were assessed in three stages [baseline, after 12 week’s combined endurance and resistance training and 4 week’s detraining in the experimental group (n=12); baseline and after 12 weeks in control group (n=12)]. Results: Indepented - Sample T test revealed that in experimental group after 12weeks trainings the insulin resistance, and body fat mass were significantly declined, whereas endurance and strength of abdominal muscles significantly increased compared to control group (p<0/05). One-way ANOVA for three different periods showed that insulin resistance, body fat mass, strength of abdominal muscles after 12week training was significantly improved in the experimental group compared with the baseline. Following 4weeks detraining insulin resistance again significantly increased (p<0/05). After detraining disturbances of physiological adaptation in obese children have more rapid course in comparison with those anthropological and functional indices. Conclusion: Results showed that participation in the regular concurrent trainings provides a decrease of insulin resistance in obese children. It may serve as a strategy in treatment of obesity and management on insulin resistance, as well as to increase endurance and strength muscles in obese children. Adaptations resulting from regular exercises following detraining are reversible.

Keywords: endurance and resistance trainings, detraining, insulin resistance, obese children

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Authors: Hui-Hsin Huang, Sheng-Tung Huang, Chi-Ming Lee, Chiao-Han Yen, Chun-Mao Lin

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At initiation stage, there are no symptoms at initiation stage; however, at late stage, patients suffer symptoms as soon as ovarian cancer metastasis. Moreover, ovarian cancer cells are resistant to some anti-ovarian cancer drugs in clinical. Thus, it is very important to find an effective treatment for resistant ovarian cancer. Anthraquinone derivatives are able to induce DNA damage and lead to cell apoptosis, so several derivatives have been used for clinical application. Therefore, to explore more effective anti-ovarian cancer drugs, this study investigates the mechanism of three new anthraquinone compounds bearing different functional groups to camptothecin-resistance ovarian cell line A2780R2000. Cell viability was determined by MTT assay after treating A2780R2000 with the three new anthraquinone compounds. The results indicated that IC50 values are 33.44μM (Compound I), 25.77μM (Compound II) and 24.59μM (Compound III). Next, through cell cycle analysis, the results demonstrated that three new anthraquinone compounds not only induced A2780R2000 cell cycle arrest at early stage but also apoptosis at late stage. Besides, through apoptosis assay, the results indicated new anthraquinone compound induced apoptosis at late stage. Furthermore, the results of western blot show that the three new anthraquinone compounds lead to A2780R2000 apoptosis through intrinsic pathway. Theses results suggested that three new anthraquinone compounds may be potential new drugs for clinical cancer treatment in the future.

Keywords: anthraquinone, camptothecin, resistance, ovarian cancer

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Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

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Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

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Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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Authors: Prabhavathi Sundaram, Heidi Abrahamse

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In recent years, nanotechnology coupled with photodynamic therapy (PDT) has received considerable attention in terms of improving the effectiveness of drug delivery in cancer therapeutics. The development of functionalized single-walled carbon nanotubes (SWCNTs) has become revolutionary in targeted photosensitizers delivery since it improves the therapeutic index of drugs. The objective of this study was to prepare, characterize and evaluate the potential of functionalized SWCNTs using hyaluronic acid and loading it with photosensitizer and to effectively target colon cancer cells. The single-walled carbon nanotubes were covalently functionalized with hyaluronic acid and the loaded photosensitizer by non-covalent interaction. The photodynamic effect of SWCNTs is detected under laser irradiation in vitro. The hyaluronic acid-functionalized nanocomposites had a good affinity with CD44 receptors, and it avidly binds on to the surface of CACO-2 cells. The cellular uptake of nanocomposites was studied using fluorescence microscopy using lyso tracker. The anticancer activity of nanocomposites was analyzed in CACO-2 cells using different studies such as cell morphology, cell apoptosis, and nuclear morphology. The combined effect of nanocomposites and PDT improved the therapeutic effect of cancer treatment. The study suggested that the nanocomposites and PDT have great potential in the treatment of colon cancer.

Keywords: colon cancer, hyaluronic acid, single walled carbon nanotubes, photosensitizers, photodynamic therapy

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Authors: V. P. Ramani, K. P. Patel, S. B. Patel

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It is necessary to dispose of generated industrial wastes in the proper way to overcome the further pollution for a safe environment. Waste can be used in agriculture for good quality higher food production. In order to evaluate the effect and rate of processed industrial biomass on yield, contents, uptake and soil status in maize, a field experiment was conducted during 2009 - 2011 at Anand on loamy sand soil for two years. The treatments of different levels of NPK i.e. 100% RD, 75% RD and 50% RD were kept to study the possibility of reduction in fertilizer application with the use of processed biomass (BM) in different proportion with FYM. (Where, RD= Recommended dose, FYM= Farm Yard Manure, BM= Processed Biomass.) The significantly highest grain yield of maize was recorded under the treatment of 75% NPK + BM application @ 10t ha-1. The higher (10t ha-1) and lower (5t ha-1) application rate of BM with full dose of NPK was found beneficial being at par with the treatment 75% NPK along with BM application @ 10t ha-1. There is saving of 25% recommended dose of NPK when combined with BM application @ 10.0t ha-1 or 50% saving of organics when applied with full dose (100%) of NPK. The highest straw yield (7734 kg ha-1) of maize on pooled basis was observed under the treatment of recommended dose of NPK along with FYM application at 7.5t ha-1 coupled with BM application at 2.5t ha-1. It was also observed that highest straw yield was at par under all the treatments except control and application of 100% recommended dose of NPK coupled with BM application at 7.5t ha-1. The Fe content of maize straw were found altered significantly due to different treatments on pooled basis and it was noticed that biomass application at 7.5t ha-1 along with recommended dose of NPK showed significant enhancement in Fe content of straw over other treatments. Among heavy metals, Co, Pb and Cr contents of grain were found significantly altered due to application of different treatments variably during the pooled. While, Ni content of maize grain was not altered significantly due to application of different organics. However, at higher rate of BM application i.e. of 10t ha-1, there was slight increase in heavy metal content of grain/ straw as well as DTPA heavy metals in soil; although the increase was not alarming Thus, the overall results indicated that the application of BM at 5t ha-1 along with full dose of NPK is beneficial to get higher yield of maize without affecting soil / plant health adversely. It also indicated that the 5t BM ha-1 could be utilized in place of 10t FYM ha-1 where FYM availability is scarce. The 10t BM ha-1 helps to reduce a load of chemical fertilizer up to 25 percent in agriculture. The lower use of agro-chemicals always favors safe environment. However, the continuous use of biomass needs periodical monitoring to check any buildup of heavy metals in soil/ plant over the years.

Keywords: alternate use of industrial waste, heavy metals, maize, processed industrial biomass

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Authors: H. M. Côrtes, J. I. Da Silva Filho, M. F. Blos, B. S. Zanon

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In a modern society the factor corresponding to the increase in the level of quality in industrial production demand new techniques of control and machinery automation. In this context, this work presents the implementation of a Paraconsistent-Fuzzy Digital PID controller. The controller is based on the treatment of inconsistencies both in the Paraconsistent Logic and in the Fuzzy Logic. Paraconsistent analysis is performed on the signals applied to the system inputs using concepts from the Paraconsistent Annotated Logic with annotation of two values (PAL2v). The signals resulting from the paraconsistent analysis are two values defined as Dc - Degree of Certainty and Dct - Degree of Contradiction, which receive a treatment according to the Fuzzy Logic theory, and the resulting output of the logic actions is a single value called the crisp value, which is used to control dynamic system. Through an example, it was demonstrated the application of the proposed model. Initially, the Paraconsistent-Fuzzy Digital PID controller was built and tested in an isolated MATLAB environment and then compared to the equivalent Digital PID function of this software for standard step excitation. After this step, a level control plant was modeled to execute the controller function on a physical model, making the tests closer to the actual. For this, the control parameters (proportional, integral and derivative) were determined for the configuration of the conventional Digital PID controller and of the Paraconsistent-Fuzzy Digital PID, and the control meshes in MATLAB were assembled with the respective transfer function of the plant. Finally, the results of the comparison of the level control process between the Paraconsistent-Fuzzy Digital PID controller and the conventional Digital PID controller were presented.

Keywords: fuzzy logic, paraconsistent annotated logic, level control, digital PID

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Authors: A. Morsli, A. Tlemçani, N. Ould Cherchali, M. S. Boucherit

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This article presents two methods for the compensation of harmonics generated by a nonlinear load. The first is the classic method P-Q. The second is the controller by modern method of artificial intelligence specifically fuzzy logic. Both methods are applied to an Active Power Filter shunt (APFs) based on a three-phase voltage converter at five levels NPC topology. In calculating the harmonic currents of reference, we use the algorithm P-Q and pulse generation, we use the intersective PWM. For flexibility and dynamics, we use fuzzy logic. The results give us clear that the rate of Harmonic Distortion issued by fuzzy logic is better than P-Q.

Keywords: fuzzy logic controller, P-Q method, pulse width modulation (PWM), shunt active power filter (sAPF), total harmonic distortion (THD)

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Authors: Emmanuel Chibuogu Asogwa, Tochukwu Sunday Belonwu

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An urgent demand for creative solutions has been created by the rapid expansion of medical knowledge, the complexity of patient care, and the requirement for more precise decision-making. As a solution to this problem, the creation of a Medical Intelligent Process Model (MIPM) utilizing ontology-based appears as a promising way to overcome this obstacle and unleash the full potential of healthcare systems. The development of a Medical Intelligent Process Model (MIPM) using ontology-based techniques is motivated by a lack of quick access to relevant medical information and advanced tools for treatment planning and clinical decision-making, which ontology-based techniques can provide. The aim of this work is to develop a structured and knowledge-driven framework that leverages ontology, a formal representation of domain knowledge, to enhance various aspects of healthcare. Object-Oriented Analysis and Design Methodology (OOADM) were adopted in the design of the system as we desired to build a usable and evolvable application. For effective implementation of this work, we used the following materials/methods/tools: the medical dataset for the test of our model in this work was obtained from Kaggle. The ontology-based technique was used with Confusion Matrix, MySQL, Python, Hypertext Markup Language (HTML), Hypertext Preprocessor (PHP), Cascaded Style Sheet (CSS), JavaScript, Dreamweaver, and Fireworks. According to test results on the new system using Confusion Matrix, both the accuracy and overall effectiveness of the medical intelligent process significantly improved by 20% compared to the previous system. Therefore, using the model is recommended for healthcare professionals.

Keywords: ontology-based, model, database, OOADM, healthcare

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Authors: Maximiliano K. Pagliarini, Ana Carolina T. Malavolta, Isabela M. Morita, Regina Maria M. Castilho

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Among the ornamental plants, the Amaryllis (Hippeastrum X hybridum Hort.) is one of the most cultivated plants in Brazil because of their large and showy flowers. Thus, the consumer market wants better quality plants or to flourish more in less time. One of the devices that can make such improvements or accelerate the flowering process is the use of growth regulators. The objective of this research was to evaluate the use of different Stimulate® growth regulator doses and its constituents separately in the development and flowering of Hippeastrum X hybridum Hort. Cv Orange Souvereign. The experiment was conducted in a Pad & Fan greenhouse at UNESP, São Paulo State, Brazil from August to October 2014. The bulbs were placed in black vases of 1.2 L filled with commercial substrate and divided into 9 treatments: T1 – 10 mL L-1 of Stimulate®, T2 – 5 mL L-1 of Stimulate®, T3 – 0.5 mg L-1 of gibberellic acid (GA), T4 – 0.25 mg L-1 of GA, T5 – 0.45 mg L-1 of kinetin, T6 – 0.9 mg L-1 of kinetin, T7 – 0.5 mg L-1 of indolbutiric acid (IBA), T8 – 0.25 mg L-1 of IBA and T9 – distilled water (control). All treatments were diluted in water. The used design was completely randomized with six repetitions and two vessels, totalling 12 vessels per treatment. The evaluated characteristics were: number of leaves, length of leaf, number of rods, maximum height of rods, maximum diameter of rods, maximum number of flowers, beginning of flowering, flowering duration, and weight of bulbs. The results showed that the Stimulate® was not efficient in the conducted experiment conditions. However, the best treatment was 0.5 mg L-1 of IBA.

Keywords: bulbs, gibberellic acid, indolbutiric acid, kinetin, ornamental plants

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Authors: Padma Sree Potru

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Abstract: A co-relational descriptive study was conducted to assess the impact of cancer event on self, on family, coping strategies of cancer clients and quality of life among them in G.G.H., Guntur, Andhra Pradesh, India. Aim: The aim of the study was to investigate the impact of cancer events on self, on family, coping of clients and quality of life among cancer patients. Methods: 50 cancer patients were selected through random sampling technique. The data were obtained by using impact of events scale, impact on family scale, coping health inventory and WHOQOL-BREF scale. Results: The results revealed that majority (32%) of them were in the age group of 36-45 years, 72% were females, 44% were having the income of Rs. 5001-10000/- per month, 40% were working for daily wage, and 15% were newly diagnosed of cancer. Among 50 cancer patients, 65% had extreme impact of events, 61% shows extreme impact on family, 46% possess minimal coping strategies and 68% had poor quality of life. This study focuses on that there is a strong positive correlation between quality of life and coping behavior r=0.603 and also between impact of event and impact on family r=0.610, but a negative correlation existed between quality of life and impact of events r= -0.201. ANOVA test reveals that there is a significant difference between subscales of impact on family and coping behavior with f values = 3.893, 3.957 respectively. Chi-square highlights that there is a significant association between impact of events with age, occupation and impact on family with duration of illness. Conclusion: Even though cancer is a dreadful disease still there are many emerging treatment modalities and innovative procedures which are focusing on improving the standards of life among cancer clients. But all this can happen only when the clients accepts the reality, increase their willpower and confidence, desire to live, focusing on coping mechanisms and good ongoing support from the family members.

Keywords: impact of event, impact on family, coping, quality of event

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Authors: Ying Zhu, Ning Wu, Hai-Dong Huang, Yu-Chao Dong, Qin-Ying Sun, Wei Zhang, Qin Wang, Qiang Li

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Background and study aims: Tracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China. Patients and Methods: Retrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination. Results: 22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45 ±10.91 years old. The most frequent symptoms at presentation were chronic cough (n=14) and increased sputum production (n=10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n=2), Stage II (n=6) and Stage III(n=14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible. Conclusions: TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Keywords: airway obstruction, bronchoscopy, etiology, Tracheobronchopathia osteochondroplastica (TO), treatment

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Authors: Alba Luna Jimenez, Maria Dolores Hernando

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The administration of veterinary treatments at higher doses than the recommended Varroa mite control in beehive matrices has the potential to generate residues in the honeybee colony and in the derived products for consumption. Honeybee colonies can also be indirectly exposed to residues of plant protection products when foraging in crops, wildflowers near the crops, or in urban gardens just after spraying. The study evaluates the presence of both types of residues, veterinary treatments, and pesticides in beeswax, bee bread, and honey. The study was carried out in apiaries located in agricultural zones and forest areas in Andalusia, Spain. Up to nineteen residues were identified above LOQ using gas chromatography-triple quadrupole-mass spectrometry analysis (GC-MS/MS). Samples were extracted by a modified QuEChERs method. Chlorfenvinphos was detected in beeswax and bee bread despite its use is not authorized for Varroa mite control. Residues of fluvalinate-tau, authorized as veterinary treatment, were detected in most of the samples of beeswax and bee bread, presumably due to overdose or also to its potential for accumulation associated with its marked liposolubility. Residues of plant protection products were also detected in samples of beeswax and bee bread. Pesticide residues were detected above the LOQ that was established at 5 µg.kg⁻¹, which is the minimum concentration that can be quantified with acceptable accuracy and precision, as described in the European guidelines for pesticide residue analysis SANTE/11945/2015. No residues of phytosanitary treatments used in agriculture were detected in honey.

Keywords: honeybee colony, mass spectrometry analysis, pesticide residues, Varroa destructor, veterinary treatment

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

Procedia PDF Downloads 447

Authors: Megan L. Srinivas

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Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.

Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis

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Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

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Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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Authors: Rithika Sriram, Kiran M. Bhojwani

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Introduction : Tuberculosis of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world. These lesions are often misdiagnosed as cancer. So in order to contribute to a better understanding of these lesions, we have conducted our study among patients affected by TB in the head and neck region with the objective of assessing the various manifestations, presentations, diagnostic techniques, risk factors such as smoking and alcohol consumption, coexisting illnesses and treatment modalities. Materials and Methods: This was a retrospective study conducted over a three year period (2012-2014) in 2 hospitals affliated to Kasturba Medical College in Mangalore, South India. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study such as clinical features and history of smoking. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi square test was used to find association between the variables and p<0.05 was considered statistically significant. Results: 104 patients were found to have TB of the head and neck and among them,the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB (4.8%), submandibular gland TB (3.8%), deep neck space abscess(3.8%) and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB disease of the lymph node.26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Conclusion: Tuberculosis affecting regions of head and neck is no longer uncommon. Sufficient knowledge and appropriate diagnostic means is required while dealing with these lesions and must be included in the differential diagnosis of pathological lesions of head and neck.

Keywords: FNAC, Mangalore, smoking, tuberculosis

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