Search results for: genome-wide association study

Authors: Soojin Kim, Yongjae Kim

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Continuous economic downturn and ongoing budget cuts poses higher education with profound challenges which has a direct impact on the collegiate athletic programs. In response to the ever-changing landscape of the fiscal environment, universities seek to boost revenues, resorting to alternative sources of funding. In particular, athletic programs have become increasingly dependent on financial support from their alumni and boosters, which is how athletic departments attempt to offset budget shortfalls and make capital improvements. Although there currently exists three major divisions within National Collegiate Athletic Association (NCAA), the majority of the sport management studies on college sport tend to focus on Division I level. Particularly within the donor motivation literature, a plethora of donor motivation studies exist, but mainly on NCAA Division I athletic programs. Since each athletic department functions differently in a number of different dimensions, while institutional difference can also have a huge impact on athletic donor motivations, the current study attempts to fill this gap that exists in the literature. As such, the purpose of this study was to (I) reexamine the factor structure of the Athletic Donor motivation scale; and (II) identify the prominent athletic donor motives in a NCAA Division II athletic program. For the purpose of this study, a total of 232 actual donors were used for analysis. A confirmatory factor analysis (CFA) was employed to test construct validity, and the reliability of the scale was assessed using Composite Reliability. To identify the prominent motivational factors, the means and standard deviations were examined. Results of this study indicated that Vicarious Achievement, Philanthropy, and Commitment are the three primary motivational factors, while Tangible Benefits, was consistently found as an important motive in prior studies was found low. Such findings highlight the key difference and suggest different salient motivations exist that are specific to the context.

Keywords: college athletics, donor, motivation, NCAA

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Authors: Ricardo Andrés Márquez Ortiz

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Objective: The objective of this literature review is to compile updated information from studies that have addressed the association between dental pathologies and agriculture. Materials and method: The research carried out corresponds to a documentary study of ex post facto retrospective, historiographic, and bibliometric design. An exhaustive bibliographic review search was carried out in databases and the Internet, books and articles on dental anthropology, archeology, and dentistry, on the relationship between dental pathologies and agriculture in prehistoric and current populations from different parts of the world. Subsequently, data collection was carried out through the ATLAS.ti computer program. Conclusions: In an influential article by Turner, which addresses the correlation between caries and the way of subsistence of both prehistoric and modern populations (hunting and gathering, mixed and agricultural economies), an average of 1.3% was found in hunter-gatherer societies, and 10.4% in agricultural societies. Sreebny compared global grain supply data (rice, wheat and corn) with DMF (spoiled, lost and blocked) rates. He concluded that rice has no association with dental caries, corn has a negative correlation, and wheat has a positive correlation. Additionally, intensive monoculture agricultural production systems cause an increase in dental pathologies. Meanwhile, polyculture agriculture, which leads to a more varied diet, generates a better state of dental health.

Keywords: dental pathologies, agricultural production systems, extensive agriculture, dental anthropology

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Authors: Orkide Donma, Mustafa M. Donma

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Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices

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Authors: Ezat Vahidian, Babak Eshrati

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Introduction: Elder abuse, a very complex issue with diverse definitions and names, has been very slow to capture the public eye and public policy since it is manifested at many levels. It requires the involvement of different types of professionals. While elder abuse is not a new phenomenon, the speed of population ageing world-wide is likely to lead to an increase in its incidence and prevalence. Elder abuse has devastating consequences for older persons such as poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. Purpose: The purpose of this study is to determine the prevalence of elder abuse and effects of social factor on it in Markazi Province. Materials and methods: The society of the study was all of the elders in Markazi Province that were available by geographical address in the table of rural and urban household societies. The study was cross sectional and multi phases in sampling the first one was classification according rural and urban area and the second one was cluster sampling with equal cluster. Estimation of samples were 472 persons and increased by design effect to 1110 persons. Collection data was done by questionnaire and analyzed by SPSS and chi 2 exam. Results: This study showed 70 persons were abused (42/8% male and 57/2% female) mean of ages was 74/7 years. 64% were marred and 31% were widows. There were not any significant meaningful association between elder abuse and area of living (pv=0.299),occupation (p.v=0.104), education (pv=0.358) and age (P.value=0.104) there were significant meaningful association between physical impairment (pv=0.08), and movement impairment (P.value=0.008). Conclusion: Results verify that maltreatment occurred in the aged persons. Analysis of data indicated that elder abuse exist in every socioeconomic group with any context of education in urban area and rural area and in men and women. Prevalence of elder abuse was 6.3% (70 persons) that verify the data of developed countries with limited sample.

Keywords: elder abuse, education, occupation, area of living

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Authors: Oleg Redkin, Olga Bernikova

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It is commonly accepted that every language is both pure linguistic phenomenon as well as socially significant communicative system, which exists on the basis of certain society - its collective 'native speaker'. Therefore the language evolution and features besides its own linguistic rules and regulations are also defined by the influence of a number of extra-linguistic factors. The above mentioned statement may be illustrated by the example of the Arabic language which may be characterized by the following peculiarities: - the inner logic of the Arabic language - the 'algebraicity' of its morphological paradigms and grammar rules; - association of the Arabic language with the sacred texts of Islam, its close ties with the pre-Islamic and Islamic cultural heritage - the pre-Islamic poetry and Islamic literature and science; - territorial distribution, which in recent years went far beyond the boundaries of its traditional realm due to the development of new technologies and the spread of mass media, and what is more important, migration processes; - association of the Arabic language with the so called 'Renaissance of Islam'. These peculiarities should be remembered while considering the status of the Modern Standard Arabic (MSA) language or the Classical Arabic (CA) language as well as the Modern Arabic (MA) dialects in synchrony or from the diachronic point of view. Continuity of any system in diachrony on the one hand depends on the level of its ability to adapt itself to changing environment and by its internal ties on the other. Structural durability of language is characterized by its inner logic, hierarchy of paradigms and its grammar rules, as well as continuity of their implementation in acts of everyday communication. Since the Arabic language is both linguistic and social phenomenon the process of the Arabic language acquisition and study should not be focused only on the knowledge about linguistic features or development of communicative skills alone, but must be supplied with the information related to culture, history and religion of peoples of certain region that will expand and enrich competences of the target audience.

Keywords: Arabic, culture, Islam, language

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Authors: Athanasia Eirini Zarkadi, Despoina Balli, Olga Elpis Kolokitha

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Objective: Impacted maxillary canines are a frequent condition and a common reason for patients seeking orthodontic treatment. Their simultaneous presence with dental anomalies raises a question about their possible connection. The aim of this study was to investigate the association of maxillary impacted canines with dental anomalies. Materials and Methods: Files of 874 patients from an orthodontic private practice in Greece were evaluated for the presence of maxillary impacted canines. From this sample, a group of 97 patients (39 males and 58 females) with at least one impacted maxillary canine were selected and consisted of the study group (canine impaction group) of this study. This group was compared to a control group of 97 patients (42 males and 55 females) that was created by random selection from the initial sample without maxillary canine impaction. The impaction diagnosis was made from the panoramic radiographs and confirmed from the surgery. The association between maxillary canine impaction and dental anomalies was examined with the chi-square test. A classification tree was created to further investigate the relations between impaction and dental anomalies. The reproducibility of diagnoses was assessed by re-examining the records of 25 patients two weeks after the first examination. Results: The found associated anomalies were cone-shaped upper lateral incisors and infraocclusion of deciduous molars. There is a significant increase in the prevalence of 12,4% of distal displacement of the unerupted mandibular second premolar in the canine impaction group compared to the control group that was 7,2%. The classification tree showed that the presence of a cone-shaped maxillary lateral incisor gave rise to the probability of an impacted canine to 83,3%. Conclusions: The presence of cone-shaped maxillary lateral incisors and infraocclusion of deciduous molars can be considered valuable early risk indicators for maxillary canine impaction.

Keywords: cone-shaped maxillary lateral incisors, dental anomalies, impacted canines, infraoccluded deciduous molars

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Authors: Naoki Yamamoto, Hidenobu Ozaki, Taiichiro Ookawa, Youming Liu, Kazunori Okada, Aiping Zheng

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Rice sheath blight is one of the destructive fungal diseases in rice. We have thought that rice sheath blight resistance is a polygenic trait. Host-pathogen interactions and secondary metabolites such as lignin and phytoalexins are likely to be involved in defense against R. solani. However, to our knowledge, it is still unknown how sheath blight resistance can be enhanced in rice breeding. To seek for an alternative genetic factor that contribute to sheath blight resistance, we mined relevant allelic variations from rice core collections created in Japan. Based on disease lesion length on detached leaf sheath, we selected 30 varieties of the top tail-end and the bottom tail-end, respectively, from the core collections to perform genome-wide association mapping. Re-sequencing reads for these varieties were used for calling single nucleotide polymorphisms among the 60 varieties to create a SNP panel, which contained 1,137,131 homozygous variant sites after filitering. Association mapping highlighted a locus on the long arm of chromosome 11, which is co-localized with three sheath blight QTLs, qShB11-2-TX, qShB11, and qSBR-11-2. Based on the localization of the trait-associated alleles, we identified an ankyryn repeat-containing protein gene (ANK-M) as an uncharacterized candidate factor for rice sheath blight resistance. Allelic distributions for ANK-M in the whole rice population supported the reliability of trait-allele associations. Gene expression characteristics were checked to evaluiate the functionality of ANK-M. Since an ANK-M homolog (OsPIANK1) in rice seems a basal defense regulator against rice blast and bacterial leaf blight, ANK-M may also play a role in the rice immune system.

Keywords: allele mining, GWAS, QTL, rice sheath blight

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Authors: Meilee Shen

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Buddhist nuns in Taiwan have shouldered various responsibilities in educational, cultural, economic, and social aspects that transforms and transcends Chinese Buddhism to a higher level in Taiwan and overseas. In the recent years, Nuns in Taiwan have formed various associations to reach their goals and satisfy their needs. This research will focus on the following: 1. How to distinguish a Buddhist organization from temple? 2. Whether the forming of female Buddhist organizations reveals religious purpose or gender conflict in Buddhism? 3. How can nuns in Taiwan be unified together to establish their identification? This paper will mainly study on the Chinese Buddhist Bhikkhuni Association (CBBA) because they have gained allies together to work for religious causes and social needs since 1996. However, with a mission to promote female practitioners’ role in Buddhist circle, CBBA did not contribute much to the gender issue in Buddhism. The research found that CBBA did not achieve their goal to unite nuns in Taiwan because they failed to support nuns' education and did not recruit young and highly educated ones as CBBA's faculties. In conclusion, the research suggests i) to connect with other Buddhist organizations in order to achieve the dream of unity, ii) to fill the generation gap by overturn hierarchical system in Buddhist community and create a new environment for new generation to grow, iii) to shift financial contribution from social charity to nuns’ education to promote female role in Buddhism in the future.

Keywords: Bhikkhuni in Taiwan, Bhikkhuni population and education, Buddhism in Taiwan, Chinese Buddhist Bhikkhuni Association

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Authors: Magdeline Pakeng Mohlala, R. L. Molatudi, M. A. Mofokeng

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Cowpea (Vigna unguiculata (L.) Walp) is an important annual leguminous crop in semi-arid and tropics. Most of cowpea grain production in South Africa is mainly used for domestic consumption, as seed planting and little or none gets to be used in industrial processing; thus, there is a need to expand the utilization of cowpea through industrial processing. Agronomic traits contribute to the understanding of the association between yield and its component traits to facilitate effective selection for yield improvement. The aim of this study was to evaluate cowpea genotypes using grain yield and canning quality traits. The field experiment was conducted in two locations in Limpopo Province, namely Syferkuil Agricultural Experimental farm and Ga-Molepo village during 2017/2018 growing season and canning took place at ARC-Grain Crops Potchefstroom. The experiment comprised of 100 cowpea genotypes laid out in a Randomized Complete Block Designs (RCBD). The grain yield, yield components, and canning quality traits were analysed using Genstat software. About 62 genotypes were suitable for canning, 38 were not due to their seed coat texture, and water uptake was less than 80% resulting in too soft (mushy) seeds. Grain yield for RV115, 99k-494-6, ITOOK1263, RV111, RV353 and 53 other genotypes recorded high positive association with number of branches, pods per plant, and number of seeds per pod, unshelled weight and shelled weight for Syferkuil than at Ga-Molepo are therefore recommended for canning quality.

Keywords: agronomic traits, canning quality, genotypes, yield

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Authors: Mustafa M. Donma, Orkide Donma

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Zinc is a vital element required for growth and development. This fact makes zinc important, particularly for children. It maintains normal cellular structure and functions. This essential element appears to have protective effects against coronary artery disease and cardiomyopathy. Higher serum zinc levels are associated with lower risk of cardiovascular diseases (CVDs). There is a significant association between low serum zinc levels and heart failure. Zinc may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis, and prognosis of CVDs. The aim of this study is to determine zinc as well as new generation cardiac markers profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children, and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. Forty-five MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99, and above 99 for N-BMI, OB, and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses, including zinc, were performed. High sensitive-cTnT and cMyBP-C concentrations were measured by kits based on enzyme-linked immunosorbent assay principle. Appropriate statistical tests within the scope of SPSS were used for the evaluation of the study data. p<0.05 was accepted as statistically significant. Four groups were matched for age and gender. Decreased zinc concentrations were measured in Groups 2, 3, and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between zinc and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between zinc and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of this physiologically essential trace element accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both zinc and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity

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Authors: Chigozie Azunna

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Various studies have been carried out in several countries to determine the relationship between inflation and unemployment. The study was carried out to review this relationship in South Africa. Secondary data was obtained from Statistics South Africa, Reserve bank, and other reliable secondary sources to review this relationship. The study incorporated yearly inflation and unemployment data in South Africa from 2000 to 2022 to explain the relationship between inflation and unemployment in South Africa. The study found the relationship to be nonlinear and lacking any significant association or relationship. Various economic schools of thought postulations were incorporated in the review as it is applied to South Africa. Essentially, the Phillips Curve was reviewed in-line with the study objective.

Keywords: inflation and unemployment in south africa, philips curve, monetarists, neo keynesian, new-classical

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Authors: Cahyaningsih Cahyaningsih, Fu'ad Rakhman

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This study examines empirically the association between corporate social responsibility (CSR) and tax avoidance. This study also investigates the effect of earnings on the relation between CSR and tax avoidance. Effective tax rate (ETR) and cash effective tax rate (CETR) were used to measure tax avoidance. Corporate social responsibility fund (CSRF) and corporate social responsibility disclosure (CSRD) were used as proxies for CSR. Test was conducted for public firms which were listed in the Indonesia Stock Exchange during the period of 2011-2014. Based on slack resource theory, this study finds that the relation between CSR and tax avoidance is moderated by earnings.

Keywords: corporate social responsibility disclosure, corporate social responsibility fund, earnings, tax avoidance

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Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

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Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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Authors: Gwendy Darras, Mattias Desmet

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Previous research showed that psychological distress has a negative impact on the disease course of viral infections. For COVID-19, the same association was observed in small samples of specific segments of the population (e.g. health care workers). The present study presents a more refined analysis of this association, measuring a broader spectrum of psychological distress in a large sample (n=3084) of the general Flemish population. Several types of psychological distress (state, trait and health anxiety, depression, intra-, and interpersonal stress) are registered throughout three periods: one year before the contamination, one week before the contamination, and during the contamination. In doing so, validated scales such as DASS-21, IIP-32, and FCV-19S are used. Furthermore, the course of COVID-19 is registered in several ways: number of symptoms, number of days sick leave due to COVID-19, and number of days the symptoms have lasted. Also, different control variables such as vaccination status, medical and psychological history are taken into account. Statistical analysis shows that all types of psychological distress are positively correlated with the severity of the COVID-19 disease course. Anxiety during the contamination shows the strongest correlation, but psychological distress one year before the onset of COVID-19 was still significantly associated with the worsening of the disease course. As the assessment of the latter type of distress happened before the onset of the COVID-19 disease course, retrospective bias resulting in artificial associations between self-reported stress and COVID-19 severity is unlikely to have impacted the observations. In view of possible future pandemics, it is important to focus on general stress and anxiety reduction in the general population as soon as possible. It is also advisable to minimize the use of stress-inducing messages to encourage the population to adhere to the measures issued during a pandemic.

Keywords: anxiety, COVID-19, depression, psychoneuroimmunology, psychological distress, stress

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Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

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We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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Authors: Edoardo Lomi

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A problem of central interest in anthropology concerns the ethnographic displacement of modernity’s conceptual sovereignty over that of native collectives worldwide. Part of this critical project has been the association of Western modernity with a dualist, naturalist ontology. Despite its demonstrated value for comparative work, this association often comes at the cost of reproducing ideas that lack an empirical ethnographic basis. This paper proposes a way forward by bringing to bear some of the results produced by an ethnographic study of a village in Wiltshire, South England. Due to its picturesque qualities, this village has served for decades as a ready-made set for fantasy movies and a backdrop to fictional stories. These forms of mediation have in turn generated some apparent paradoxes, such as fictitious characters that affect actual material changes, films that become more real than history, and animated stories that, while requiring material grounds to unfold, inhabit a time and space in other respects distinct from that of material processes. Drawing on ongoing fieldwork and interviews with locals and tourists, this paper considers the ways villagers engage with fiction as part of their everyday lives. The resulting image is one of convergence, in the same landscape, of people and things having different ontological status. This study invites reflection on the implications of this image for diversifying our imagery of Western lifeworlds. To this end, the notion of ‘real fictions’ is put forth, connecting the ethnographic blurring of modernist distinctions–such as sign and signified, mind and matter, materiality and immateriality–with discussions on anthropology’s own reliance on fictions for critical comparative work.

Keywords: England, ethnography, landscape, modernity, mediation, ontology, post-structural theory

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Authors: Jon Gunnar Bernburg

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The present study addresses a topic that is fundamental to social movement theory, namely, the contingent link between movement support and movement participation. Usually, only a small fraction of those who agree with the cause of a social movement is mobilized into participating in it (a pattern sometimes referred to as 'the collective action problem'). However, historical moments sometimes emerge when many supporters become mobilized to participate in the movement, greatly enhancing the chance of movement success. By studying a case in point, this paper addresses the limited work on how support and participation are related at such critical moments. Specifically, the paper examines the association between supporting and participating in a huge 'pro-democracy' protest in Iceland in April 2016, in the wake of the global Panama Papers scandal. Organized via social media by only a handful of activists, but supported by a majority of Icelanders, the protest attracted about a fourth of the urban population, leading to a snap election and government change. Surveying Iceland’s urban population, this paper tests hypotheses about the processes mobilizing supporters to participate in the protest. The findings reveal how variables derived from the theories of biographical availability (males vs. females, working class vs. professionals), critical mass (expectations, prior protest success), and social embeddedness (close ties with protesters) moderate the association between protest support and participation. The study helps to account for one of the largest protests in Iceland’s history while contributing to the theory about how historical contexts shape the behavior of movement supporters.

Keywords: Iceland, crisis, protest support vs. participation, theories of mass mobilization

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Authors: Orly Yona Drori, Shirley Ben Shlomo

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Objectives: The participants will be able to recognize the predictors of binge eating addiction among women who suffer from psychological abuse in their relationships and will recognize the role of woman's defense mechanisms in moderating the association between psychological abuse and binge eating addiction. Methods: A convenience sample of 380 Israeli women in relationships were located via the Internet, and after consenting to participate in the study, they completed a series of structured questionnaires (The Yale Food Addiction Scale; The Defense Style Questionnaire; psychological maltreatment of women by their male partners; level of differentiation of self; sociodemographic questionnaire). Results: The higher the level of differentiation and mature defense mechanisms, the less addictive a woman is. However, the level of addiction among women who experience psychological abuse within their intimate relations is higher than women who do not experience psychological abuse in their relationship. Among women who experienced psychological abuse in their relations, the defense mechanisms moderate the association between psychological abuse within intimate relations and the extent of the addiction to binge eating. Conclusions: The study contributes to the therapy of women with binge eating addictions, as it raises awareness of therapeutic-related content that could strengthen women and help them to cope with situations in their lives without the need to binge. One of the significant variables for therapeutic work is the level of differentiation of the self. In addition, identifying the types of defense mechanisms might help to match treatment to the woman's emotional needs. The current study found also that it is important to identify the environmental systems by which the addict is surrounded, such as whether woman is in an abusive relationship. Finally the study leads to the recognition that binge eating, which is usually treated with an emphasis on nutritional behavior change, is an addiction, and as such, it requires a combination of mental, nutritional and behavioral therapy. In view of this approach, it is recommended that treating a woman who is addicted to binge eating should involve a multi-disciplinary team comprised of physicians, clinical dietitians, and clinical psychotherapists.

Keywords: binge eating, defence mechanism, food addiction, psychological abuse

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Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

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Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

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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: Othman Elmahdy Othman

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The objectives of this study were to identify polymorphisms in the STAT5A using Restriction Fragment Length Polymorphism and DGAT1 using Single-Strand Conformation Polymorphism genes among three Egyptian goat breeds (Barki, Zaraibi, and Damascus) as well as investigate the effect of their genotypes on milk composition traits of Zaraibi goats. One hundred and fifty blood samples were collected for DNA extraction, 60 from Zaraibi, 40 from Damascus and 50 from Barki breeds. Fat, protein and lactose percentages were determined in Zaraibi goat milk using an automatic milk analyzer. Two genotypes, CC and CT (for STAT5A) and C-C- and C-C+ (for DGAT1), were identified in the three Egyptian goat breeds with different frequencies. The associations between these genotypes and milk fat, protein and lactose were determined in Zaraibi breed. The results showed that the STAT5A genotypes had significant effects on milk yield, protein, fat and lactose with the superiority of CT genotype over CC. Regarding DGAT1 polymorphism, the result showed the only association between it with milk fat where the animals with C-C+ genotype had greater milk fat than animals possess C-C- genotype. The association of combined genotypes with milk trait declared that the does with heterozygous genotypes for both genes are preferred than does with homozygous genotypes where the animals with CTC-C+ have more milk yield, fat and protein than those with CCC-C- genotype. In conclusion, the result showed that C/T and C-/C+ SNPs of STAT5A and DGAT1 genes respectively may be useful markers for assisted selection programs to improve goat milk composition

Keywords: DGAT1, genetic polymorphism, milk trait, STAT5A

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Authors: Yeasir Arafat Alve, Nazmun Nahar, Salma BeguM

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Introduction / Rationale: Caregivers of stroke survivors have experienced financial, emotional, physical and mental anxiety and have influence of family bonding and social customs, where 80% of caregivers were women and majority of the patients were cared for by immediate family members for example a spouse, son/daughter, son-in-law, daughter-in-law, siblings and they are significantly feel burden as a caregiver. In Bangladeshi context, there has a limitation of knowledge about the level of caregiver burden. This study could be suggested the health professional to focus on the care giving stress to provide a better support to them and also it will be advisable to provide equivalent services for caregivers and their families. Objectives: The study finds out the socio-demographic image of caregivers of stroke survivors in Bangladesh as well as discovers the level of burden of caregiver of stroke survivor in relation to general strain, isolation, disappointment, emotional involvement and environment. The study will find out the association between level of burden among caregivers and onset of stroke of survivors & duration of care giving. As well as to determine the association between level of burden among caregivers and caregiver’s age, gender, occupation and caregiver’s relationship with stroke survivors. Method / Approach: The study is a non experimental cross-sectional study design where 151 participants were selected through purposive comprehensive sampling. Data were selected from occupational therapy outdoor and stroke rehab unit, CRP (Savar & Mirpur) where using the Caregiver Burden Scale (a structured questionnaire) with face to face interview. Results: Most of the caregivers (78.8%) of stroke survivors faced moderate level of burden in general strain (37.7%), isolation (27.2%) but in case of disappointment (60.3%) feel higher burden and lower burden in emotional involvement (9.9%) and environment (0.7%). Caregiver burden level was significantly associated with caregivers’ age (P=0.006), sex (P=0.002), occupation (p= 0.04), relationship with stroke survivors (P=0.02), care giving duration (P=0.000), care giving hours (P=0.009), and onset of stroke (P=0.000) of stroke survivors. Conclusion: The study findings revealed that most of the caregivers faced moderate burden where no environmental burden for them, this is possibly in case of Bangladeshi culture where people hospitable. Through this study, it was also found that there is a possibility to have the higher burden. Finally, it is being also suggested that appropriate advice and support may preserve care giving which eventually enables the survivors to live a longer and more fulfilling life in the community.

Keywords: caregiver, level of caregiver burden, stroke survivor, stroke rehab unit

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Authors: Ajmal Hussain

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In Indian music parlance, Rasa denotes a distinct aesthetic experience that builds up in the mind of the listeners while listening to a piece of Indian classical music. The distinction of the experience is rooted in the concept that it gives rise to an enhanced awareness about the Self or God and creates a mental state detached from mundane issues of everyday life. The theory of Rasa was initially proposed in the context of theatre but became a part of Indian musicological discourse roughly two thousand years ago, however, to this day, it remains shrouded in mystery due to its religious associations and connotations. This paper attempts to demystify the theory of Rasa in the light of available scientific knowledge fund particularly in Brain and Mind sciences. The paper initially describes the religious context of the theory of Rasa and then discusses its classical formulations by Bharata and Abhinavagupta including the steps and stages laid down by the latter to explain the creation of musical experience. The classical formulations are then interpreted with reference to the scientific knowledge fund about the human mind and mechanics of perception. The study uses the model of human mind as proposed by Portuguese-American neuroscientist Antonio Damasio in his theory ‘A Nesting Principle’. On the basis of the findings by Damasio, the paper interprets the experience of Rasa from a scientific perspective and clarifies the sequence of steps and stages involved in the making of musical experience. The study concludes that although the classical formulations of Rasa identify key aspects of musical experience, the association of Rasa with religion is misleading. The association with religion does not depend upon musical stimulus but the intellectual orientation of the listener. It further establishes that the function of Rasa is more profound as, from an evolutionary perspective, it can be seen as a catalyst for higher consciousness.

Keywords: aesthetic, consciousness, music, Rasa

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Authors: Matthew Venunye Fianu, Jerry Fiave, Ebenezer Kye-Mensah, Dacosta Aboagye, Felix Osei-Sarpong

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Introduction: Road traffic accidents involving motorbikes are a priority public health concern in Ghana. While there are local initiatives to address this public health challenge, little is known about motor riders’ knowledge and compliance with road safety regulations (RSR) and their association with RTAs. The aim of this study was, therefore, to assess motorbike riders’ knowledge and compliance with RSRs. Methodology: Motorbike riders in Hohoe Municipality were randomly sampled in a cross-sectional study in June 2022. Data were collected from 237 riders using a questionnaire designed in Kobocollect and administered by ten research assistants. A score of 70% or less is considered low for knowledge and compliance. The data were exported into Excel and imported into STATA 17 for analysis. A chi-square test was performed to generate descriptive and inferential statistics to establish the association between independent and dependent variables. Results: All 237 respondents were male, and each of them completed the questionnaire representing a 100% response rate. Participants who had knowledge about speed limit at different segments of the road were 59(24.9%), the use of helmet were 124 (52.3%), and alcohol use were 152 (64.1%). Participants who complied with regulations on speed limits, helmet use, and alcohol use were 108 (45.6%), 179(75.5%), and 168(70.8%), respectively. Riders who had at least junior high school education were 2.43 times more likely to adhere to RSR [cOR =2.43(95%CI= 1.15-6.33) p= 0.023] than those who had less education. Similarly, riders who had high knowledge about RSR were 2.07 times more likely to comply with RSR than those who had less knowledge [AOR= -2.07 (95% CI= 0.34-0.97), p=0.038]. Conclusion: Motor riders in the Hohoe Municipality had low knowledge as well as low compliance with road safety regulations. This could be a contributor to road traffic accidents. It is therefore recommended that road safety regulatory authorities and relevant stakeholders enhance the enforcement of RSR. There should also be country-specific efforts to increase awareness among all motor riders, especially those with less than junior high school education.

Keywords: compliance, motor riders, road safety regulations, road traffic accident

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Authors: O. P. Tripathi, P. L. Verma

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Coronal Mass Ejections (CMEs) are mostly reached on Earth from 1 to 5 days from the Sun. As a consequence, slow CMEs are accelerated toward the speed of solar wind and fast CMEs are decelerated toward the speed of the solar wind. Coronal mass ejections (CMEs) are bursts of solar material i.e. clouds of plasma and magnetic fields that shoot off the sun’s surface. Other solar events include solar wind streams that come from the coronal holes on the Sun and solar energetic particles that are primarily released by CMEs. We have studied geomagnetic storms (DST ≤ - 80nT) during 1997-2012 with halo and partial halo coronal mass ejections and found that 73.28% CMEs (halo and partial halo coronal mass ejections) are associated with geomagnetic storms. The association rate of halo and partial halo coronal mass ejections are found 67.06% and 32.94% with geomagnetic storms respectively. We have also determined positive co-relation between magnitude of geomagnetic storms and speed of coronal mass ejection with correlation co-efficient 0.23.

Keywords: geomagnetic storms, coronal mass ejections (CMEs), disturbance storm time (Dst), interplanetary magnetic field (IMF)

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Authors: Sajid Ali, Dietrich Schröder

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The merging of internet and Web has created many disciplines and Web GIS is one these disciplines which is effectively dealing with the geospatial data in a proficient way. Web GIS technologies have provided an easy accessing and sharing of geospatial data over the internet. However, there is a single platform for easy and multiple accesses of the data lacks for the European Caribbean Association (Europaische Karibische Gesselschaft - EKG) to assist their members and other research community. The technique presented in this paper deals with designing of a geodatabase using PostgreSQL/PostGIS as an object oriented relational database management system (ORDBMS) for competent dissemination and management of spatial data and Web GIS by using OpenGeo Suite for the fast sharing and distribution of the data over the internet. The characteristics of the required design for the geodatabase have been studied and a specific methodology is given for the purpose of designing the Web GIS. At the end, validation of this Web based geodatabase has been performed over two Desktop GIS software and a web map application and it is also discussed that the contribution has all the desired modules to expedite further research in the area as per the requirements.

Keywords: desktop GISSoftware, European Caribbean association, geodatabase, OpenGeo suite, postgreSQL/PostGIS, webGIS, web map application

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Authors: Kalpana Poudel-Tandukar

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Background: Human Immunodeficiency Virus (HIV) infection has been frequently associated with vitamin D deficiency and depression. Vitamin D deficiency increases the risk of depression in people without HIV. We assessed the cross-sectional and prospective associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and depression in a HIV-positive people. Methods: A survey was conducted among 316 HIV-positive people aged 20-60 years residing in Kathmandu, Nepal for a cross-sectional association at baseline, and among 184 participants without depressive symptoms at baseline who responded to both baseline (2010) and follow-up (2011) surveys for prospective association. The competitive protein-binding assay was used to measure 25(OH)D levels and the Beck Depression Inventory-Ia method was used to measure depression, with cut off score 20 or higher. Relationships were assessed using multiple logistic regression analysis with adjustment of potential confounders. Results: The proportion of participants with 25(OH)D level of <20ng/mL, 20-30ng/mL, and >30ng/mL were 83.2%, 15.5%, and 1.3%, respectively. Only four participants with 25(OH)D level of >30ng/mL were excluded in the further analysis. The mean 25(OH)D level in men and women were 15.0ng/mL and 14.4ng/mL, respectively. Twenty six percent of participants (men:23%; women:29%) were depressed. Participants with 25(OH)D level of < 20 ng/mL had a 1.4 fold higher odds of depression in a cross-sectional and 1.3 fold higher odds of depression after 18 months of baseline compared to those with 25(OH)D level of 20-30ng/mL (p=0.40 and p=0.78, respectively). Conclusion: Vitamin D may not have significant impact against depression among HIV-positive people with 25(OH)D level below normal ( > 30ng/mL).

Keywords: depression, HIV, Nepal, vitamin D

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Authors: Jerry Fiave, Dacosta Aboagye, Stephen Ayisi-Addo, Mabel Kissiwah Asafo, Felix Osei-Sarpong, Ebenezer Kye-Mensah, Renee Opare-Otoo

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Background: Acceptability and preference of social and behaviour change (SBC) materials by target audiences is an important determinant of effective health communication outcomes. In Ghana, however, pre-test and post-test studies on acceptability and preference of specific SBC materials for specific audiences are rare. The aim of this study was therefore to assess the acceptability and preference of printed posters on COVID-19 related stigma as suitable SBC materials for health workers to influence behaviours that promote uptake of HIV-focused services. Methods: A total of 218 health workers who provide HIV-focused services were purposively sampled in 16 polyclinics where the posters were distributed in the Greater Accra region of Ghana. Data was collected in March 2021 using an adapted self-administered questionnaire in Google forms deployed via WhatsApp to participants. The data were imported into SPSS version 27 where chi-square test and regression analyses were performed to establish association as well as strength of association between variables respectively. Results: A total of 142 participants (physicians, nurses, midwives, lab scientists, health promoters, diseases control officers) made up of 85(60%) females and 57(40%) males responded to the questionnaire, giving a response rate of 65.14%. Only 88 (61.97%) of the respondents were exposed to the posters. The majority of those exposed said the posters were informative [82(93.18%)], relevant [85(96.59%)] and attractive [83(94.32%)]. They [82(93.20%)] also rated the material as acceptable with no statistically significant association between category of health worker and acceptability of the posters (X =1.631, df=5, p=0.898). However, participants’ most preferred forms of material on COVID-19 related stigma were social media [38(26.76%)], television [33(23.24%)], SMS [19(13.38%)], and radio [18(12.70%)]. Clinical health workers were 4.88 times more likely to prefer online or electronic versions of SBC materials than nonclinical health workers [AOR= 4.88 (95% CI= 0.31-0.98), p=0.034]. Conclusions: Printed posters on COVID-19 related stigma are acceptable SBC materials in communicating behaviour change messages that target health workers in promoting uptake of HIV-focused services. Posters are however, not among the most preferred materials for health workers. It is therefore recommended that material assessment studies are conducted to inform the development of acceptable and preferred materials for target audiences.

Keywords: acceptability, AIDS, HIV, posters, preference, SBC, stigma, social and behaviour change communication

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Authors: Rajender Singh, Nidhi Sharma, Aastha Chauhan, Meenakshi Barsaul, Jyoti Deswal, Chetan Chhikara

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Introduction: Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy with multisystem involvement and are common causes of morbidity and mortality in obstetrics. It is believed that changes in retinal arterioles may indicate similar changes in the placenta. Therefore, this study was undertaken to evaluate the ocular manifestations in cases of pre-eclampsia and eclampsia and to deduce any association between the retinal changes and blood pressure, the severity of disease, gravidity, proteinuria, and other lab parameters so that a better approach could be devised to ensure maternal and fetal well-being. Materials and Methods: This was a hospital-based cross-sectional study conducted over a period of one year, from April 2021 to May 2022. 350 admitted patients with diagnosed pre-eclampsia, eclampsia, and pre-eclampsia superimposed on chronic hypertension were included in the study. A pre-structured proforma was used. After taking consent and ocular history, a bedside examination to record visual acuity, pupillary size, corneal curvature, field of vision, and intraocular pressure was done. Dilated fundus examination was done with a direct and indirect ophthalmoscope. Age, parity, BP, proteinuria, platelet count, liver and kidney function tests were noted down. The patients with positive findings only were followed up after 72 hours and 6 weeks of termination of pregnancy. Results: The mean age of patients was 26.18±4.33 years (range 18-39 years).157 (44.9%) were primigravida while 193(55.1%) were multigravida.53 (15.1%) patients had eclampsia, 128(36.5%) had mild pre-eclampsia,128(36.5%) had severe pre-eclampsia and 41(11.7%) had chronic hypertension with superimposed pre-eclampsia. Retinal changes were found in 208 patients (59.42%), and grade I changes were the most common. 82(23.14%) patients had grade I changes, 75 (21.4%) had grade II changes, 41(11.71%) had grade III changes, and 11(3.14%) had serous retinal detachment/grade IV changes. 36 patients had unaided visual acuity <6/9, of these 17 had refractive error and 19(5.4%) had varying degrees of retinal changes. 3(0.85%) out of 350 patients had an abnormal field of vision in both eyes. All 3 of them had eclampsia and bilateral exudative retinal detachment. At day 4, retinopathy in 10 patients resolved, and 3 patients had improvement in visual acuity. At 6 weeks, retinopathy in all the patients resolved spontaneously except persistence of grade II changes in 23 patients with chronic hypertension with superimposed pre-eclampsia, while visual acuity and field of vision returned to normal in all patients. Pupillary size, intraocular pressure, and corneal curvature were found to be within normal limits at all times of examination. There was a statistically significant positive association between retinal changes and mean arterial pressure. The study showed a positive correlation between fundus findings and severity of disease (p value<0.05) and mean arterial pressure (p value<0.005). Primigravida had more retinal changes than multigravida patients. A significant association was found between fundus changes and thrombocytopenia and deranged liver and kidney function tests (p value<0.005). Conclusion: As the severity of pre-eclampsia and eclampsia increases, the incidence of retinopathy also increases, and it affects visual acuity and visual fields of the patients. Thus, timely ocular examination should be done in all such cases to prevent complications.

Keywords: eclampsia, hypertensive, ocular, pre-eclampsia

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