Search results for: toxic shock syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2314

Search results for: toxic shock syndrome

1924 Serum 25-Dihydroxy Vitamin D3 Level Estimation and Insulin Resistance in Women of 18-40 Years Age Group with Polycystic Ovarian Syndrome

Authors: Thakur Pushpawati, Singh Vinita, Agrawal Sarita, Mohapatra Eli

Abstract:

Polycystic ovary syndrome (PCOS) is a disease of endocrine and frequently encountered in women in their reproductive period, and it is characterized by clinical features of anovulation, clinical and biochemical features of hyperandrogenism, and PCOS morphology on ultrasonographic examination. In Indian scenario, only a few studies are available on the correlation of serum 25-dihydroxy vitamin D3 level and insulin level. The present study is a prospective case-control study and aims to estimate the concentration of serum 25-dihydroxy vitamin D3 and insulin resistance and determine the association of serum 25-dihydroxy vitamin D3 with insulin resistance in PCOS women of 18-40 years age group. In this study, the primary objective is to estimate the concentration of 25-dihydroxy vitamin D3, insulin, glycaemic status, calcium and phosphorus levels in 18-40 year age women with polycystic ovary syndrome and to compare these parameters with age and BMI matched healthy control of same age group women. The secondary objective is to determine the association between 25-dihydroxy vitamin D3 concentration and insulin resistance among PCOS cases in 18-40 years age group women. This study was carried on at outpatient Department of Obstetrics & Gynaecology, Aiims Raipur. It took one year from the date of approval. In case, 32 women were diagnosed (Diagnosed PCOS cases as per Rotterdoms criteria among women of 18-40 years of age), as control group 32 women of 18-40 years of age were diagnosed As a result, serum insulin level was elevated among PCOS women along with 25-dihydroxy vitamin D3 deficiency.Conclude up, PCOS is more common in the age group of 20-40 years. There is a strong correlation between vitamin D deficiency and insulin resistance among PCOS patients.

Keywords: vitamin D, insulin resistance, PCOS, reproductive age group

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1923 Testing Ammonia Borane for Multilayer Aprons in Nuclear Medicine as a Promising Non-toxic, Lightweight, Hydrogen Rich Material and to Enhance the Efficiency of Aprons for Workers Who Deal with Neutrons Radiation in Nuclear Medicine

Authors: Wed Othman Alghamdi

Abstract:

The current study aims to find a non-toxic, low density, hydrogen-rich material that can be used in aprons without causing health issues for nuclear medical workers that could hinder their work and negatively affect patients. Five samples were tested in terms of fast neutron removal cross-section(C21H25ClO5, C2H4, LiH,H3NBH3,MgH2) mathematically using computer program called Phy-x/PSD it is a computer program designed to calculate the fast neutron removal cross section, and it was obtained that ammonia borane (đ»3đ‘đ”đ»3) with a density of 0.78 (g/ cm3) ,And it containment of the three most important elements that play a major role in protection shields, which are (hydrogen, boron, nitrogen), Hydrogen works as a moderator that slows neutrons and turn them into thermal neutrons, boron and nitrogen both have the largest neutron absorption cross section. Ammonia borane has the highest fast neutron removal cross-section with the value of (0.122959317985393cm-1) and the least for polyethylene (đ¶2đ»4) with the value of (0.0838038707225853 cm-1) which made the ammonia borane a better candidate than polyethylene and other compounds that have been tasted in previous research for multi-layer aprons in nuclear medicine, and may approve a proper protection against the hazard radiations that its produced in nuclear medicine filed by several ways, due to it is low density and non-toxicity.

Keywords: aprons, radiation, non-toxic, nuclear medicine, neutrons

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1922 Evaluation of Toxic Elements in Thai Rice Samples

Authors: W. Srinuttrakul, V. Permnamtip

Abstract:

Toxic elements in rice samples are great concern in Thailand because rice (Oryza sativa) is a staple food for Thai people. Furthermore, rice is an economic crop of Thailand for export. In this study, the concentrations of arsenic (As), cadmium (Cd) and lead (Pb) in rice samples collected from the paddy fields in the northern, northeastern and southern regions of Thailand were determined by inductively coupled plasma mass spectrometry. The mean concentrations of As, Cd and Pb in 55 rice samples were 0.112±0.056, 0.029±0.037 and 0.031±0.033 mg kg-1, respectively. All rice samples showed As, Cd and Pb lower than the limit data of Codex. The estimated daily intakes (EDIs) of As, Cd, and Pb from rice consumption were 0.026±0.013, 0.007±0.009 and 0.007±0.008 mg day-1, respectively. The percentage contribution to Provisional Tolerable Weekly Intake (PTWI) values of As, Cd and Pb for Thai male (body weight of 69 kg) was 17.6%, 9.7%, and 2.9%, respectively, and for Thai female (body weight of 57 kg) was 21.3%, 11.7% and 3.5%, respectively. The findings indicated that all studied rice samples are safe for consumption.

Keywords: arsenic, cadmium, ICP-MS, lead, rice

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1921 Between Leader-Member Exchange and Toxic Leadership: A Theoretical Review

Authors: Aldila Dyas Nurfitri

Abstract:

Nowadays, leadership has became the one of main issues in forming organization groups even countries. The concept of a social contract between the leaders and subordinates become one of the explanations for the leadership process. The interests of the two parties are not always the same, but they must work together to achieve both goals. Based on the concept at the previous it comes “The Leader Member Exchange Theory”—well known as LMX Theory, which assumes that leadership is a process of social interaction interplay between the leaders and their subordinates. High-quality LMX relationships characterized by a high carrying capacity, informal supervision, confidence, and power negotiation enabled, whereas low-quality LMX relationships are described by low support, large formal supervision, less or no participation of subordinates in decision-making, and less confidence as well as the attention of the leader Application of formal supervision system in a low LMX behavior was in line with strict controls on toxic leadership model. Leaders must be able to feel toxic control all aspects of the organization every time. Leaders with this leadership model does not give autonomy to the staff. This behavior causes stagnation and make a resistant organizational culture in an organization. In Indonesia, the pattern of toxic leadership later evolved into a dysfunctional system that is growing rapidly. One consequence is the emergence of corrupt behavior. According to Kellerman, corruption is defined as a pattern and some subordinates behave lie, cheat or steal to a degree that goes beyond the norm, they put self-interest than the common good.According to the corruption data in Indonesia based on the results of ICW research on 2012 showed that the local government sector ranked first with 177 cases. Followed by state or local enterprises as much as 41 cases. LMX is defined as the quality of the relationship between superiors and subordinates are implications for the effectiveness and progress of the organization. The assumption of this theory that leadership as a process of social interaction interplay between the leaders and his followers are characterized by a number of dimensions, such as affection, loyalty, contribution, and professional respect. Meanwhile, the toxic leadership is dysfunctional leadership in organization that is led by someone with the traits are not able to adjust, do not have integrity, malevolent, evil, and full of discontent marked by a number of characteristics, such as self-centeredness, exploiting others, controlling behavior, disrespecting others, suppress innovation and creativity of employees, and inadequate emotional intelligence. The leaders with some characteristics, such as high self-centeredness, exploiting others, controlling behavior, and disrespecting others, tends to describe a low LMX relationships directly with subordinates compared with low self-centeredness, exploiting others, controlling behavior, and disrespecting others. While suppress innovation and creativity of employees aspect and inadequate emotional intelligence, tend not to give direct effect to the low quality of LMX.

Keywords: leader-member exchange, toxic leadership, leadership

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1920 Visualising Charles Bonnet Syndrome: Digital Co-Creation of Pseudohallucinations

Authors: Victoria H. Hamilton

Abstract:

Charles Bonnet Syndrome (CBS) is when a person experiences pseudohallucinations that fill in visual information from any type of sight loss. CBS arises from an epiphenomenal process, with the physical actions of sight resulting in the mental formations of images. These pseudohallucinations—referred to as visions by the CBS community—manifest in a wide range of forms, from complex scenes to simple geometric shapes. To share these unique visual experiences, a remote co-creation website was created where CBS participants communicated their lived experiences. This created a reflexive process, and we worked to produce true representations of these interesting and little-known phenomena. Digital reconstruction of the visions is utilised as it echoes the vivid, experiential movie-like nature of what is being perceived. This paper critically analyses co-creation as a method for making digital assets. The implications of the participants' vision impairments and the application of ethical safeguards are examined in this context. Important to note, this research is of a medical syndrome for a non-medical, practice-based design. CBS research to date is primarily conducted by the ophthalmic, neurological, and psychiatric fields and approached with the primary concerns of these specialties. This research contributes a distinct approach incorporating practice-based digital design, autoethnography, and phenomenology. Autoethnography and phenomenology combine as a foundation, with the first bringing understanding and insights, balanced by the second philosophical, bigger picture, and established approach. With further refining, it is anticipated that the research may be applied to other conditions. Conditions where articulating internal experiences proves challenging and the use of digital methods could aid communication. Both the research and CBS communities will benefit from the insights regarding the relationship between cognitive perceptions and the vision process. This research combines the digital visualising of visions with interest in the link between metaphor, embodied cognition, and image. The argument for a link between CBS visions and metaphor may appear evident due to the cross-category mapping of images that is necessary for comprehension. They both are— CBS visions and metaphors—the experience of picturing images, often with lateral connections and imaginative associations.

Keywords: Charles Bonnet Syndrome, digital design, visual hallucinations, visual perception

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1919 Graphene-Based Nanobiosensors and Lab on Chip for Sensitive Pesticide Detection

Authors: Martin Pumera

Abstract:

Graphene materials are being widely used in electrochemistry due to their versatility and excellent properties as platforms for biosensing. Here we present current trends in the electrochemical biosensing of pesticides and other toxic compounds. We explore two fundamentally different designs, (i) using graphene and other 2-D nanomaterials as an electrochemical platform and (ii) using these nanomaterials in the laboratory on chip design, together with paramagnetic beads. More specifically: (i) We explore graphene as transducer platform with very good conductivity, large surface area, and fast heterogeneous electron transfer for the biosensing. We will present the comparison of these materials and of the immobilization techniques. (ii) We present use of the graphene in the laboratory on chip systems. Laboratory on the chip had a huge advantage due to small footprint, fast analysis times and sample handling. We will show the application of these systems for pesticide detection and detection of other toxic compounds.

Keywords: graphene, 2D nanomaterials, biosensing, chip design

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1918 The Effect of TiO₂ Nanoparticles on Zebrafish Embryos

Authors: Elena Maria Scalisi

Abstract:

Currently, photodegradation by nanoparticles (NPs) is a common solution for wastewater treatment. Nanoparticles are efficient for removing organic and inorganic pollutants, heavy metals from wastewater and killing microorganisms through environmentally friendly. In this context, the major representative of photocatalytic technology for industrial wastewater treatment are TiO₂ nanoparticles (TiO₂-NPs). TiO₂-NPs have a strong catalytic activity that depends to their physicochemical properties. Thanks to their small size (between 1-100 nm), nanoparticles occupy less volume, then their surface area increases. The increase in the surface-to-volume ratio results in the increase of the particle surface energy, which improve their reactivity potential. However, these unique properties represent risks to the ecosystems and organisms when unintentionally TiO₂-NPs are release into the environment and absorbed by living organisms. Several studies confirm that there is a high level of interest concerning the safety of TiO₂-NPs in the aquatic environment, furthermore, ecotoxicological tools are useful to correctly evaluate their toxicity. In the current study, we aimed to characterize potential toxic effects of TiO₂-NP suspension to zebrafish during embryo-larval stages to evaluate parameters such as survival rates, malformation, hatching, the overall length of the larvae heartbeat, and biochemical biomarkers that reflect the acute toxicity and sublethal effects of TiO₂-NPs. Zebrafish embryos were exposed to titanium dioxide nanoparticles (TiO₂-NPs at 1mg/L, 2mg/L, and 4mg/L) from fertilization to the free swimming stage (144hpf). Every day, we recorded the toxicological endpoints, moreover, immunohistochemical analysis has been performed at the end of the exposure. In particular, we have evaluate the expression of the following biomarkers: Heat Shock Protein 70 (HSP70), Poly ADP-Ribose Polymerase-1 (PARP-1), Metallothioneins (MTs). Our results have shown that hatch ability, survival, and malformation rate were not affected by TiO₂ NPs at these exposure levels. However, TiO₂-NPs caused an increase of heartbeat and reduction of body length; at the same time, TiO₂-NPs have inducted the production of ROS and the expression of oxidative stress biomarkers HSP70 and PARP-1. Hight positivity for PARP-1 at all concentration tested was observed. As regards MT, positivity was found in the expression of this biomarker in the whole body of the embryo, with the exception of the end of the tail. Metallothioneins (MT) are biomarkers widely used in environmental monitoring programs for aquatic creatures. At the light of our results i.e. no death until the end of the experiment (144hpf), no malformation and expression of the biomarkers mentioned, it is evident that zebrafish larvae with their natural detoxification pathways are able to resist the presence of toxic substances and then they can tolerate the presence of metal concentrations. However, an excessive oxidative state can compromise cell function, therefore the uncontrolled release of nanoparticles into the environment is severe and must be constantly monitored.

Keywords: nanoparticles, embryo zebrafish, HSP70, PARP-1

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1917 The Management of Behcet's Disease Patient's Mandibular Total Edentulism with Custom Made Implant Supported Bar Retainer: A Case Report

Authors: Faruk Emir, Simel Ayyıldız, Cem ƞahin

Abstract:

Behçet’s disease or Behçet’s syndrome is a chronic and multi-systemic inflammatory disease of unknown cause. This syndrome often presents with mucous membrane ulceration and ocular problems. As a systemic disease Behcet includes triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. Nearly all patients present with some form of painful oral mucocutaneous ulcerations in the form of aphthous ulcers. The aim of the treatment plan for Behçet’s Disease patients is to eliminate oral problems and increase the patient comfort.This clinical report represents the prosthodontic rehabilitation of Behcet’s disease patients mandibular total edentulism with the use of implant supported prosthesis that planned on custom abutments and bar retainers via CAD/CAM technology and patient satisfaction has been achieved in function and aesthetics.

Keywords: Behçet’s disease, CAD/CAM, custom-made manufacturing, titanium milled bar retainer

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1916 Application of Residual Correction Method on Hyperbolic Thermoelastic Response of Hollow Spherical Medium in Rapid Transient Heat Conduction

Authors: Po-Jen Su, Huann-Ming Chou

Abstract:

In this article we uses the residual correction method to deal with transient thermoelastic problems with a hollow spherical region when the continuum medium possesses spherically isotropic thermoelastic properties. Based on linear thermoelastic theory, the equations of hyperbolic heat conduction and thermoelastic motion were combined to establish the thermoelastic dynamic model with consideration of the deformation acceleration effect and non-Fourier effect under the condition of transient thermal shock. The approximate solutions of temperature and displacement distributions are obtained using the residual correction method based on the maximum principle in combination with the finite difference method, making it easier and faster to obtain upper and lower approximations of exact solutions. The proposed method is found to be an effective numerical method with satisfactory accuracy. Moreover, the result shows that the effect of transient thermal shock induced by deformation acceleration is enhanced by non-Fourier heat conduction with increased peak stress. The influence on the stress increases with the thermal relaxation time.

Keywords: maximum principle, non-Fourier heat conduction, residual correction method, thermo-elastic response

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1915 Pregnant Women with Dental Amalgam Fillings Limiting Their Exposure to Electromagnetic Fields to Prevent the Toxic Effects of Mercury in Their Fetuses

Authors: Ghazal Mortazavi, S. M. J. Mortazavi

Abstract:

Although seems to be ultra-conservative, it has recently been suggested that whenever it is possible, pregnant women should postpone dental amalgam restorations to avoid the toxic effect of mercury on the foetus. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. As a strong positive correlation between maternal and cord blood mercury levels has been found in some studies, our findings regarding the effect of exposure to electromagnetic fields on the release of mercury from dental amalgam fillings lead us to this conclusion that pregnant women with dental amalgam fillings should limit their exposure to electromagnetic fields to prevent toxic effects of mercury in their foetuses.

Keywords: pregnancy, foetus, mercury release, dental amalgam, electromagnetic fields, MRI, mobile phones

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1914 Assessment of Health Literacy and Awareness of Female Residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on Polycystic Ovarian Syndrome: A Cross-Sectional Study

Authors: Jean Gray C. Achapero, Mary Margareth P. Ancheta, Patricia Anjelika A. Angeles, Shannon Denzel S. Ao Tai, Carl Brandon C. Barlis, Chrislen Mae B. Benavidez

Abstract:

Health literacy and awareness of Polycystic ovarian syndrome (PCOS) is a global issue that is under-addressed in the Philippines. Conducting a thorough review of the country's ability to recognize and comprehend the severity of the syndrome should be undertaken, as early treatment is essential to avoid further disorder complications. This research aims to assess the health literacy and awareness of the female residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on PCOS. It followed a cross-sectional study, and data gathering was done through a pre-assessment using the Single Item Literacy Screener (SILS) and an online population-based survey questionnaire about PCOS awareness. The participants, as based on the objectives and purposive sampling method, were females aged 18-45 years old. Data were analyzed statistically using STATA 13.1 software. The study showed that 339 (76%) out of 444 respondents passed the SILS meaning the residents have proficient health literacy. Among the 339 respondents, 87% (287) had previous knowledge about PCOS. The respondents showed minimal awareness of PCOS symptoms which could be attributed to its broad spectrum of information. Respondents were shown to be most knowledgeable about PCOS physiology, treatment, beliefs, and its remedies. The respondents’ age had no significant association with their health literacy (p=0.31) and PCOS awareness (p=0.60). A significant association was noted, however, in their educational attainment linked with their health literacy (p=<0.0001) and PCOS awareness (p=0.001). It is suggested that reproductive health education even in the lower year levels must be optimized and Local Government Unit (LGU)/Non-Government Organization (NGO)-held seminars should be conducted for knowledge reinforcement. Reliable health information should be more accessible to the public and clinicians must emphasize the importance of the majority of early screening as part of routine physical examination for women of reproductive age to increase health literacy and awareness about PCOS and actively engage in the management of the disease.

Keywords: age, awareness, educational attainment, health literacy, polycystic ovarian syndrome

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1913 Grating Assisted Surface Plasmon Resonance Sensor for Monitoring of Hazardous Toxic Chemicals and Gases in an Underground Mines

Authors: Sanjeev Kumar Raghuwanshi, Yadvendra Singh

Abstract:

The objective of this paper is to develop and optimize the Fiber Bragg (FBG) grating based Surface Plasmon Resonance (SPR) sensor for monitoring the hazardous toxic chemicals and gases in underground mines or any industrial area. A fully cladded telecommunication standard FBG is proposed to develop to produce surface plasmon resonance. A thin few nm gold/silver film (subject to optimization) is proposed to apply over the FBG sensing head using e-beam deposition method. Sensitivity enhancement of the sensor will be done by adding a composite nanostructured Graphene Oxide (GO) sensing layer using the spin coating method. Both sensor configurations suppose to demonstrate high responsiveness towards the changes in resonance wavelength. The GO enhanced sensor may show increased sensitivity of many fold compared to the gold coated traditional fibre optic sensor. Our work is focused on to optimize GO, multilayer structure and to develop fibre coating techniques that will serve well for sensitive and multifunctional detection of hazardous chemicals. This research proposal shows great potential towards future development of optical fiber sensors using readily available components such as Bragg gratings as highly sensitive chemical sensors in areas such as environmental sensing.

Keywords: surface plasmon resonance, fibre Bragg grating, sensitivity, toxic gases, MATRIX method

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1912 Design of Built-Spaces and Enhanced Psychological Wellbeing by Limiting Effect of SBS: An Analytical Study across Students in Indian Universities

Authors: Sadaf H. Khan, Jyoti Kumar

Abstract:

Sick Building Syndrome (SBS) is a situation in which inhabitants of a building develop illness symptoms or get infected with a chronic disease as a result of the building in which they reside or work. Certain symptoms tend to get more severe as an individual spends more time in the building; however, they generally improve with time or even disappear when they leave that space. Though ‘Design of Built-Spaces’ is a crucial factor in regulating these symptoms but it still needs to be identified further as to what specific design features of a ‘Built-Space’ trigger sick building syndrome (SBS). Much of the research work present to date is focused on the physiological or physical sickness caused due to inappropriate built-space design. In this paper, the psychological aspects of sick building syndrome (SBS) will be investigated across the adult population, more specifically graduate students in India trying to settle in back to their previous physical work environments, i.e., campus, classrooms, hostels, after a very long hold which lasted more than a year due to lockdowns during Covid-19 crisis all over the world. The study will follow an analytical approach and the data will be collected through self-reported online surveys. The purpose of this study is to enquire causal agents, diagnosable symptoms and remedial design of built spaces which can enhance the productive level of built environments and better facilitate the inhabitants by improving their psychological wellbeing, which is the most uprising concern. The fact that SBS symptoms can be studied only within the initial few weeks as an occupant starts interacting with a built-environment and leaves as the occupant leaves that space or zone, the post-lockdown incoming of students back to their respective campuses provides an opportunity to clearly draw multiple conclusions of the relationship that exist between the Design of Built-Spaces and Psychological Sickness Syndrome associated with it. The study will be one of a kind approach for understanding and formulating methods to improve psychological wellbeing within a built-setting by better identifying factors associated with these psychological symptoms, including anxiety, mental fatigue, reduced attention span and reduced memory span as refined symptoms of SBS discussed in 1987 by Molhave within his study.

Keywords: built-environment psychology, built-space design, healthcare architecture, psychological wellbeing

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1911 The Effect of Biochar, Inoculated Biochar and Compost Biological Component of the Soil

Authors: Helena Dvoƙáčková, Mikajlo Irina, Záhora Jaroslav, Elbl Jakub

Abstract:

Biochar can be produced from the waste matter and its application has been associated with returning of carbon in large amounts into the soil. The impacts of this material on physical and chemical properties of soil have been described. The biggest part of the research work is dedicated to the hypothesis of this material’s toxic effects on the soil life regarding its effect on the soil biological component. At present, it has been worked on methods which could eliminate these undesirable properties of biochar. One of the possibilities is to mix biochar with organic material, such as compost, or focusing on the natural processes acceleration in the soil. In the experiment has been used as the addition of compost as well as the elimination of toxic substances by promoting microbial activity in aerated water environment. Biochar was aerated for 7 days in a container with a volume of 20 l. This way modified biochar had six times higher biomass production and reduce mineral nitrogen leaching. Better results have been achieved by mixing biochar with compost.

Keywords: leaching of nitrogen, soil, biochar, compost

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1910 Parsonage Turner Syndrome PTS, Case Report

Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

Abstract:

Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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1909 Evaluation of Toxic Metals in Water Hyacinth (Eichhornia crassipes) from Valsequillo Reservoir, Puebla, Central Mexico

Authors: Jacobo Tabla, P. F. Rodriguez-Espinosa, M. E. Perez-Lopez

Abstract:

Valsequillo reservoir located in Puebla City, Central Mexico receives water from the Atoyac River (Northwest) and from Alseseca River in the north. It has been the receptacle of municipal and industrial wastes for the past few decades affecting the water quality lethally. As a result, there is an outburst of water hyacinths (Eichhornia crassipes) in the reservoir occupying around 50 % of the total area. Therefore, the aim of the present work was to assess the concentration levels of toxic metals (Co, Zn, Ni, Cu and As) in the water hyacinths and the ambient waters during the dry season. Fourteen water samples and three water hyacinth samples were procured from the Valsequillo reservoir. The collected samples of water hyacinth (roots, rhizome, stems and leaves) were analyzed using an Inductively coupled plasma mass spectrometry (ICP-MS) Ultramass 700 (Varian Inc.) to determine the metal levels. Results showed that water hyacinth presented an exhaustion in metal capture from the inlet to outlet of the reservoir. The maximum bioaccumulation factors (BF) of Co, Zn, Ni, Cu and As were 5000, 47474, 4929, 17090 and 74000 respectively. On the other hand, the maximum Translocation Factor (TF) of 0.85 was observed in Zn, whilst Co presented the minimum TF of 0.059. Thus, the results presented the fact that water hyacinth in Valsequillo reservoir proves to be an important environmental utility for efficiently accumulating and translocating heavy metals from the ambient waters to its organelles (stems and leaves).

Keywords: bioaccumulation factor, toxic metals, translocation factor, water hyacinth

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1908 Effect of SCN5A Gene Mutation in Endocardial Cell

Authors: Helan Satish, M. Ramasubba Reddy

Abstract:

The simulation of an endocardial cell for gene mutation in the cardiac sodium ion channel NaV1.5, encoded by SCN5A gene, is discussed. The characterization of Brugada Syndrome by loss of function effect on SCN5A mutation due to L812Q mutant present in the DII-S4 transmembrane region of the NaV1.5 channel protein and its effect in an endocardial cell is studied. Ten Tusscher model of human ventricular action potential is modified to incorporate the changes contributed by L812Q mutant in the endocardial cells. Results show that BrS-associated SCN5A mutation causes reduction in the inward sodium current by modifications in the channel gating dynamics such as delayed activation, enhanced inactivation, and slowed recovery from inactivation in the endocardial cell. A decrease in the inward sodium current was also observed, which affects depolarization phase (Phase 0) that leads to reduction in the spike amplitude of the cardiac action potential.

Keywords: SCN5A gene mutation, sodium channel, Brugada syndrome, cardiac arrhythmia, action potential

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1907 The Relationships between AntimĂŒLlerian Hormone, Androgens and Ovarian Reserve in Non-Obese East Indian Women with and without Polycystic Ovary Syndrome

Authors: Dipanshu Sur, Ratnabali Chakravorty, Rimi Pal, Siddhartha Chatterjee, Joyshree Chaterjee, Amal Mallik

Abstract:

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disease in reproductive women with a complex hormonal disturbance that affects the menstrual cycle and leads to metabolic consequences in later life. Hyperandrogenaemia is noticeable features of PCOS and influence the process of folliculogenesis in women. The levels of AntimĂŒllerian Hormone (AMH) reflect the number of pre-antral follicles and thus are a marker of oocyte pool – germinal reserve of the ovary for reproduction. Besides its utilization in IVF (In-vitro fertilization), determination of AMH may serve as an additional marker in the diagnostics of PCOS, where increased AMH levels reflect the severity of the disease. The positive correlation of serum AMH with the number of antral follicles was found also in patients with PCOS. Objective: The objective of this study was to investigate the relationship between AMH androgens and whether AMH contributes to altered folliculogenesis in non-obese women with PCOS. Methods: We designed a prospective study which included a total of 65 IVF individuals. It enrolled 26 cases of PCOS based on 2003 Rotterdam criteria and 39 ovulatory normal- non PCOS, healthy, age-matched controls. AMH levels and ovarian morphology were assessed. The relationships between AMH and androgenaemia in patients with and without PCOS were studied. Results: Mean age of PCOS patients were slightly higher than controls (32±4 and 28±3 years, respectively). AMH generally increased with antral follicle count (AFC) [P=0.001], testosterone, and luteinising hormone, and decreased with age, and serum sex hormone binding globulin (SHBG). No significant relationships were found between circulating AMH levels and BMI between PCOS and non-PCOS patients. The calculation of AMH production per antral follicle (AMH/AF) showed that there was a significant difference in median AMH/AF between PCOS and non-PCOS (P =0.001). Both PCOS and non-PCOS groups showed a very similar increase in AMH with increases in AFC, but the PCOS patients had consistently higher AMH across all AFC levels. Conclusions: These observations indicate that there is a connection between AMH and androgens levels between PCOS and non-PCOS East Indian women. Excessive granulosa cell activity may be implicated in the abnormal follicular dynamic of the syndrome. They are higher in women with PCOS and, on the other hand, very low in women with an ovarian failure.

Keywords: anti-Mullerian hormone, polycystic ovary syndrome, antral follicle count, androgens

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1906 The Drama and Dynamics of Economic Shocks and Households Responses in Nigeria

Authors: Doki Naomi Onyeje, Doki Gowon Ama

Abstract:

The past 4 years have been traumatic for Nigerians, having to deal with a number of complex economic issues with dire consequences for the economy. Households have had to respond variously to some of these problems in peculiar ways, depending, of course, on the nature and character of a particular shock. The type, magnitude, intensity and duration of a particular shock might be the determinant of different household responses. While households’ responses to the Global Financial Crisis and Covid 19 Pandemic have been documented by researchers, other economic shocks have continued to emerge in Nigeria. The dramatic turn of events since coming on board of the new government on May 29th 2023, has introduced a new economic twist that households will have to adjust to. This study, therefore, sets out to examine household responses by disaggregating them by their livelihood sources. A survey of 420 households across North Central Nigeria will be done to generate information on the respective responses. A Multinomial logit regression analysis will be employed to test the hypothesis that livelihood source(s) influences household responses to economic shocks. Consequently, responses from public and private households will be examined. The expected results should be that household responses might have some similarities, but it is expected that some peculiar responses across groups will emerge and these differences will guide for group-specific interventions. The Theatre for Development (TfD) approach will be used to disseminate and propagate results from this study to and among stakeholders for effective policy frameworks.

Keywords: drama, dynamics, economic shocks, household responses, Nigeria

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1905 Fasted and Postprandial Response of Serum Physiological Response, Hepatic Antioxidant Abilities and Hsp70 Expression in M. amblycephala Fed Different Dietary Carbohydrate

Authors: Chuanpeng Zhou

Abstract:

The effect of dietary carbohydrate (CHO) level on serum physiological response, hepatic antioxidant abilities and heat shock protein 70 (HSP70) expression of Wuchang bream (Megalobrama amblycephala) was studied. Two isonitrogenous (28.56% crude protein) and isolipidic (5.28% crude lipid) diets were formulated to contain 30% or 53% wheat starch. Diets were fed for 90 days to fish in triplicate tanks (28 fish per tank). At the end of feeding trial, significantly higher serum triglyceride level, insulin level, cortisol level, malondialdehyde (MDA) content were observed in fish fed the 53% CHO diet, while significantly lower serum total protein content, alkaline phosphatase (AKP) activity, superoxide dismutase (SOD) activity and total antioxidative capacity (T-AOC) were found in fish fed the 53% CHO diet compared with those fed the 30% diet. The relative level of hepatic heat shock protein 70 mRNA was significantly higher in the 53% CHO group than that in the 30% CHO at 6, 12, and 48 h after feeding. The results of this study indicated that ingestion of 53% dietary CHO impacted the nonspecific immune ability and caused metabolic stress of Megalobrama amblycephala.

Keywords: Megalobrama amblycephala, carbohydrate, fasted and postprandial response, immunity, Hsp70

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1904 Risk of Androgen Deprivation Therapy-Induced Metabolic Syndrome-Related Complications for Prostate Cancer in Taiwan

Authors: Olivia Rachel Hwang, Yu-Hsuan Joni Shao

Abstract:

Androgen Deprivation Therapy (ADT) has been a primary treatment for patients with advanced prostate cancer. However, it is associated with numerous adverse effects related to Metabolic Syndrome (MetS), including hypertension, diabetes, hyperlipidaemia, heart diseases and ischemic strokes. However, complications associated with ADT for prostate cancer in Taiwan is not well documented. The purpose of this study is to utilize the data from NHIRD (National Health Insurance Research Database) to examine the trajectory changes of MetS-related complications in men receiving ADT. The risks of developing complications after the treatment were analyzed with multivariate Cox regression model. Covariates including in the model were the complications before the diagnosis of prostate cancer, the age, and the year at cancer diagnosis. A total number of 17268 patients from 1997-2013 were included in this study. The exclusion criteria were patients with any other types of cancer or with the existing MetS-related complications. Changes in MetS-related complications were observed among two treatment groups: 1) ADT (n=9042), and 2) non-ADT (n=8226). The ADT group appeared to have an increased risk in hypertension (hazard ratio 1.08, 95% confidence interval 1.03-1.13, P = 0.001) and hyperlipidemia (hazard ratio 1.09, 95% confidence interval 1.01-1.17, P = 0.02) when compared with non-ADT group in the multivariate Cox regression analyses. In the risk of diabetes, heart diseases, and ischemic strokes, ADT group appeared to have an increased but not significant hazard ratio. In conclusion, ADT was associated with an increased risk in hypertension and hyperlipidemia in prostate cancer patients in Taiwan. The risk of hypertension and hyperlipidemia should be considered while deciding on ADT, especially those with the known history of hypertension and hyperlipidemia.

Keywords: androgen deprivation therapy, ADT, complications, metabolic syndrome, MetS, prostate cancer

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1903 Effect of Arsenic Treatment on Element Contents of Sunflower, Growing in Nutrient Solution

Authors: Szilvia VĂĄrallyay, Szilvia Veres, Éva BĂłdi, Farzaneh Garousi, BĂ©la KovĂĄcs

Abstract:

The agricultural environment is contaminated with heavy metals and other toxic elements, which means more and more threats. One of the most important toxic element is the arsenic. Consequences of arsenic toxicity in the plant organism is decreases the weight of the roots, and causes discoloration and necrosis of leaves. The toxicity of arsenic depends on the quality and quantity of the arsenic specialization. The arsenic in the soil and in the plant presents as a most hazardous specialization. A dicotyledon plant were chosen for the experiment, namely sunflower. The sunflower plants were grown in nutrient solution in different As(III) levels. The content of As, P, Fe were measured from experimental plants, using by ICP-MS.Negative correlation was observed between the higher concentration of As(V) and As(III) in the nutrition solution and the content of P in the sunflower tissue. The amount of Fe was decreasing if we used a higher concentration of arsenic (30 mg kg-1). We can tell the conclusion that the arsenic had a negative effect on the sunflower tissue P and Fe content.

Keywords: arsenic, sunflower, ICP-MS, toxicity

Procedia PDF Downloads 646
1902 Multiple Strategies in Prevention of Metabolic Syndrome Result from Vitamin D Deficiency in Children

Authors: Maryam Ghavam Sadri, Maryam Shahrooz

Abstract:

Background: Nowadays the prevalence of metabolic syndrome (Mets) has taken on a growing trend. Studies have shown the relationship between vitamin D deficiency (VDD) status and Mets in children. Also studies have recorded that exerting strategies for vitamin D status improvement can help prevent Mets in children. This study investigated multiple strategies of prevention of Mets resulting from VDD in children. Methods: This review study has been done by using keywords related to the topic and 54 articles were found (2000-2015) that 25 were selected according to the indicators of Mets, supplementation and fortification of foods with vitamin D and attention to children environment and life style. Results: Studies have suggested the correlation between serum levels of vitamin D with waist circumference (p < 0.0001), systolic blood pressure (p=0.01), HOMA-IR (p=0.001) and HDL cholesterol (p < 0.0001). An inverse correlation between serum 25 (OH) D and HOMA-IR (p = 0.006) and insulin (P = 0.002) has been proved in overweight group. Higher HOMASDS and triglycerides found in vitamin D deficient obese children compared to control group without VDD (p=0.04). After supplementation with vitamin D, serum TG concentration decreases significantly (p=0.04), and improves insulin resistance (p=0.02). The prevalence of VDD is associated with time of watching TV (P < 0.01), hours of physical activity per week (P = 0.01), skipping breakfast (P < 0.001) soda intake (P < 0.001), and milk intake per day (P < 0.01). Conclusion: According to the beneficial role of vitamin D in prevention of Mets and proven relationship between serum levels of vitamin D and Mets indicators, we can prevent childhood Mets through the application of appropriate strategies such as supplementation and food fortification with vitamin D and positive changes in children life style with especial attention to physical activity in exposure of sunlight and their environment condition.

Keywords: children, metabolic syndrome, prevention strategies, vitamin D

Procedia PDF Downloads 567
1901 Comparative Therapeutic Effect of Acalypha indica Linn. Extract and Gemfibrozil on High Fructose and Cholesterol Diet Induced Pancreas Steatosis in Sprague-Dawley Mice

Authors: Adrian Reynaldo Sudirman, Siti Farida, Aisyah Aminy Maulidina, Caren Andika Surbakti

Abstract:

Sedentary lifestyle and imbalance consumption pattern has made metabolic syndrome as the global time bomb phenomenon in the world. The increasing tendency of people in consuming high amount of fructose and cholesterol food has worsened this issue in the society. Pancreas steatosis become one of the most comorbid when early diagnosis and prompt treatment has not been applied on hyperglycemic and hyperlipidemic condition in metabolic syndrome patient. Gemfibrozil become the drug of choice to prevent this issue, yet the efficacy of this regiment was still questionable. Acalypha indica Linn. is the herb that has protective effect on hyperlipidemic and hyperglycemic condition. This study was aimed to compare therapeutic effect of gemfibrozil (G) and Acalypha indica Linn. (AI) on high fructose and cholesterol diet-induced pancreas steatosis in Sprague-Dawley mice. The post induction mice were divided into four groups: control, gemfibrozil, AI extract, and G+AI combination regiment. Each group received four weeks intervention. The result of statistical analysis using the One-Way ANOVA test and Tukey Post Hoc test showed significant decrease in pancreatic steatosis between the control group and administered Acalypha indica group (p = 0.004, 95% CI: 0.170-0.959) and the group administered with a combination of Gemfibrozil-Acalypha indica (p = 0.023, 95% CI: 0.537-0.813). The protective effect of Acalypha indica Linn. shows that this plant has the potential as therapeutic option in overcoming the condition of pancreas steatosis in metabolic syndrome.

Keywords: Acalypha Indica Linn., Cholesterol, Fructose, Gemfibrozil, Pancreas Steatosis

Procedia PDF Downloads 307
1900 Sewage Induced Behavioural Responses in an Air-Breathing Fish, Pangasius pangasius

Authors: Sasikala Govindaraj, P. Palanisamy, G. M. Natarajan

Abstract:

Domestic sewage poses major threats to the aquatic environment in third world countries due to lack of technical and economic sources which can have significant impacts on fish. The tolerance limits to toxicants found in domestic effluents vary among species and their integrative effects may lead to reproductive failure and reduction of survival and growth of the more sensitive fish species. The mechanism of action of toxic substances upon various concentrations of sewage was taken aiming to evaluate locomotory, physiological, neurological and morbidity response of fish. The rapid biomonitoring assessment technique for qualitative evaluation of various industrial pollutants, behavioral responses of an air-breathing fish Pangasius pangasius were used as biomarkers for water quality assessment. The present investigation concluded that sewage is highly toxic to the fish and severely affects their physiology and behavior.

Keywords: air-breathing organs, behavioral, locomotory, morbidity, neurological, physiological, sewage

Procedia PDF Downloads 281
1899 The Effects of Androgen Receptor Mutation on Cryptorchid Testes in 46, XY Female

Authors: Ihtisham Bukhari

Abstract:

In the current study, we enrolled a 46, XY phenotypically female patient bearing testes in her inguinal canal. DNA sequencing of the AR gene detected a missense mutation C.1715A > G (p. Y572C) in exon 2 which is already known to cause Complete androgen insensitivity syndrome (CAIS). We further studied the effects of this mutation on the testicular histopathology of the patient. No spermatocytes were seen in the surface spreading of testicular tissues while H&E staining showed that seminiferous tubules predominantly have only Sertoli cells. To confirm this meiotic failure is likely due to the current AR mutation we performed mRNA expression of genes associated with AR pathway, expression and location of the associated proteins in testicular tissues. Western blot and real-time PCR data showed that the patient had high levels of expression of AMH, SOX9, and INNB in testis. Tubules were stained with SOX9 and AMH which revealed Sertoli cell maturation arrest. Therefore, we suggest that AR mutation enhances AMH expression which ultimately leads to failure in the maturation of Sertoli cells and failure in spermatogenesis.

Keywords: androgen receptor, spermatogenesis, infertility, Sertoli cell only syndrome

Procedia PDF Downloads 143
1898 Germline Mutations of Mitogen-Activated Protein Kinases Pathway Signaling Pathway Genes in Children

Authors: Nouha Bouayed Abdelmoula, Rim Louati, Nawel Abdellaoui, Balkiss Abdelmoula, Oldez Kaabi, Walid Smaoui, Samir Aloulou

Abstract:

Background and Aims: Cardiofaciocutaneous syndrome (CFC) is an autosomal dominant disorder with the vast majority of cases arising by a new mutation of BRAF, MEK1, MEK2, or rarely, KRAS genes. Here, we report a rare Tunisian case of CFC syndrome for whom we identify SOS1 mutation. Methods: Genomic DNA was obtained from peripheral blood collected in an EDTA tube and extracted from leukocytes using the phenol/chloroform method according to standard protocols. High resolution melting (HRM) analysis for screening of mutations in the entire coding sequence of PTPN11 was conducted first. Then, HRM assays to look for hot spot mutations coding regions of the other genes of the RAS-MAPK pathway (RAt Sarcoma viral oncogene homolog Mitogen-Activated Protein Kinases Pathway): SOS1, SHOC2, KRAS, RAF1, KRAS, NRAS, CBL, BRAF, MEK1, MEK2, HRAS, and RIT1, were applied. Results: Heterozygous SOS1 point mutation clustered in exon 10, which encodes for the PH domain of SOS1, was identified: c.1655 G > A. The patient was a 9-year-old female born from a consanguineous couple. She exhibited pulmonic valvular stenosis as congenital heart disease. She had facial features and other malformations of Noonan syndrome, including macrocephaly, hypertelorism, ptosis, downslanting palpebral fissures, sparse eyebrows, a short and broad nose with upturned tip, low-set ears, high forehead commonly associated with bitemporal narrowing and prominent supraorbital ridges, short and/or webbed neck and short stature. However, the phenotype is also suggestive of CFC syndrome with the presence of more severe ectodermal abnormalities, including curly hair, keloid scars, hyperkeratotic skin, deep plantar creases, and delayed permanent dentition with agenesis of the right maxillary first molar. Moreover, the familial history of the patient revealed recurrent brain malignancies in the paternal family and epileptic disease in the maternal family. Conclusions: This case report of an overlapping RASopathy associated with SOS1 mutation and familial history of brain tumorigenesis is exceptional. The evidence suggests that RASopathies are truly cancer-prone syndromes, but the magnitude of the cancer risk and the types of cancer partially overlap.

Keywords: cardiofaciocutaneous syndrome, CFC, SOS1, brain cancer, germline mutation

Procedia PDF Downloads 153
1897 Biological Activities of Flaxseed Peptides (Linusorbs)

Authors: Youn Young Shim, Ji Hye Kim, Jae Youl Cho, Martin J. T. Reaney

Abstract:

Flaxseed (Linum usitatissimum L.) is gaining popularity in the food industry as a superfood due to its health-promoting properties. The flax plant synthesizes an array of biologically active cyclic peptides or linusorbs (LOs, a.k.a. cyclolinopeptides) from three or more ribosome-derived precursors. [1–9-NαC]-linusorb B3 and [1–9-NαC]-linusorb B2, suppress immunity, induce apoptosis in human epithelial cancer cell line (Calu-3) cells, and inhibit T-cell proliferation, but the mechanism of LOs action is unknown. Using gene expression analysis in nematode cultures and human cancer cell lines, we have observed that LOs exert their activity, in part, through induction of apoptosis. Specific LOs’ properties include: 1) distribution throughout the body after flaxseed consumption; 2) induce heat shock protein (HSP) 70A production as an indicator of stress and address the issue in Caenorhabditis elegans (exposure of nematode cultures to [1–9-NαC]-linusorb B3 induced a 30% increase in production of the HSP 70A protein); 3) induce apoptosis in Calu-3 cells; and 4) modulate regulatory genes in microarray analysis. These diverse activities indicate that LOs might induce apoptosis in cancer cells or act as versatile platforms to deliver a variety of biologically active molecules for cancer therapy.

Keywords: flaxseed, linusorb, cyclic peptide, orbitides, heat shock protein, apoptosis, anti-cancer

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1896 Poor Medical Waste Management (MWM) Practices and Its Risks to Human Health and the Environment

Authors: Babanyara Y. Y., Ibrahim D. B., Garba T., Bogoro A. G., Abubakar, M. Y.

Abstract:

Medical care is vital for our life, health, and well-being. However, the waste generated from medical activities can be hazardous, toxic, and even lethal because of their high potential for diseases transmission. The hazardous and toxic parts of waste from healthcare establishments comprising infectious, medical, and radioactive material as well as sharps constitute a grave risks to mankind and the environment, if these are not properly treated/disposed or are allowed to be mixed with other municipal waste. In Nigeria, practical information on this aspect is inadequate and research on the public health implications of poor management of medical wastes is few and limited in scope. Findings drawn from Literature particularly in the third world countries highlights financial problems, lack of awareness of risks involved in MWM, lack of appropriate legislation and lack of specialized MWM staff. The paper recommends how MWM practices can be improved in medical facilities.

Keywords: environmental pollution, infectious, management, medical waste, public health

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1895 Recurrent Fevers with Weight Gain - Possible Rapid onset Obesity with Hypoventilation, Hypothalamic Dysfunction and Autonomic Dysregulation Syndrome

Authors: Lee Rui, Rajeev Ramachandran

Abstract:

The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

Procedia PDF Downloads 107