Search results for: symptom screening
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1508

Search results for: symptom screening

1058 Lacunarity measures on Mammographic Image Applying Fractal Dimension and Lacunarity Measures

Authors: S. Sushma, S. Balasubramanian, K. C. Latha, R. Sridhar

Abstract:

Structural texture measures are used to address the aspect of breast cancer risk assessment in screening mammograms. The current study investigates whether texture properties characterized by local Fractal Dimension (FD) and lacunarity contribute to assess breast cancer risk. Fractal Dimension represents the complexity while the lacunarity characterize the gap of a fractal dimension. In this paper, we present our result confirming that the lacunarity value resulted in algorithm using mammogram images states that level of lacunarity will be low when the Fractal Dimension value will be high.

Keywords: breast cancer, fractal dimension, image analysis, lacunarity, mammogram

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1057 The Association of IL-17 Serum Levels with Disease Severity and Onset of Symptoms in Rheumatoid Arthritis Patients

Authors: Fatemeh Keshavarz

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Background: Rheumatoid arthritis (RA) is one of the most common autoimmune diseases, often leading to joint damage and physical disability. This study aimed to investigate the relationship of serum levels of interleukin 17 and anti-CCP factor with disease severity in RA patients. Materials and Methods: Fifty-four patients with RA confirmed by clinical and laboratory criteria were recruited. A 5 ml venous blood sample was taken from every patient, its serum was separated. Based on clinical data and severity of symptoms, patients were classified into three groups of those with mild, moderate, and severe symptoms. Serum levels of IL-17 and anti-CCP in all samples were measured using ELISA. Results: Analysis of IL-17 serum levels in different groups showed that its amount was higher in the group with mild clinical symptoms than in other groups. Comparison of IL-17 serum levels between mild and moderate disease severity groups showed a statistically significant relationship. There was also a positive linear relationship between anti-CCP and serum IL-17 levels in different groups of the disease, and serum IL-17 levels were inversely related to the duration of exposure to the disease. Conclusion: Higher IL-17 serum levels in patients with mild symptom severity confirm that this highly specific marker is involved in the pathogenesis of RA and may be effective in initiating patients’ clinical symptoms.

Keywords: IL-17, anti-CCP, rheumatoid arthritis, autoimmune

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1056 Sexual Satifaction in Women with Polycystic Ovarian Syndrome

Authors: Nashi Khan, Amina Khalid

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Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

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1055 Using Deep Learning in Lyme Disease Diagnosis

Authors: Teja Koduru

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Untreated Lyme disease can lead to neurological, cardiac, and dermatological complications. Rapid diagnosis of the erythema migrans (EM) rash, a characteristic symptom of Lyme disease is therefore crucial to early diagnosis and treatment. In this study, we aim to utilize deep learning frameworks including Tensorflow and Keras to create deep convolutional neural networks (DCNN) to detect images of acute Lyme Disease from images of erythema migrans. This study uses a custom database of erythema migrans images of varying quality to train a DCNN capable of classifying images of EM rashes vs. non-EM rashes. Images from publicly available sources were mined to create an initial database. Machine-based removal of duplicate images was then performed, followed by a thorough examination of all images by a clinician. The resulting database was combined with images of confounding rashes and regular skin, resulting in a total of 683 images. This database was then used to create a DCNN with an accuracy of 93% when classifying images of rashes as EM vs. non EM. Finally, this model was converted into a web and mobile application to allow for rapid diagnosis of EM rashes by both patients and clinicians. This tool could be used for patient prescreening prior to treatment and lead to a lower mortality rate from Lyme disease.

Keywords: Lyme, untreated Lyme, erythema migrans rash, EM rash

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1054 Yawning and Cortisol as a Potential Biomarker for Early Detection of Multiple Sclerosis

Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

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1053 A Multicenter Assessment on Psychological Well-Being Status among Medical Residents in the United Arab Emirates

Authors: Mahera Abdulrahman

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Objective: Healthcare transformation from traditional to modern in the country recently prompted the need to address career choices, accreditation perception and satisfaction among medical residents. However, a concerted nationwide study to understand and address burnout in the medical residency program has not been conducted in the UAE and the region. Methods: A nationwide, multicenter, cross-sectional study was designed to evaluate professional burnout and depression among medical residents in order to address the gap. Results: Our results indicate that 75.5% (216/286) of UAE medical residents had moderate to high emotional exhaustion, 84% (249/298) had high depersonalization, and 74% (216/291) had a low sense of personal accomplishment. In aggregate, 70% (212/302) of medical residents were considered to be experiencing at least one symptom of burnout based on a high emotional exhaustion score or a high depersonalization score. Depression ranging from 6-22%, depending on the specialty was also striking given the fact the Arab culture lays high emphasis on family bonding. Interestingly 83% (40/48) of medical residents who had high scores for depression also reported burnout. Conclusion: Our data indicate that burnout and depression among medical residents is epidemic. There is an immediate need to address burnout through effective interventions at both the individual and institutional levels. It is imperative to reconfigure the approach to medical training for the well-being of the next generation of physicians in the Arab world.

Keywords: mental health, Gulf, Arab, residency training, burnout, depression

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1052 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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1051 Enhancing Inhibition on Phytopathogens by Complex Using Biogas Slurry

Authors: Fang-Bo Yu, Li-Bo Guan, Sheng-Dao Shan

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Biogas slurry was mixed with six commercial fungicides and screening against 11 phytopathogens was carried out. Results showed that inhibition of biogas slurry was different for the test strains and no significant difference between treatments of Didymella bryoniae, Fusarium oxysporum f. sp. vasinfectum, Aspergillus niger, Rhizoctonia cerealis, F. graminearum and Septoria tritici was observed. However, significant differences were found among Penicillium sp., Botrytis cinerea, Alternaria sonali, F. oxysporum F. sp. melonis and Sclerotinia sclerotiorum. The approach described here presents a promising alternative to current manipulation although some issues still need further examination. This study could contribute to the development of sustainable agriculture and better utilization of biogas slurry.

Keywords: anaerobic digestion, biogas slurry, phytopathogen, sustainable agriculture

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1050 A Framework for Early Differential Diagnosis of Tropical Confusable Diseases Using the Fuzzy Cognitive Map Engine

Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

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The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis

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1049 Correction of Urinary Incontinence in Severe Spinal Canal Stenosis, Treated Patients

Authors: Ilirian Laçi, Alketa Spahiu

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Ageing causes an increase in the number of patients with spinal canal stenosis. Most of the patients have back pain, leg pain, numbness of the legs, as well as urinary incontinence as a very common symptoms. Urinary incontinence impairs the quality of life. Correction of the symptom of urinary incontinence is possible in the early and adequate treatment of spinal stenosis. Methods: This study observed patients with urinary incontinence and spinal canal stenosis. These patients underwent mechanical decompression of the spinal stenosis through surgery. At the same time, these patients were observed clinically with clinical consultations. Cystoscopy and urodynamic tests were conducted at intervals of 2 and 6 months. As a result of treatment, 60% of patients did recover. The patients in this group who benefit from treatment were the patients who were early diagnosed and treated. Conclusions: An important factor in the prognosis of this pathology is the early diagnosis and treatment. The proper treatment of this pathology makes it curable in most cases. An important role in this pathology is played by the neurosurgeon. Surgery accompanied by laminotomy and mechanical decompression is the best way of treatment. Other factors that played a role in this pathology are also a large number of childbirths for women, obesity, etc.

Keywords: urinary incontinence, quality of life, spinal canal stenosis, early diagnosis, treatment

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1048 Demographic Characteristics as a Determinant of the use of Health Care Services: Case of Nsukka, Southwest Nigeria

Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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1047 Screening for Non-hallucinogenic Neuroplastogens as Drug Candidates for the Treatment of Anxiety, Depression, and Posttraumatic Stress Disorder

Authors: Jillian M. Hagel, Joseph E. Tucker, Peter J. Facchini

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With the aim of establishing a holistic approach for the treatment of central nervous system (CNS) disorders, we are pursuing a drug development program rapidly progressing through discovery and characterization phases. The drug candidates identified in this program are referred to as neuroplastogens owing to their ability to mediate neuroplasticity, which can be beneficial to patients suffering from anxiety, depression, or posttraumatic stress disorder. These and other related neuropsychiatric conditions are associated with the onset of neuronal atrophy, which is defined as a reduction in the number and/or productivity of neurons. The stimulation of neuroplasticity results in an increase in the connectivity between neurons and promotes the restoration of healthy brain function. We have synthesized a substantial catalogue of proprietary indolethylamine derivatives based on the general structures of serotonin (5-hydroxytryptamine) and psychedelic molecules such as N,N-dimethyltryptamine (DMT) and psilocin (4-hydroxy-DMT) that function as neuroplastogens. A primary objective in our screening protocol is the identification of derivatives associated with a significant reduction in hallucination, which will allow administration of the drug at a dose that induces neuroplasticity and triggers other efficacious outcomes in the treatment of targeted CNS disorders but which does not cause a psychedelic response in the patient. Both neuroplasticity and hallucination are associated with engagement of the 5HT2A receptor, requiring drug candidates differentially coupled to these two outcomes at a molecular level. We use novel and proprietary artificial intelligence algorithms to predict the mode of binding to the 5HT2A receptor, which has been shown to correlate with the hallucinogenic response. Hallucination is tested using the mouse head-twitch response model, whereas mouse marble-burying and sucrose preference assays are used to evaluate anxiolytic and anti-depressive potential. Neuroplasticity is assays using dendritic outgrowth assays and cell-based ELISA analysis. Pharmacokinetics and additional receptor-binding analyses also contribute the selection of lead candidates. A summary of the program is presented.

Keywords: neuroplastogen, non-hallucinogenic, drug development, anxiety, depression, PTSD, indolethylamine derivatives, psychedelic-inspired, 5-HT2A receptor, computational chemistry, head-twitch response behavioural model, neurite outgrowth assay

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1046 Prevalence Of Periodontal Disease In Felines In The Outskirts Of The City Of Manaus, Brazil: An Epidemiological Study

Authors: Pármenas Costa Macedo do Nascimento

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Periodontal disease is the most common disease in the oral cavity of felines. It starts with the accumulation of bacteria on the tooth surface supporting the tissues of the periodontal tissue, namely gums, alveolar bone, cementum, and periodontal ligament. The main clinical symptom observed by the owner is bad breath, which may lead to local and systemic consequences depending on the stage of periodontal disease, such as bleeding and bone loss. Therefore, the study is important to educate tutors to take better care of the felines oral health in order to try to prevent the disease. For this epidemiological study, the target population has been felines, located on the outskirts of Manaus, in the state of Amazonas, with a geographic area of 155.68 km², with no defined breed, from October 1st to 10th, 2021, whose samples has been randomly selected, with a detailed profile. The variables of interest for this study have been: absence or presence of periodontal disease, gender, age (delimited by age group), and condition (domiciled or homeless). Using a sample of 40 felines from 4 districts of the east side of Manaus chosen at random, an oral exam has been made to identify the studied disease. The animal's apparent age, condition, sex, and presence or absence of periodontal disease has been noted. It has been observed that 70% (28/40) of them had periodontal disease, mostly females, aged between 0 and 5 years and domiciled, totaling 30% (12/40).

Keywords: felines, oral cavity, oral exam, periodontal disease

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1045 Systems Strengthening for Sustainable Family Planning Service Provision in Uganda

Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

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Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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1044 The Role of the Renal Specialist Podiatrist

Authors: Clara Luwe, Oliver Harness, Helena Meally, Kim Martin, Alexandra Harrington

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Background: The role of ‘Renal Specialist Podiatrist’ originated in 2022 due to prevailing evidence of patients with diabetes and end-stage renal disease (ESRD) on haemodialysis (HD) and active ulcerations that were at higher risk of rapid deterioration, foot-related hospital admissions, and lower limb amputations. This role started in April 2022 with the aim of screening all patients on haemodialysis and instigating preventative measures to reduce serious foot related complications. Methods: A comprehensive neurovascular foot assessment was completed to establish baseline vascular status and identify those with peripheral arterial disease (PAD) for all patients on HD. Individual’s foot risk was stratified, advice and education tailored and issued. Identifying all diabetes patients on HD as high-risk for diabetic foot complications. Major Findings: All patients screened revealed over half of the caseload had diabetes, and more than half had a clinical presentation of PAD. All those presenting with ulcerations had a diagnosis of diabetes. Of the presenting ulcerations, the majority of these ulcers predated the renal specialist post and were classified as severe >3 SINBAD Score. Since April’22, complications have been identified quicker, reducing the severity (SINBAD<3 or below), and have improved healing times, in line with the national average. During the eight months of the role being in place, we have seen a reduction in minor amputations and no major amputations. Conclusion: By screening all patients on haemodialysis and focusing on education, early recognition of complications, appropriate treatment, and timely onward referral, we can reduce the risk of foot Diabetic foot ulcerations and lower limb amputations. Having regular podiatry input to stratify and facilitate high-risk, active wound patients across different services has helped to keep these patients stable, prevent amputations, and reduce foot-related hospital admissions and mortality from foot-related disease. By improving the accessibility to a specialist podiatrist, patients felt able to raise concerns sooner. This has helped to implement treatment at the earliest possible opportunity, enabling the identification and healing of ulcers at an earlier and less complex stage (SINBAD <3), thus, preventing potential limb-threatening complications.

Keywords: renal, podiatry, haemodialysis, prevention, early detection

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1043 Similarity Based Retrieval in Case Based Reasoning for Analysis of Medical Images

Authors: M. Dasgupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: case based reasoning, exudates, retina image, similarity based retrieval

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1042 Haematological Correlates of Ischemic Stroke and Transient Ischemic Attack: Lessons Learned

Authors: Himali Gunasekara, Baddika Jayaratne

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Haematological abnormalities are known to cause Ischemic Stroke or Transient Ischemic Attack (TIA). The identification of haematological correlates plays an important role in a management and secondary prevention. The objective of this study was to describe haematological correlates of stroke and their association between stroke profile. The haematological correlates screened were Lupus Anticoagulant, Dysfibroginemia, Paroxysmal nocturnal haemoglobinurea (PNH), Sickle cell disease, Systemic Lupus Erythematosis (SLE) and Myeloploriferative Neoplasms (MPN). A cross sectional descriptive study was conducted in a sample of 152 stroke patients referred to haematology department of National Hospital of Sri Lanka for thrombophilia screening. Different tests were performed to assess each hematological correlate. Diluted Russels Viper Venom Test and Kaolin clotting time were done to assess Lupus anticoagulant. Full blood count (FBC), blood picture, Sickling test and High Performance Liquid Chromatography were the tests used for detection of Sickle cell disease. Paroxysmal nocturnal haemoglobinurea was assessed by FBC, blood picture, Ham test and Flowcytometry. FBC, blood picture, Janus Kinase 2 (V617F) mutation analysis, erythropoietin level and bone marrow examination were done to look for the Myeloproliferative neoplasms. Dysfibrinogenaemia was assessed by TT, fibrinogen antigen test, clot observation and clauss test. Anti nuclear antibody test was done to look for systemic lupus erythematosis. Among study sample, 134 patients had strokes and only 18 had TIA. The recurrence of stroke/TIA was observed in 13.2% of patients. The majority of patients (94.7%) have had radiological evidence of thrombotic event. One fourth of patients had past thrombotic events while 12.5% had family history of thrombosis. Out of haematological correlates screened, Lupus anticoagulant was the commonest haematological correlate (n=16 ) and dysfibrigonaemia(n=11 ) had the next high prevalence. One patient was diagnosed with Essential thrombocythaemia and one with SLE. None of the patients were positive for screening tests done for sickle cell disease and PNH. The Haematological correlates were identified in 19% of our study sample. Among stroke profile only presence of past thrombotic history was statistically significantly associated with haematological disorders (P= 0.04). Therefore, hematological disorders appear to be an important factor in etiological work-up of stroke patients particularly in patients with past thrombotic events.

Keywords: stroke, transient ischemic attack, hematological correlates, hematological disorders

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1041 Mental Health and Psychosocial Needs of Palestine Refugees in Lebanon and Syria

Authors: Cosette Maiky

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Background: In the context of the Syrian crisis, the past few years have witnessed an exponential growth in the number of refugee mental health studies, which have essentially focused either on the affected Syrian population and/or host communities. However, the Palestinian communities in the region did not receive sufficient that much of attention. Aim: The study aimed at identifying trends and patterns of mental health and and psychosocial conditions among Palestinian refugees in the context of the Syrian crisis, including the recognition of gaps in appropriate services. Methods: The research model comprised a systematic documentary review, a mapping of available contextual analyses, a quantitative survey, focus group discussions as well as key informant interviews (with relevant stakeholders and beneficiaries). Findings: Content analysis revealed multiple effects of transgenerational transmission of trauma among Palestinian refugees in the context of the Syrian crisis, which showed to be neither linear nor one-dimensional occurrence. In addition to highlights on exposure to traumatic events and psychological sequelae, the review outlines the most prevailing coping mechanisms and essential protective factors. Conclusion: Away from a trauma-centered or symptom-focused exercise, practitioners may take account of the present study to better focus research and intervention methodologies.

Keywords: Palestine refugees, Syria crisis, psychosocial, mental health

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1040 Computational Approach to Identify Novel Chemotherapeutic Agents against Multiple Sclerosis

Authors: Syed Asif Hassan, Tabrej Khan

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Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder, of the central nervous system (CNS). In the present scenario, the current therapies either do not halt the progression of the disease or have side effects which limit the usage of current Disease Modifying Therapies (DMTs) for a longer period of time. Therefore, keeping the current treatment failure schema, we are focusing on screening novel analogues of the available DMTs that specifically bind and inhibit the Sphingosine1-phosphate receptor1 (S1PR1) thereby hindering the lymphocyte propagation toward CNS. The novel drug-like analogs molecule will decrease the frequency of relapses (recurrence of the symptoms associated with MS) with higher efficacy and lower toxicity to human system. In this study, an integrated approach involving ligand-based virtual screening protocol (Ultrafast Shape Recognition with CREDO Atom Types (USRCAT)) to identify the non-toxic drug like analogs of the approved DMTs were employed. The potency of the drug-like analog molecules to cross the Blood Brain Barrier (BBB) was estimated. Besides, molecular docking and simulation using Auto Dock Vina 1.1.2 and GOLD 3.01 were performed using the X-ray crystal structure of Mtb LprG protein to calculate the affinity and specificity of the analogs with the given LprG protein. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has a higher hypothetical affinity, also has greater negative value. Further, the non-specific ligands were screened out using the structural filter proposed by Baell and Holloway. Based on the USRCAT, Lipinski’s values, toxicity and BBB analysis, the drug-like analogs of fingolimod and BG-12 showed that RTL and CHEMBL1771640, respectively are non-toxic and permeable to BBB. The successful docking and DSX analysis showed that RTL and CHEMBL1771640 could bind to the binding pocket of S1PR1 receptor protein of human with greater affinity than as compared to their parent compound (Fingolimod). In this study, we also found that all the drug-like analogs of the standard MS drugs passed the Bell and Holloway filter.

Keywords: antagonist, binding affinity, chemotherapeutics, drug-like, multiple sclerosis, S1PR1 receptor protein

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1039 Effect of Migraine on Functional Performance and Reported Symptoms in Children with Concussion

Authors: Abdulaziz Alkathiry

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Concussion is a common brain injury that affect physical and cognitive performance. While several studies indicated that adolescents are more likely to develop concussion, in the last decade concussion has been mainly explored in adults. Migraine has been identified as a common symptom reported after concussion and was tied with worse prognoses. Hence, we aimed to investigate the effect of migraine on functional performance and self-reported symptoms in children with concussion. This cross-sectional study involved 35 symptomatic children aged 9 – 17 years recruited within 1 year from their concussion injury at a tertiary balance center. Participants’ symptoms and functional performance were assessed using the post-concussion symptoms scale (PCSS) and the functional gait assessment (FGA) respectively. Concussed children with migraine showed significantly worse symptoms including fatigue, sleeping impairment, difficulty concentrating, and visual problems (P < 0.05). Functional performance didn’t show differences between concussed children with and without migraine. Although concussed children with and without migraine didn’t show any differences on functional performance, worse cognitive symptoms were found in concussed children with migraine. A customized treatment approach is indicated in the presence of migraine for the management of children with concussion. Keywords: Concussion; Migraine; Balance; Post-Concussion Symptoms Scale; Functional Gait Assessment

Keywords: concussion, migraine, post-concussion symptoms scale, functional gait assessment, balance

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1038 View Synthesis of Kinetic Depth Imagery for 3D Security X-Ray Imaging

Authors: O. Abusaeeda, J. P. O. Evans, D. Downes

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We demonstrate the synthesis of intermediary views within a sequence of X-ray images that exhibit depth from motion or kinetic depth effect in a visual display. Each synthetic image replaces the requirement for a linear X-ray detector array during the image acquisition process. Scale invariant feature transform, SIFT, in combination with epipolar morphing is employed to produce synthetic imagery. Comparison between synthetic and ground truth images is reported to quantify the performance of the approach. Our work is a key aspect in the development of a 3D imaging modality for the screening of luggage at airport checkpoints. This programme of research is in collaboration with the UK Home Office and the US Dept. of Homeland Security.

Keywords: X-ray, kinetic depth, KDE, view synthesis

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1037 The Interventional, Prospective, Real-World Post-Marketing Clinical Follow-Up Trial of a Polycarbophil Vaginal Moisturising Gel in Women Affected by Vaginal Dryness in Late Menopausal Transition and Postmenopause: A Triple Investigation

Authors: A. Cagnacci, D. F. Barattini, E. Casolati, M. Mangrella, E. Piccolo, S. Rosu, L. C. Pătrașcu

Abstract:

This Triple study aimed to evaluate the efficacy of polycarbophil vaginal gel (PCV) in treating symptoms of vaginal atrophy (VA) in peri- and post-menopausal women. Women in peri- (n=29) and postmenopause (n=54) diagnosed with VA were progressively enrolled and treated once a day for 30 days. Thereafter, those wishing to continue (n=73) received the PCV treatment for an additional 180 days. The vaginal health index (VHI) and vaginal dryness, irritation, and pain at intercourse, along with treatment safety, were evaluated at baseline, 30 days of treatment, and after additional 180 days. At baseline, the VHI (p<0.056) and VAS of vaginal dryness (p=0.0001,) irritation (p=0.002), and pain at intercourse (p=0.0001) were worse in postmenopausal women than in perimenopausal women. VHI and VA symptoms improved in all women, and after 30 days of PCV administration, they were similar between peri-and postmenopausal women. After an additional 180 days of treatment, VHI further increased (p=0.0001), VAS of all symptoms (P=0.0001) and the Global Symptom Score (P=0.0001) further decreased. The treatment was safe. Treatment with PCV improves VA symptoms in both peri- and post-menopausal women. Prolongation of treatment up to 6 months increases the efficacy of treatment with no side effects.

Keywords: late menopausal transition, postmenopause, polycarbophil, sexuality, vaginal dryness

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1036 Nephroblastoma at Universitas Academic Hospital Complex in the Last 20 Years

Authors: I. Iroka, L. Mgidlana, J. Willoughby, S. Dhlamini, P. Nxumalo, S. Sefadi, A. Mthembu, E. Gerber, E. Brits

Abstract:

Introduction: Nephroblastoma is a common paediatric tumor with good survival rates when diagnosed and treated early. Method: This retrospective study aimed to describe the patients with nephroblastoma seen at Universitas Academic Hospital Complex between the years 2000 and 2020. Results: In the study period, there were 207 patients identified. The patient profile had slightly more male than female patients; the median age was under four years of age. The study found a median delay of one month between symptom onset and diagnosis; a common cause was a delay in seeking care. Patients diagnosed and treated more than a month after symptoms started had poorer survival rates. There was a higher rate of Stage IV disease compared to similar studies in South Africa. Good preoperative histology and no relapse had good survival rates.. Patients from Lesotho had longer delays and presented with more severe diseases than the South African cohort. Conclusion: Early identification and treatment lead to better outcomes. Health-seeking behaviour, misdiagnosis, and referral delays might contribute to the long delays. A targeted study for patients from Lesotho is recommended.

Keywords: nephroblastoma, South Africa, Lesotho, developing country

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1035 Phytochemical Investigation of Berries of the Embelia schimperi Plant

Authors: Tariku Nefo Duke

Abstract:

Embelia is a genus of climbing shrubs in the family Myrsinaceae. Embelia schimperi is as important in traditional medicine as the other species in the genus. The plant has been much known as a local medicine for the treatment of tapeworms. In this project, extraction, phytochemical screening tests, isolation, and characterization of berries of the Embelia schimperi plant have been conducted. The chemical investigations of methanol and ethyl acetate (1:1) ratio extracts of the berries lead to the isolation of three new compounds. The compounds were identified to be alkaloids coded as AD, AN, and AG. Structural elucidations of the isolated compounds were accomplished using spectroscopic methods (IR, UV, ¹H NMR, ¹³C NMR, DEPT and 2D NMR, HPLC, and LC-MS). The alkaloid coded as (AN) has a wide MIC range of 6.31-25.46 mg/mL against all tested bacteria strains.

Keywords: Embelia schimper, HPLC, alkaloids, 2D NMR, MIC

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1034 Study of the Prevalence, Associated Factors and Impact of Maternal Perinatal Depression in Women Alexandria 2022

Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

Abstract:

Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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1033 Effects of Cell Phone Usage on Psychological Health of Students

Authors: Avadhesh Kumar

Abstract:

Background: The cell phone has rapidly become an integral, and, for some, an essential communication tool that is being used worldwide. Their use without any knowledge of their harmful effects like cancers and other health effects is not ‘quite’ safe. Studies on cancers due to electromagnetic radiations from cell phones are available, but there is a need to research on the detrimental physical and psychological effects on users like students. This study focused on certain psychological or mental health effects of cell phone usage amongst students. Materials and methods: The present study will be carried out on all the students of Banaras Hindu University. Students of both sexes from urban and rural backgrounds were selected at random and administered a pre- tested questionnaire which included aspects related to few common adverse psychological health signs and symptoms attributed to cell phone over-usage. Results: Stress was found to be the commonest symptom (51.47%) followed by irritability/anger (43.79%). Other common mental symptoms included lack of concentration and academic performance, insomnia, anxiety etc. Suggestions: This study confirms that the younger generation, who are the most frequent cell phone users, needs to be aware of the adverse health effects of cell phone usage especially the mental aspects and take preventive measures to minimize and control the same. Less dependence on the device, a curtailing time period spent on talking, communicating more by texting, etc. are some of the practical measures suggested.

Keywords: cell phones, psychological health effects, students, mental health

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1032 Isolation, Characterization, and Optimization of Immobilized L-Asparginase- Anticancer Enzyme from Aspergillus.Niger

Authors: Supriya Chatla, Anjana Male, Srikala Kamireddy

Abstract:

L-asparaginase (E.C.3.5.1.1) is an anti-cancer enzyme that has been purified and characterized for decades to study and evaluate its anti-carcinogenic activity against Hodgkin’s lymphoma. The present investigation deals with screening, isolation and optimization of L-asparaginase giving fungal strain of soil samples from different areas of AP, India. L-Aspariginase activity was estimated on the basis of the pink color surrounding the growing colony. A total of 132 colonies were screened and isolated from different samples. Based on the zone diameter, L-asparaginase activity is determined, L- asparaginase activity is optimized at 28oc and Immobilized Aspariginase had more potency than the free enzymes.

Keywords: aspariginase, anticancer enzyme, Isolation, optimization

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1031 Phytochemical Screening of Roots of Peltophorum pterocarpum

Authors: Vidyadhar Suram, D. Chamundeeswari, Umamaheswara Rao, Krishna Mohan Chinnala

Abstract:

Peltophorum pterocarpum known as copper pod belongs to the family Fabaceae, native to tropical south-eastern asia and a popularly ornamental tree grown around the world. In traditional medicine it is used as an astringent to cure or relieve intestinal disorders after pain at childbirth, sprains, bruises and swelling or as a lotion for eye troubles, muscular pains and sores. It is also used for gargles and tooth powders. Medcinally; it has proven to possess various pharmacological activities. The powdered root part of Peltophorum pterocarpum (250gr) were extracted exhaustively using different solvents and phytochemical investigations has shown the presence of various secondary metabolites like alkaloids, flavanoids, tannins, saponins, proteins, glycosides, steriods, and volatile.

Keywords: antibacterialactivity, fabaceae, peltophorum pterocarpum, isocoumari, alkaloids

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1030 Phytochemical Screening, Proximate Analysis, Lethality Studies and Anti-Tumor Potential of Annona muricata L. (Soursop) Fruit Extract in Rattus novergicus

Authors: O. C. Abbah, O. Obidoa, J. Omale

Abstract:

Prostate tumor is fast becoming a leading cause of morbidity and mortality in human male adults, with 50 percent of men aged 50 years and above having histological evidence of the benign tumor. The study was set out to undertake phytochemical screening and proximate analysis of the pulp of A. muricata fruit - soursop; to determine the acute toxicity of the fruit pulp extract and its effect on male albino Wistar rats with concurrent induction of experimental benign prostate hyperplasia (BPH). Eighteen rats (average weight of 100g) were used for the lethality studies and were orally administered graded doses of aqueous extracts of the fruit pulp up to 5000 mg/kg body weight. Twenty five rats weighing 150-200g were divided into five groups of five rats each for the tumor studies. The groups included four controls – Hormone control, HC, which took Testosterone, T; and Estradiol, E2 – only, in olive oil as vehicle; Vehicle control, VC; Soursop control, SC, which received the extract only; VS, Vehicle and Soursop – and the Test group, TG (500mg/kg b.w.). All rats were dosed orally. Tumor was induced with exogenous Testosterone propionate: Estradiol valerate at 300µg: 80µg/kg b.w. (respectively) in olive oil, administered subcutaneously in the inguinal region of the rats on alternate days for 21 days. Administration of the fruit pulp at graded doses up to 5000mg/kg resulted in no lethality even after 72 hours. Results from tumor studies revealed that the administration of the fruit extracts significantly (p < 0.05) reduced the relative prostate weight of the TG compared with the HC, with values of 006±0.001 and 0.010±0.003 respectively. Treatment with vehicle, soursop and vehicle with soursop caused no significant (p>0.05) change in prostate size, with their respective relative prostate weights being 0.002±0.001, 0.004±0.002 and 0.002±0.001 compared with TG. Also, treatment with A. muricata fruit extract significantly decreased (p < 0.05) serum prostate specific antigen, PSA, in TG compared with HC, with values 0.055±0.017 and 0.194±0.068 ng/ml respectively. Furthermore, A. muricata administration displayed Testosterone boosting, Estradiol lowering and consequently testosterone-estradiol ratio increasing potential at the end of the 21 days. The preventive property of soursop against experimental BPH was corroborated by histological evidence in this study. The study concludes that A. muricata fruit holds a great potential for benign prostate tumor prevention and, possibly, management.

Keywords: annona muricata, benign prostate tumor, hormone, preventive potential, soursop

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1029 Can Demyelinative Lesion Cause To Behaviora Change?

Authors: Arezou Hajhashemi, Karim Asgari, Masoud Etemadifar, Maryam Keyvani, Ali Hekmatnia

Abstract:

Multiple Sclerosis (MS) is one of the most prevalent demyelinating diseases in CNS. As in other chronic cerebral diseases, impairment in cognitive functioning and in memory is popular. Because of the inflammatory and demyelinating nature of the disease, the localization of plaques in different parts of the Prefrontal and Limbic System, may lead to memorial symptoms. This investigation was intended to study relationship between frequency of plaques and memorial symptoms arising from dysfunction limbic system and prefrontal of patients with MS. The sample was selected randomly from patients with MS with memory problem, who have been referred to Isfahan Multiple Sclerosis Society. Brain System Test and Memory Test was administered to the sample, and their MRI's were analyzed by specialist in order to indentify two different parts of plaques. The data was analyzed by SPSS. The results showed that there were significant relationship between MS plaques and prefrontal's dysfunction and memorial symptom related to prefrontal area; however, there were no significant relationship between MS plaques and limbic system's dysfunction and memorial symptoms related to limbic system area. The results of this study suggest that memorial symptoms due to injury regions of the brain have the most significant relationship to prefrontal. Better judgment about these results needs more studies in future.

Keywords: multiple sclerosis, magnetic image, brain injury, behavior disorder

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