Search results for: kahsay abera general hospital

Authors: Liaqat Ali, Ehsan, Muhammad Shahzad, Nasir Orakzai

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Introduction: Internal optical urethrotomy is the main stay treatment modality in management of urethral stricture. Being minimal invasive with less morbidity, it is commonly performed and favored procedure by urologists across the globe. Although short-term success rate of optical urethrotomy is promising but long-term efficacy of IOU is questionable with high recurrence rate in different studies. Numerous techniques had been adopted to reduce the recurrence after IOU like prolong catheterization and self-clean intermittent catheterization with varying success. Mitomycin C has anti-fibroblast and anti-collagen properties and has been used in trabeculectomy, myringotomy and after keloid scar excision in contemporary surgical practice. Present study according to the best of our knowledge is a pioneer pilot study in Pakistan to determine the efficacy of Mitomycin C in preventing recurrence of urethral stricture after internal optical urethrotomy. Objective: To determine the efficacy of Mitomycin C in reducing the recurrence of anterior urethral stricture after internal optical urethrotomy. Methods: It is a randomized control trial conducted in department of urology, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from March 2011 till December 2013. After approval of hospital ethical committee, we included maximum of 2 cm anterior urethral stricture irrespective of etiology. Total of 140 patients were equally divided into two groups by lottery method. Group A (Case) comprising of 70 patients in whom Mitomycin C 0.1% was injected sub mucosal in stricture area at 1,11,6 and 12 O clock position using straight working channel paediatric cystoscope after conventional optical urethrotomy. Group B (Control) 70 patients in whom only optical urethrotomy was performed. SCIC was not offered in both the groups. All the patients were regularly followed on a monthly basis for 3 months then three monthly for remaining 9 months. Recurrence was diagnosed by using diagnostic tools of retrograde urethrogram and flexible urethroscopy in selected cased. Data was collected on structured Proforma and was analyzed on SPSS. Result: The mean age in Group A was 33 ±1.5 years and Group B was 35 years. External trauma was leading cause of urethral stricture in both groups 46 (65%) Group A and 50 (71.4%) Group B. In Group A. Iatrogenic urethral trauma was 2nd etiological factor in both groups. 18(25%) Group A while 15( 21.4%) in Group B. At the end of 1 year, At the end of one year, recurrence of urethral stricture was recorded in 11 (15.71%) patient in Mitomycin C Group A and it was recorded in 27 (38.5 %) patients in group B. Significant difference p=0.001 was found in favour of group A Mitomycin group. Conclusion: Recurrence of urethral stricture is high after optical urethrotomy. Mitomycin C is found highly effective in preventing recurrence of urethral stricture after IOU.

Keywords: urethral stricture, mitomycine, internal optical urethrotomy, medical and health sciences

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Authors: Priscilla Adoley Moffat

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One common element of African cultures is gender role socialization. This is a significant component of African cultures because gender roles are considered in these cultures, to define males and females and distinguish males from females. Various studies have established the impact of gender role socialization on individuals, on activities of individuals, including business activities, and on society, in general. This study further examined the effect of gender role socialization on the marketing of gendered products. The study sought to establish whether gender role socialization affects marketing, particularly word-of-mouth marketing, of gender-specific products. For a comprehensive examination of the influence of gender role socialization on word-of-mouth marketing of gendered products, 2150 respondents (1075 males and 1075 females), comprising 550 students of Marketing from various Ghanaian universities/colleges and 1600 other individuals (100 from each of the 16 regions of Ghana, representing the various cultures) were randomly sampled and interviewed. The study found that females are more willing to market male products than males when tasked to market female products. Also, females are more efficient in marketing male products than males in marketing female products. Again, most female audiences feel uncomfortable or embarrassed and are less receptive when approached by a male marketer of female products. Then, the study found that the fear of stigmatization is a major influencer of males’ negative attitude towards marketing of female products and that female marketers of male products, however, suffer less or no stigma. Aside from its addition to the literature on the impact of gender role socialization on marketing and, for that matter, the influence of socialization on marketing, the findings of the study are useful to multinational companies, which become better informed in their strategy when assigning marketing roles, especially in Africa.

Keywords: gender, socialization, marketing, gendered, role, Ghana

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Authors: Eglė Žurauskaitė, Eglė Gudavičienė

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The goal of this paper is to reveal how polarization is constructed through the use of impoliteness strategies. In general, media helps to spread various ideas very fast, and it means that processes of polarization are best revealed in computer-mediated communication (CMC) contexts. For this reason, data for the research was collected from online texts about a current, very diverse topic in Lithuania - Lithuanian language policy and regulations, because this topic is causing a lot of tension in Lithuanian society. Computer-mediated communication allows users to edit their message before they send it. It means that addressees carefully select verbal expressions to convey their message. In other words, each impoliteness strategy and its verbal expression were created intentionally. Impoliteness strategies in this research are understood as various ways to reach a communicative goal: belittle the other. To reach the goal, the public opinions of various Lithuanian public figures (e. g., cultural people, politicians, officials) were collected from new portals in 2019–2023 and analyzed using both quantitative and qualitative approaches. First, problematic aspects of the language policy, for which public figures complain, were identified. Then instances when public figures take a defensive position were analyzed: how they express this position and what it reveals about Lithuanian culture. Findings of this research demonstrate how concepts of impoliteness theory can be applied in analyzing the process of polarization in Lithuanian society on issues related to the State language policy. Also, to reveal how polarization is constructed, these tasks were set: a) determine which impoliteness strategies are used throughout the process of creating polarization, b) analyze how they were expressed verbally (e. g., as an advice, offer, etc.).

Keywords: impoliteness, Lithuanian language policy, polarization, impoliteness strategies

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Authors: Hagos Abraham, Solomon Gizaw, Mengistu Urge

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A sound breeding objective is the basis for genetic improvement in overall economic merit of farm animals. Begait goat is one of the identified breeds in Ethiopia, which is a multipurpose breed as it serves as source of cash income and source of food (meat and milk). Despite its importance, no formal breeding objectives exist for Begait goat. The objective of the present study was to identify breeding objectives for the breed through two approaches: using own-flock ranking experiment and developing deterministic bio-economic models as a preliminary step towards designing sustainable breeding programs for the breed. In the own-flock ranking experiment, a total of forty five households were visited at their homesteads and were asked to select, with reasons, the first best, second best, third best and the most inferior does from their own flock. Age, previous reproduction and production information of the identified animals were inquired; live body weight and some linear body measurements were taken. The bio-economic model included performance traits (weights, daily weight gain, kidding interval, litter size, milk yield, kid mortality, pregnancy and replacement rates) and economic (revenue and costs) parameters. It was observed that there was close agreement between the farmers’ ranking and bio-economic model results. In general, the results of the present study indicated that Begait goat owners could improve performance of their goats and profitability of their farms by selecting for litter size, six month weight, pre-weaning kid survival rate and milk yield.

Keywords: bio-economic model, economic parameters, own-flock ranking, performance traits

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Authors: E. Er, Y. S. Cheng

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The role of parents and caregivers in their children’s education is pivotal. Parental involvement (PI) is often associated with a range of student outcomes. This includes academic achievements, socioemotional development, adaptive skills, physical fitness and school attendance. This study is the first in Singapore to (1) explore the relationship between parental involvement and student outcomes; (2) determine the effects of family structure and socioeconomic status (SES) on parental involvement and (3) investigate factors that inform involvement in parents of children with specific developmental disabilities. Approval for the study was obtained from Nanyang Technological University’s Institutional Review Board in Singapore. The revised version of a comprehensive theoretical model on parental involvement was used as the theoretical framework in this study. Parents were recruited from a SPED school in Singapore which caters to school-aged children (7 to 21 years old). Pearson’s product moment correlation, analysis of variance and multiple regression analyses were used as statistical techniques in this study. Results indicate that there are significant associations between parental involvement and educational outcomes in students with developmental disabilities. Next, SES has a significant impact on levels of parental involvement. In addition, parents in the current study reported being more involved at home, in school activities and the community, when teachers specifically requested their involvement. Home-based involvement was also predicted by parents’ perceptions of their time and energy, efficacy and beliefs in supporting their child’s education, as well as their children’s invitations to be more involved. An interesting and counterintuitive inverse relationship was found between general school invitations and parental involvement at home. Research findings are further discussed, and suggestions are put forth to increase involvement for this specific group of parents.

Keywords: autism, developmental disabilities, intellectual disabilities, parental involvement, Singapore

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Authors: K. Godazandeh, K. Sadeghy

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In the present study, the effect of magnetic field on the hydrodynamic instability of Taylor-Couette flow between two concentric rotating cylinders has been numerically investigated. At the beginning the basic flow has been solved using continuity, Cauchy equations (with regards to Lorentz force) and the constitutive equations of a viscoelastic model called "Giesekus" model. Small perturbations, considered to be normal mode, have been superimposed to the basic flow and the unsteady perturbation equations have been derived consequently. Neglecting non-linear terms, the general eigenvalue problem obtained has been solved using pseudo spectral method (combination of Chebyshev polynomials). The objective of the calculations is to study the effect of magnetic fields on the onset of first mode of instability (axisymmetric mode) for different dimensionless parameters of the flow. The results show that the stability picture is highly influenced by the magnetic field. When magnetic field increases, it first has a destabilization effect which changes to stabilization effect due to more increase of magnetic fields. Therefor there is a critical magnetic number (Hartmann number) for instability of Taylor-Couette flow. Also, the effect of magnetic field is more dominant in large gaps. Also based on the results obtained, magnetic field shows a more considerable effect on the stability at higher Weissenberg numbers (at higher elasticity), while the "mobility factor" changes show no dominant role on the intense of suction and injection effect on the flow's instability.

Keywords: magnetic field, Taylor-Couette flow, Giesekus model, pseudo spectral method, Chebyshev polynomials, Hartmann number, Weissenberg number, mobility factor

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Authors: Nasrin Badrkhani

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Human beings step into this world to live thus, the way of living holds undeniable importance. Addressing the contemporary lifestyle is a necessity that has attracted the attention of scholars. To formulate an ideal lifestyle, we need to progress in two dimensions: the instrumental and the content dimensions. In the context of lifestyle, which is the software part of Islamic civilization, we have not made significant progress. In analyzing the Iranian-Islamic lifestyle, it must be said that our current lifestyle is eclectic, and we need to refine it by selecting one or two main factors, which other factors are dependent on, and work on them so that the secondary factors change on their own. Lifestyle is a broad concept that, in addition to goals, includes an individual's thoughts about themselves, the world, and their unique way of striving to achieve their goals under specific conditions. The discussion of harm becomes relevant for an institution when it cannot fulfill the expected functions or is on the verge of dissolution. There is no doubt that today's Iranian family is far from being the balanced family that should be the cornerstone of a healthy society. The generation gap, as a global issue, is a problem facing Iranian society and families. The weakening of the element of faith, prioritizing worldly benefits over divine satisfaction, the prominence of material pleasures over spiritual joy, individualism and attention to personal interests instead of altruism and sacrifice, increased grounds for establishing relationships outside the framework of marriage, and the fading culture of hijab reduce the felt need to form a family. In a general summary regarding the pathology of the lifestyle of Iranians, it must be said that the consumerist lifestyle or the libertinism that some of our families have adopted is, whatever it may be, not beneficial for our country and society in terms of the development and perfection of future generations. We need to design alternative lifestyles that are suitable for our society and are also geared towards the elevation of our children.

Keywords: social problems, gap generation, communication, lifestyle of Iranians

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Authors: Einav Srulovici, Michal Grinstein-Weiss, George Knafl, Linda Beeber, Shawn Kneipp, Barbara Mark

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Background: The asset-building theoretical framework (ABTF) is acknowledged as the most complete framework thus far for depicting the relationships between asset accumulation (the stock of a household’s saved resources available for future investment) and health outcomes. Although the ABTF takes into consideration the reciprocal relationship between asset accumulation and health, no ABTF based study has yet examined this relationship. Therefore, the purpose of this study was to test the ABTF and psychological distress, focusing on the reciprocal relationship between assets accumulation and psychological distress. Methods: The study employed longitudinal data from 6,295 families from the 2001 and 2007 Panel Study of Income Dynamics data sets. Structural equation modeling (SEM) was used to test the reciprocal relationship between asset accumulation and psychological distress. Results: In general, the data displayed a good fit to the model. The longitudinal SEM found that asset accumulation significantly increased with a decreased in psychological distress over time, while psychological distress significantly increased with an increase in asset accumulation over time, confirming the existence of the hypothesized reciprocal relationship. Conclusions: Individuals who are less psychological distressed might have more energy to engage in activities, such as furthering their education or obtaining better jobs that are in turn associated with greater asset accumulation, while those who have greater assets may invest those assets in riskier investments, resulting in increased psychological distress. The confirmation of this reciprocal relationship highlights the importance of conducting longitudinal studies and testing the reciprocal relationship between asset accumulation and other health outcomes.

Keywords: asset-building theoretical framework, psychological distress, structural equation modeling, reciprocal relationship

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Authors: Marko Kolakovic

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Creative industries are an important sector of growth and development of knowledge economies. They have a positive impact on employment, economic growth, export and the quality of life in the areas where they are developed. Creative sectors include architecture, design, advertising, publishing, music, film, television and radio, video games, visual and performing arts and heritage. Following the positive trends of development of creative industries on the global and European level, this paper analyzes creative industries in general and specific characteristics of creative entrepreneurship. Special focus in this paper is put on the influence of the information communication technology on the development of new creative business models and protection of the intellectual property rights. One part of the paper is oriented on the analysis of the status of creative industries and creative entrepreneurship in Croatia. The main objective of the paper is by using the statistical analysis of creative industries in Croatia and information gained during the interviews with entrepreneurs, to make conclusions about potentials and development of creative industries in Croatia. Creative industries in Croatia are at the beginning of their development and growth strategy still does not exist at the national level. Statistical analysis pointed out that in 2015 creative enterprises made 9% of all enterprises in Croatia, employed 5,5% of employed people and their share in GDP was 4,01%. Croatian creative entrepreneurs are building competitive advantage using their creative resources and creating specific business models. The main obstacles they meet are lack of business experience and impossibility of focusing on the creative activities only. In their business, they use digital technologies and are focused on export. The conclusion is that creative industries in Croatia have development potential, but it is necessary to take adequate measures to use this potential in a right way.

Keywords: creative entrepreneurship, knowledge economy, business models, intellectual property

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Authors: Afrah Saad Mohsen Al-Mahfadi

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In rural areas of developing countries, participation of all stakeholders in water supply projects is an important step towards further development. As most of the beneficiaries are women, it is important that they should be involved to achieve successful and sustainable water supply projects. Women are responsible for the management of water both inside and outside home, and often spend more than six-hours a day fetching drinking water from distant water sources. The problem is that rural women play a role of little importance in the water supply projects’ phases in rural Yemen. Therefore, this research aimed at analyzing the different reasons of their lack of participation in projects and in what way a full participation -if achieved- could contribute to sustainable water supply projects in the rural mountainous areas in Yemen. Four water supply projects were selected as a case study in Al-Della'a Alaala sub-district in the Al-Mahweet governorate, two of them were implemented by the Social Fund and Development (SFD), while others were implemented by the General Authority for Rural Water Supply Projects (GARWSSP). Furthermore, the successful Al-Galba project, which is located in Badan district in Ibb governorate, was selected for comparison. The rural women's active participation in water projects have potential consequences including continuity and maintenance improvement, equipment security, and improvement in the overall health and education status of these areas. The majority of respondents taking part in GARWSSP projects estimated that there is no reason to involve women in the project activities. In the comparison project - in which a woman worked as a supervisor and implemented the project – all respondents indicated that the participation of women is vital for sustainability. Therefore, the results of this research are intended to stimulate rural women's participation in the mountainous areas of Yemen.

Keywords: assessment, rural woman, sustainability, water management

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Authors: Vilar, Katila

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Rapid urbanization have made of spontaneous settlements one of the dominant´s social subjects of the XXIst century. Currently, it´s recognized that these territories cannot easily be eradicated and are a way of life to many populations of emergent countries. Since late 90s, there is an urgent concern in finding planning and efficient urban design strategies to poverty reduction, spatial integration and social inclusion of low-income communities. The article aims to identify, understand and evaluate the social inclusion´s processes through the urban transformation that has been undertaken in Moravia and how they affected the community´s social capital. To achieve this objective, we start to analyse the PPMIM´s planning discourse in which prevails the sustainability´s concept, to further identify, through the analysis of the project carried out, the urban design strategies implemented and their impact on the perception and on the community´s experience, and, finally, how these focused on the social capital. It relies on concepts such as urban design, social capital, local development and sustainability. At the urban design level it starts on the current principles of “making places”, on the new urbanism concepts and on the practices on the ground carried out by a new generation of architects/planners whose have the main ethical approach in order to create more opportunities and greater social impact to these territories. At the social capital´s level and on the development´s theory, relies on authors such as Coleman, Putman Kliksberg and Amartya Sen. Finally, it aims to address a general discussion about the positive and negative implications of slum upgrading programmes and some necessary recommendations for urban design and social capital can really be translated into real resources for the self sustainable development of low-income communities and their future generations.

Keywords: local and sustainable development, social capital, spontaneous settlements, urban design

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Authors: Bernardita Tornero

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Cognitive Acceleration in Mathematics Education (CAME) programmes have been used successfully for promoting the development of thinking skills in school students for the last 30 years. Given that the approach has had a tremendous impact on the thinking capabilities of participating students, this study explored the experience of using the programme with prospective primary teachers in Chile. Therefore, this study not only looked at the experience of prospective primary teachers during the CAME course as learners, but also examined how they perceived the approach from their perspective as future teachers, as well as how they could transfer the teaching strategies they observed to their future classrooms. Given the complexity of the phenomenon under study, this research used a mixed methods approach. For this reason, the impact that the CAME course had on prospective teachers’ thinking skills was not only approached by using a test that assessed the participants’ improvements in these skills, but their learning and teaching experiences were also recorded through qualitative research tools (learning journals, interviews and field notes). The main findings indicate that, at the end of the CAME course, prospective teachers not only demonstrated higher thinking levels, but also showed positive attitudinal changes towards teaching and learning in general, and towards mathematics in particular. The participants also had increased confidence in their ability to teach mathematics and to promote thinking skills in their students. In terms of the CAME methodology, prospective teachers not only found it novel and motivating, but also commented that dealing with the thinking skills topic during a university course was both unusual and very important for their professional development. This study also showed that, at the end of the CAME course, prospective teachers felt they had developed strategies that could be used in their classrooms in the future. In this context, the relevance of the study is not only that it described the impact and the positive results of the first experience of using a CAME approach with prospective teachers, but also that some of the conclusions have significant implications for the teaching of thinking skills and the training of primary school teachers.

Keywords: cognitive acceleration, formal reasoning, prospective teachers, initial teacher training

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Authors: Kveta Olsanova, Gina Cook, Marija Zlatic

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This paper discusses the theoretical framework suggesting the dependencies between luxury brands’ CSR (Corporate Social Responsibility) variables and the purchase intention of luxury shoppers. The framework is based on a literature review and in-depth individual interviews with a sample of luxury users and buyers. The measures of the model are based on existing research and the authors' qualitative research results. The model suggests that purchase intention in the luxury segment is dependent on the luxury values (symbolic, experiential, functional and social), individual sustainable dimension (composed of societal, environmental and economic variables) and awareness of the brand’s CSR, the last two relationships being potentially moderated by certain conditions such as demographics and general attitudes towards CSR and sustainability. The model’s output is in the formulation of several hypotheses, to be tested in an upcoming quantitative study. The qualitative phase indicated that the perceived symbolic, functional and experiential value dimensions of luxury brands were stronger drivers of purchase intention compared to the sustainable dimension. The contribution of the research consists of highlighting CSR’s impact on customer purchase intent as a potential implication for luxury brand management due to two aspects: (i) consumer awareness of the existing CSR activities of luxury brands is low, and this might be challenged by the demands of Gen Z entrants into the lux industry as they are known for their positive approach to CSR; (ii) the UN’s SDGs will bring CSR to the attention of all industries, including currently 'CSR silent' segments represented by luxury. Our research should contribute to incorporation of strategic CSR into the policies and strategies of the luxury segment by providing evidence that luxury customers do care.

Keywords: CSR, luxury shoppers, purchase intention, sustainability

Procedia PDF Downloads 154

Authors: Jose G. Tshikuka, Goabaone Rankgoane-Pono, Mgaywa G. M. D. Magafu, Julius C. Mwita, Tiny Masupe, Fortunat M. Kandanda, Shimeles G. Hamda, Roy Tapera, Mooketsi Molefi, John T. Tlhakanelo

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Background: Factors associated with overweight and obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. We aimed to study (i) the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) changes in body mass index (BMI) categories among recipients before ART initiation (BMI-1) and after ART initiation (BMI-2), (iii) associations between ART and overweight/obesity and (iv) factors associated with BMI changes among ART recipients. Methods: A 12 years retrospective record-based review was conducted. Factors potentially associated with BMI change among patients after at least three years of ART exposure were examined using multiple regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus related comorbidities (DRC) were investigated as potential factors associated with overweight/obesity. Results: Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obesity recipients were more likely to be female, to have DRC and less likely to have nadir CD4 count or CD4 count between 201 – 249 cells/mm³. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity more than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusions: These results indicate that overweight/obesity seen among ART recipients is not directly induced by ART. ART used CD4 and/or DRC pathway to induce overweight/obesity seen among recipients; suggesting that, weight gain documented herein is likely a reflection of improved health status that mirrors trends in the general population or a DRC related effect. Weight management programs may be important components of HIV care.

Keywords: overweight/obesity, recipients of antiretroviral therapy, HIV/AIDS, Botswana

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Authors: Kerolis Samoul Zaghloul Noaman

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area law is the brand new access in the basket of worldwide law in the latter half of the 20 th Century. inside the last hundred and fifty years, courts and pupils advanced a consensus that, the custom is an vital supply of global law. Article 38(1) (b) of the statute of the international court of Justice identified global custom as a supply of global law. country practices and usages have a more role to play in formulating commonplace international regulation. This paper examines those country practices which may be certified to emerge as global standard law. due to the fact that, 1979 (after Moon Treaty) no hard law had been developed within the vicinity of space exploration. It attempts to link among country practices and custom in area exploration and development of standard global regulation in area activities. The paper makes use of doctrinal approach of felony research for inspecting the current questions of worldwide regulation. The paper explores exceptional worldwide prison files which include general meeting Resolutions, Treaty standards, working papers of UN, cases relating to commonplace global law and writing of jurists regarding area law and standard international law. it's far argued that, ideas such as common background of mankind, non-navy region, sovereign equality, nuclear weapon unfastened area and protection of outer area environment, etc. evolved nation practices a number of the worldwide community which can be certified to turn out to be international customary regulation.

Keywords: social networks privacy issues, social networks security issues, social networks privacy precautions measures, social networks security precautions measures

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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Authors: Recep Kesli, Huseyin Bilgin, Yasar Unlu, Gokhan Gungor

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Aim: The aim of this study was to compare diagnostic values of two different molecular-based tests (GenoType® HelicoDR ve Seeplex® H. pylori-ClaR- ACE Detection) in detection presence of the H. pylori from gastric biopsy specimens. In addition to this also was aimed to determine resistance ratios of H. pylori strains against to clarytromycine and quinolone isolated from gastric biopsy material cultures by using both the genotypic (GenoType® HelicoDR, Seeplex ® H. pylori -ClaR- ACE Detection) and phenotypic (gradient strip, E-test) methods. Material and methods: A total of 266 patients who admitted to Konya Education and Research Hospital Department of Gastroenterology with dyspeptic complaints, between January 2011-June 2013, were included in the study. Microbiological and histopathological examinations of biopsy specimens taken from antrum and corpus regions were performed. The presence of H. pylori in all the biopsy samples was investigated by five differnt dignostic methods together: culture (C) (Portagerm pylori-PORT PYL, Pylori agar-PYL, GENbox microaer, bioMerieux, France), histology (H) (Giemsa, Hematoxylin and Eosin staining), rapid urease test (RUT) (CLOtest, Cimberly-Clark, USA), and two different molecular tests; GenoType® HelicoDR, Hain, Germany, based on DNA strip assay, and Seeplex ® H. pylori -ClaR- ACE Detection, Seegene, South Korea, based on multiplex PCR. Antimicrobial resistance of H. pylori isolates against clarithromycin and levofloxacin was determined by GenoType® HelicoDR, Seeplex ® H. pylori -ClaR- ACE Detection, and gradient strip (E-test, bioMerieux, France) methods. Culture positivity alone or positivities of both histology and RUT together was accepted as the gold standard for H. pylori positivity. Sensitivity and specificity rates of two molecular methods used in the study were calculated by taking the two gold standards previously mentioned. Results: A total of 266 patients between 16-83 years old who 144 (54.1 %) were female, 122 (45.9 %) were male were included in the study. 144 patients were found as culture positive, and 157 were H and RUT were positive together. 179 patients were found as positive with GenoType® HelicoDR and Seeplex ® H. pylori -ClaR- ACE Detection together. Sensitivity and specificity rates of studied five different methods were found as follows: C were 80.9 % and 84.4 %, H + RUT were 88.2 % and 75.4 %, GenoType® HelicoDR were 100 % and 71.3 %, and Seeplex ® H. pylori -ClaR- ACE Detection were, 100 % and 71.3 %. A strong correlation was found between C and H+RUT, C and GenoType® HelicoDR, and C and Seeplex ® H. pylori -ClaR- ACE Detection (r:0.644 and p:0.000, r:0.757 and p:0.000, r:0.757 and p:0.000, respectively). Of all the isolated 144 H. pylori strains 24 (16.6 %) were detected as resistant to claritromycine, and 18 (12.5 %) were levofloxacin. Genotypic claritromycine resistance was detected only in 15 cases with GenoType® HelicoDR, and 6 cases with Seeplex ® H. pylori -ClaR- ACE Detection. Conclusion: In our study, it was concluded that; GenoType® HelicoDR and Seeplex ® H. pylori -ClaR- ACE Detection was found as the most sensitive diagnostic methods when comparing all the investigated other ones (C, H, and RUT).

Keywords: Helicobacter pylori, GenoType® HelicoDR, Seeplex ® H. pylori -ClaR- ACE Detection, antimicrobial resistance

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Emmanuel Iyamuremye, Edouard Singirankabo, Alexis Habineza, Yunvirusaba Nelson

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Temperature is one of the most important climatic factors for crop production. However, severe temperatures cause drought, feverish and cold spells that have various consequences for human life, agriculture, and the environment in general. It is necessary to provide reliable information related to the incidents and the probability of such extreme events occurring. In the 21st century, the world faces a huge number of threats, especially from climate change, due to global warming and environmental degradation. The rise in temperature has a direct effect on the decrease in rainfall. This has an impact on crop growth and development, which in turn decreases crop yield and quality. Countries that are heavily dependent on agriculture use to suffer a lot and need to take preventive steps to overcome these challenges. The main objective of this study is to model the statistical behaviour of extreme maximum temperature values in Rwanda. To achieve such an objective, the daily temperature data spanned the period from January 2000 to December 2017 recorded at nine weather stations collected from the Rwanda Meteorological Agency were used. The two methods, namely the block maxima (BM) method and the Peaks Over Threshold (POT), were applied to model and analyse extreme temperature. Model parameters were estimated, while the extreme temperature return periods and confidence intervals were predicted. The model fit suggests Gumbel and Beta distributions to be the most appropriate models for the annual maximum of daily temperature. The results show that the temperature will continue to increase, as shown by estimated return levels.

Keywords: climate change, global warming, extreme value theory, rwanda, temperature, generalised extreme value distribution, generalised pareto distribution

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Authors: Yasuyuki Takahashi, Akemi Yoshida, Hirotaka Shimada

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99mTc-2-methoxy-isobutyl-isonitrile (MIBI) and 99mTcmercaptoacetylgylcylglycyl-glycine (MAG3 ) are heat to 368-372K and are labeled with 99mTc-pertechnetate. Quality control (QC) of 99mTc-labeled radiopharmaceuticals is performed at hospitals, using liquid chromatography, which is difficult to perform in general hospitals. We used chromatography strips to simplify QC and investigated the effects of the test procedures on quality control. In this study is 99mTc- MAG3. Solvent using chloroform + acetone + tetrahydrofuran, and the gamma counter was ARC-380CL. The changed conditions are as follows; heating temperature, resting time after labeled, and expiration year for use: which were 293, 313, 333, 353 and 372K; 15 min (293K and 372K) and 1 hour (293K); and 2011, 2012, 2013, 2014 and 2015 respectively were tested. Measurement time using the gamma counter was one minute. A nuclear medical clinician decided the quality of the preparation in judging the usability of the retest agent. Two people conducted the test procedure twice, in order to compare reproducibility. The percentage of radiochemical purity (% RCP) was approximately 50% under insufficient heat treatment, which improved as the temperature and heating time increased. Moreover, the % RCP improved with time even under low temperatures. Furthermore, there was no deterioration with time after the expiration date. The objective of these tests was to determine soluble 99mTc impurities, including 99mTc-pertechnetate and the hydrolyzed-reduced 99mTc. Therefore, we assumed that insufficient heating and heating to operational errors in the labeling. It is concluded that quality control is a necessary procedure in nuclear medicine to ensure safe scanning. It is suggested that labeling is necessary to identify specifications.

Keywords: quality control, tc-99m labeled radio-pharmaceutical, chromatography strip, nuclear medicine

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Authors: Mahzad Yousefi, Azin Tavakoli

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Periodontal disease is an inflammatory reaction; therefore, it is predicted that changes may occur in some inflammatory parameters that can be detected in routine blood tests. The objective of this study was to evaluate the hematological and biochemistry changes that occur in dogs affected with advanced stages of periodontal disease. 87 dogs were diagnosed with periodontal disease (PD group), and 76 healthy dogs entered the study. The PD dogs had been affected with periodontitis stage 3 or 4 and were candidates for any dental extractions. The healthy dogs were either referred for annual checkups or for issuing health travel certificates that their owners asked for complete lab tests. Neither the diseased nor healthy subjects had a history of infectious, or other general health problems or surgery in the past 3 months. Age, as well as all hematologic including PCV, WBC and RBC count, Hb, MCV, MCH, MCHC, PLT, CBC, NLR, and biochemistry data, including total protein, albumin, glucose, BUN, Creatinine, ALT, AST, and ALP, were recorded and analyzed statistically. Results confirmed that aging has a significant direct relationship with the advanced stages of periodontal disease. Mild leukocytosis occurred in the diseased group; however, it was not significant. Also, the mean total protein of the PD group was lower than that of the healthy dogs, and serum levels of albumin were found to be lower significantly in the diseased group (P<0.05). Mean ±SD amount of Platelet, MCH, and ALT were significantly higher in the diseased group in comparison to the healthy dogs (P<0.05). No significant differences were reported in other evaluated parameters. It is concluded that CBC indices of PD dogs are not systemic inflammatory; however, only a decrease in albumin showed inflammatory responses. Some indices in routine laboratory tests can be changed significantly during advanced stages of the periodontal disease dogs.

Keywords: periodontal disease, dogs, hematological factors, advanced stages, blood tests

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Taner Cindik, Ferya Tas Ciftci

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Mobbing in the public sector and specific issues (i.e., the demand for non-pecuniary damages) regarding mobbing have become very important in the light of the precedents constituted by the Turkish Council of State in 2010. The legal scope of mobbing is not able to be determined since the concept of mobbing is not defined in Turkish law system. This study aims to reveal three major problems caused by the lack of laws related to mobbing in the Turkish legal system. First, the absence of an arrangement for disciplinary penalties leads that general provisions in the disciplinary law are implemented. This situation, therefore, causes difficulties in practice. Second, not being drawn of the lines in the topic concerning mobbing in public sector leads confusions in being direction of hostility. Third, the fact that there is a legal gap on seeking non-pecuniary compensation when employees in public sector are exposed to mobbing might make it difficult to obtain non-pecuniary compensation. Within the context of these major problems, civil servants in Turkey do not have enough protection mechanism. However, some possible legal arrangements will help civil servants to protect against mobbing. This study may be considered important because of the fact that mobbing in the public sector is at a significant level and has not been evaluated in this context before. This research is mainly a study of Turkish legal system and evaluates critically law case to determine legal problems. As a result of this study, three main problems might be identified because there is legal gap regarding mobbing in the public sector. In conclusion, the introduction of the major problems related to mobbing in this study might shed light on making the proper regulations of this subject in Turkish law system. In this respect, the plaintiff will be provided convenience in the point of non-pecuniary damages and this study will guide the assessment of legal liability of those who implement mobbing.

Keywords: human rights violations, mobbing, public sector, direction of hostility, non-pecuniary compensation, disciplinary law

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Authors: Claudio Calosi, Damiano Costa, Paolo Natali

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Determination is the relation that holds between certain kinds of properties, determinables – such as “being colored”, and others, determinates – such as “being red”. Subordination is the relation that holds between genus properties – such as “being an animal”, and others, species properties – such as “being human”'. It is widely held that Determination and Subordination share important similarities, yet also crucial differences. But what grounds such similarities and differences? This question is hardly ever addressed. The present paper provides the first step towards filling this gap in the literature. It argues that a locational theory of instantiation, roughly the view that to have a property is to occupy a location in quality space, holds the key for such an answer. More precisely, it argues that both principles of Determination and Subordination are just examples of more general principles of location. Consider Determination. The principle that everything that has a determinate has a determinable boils down to the claim that everything that has a precise location in quality space is in quality space – an eminently reasonable principle. The principle that nothing can have two determinates (at the same level of determination) boils down to the principle that nothing can be “multilocated” in quality space. In effect, the following provides a “translation table” between principles of location and determination: LOCATION DETERMINATION Functionality At Most One Determination Focus At Most One Determination & Requisite Determination* Exactness Requisite Determination* Super-Exactness Requisite Determination Exactitude Requisite Determination Converse-Exactness Determinable Inehritance This grounds the similarity between Determination and Subordination. What about the differences? The paper argues that the differences boil down to the mereological structure of the regions that are occupied in quality space, in particular whether they are simple or complex. The key technical detail is that Determination and Subordination induce a “set-theoretic rooted tree” structure over the domain of properties. Interestingly, the analysis also provides a possible justification for the Aristotelian claim that being is not a genus property – an argument that the paper develops in some detail.

Keywords: determinables/determinates, genus/species, location, Aristotle on being is not a genus

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Authors: Adan H. Hidalgo, Esmeralda S. Perez, Rubi G. Sotelo-Marquina, Rocio G. Avilez-Garcia, Itzayana S. Suarez, Viridiana M. Gallardo, Roger C. Palomera, Nini R. Mathews, X. Mathew

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This work explores the Sb2S3 thin-film deposition conditions by close spaced sublimation (CSS). Among the various film deposition techniques available for this material, in general, the CSS has the advantages such as fast deposition, large grains, and lower defect density in films. Different batches of films were deposited with substrate temperature in range 250 to 400 oC and the structural, morphological, optical, spectroscopic and opto-electronic properties were analyzed. In the studied temperature range, the films were pure without any oxide phases. The stoichiometry was close to ideal value for the film deposited at 350 oC. The films showed strong preference for the crystallographic planes with miller index terminating in “1” (hk1), which implies that the grain growth is either perpendicular or inclined to the substrate. This was supported by the SEM cross-section images showing long vertical or inclined ribbons. The photoluminescence showed a dependance on deposition temperature. However, contrary to the expectation it was observed that the photosensitivity has an inverse dependance on the deposition temperature. There is no reason to believe that it is due to the film degradation, but possibly due to the defects or barriers at the interface between the film and the current collecting electrodes, which needs further research.

Keywords: photosensitivity, Sb2S3, close spaced sublimation, vertical grain growth

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Authors: Haidy Weliam Megaly Gouda

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Dermatology is often a neglected specialty in low-resource settings despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV-positive patients. African countries have the highest HIV infection rates, and skin conditions are frequently misdiagnosed and mismanaged because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve the diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV-positive patients. A literature search within Embassy, Medline and Google Scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff, a list of 15 skin conditions was included, and a booklet was created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions, quality switched ruby laser, skin color river blindness, clinical signs, circularity index, grey level run length matrix, grey level co-occurrence matrix, local binary pattern, object detection, ring detection, shape identification

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Authors: Bezuglov Eduard, Ryland Morgans, Talibov Oleg, Kalinin Evgeny, Butovsky Mikhail, Savin Evgeny, Tzgoev Eduard, Artemii Lazarev, Bekzhan Pirmakhanov, Anthony C. Hackney

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Currently, there is conflicting evidence regarding the efficacy of citrulline for physical performance and post-exercise recovery. Moreover, the vast majority of studies conducted used physically active volunteers from the general population and heterogeneous exercise protocols that are not specific to most sports. A single use of citrulline, regardless of the dose, will not have a significant effect on physical performance and post-exercise recovery in highly trained soccer players performing sport-specific exercises at maximum intensity. To evaluate the effectiveness of a single administration of citrulline at various doses in adult male professional soccer players performing sport-specific exercise at maximum intensity. A randomized, double-blind, placebo-controlled study analyzing eighteen soccer players from the top divisions of several European countries. The participants were randomized into three groups of six and performed a field-based soccer-specific test at 115% VO2max for 18-minutes. Comparative analysis of the cardiovascular system, physical activity, subjective perceived fatigue and post-exercise recovery was conducted. There were no statistically significant differences in more than one analyzed parameter. A single application of 3 to 6 grams of citrulline does not affect physical performance, subjective feeling of fatigue and post-exercise recovery in adult professional soccer players who have performed a sport-specific test. Currently, citrulline cannot be recommended for use as a supplement in adult professional soccer players

Keywords: citrulline, performance, recovery, soccer players

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Authors: Janaki Rama Raju Patchamatla, Emani Pavan Kumar

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The idea of increasing the existing train speeds and introduction of the high-speed trains in India as a part of Vision-2020 is really challenging from both economic viability and technical feasibility. More than economic viability, technical feasibility has to be thoroughly checked for safe operation and execution. Trains moving at high speeds need a well-established firm and safe track thoroughly tested against vibration effects. With increased speeds of trains, the track structure and layered soil-structure interaction have to be critically assessed for vibration and displacements. Physical establishment of track, testing and experimentation is a costly and time taking process. Software-based modelling and simulation give relatively reliable, cost-effective means of testing effects of critical parameters like sleeper design and density, properties of track and sub-grade, etc. The present paper reports the applicability of infinite elements in reducing the unrealistic stress-wave reflections from so-called soil-structure interface. The influence of the infinite elements is quantified in terms of the displacement time histories of adjoining soil and the deformation pattern in general. In addition, the railhead response histories at various locations show that the numerical model is realistic without any aberrations at the boundaries. The numerical model is quite promising in its ability to simulate the critical parameters of track design.

Keywords: high speed railway track, finite element method, Infinite elements, vibration analysis, soil-structure interface

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Authors: Haiqiao Du, Qian Wang, Shuwei Wang, Jianan Li

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Purpose: The aim is to evaluate the effect of cochlear implantation (CI) in patients with unilateral hearing loss, with a view to providing data support for the selection of therapeutic interventions for patients with single-sided deafness (SSD)/asymmetric hearing loss (AHL) and the broadening of the indications for CI. Methods: The study subjects were patients with unilateral hearing loss who underwent cochlear implantation surgery in our hospital in August 2022 and were willing to cooperate with the test and were divided into 2 groups: SSD group and AHL group. The enrolled patients were followed up for hearing level, tinnitus changes, speech recognition ability, sound source localization ability, and quality of life at five-time points: preoperatively, and 1, 3, 6, and 12 months after postoperative start-up. Results: As of June 30, 2024, a total of nine patients completed follow-up, including four in the SSD group and five in the AHL group. The mean postoperative hearing aid thresholds on the CI side were 31.56 dB HL and 34.75 dB HL in the two groups, respectively. Of the four patients with preoperative tinnitus symptoms (three patients in the SSD group and one patient in the AHL group), all showed a degree of reduction in Tinnitus Handicap Inventory (THI) scores, except for one patient who showed no change. In both the SSD and AHL groups, the sound source localization results (expressed as RMS error values, with smaller values indicating better ability) were 66.87° and 77.41° preoperatively and 29.34° and 54.60° 12 months after postoperative start-up, respectively, which showed that the ability to localize the sound source improved significantly with longer implantation time. The level of speech recognition was assessed by 3 test methods: speech recognition rate of monosyllabic words in a quiet environment and speech recognition rate of different sound source directions at 0° and 90° (implantation side) in a noisy environment. The results of the 3 tests were 99.0%, 72.0%, and 36.0% in the preoperative SSD group and 96.0%, 83.6%, and 73.8% in the AHL group, respectively, whereas they fluctuated in the postoperative period 3 months after start-up, and stabilized at 12 months after start-up to 99.0%, 100.0%, and 100.0% in the SSD group and 99.5%, 96.0%, and 99.0%. Quality of life was subjectively evaluated by three tests: the Speech Spatial Quality of Sound Auditory Scale (SSQ-12), the Quality-of-Life Bilateral Listening Questionnaire (QLBHE), and the Nijmegen Cochlear Implantation Inventory (NCIQ). The results of the SSQ-12 (with a 10-point score out of 10) showed that the scores of preoperative and postoperative 12 months after start-up were 6.35 and 6.46 in the SSD group, while they were 5.61 and 9.83 in the AHL group. The QLBHE scores (100 points out of 100) were 61.0 and 76.0 in the SSD group and 53.4 and 63.7 in the AHL group for the preoperative versus the postoperative 12 months after start-up. Conclusion: Patients with unilateral hearing loss can benefit from cochlear implantation: CI implantation is effective in compensating for the hearing on the affected side and reduces the accompanying tinnitus symptoms; there is a significant improvement in sound source localization and speech recognition in the presence of noise; and the quality of life is improved.

Keywords: single-sided deafness, asymmetric hearing loss, cochlear implant, unilateral hearing loss

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Authors: Shivayogi Charantimath

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Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1^st and 2^nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1^st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1^st and 2^nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1^st week and 53.6% for 2^nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1^st week and 33.3% in 2^nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1^st week follow up and 0.000 for 2^nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.

Keywords: curcumin, chemotheraphy, mucositis, radiotheraphy

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