Search results for: 'mother tongue' (muyu)

Authors: Maryam Firouzmandi, Moosa Miri

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Common reasons for early tooth loss are trauma, extraction due to caries or periodontal disease and congenital missing. The remaining space after tooth loss may cause functional and esthetic problems. Therefore restorative dentists should attempt to manage these spaces using conservative methods. The goal is to restore the lost esthetic and function, prevent phonetic, self-esteem and personality problems and tongue habits. Preserving alveolar bone is also of great importance during the growth stage. Purpose: When deciding about the management of the missing tooth, space implants are contradicted until the completion of dentoalveolar development. Even in adulthood, due to systemic or periodontal problems or biological and economic issues, the implant might not be indicated. In this article, the alternative conservative restorative methods of space maintenance are going to be discussed. Essix retainers are made chair-side as easy as forming a custom bleaching tray with some modifications. They are esthetically acceptable and not expensive. These temporaries provide support for the lips but could not be used during function. Mini-screw-supported temporaries are another option for maintaining the space, especially after orthodontic treatment when there is a time lag between the termination of orthodontic treatment and definitive restoration. Two techniques will be presented for this kind of restoration: Denture tooth pontic or a composite crown. The benefits are alveolar bone preservation, Physiologic pressure on the alveolar ridge to increase its density and even can be retained until the completion of the definitive treatment. Bonded fixed partial denture includes Maryland bridge, fiber-reinforced composite bridge, resin-bonded bridge, and ceramic bonded bridge. These types of bridges are recommended to be used after a pubertal growth spurt and a recent meta-analysis considered their clinical success similar to conventional FDPs and implant-supported crowns. However, they have several advantages that are going to be discussed by presenting some clinical examples. Practical instruction on how to construct an FRC bridge and a novel chair-side Maryland bridge will be given by means of clinical cases. Clinical relevance: minimally invasive options should always be considered and destruction of healthy enamel and dentin during the preparation phase should be avoided as much as possible.

Keywords: tooth missing, fiber-reinforced composite, Maryland, Essix retainers, screw-retained restoration

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Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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Authors: Aldrin Avergas, Quennie Mariel Peñaranda, Niña Karen San Miguel, Alexis Katrina Agustin, Peralta Xusha Mae, Maria Luisa Sison

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The research is entitled “The Relationship of Socioeconomic Status and Levels of Delinquency among Senior High School Students with Secured Attachment to their Mothers”. The researchers had explored the relationship between socioeconomic status and delinquent tendencies among grade 11 students. The objective of the research is to discover if delinquent behavior will have a relationship with the current socio-economic status of an adolescent student having a warm relationship with their mothers. The researchers utilized three questionnaires that would measure the three variables of the study, namely: (1) 1SEC 2012: The New Philippines Socioeconomic Classification System was used to show the current socioeconomic status of the respondents, (2) Self-Reported Delinquency – Problem Behavior Frequency Scale was utilized to determine the individual's frequency in engaging to delinquent behavior, and (3) Inventory of Parent and Peer Attachment Revised (IPPA-R) was used to determine the attachment style of the respondents. The researchers utilized a quantitative research design, specifically correlation research. The study concluded that there is no significant relationship between socioeconomic status and academic delinquency despite the fact that these participants had secured attachment to their mother hence this research implies that delinquency is not just a problem for students belonging in the lower socio-economic status and that even having a warm and close relationship with their mothers is not sufficient enough for these students to completely be free from engaging in delinquent acts. There must be other factors (such as peer pressure, emotional quotient, self-esteem or etc.) that are might be contributing to delinquent behaviors.

Keywords: adolescents, delinquency, high school students, secured attachment style, socioeconomic status

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Authors: Ayperi̇ Haspolat Özcan, Meltem Anafarta Şendağ

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This study aimed to establish a model in the light of current approaches for understanding the mediating role of early maladaptive schemas in the relationship between attachment and anger. Accordingly, the proposed mediation model was tested by mediation with bootstrapping technique, considering gender and attachment figure differences. The university students (N= 444) with ages ranging from 17 to 28 participated in the study. Participants filled out Parental and Peer Attachment Scale Short Form, Young Schema Questionnaire - Short Form 3, Trait Anger and Anger Expression Scales. The mediating role of early maladaptive schemas (impaired autonomy, disconnection and rejection, unrelenting standards, other-directedness, and impaired limits) in the relationship between attachment (mother and father) and anger aspects (trait anger, anger in, anger out and anger control) were found to be significant for both male and female participants. Separate mediation analyses for both genders and different attachment figures have also drawn attention to noticeable differences in the results. Specifically, for females, various paths were discovered in predicting various aspects of anger (anger in, anger out, anger control, and trait anger). On the other hand, for males only anger directed inwards was found to be predicted by any source of attachment through disconnection and rejection schema only. These obvious gender differences in understanding the mechanism of anger are discussed in the light of cultural gender roles and the social acceptance of anger in males. In the area of application, the study of various aspects of anger with particular attention to attachment and early maladaptive schemas as well as the importance of distinguishing the gender differences are emphasized as important points.

Keywords: anger expression, attachment, early maladaptive schemas, trait anger

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Authors: Seyed Saeid Nabavi

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Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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Authors: Marilei Amadeu Sabino

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Idiomatic expressions are linguistic phraseologisms present in natural languages. Known to be metaphorical linguistic combinations, a good majority of them provide elements that reveal important cultural aspects of their linguistic community through their metaphors. With the advent of Cognitive Linguistics (more specifically of Cognitive Semantics), the metaphor ceased to be related to poetic language and rhetorical embellishment and came to be seen as part of simple everyday language, reflecting the way human beings think, act and conceive reality, i. e., a fundamental mechanism of human conceptualizations of the world. In this sense, it came to be conceived as an inevitable mechanism for representing the nature of thought and language. The speakers, in conceptualizing reality, often use metaphorically parts of the body in expressions known as somatic. Several conceptual metaphors appear to be potentially universal or near-universal, because people across the world share certain bodily experiences. In these terms, many linguistic metaphors may be identical or very similar in several languages. These similarities, according to the Theory of Conceptual Metaphor, derive from universal aspects of the human body. Thus, this research aims to investigate the nature of some metaphors underlying somatic idiomatic expressions of Portuguese, Italian and English languages, establishing a pattern of similarities and differences among them from a trilingual perspective. The analysis shows that much of the studied expressions are really structurally, semantically and metaphorically identical or similar in the three languages. These findings incite relevant discussions concerning mother and foreign language learning and aim to contribute to the teaching of phraseological Lexicon as well as to materials development in mono and multilingual perspectives.

Keywords: idiomatic expressions, materials development, metaphors, phraseological lexicon, teaching and learning

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Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

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Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

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Authors: Pranee Liamputtong

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Childlessness in non-Western societies has wide-ranging social implications and profoundly affects the gender identity and well-being of women. The aspirations of women in these societies are shaped by various sociocultural expectations, encompassing social norms and their own social standing. Currently, there is limited knowledge regarding the perceptions and experiences of Zimbabwean migrant women living in Australia regarding childlessness and motherhood. This paper explores the cultural perspective on children in Zimbabwean society and investigates the personal and social consequences of infertility, as well as the cultural expectations of motherhood among Zimbabwean migrant women residing in Australia. The perceptions and experiences of this migrant community are of utmost importance in order to prevent misunderstandings about the core essence of motherhood among Zimbabwean women. Ultimately, this will lead to the provision of sensitive and culturally appropriate healthcare and social support for migrants in Australia's multicultural society. The study adopts a constructivist paradigm and employs qualitative methods, including in-depth interviews, drawings, and photo elicitation, involving 15 Zimbabwean women. Thematic analysis was employed to analyze the data. In Zimbabwean culture, the ability to bear a child holds significant meaning for women. Children not only ensure the continuity of society but also provide social security, as parents rely on their children for care in old age. Childlessness jeopardizes a woman's social status and carries social repercussions that have a profound impact on their gender identity and well-being. Cultural expectations of motherhood place the sole responsibility for the emotional and physical care of children on the mother. Despite residing in Australia, the procreative value has not diminished for Zimbabwean women. Raising awareness of the procreative needs of Zimbabwean women in a culturally sensitive manner would enhance the emotional well-being of these women.

Keywords: motherhood, culture, migrant women, Zimbabwe, Australia

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Nilüfer Kuru, Berrin Akman

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In this study, science process skills of children with ages varying between 48-months and 66-months are analyzed. Science process skills of children are investigated in terms of factors including gender of children, attendance of children to the previous educational institution and duration of their attendance, educational background of their parents, ages of children and teachers, professional experience of teachers, educational background, and department of graduation of teachers, type of pre-school education institution of teachers and children. Sample of research consists of 250 children aged between 48-months and 66-months who attend state and private kindergartens under the Ministry of National Education, nursery classes of elementary schools and kindergartens of establishments in central districts of Ankara and 50 teachers who serve in these children’s classes. Science Observation Form, reached from the website of Alaska Department of Education & Early, are analyzed in terms of language, content, construct validity, and reliability by the researchers. Additionally, Personal Information Form is also developed by the researchers. Data obtained in the study are analyzed with SPSS 16.0 package program to obtain percentage and frequency, Kruskal Wallis H-test, and Mann- Whitney U test, which are one of the non-parametric tests, are used. Within the context of this study it has been seen that independent variables of age, type of school attending and status of attendance to pre-school education, educational background of children’s father are meaningful expositive in gaining science process skills for children. It has been seen that period of service of teachers, duration of attendance to pre-school education for children, gender of children and educational background of children’s mother are not meaningful expositive in gaining science process skills for children.

Keywords: preschool, science process skills, early childhood education, science

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Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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Authors: Zaima Umar, Anas S. Qureshi, Adeel Sarfraz, Saqib Umar, Talha Umar, Muhammad Usman

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Ostrich has been a good source of food and income for people across the world. To get a better understanding of health and health-related problems, the knowledge of its digestive system is of utmost importance. The present study was conducted to determine the morphological and histometrical variations in the digestive system and associated glands of ostrich (Struthio camelus) as regard to the gender and progressive age. A total of 40 apparently healthy ostriches of both genders and two progressive age groups; young one (less than two year, group A); and adult (2-15 years, group B) in equal number were used in this study. Digestive organs including tongue, esophagus, proventriculus, gizzard, small and large intestines and associated glands like liver and pancreas were collected immediately after slaughtering the birds. The organs of the digestive system and associated glands of each group were studied grossly and histologically. Grossly colour, shape consistency, weight and various dimensions (length, width, and circumference) of organs of the digestive tract and associated glands were recorded. The mean (± SEM) of all gross anatomical parameters in group A were significantly (p ≤ 0.01) different from that of group B. For microscopic studies, 1-2 cm tissue samples of organs of the digestive system and associated glands were taken. The tissue was marked and fixed in the neutral buffer formaldehyde solution for histological studies. After fixation, the sections of 5-7 µm were cut and stained by haematoxylin and eosin stain. All the layers (epithelium, lamina propria, lamina muscularis, submucosa and tunica muscularis) were measured (µm) with the help of automated computer software Image J®. The results of this study provide valuable information on the gender and age-related histological and histometrical variations in the digestive organs of ostrich (Struthio camelus). The microscopic studies of different parts of the digestive system revealed highly significant differences (p ≤ 0.01) among the two groups. The esophagus was lined by non-keratinized stratified squamous epithelium. The duodenum, jejunum, and ileum showed similar histological structures. Statistical analysis revealed significant (p ≤ 0.05) increase in the thickness of different tunics of the gastrointestinal tract in adult birds (up to 15 years) as compared with young ones (less than two years). Therefore, it can be concluded that there is a gradual but consistent growth in the observed digestive organs mimicking that of other poultry species and may be helpful in determining the growth pattern in this bird. However, there is a need to record the changes at closer time intervals.

Keywords: ostrich, digestive system, histomorphometry, grossly

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Authors: Sonia Mannan

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A qualitative study was conducted in a rural area of the southwestern region of Bangladesh to identify perceptions, practices, and the role of first-time mothers surrounding acute respiratory infections (ARI) in infants and children aged under four years. The study reveals that all mothers had knowledge of ARI and were able to identify a number of signs and symptoms. They also recognized pneumonia and thought it to be caused by exposure to cold or weather change, supernatural causes, evil influences, mothers’ negligence, and failure to observe ‘purdah’. They were able to identify chest retractions, difficult breathing, and inability to feed as signs of severe disease needing treatment outside the home. In these cases, spiritual healers were sought, and allopathic treatment was delayed or avoided. Home care practices involved massaging the child with oil and avoiding 'cooling' foods, including water. With the presence of fever and breathing difficulty, mothers tended to increase the number and diversity of medicines, although more concern was expressed about fever than about breathing difficulty. Effective medical care was more likely to be delayed for infants than for older children (they often waited 2-5 days after signs of illness appeared); infants were also more likely to be taken to a spiritual healer as the first-choice provider. The reasons for these perceptions and practices and their implications on the ARI of infants and young children are discussed. Community intervention is identified as viable, effective, and practical to address the body of local socio-cultural knowledge about family practices and the role of the mother regarding the mitigation of ARI in infants and young children.

Keywords: acute respiratory infections , public health, pneumonia, Bangladesh

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Authors: Yin-Chen Liu, Chih-Chun Wu, Mei-He Shih

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In this technology society, using ICT(Information and communications technology) to contact each other is very common. Interpersonal ICT communication maintains social support. Therefore, the study investigated the ICT communication between undergraduates and their parents, and gender differences were also detected. The sample size was 1,209 undergraduates, including 624(51.6%) males, 584(48.3%) females, and 1 gender unidentified. In the sample, 91.8% of the sample used phones to contact their fathers and 93.8% of them use phones to contact their mothers. 78.5% and 87.6% of the sample utilized LINE to contact their fathers and mothers respectively. As for Facebook, only 13.4% and 16.5% of the sample would use to contact their fathers and mothers respectively. Aforementioned results implied that the undergraduates nowadays use phone and LINE to contact their parents more common than Facebook. According to results from Pearson correlations, the more undergraduates refused to add their fathers as their Facebook friends, the more they refused to add their mothers as Facebook friends. The possible reasons for it could be that to distinguish different social network such as family and friends. Another possible reason could be avoiding parents’ controlling. It could be why the kids prefer to use phone and LINE to Facebook when contacting their parents. Result from Pearson correlations showed that the more undergraduates actively contact their fathers, the more they actively contact their mothers. On the other hand, the more their fathers actively contact them, the more their mothers actively contact them. Based on the results, this study encourages both parents and undergraduates to contact each other, for any contact between any two family members is associated with contact between other two family members. Obviously, the contact between family members is bidirectional. Future research might want to investigate if this bidirectional contact is associated with the family relation. For gender differences, results from the independent t-tests showed that compared to sons, daughters actively contacted their parents more. Maybe it is because parents keep saying that it is dangerous out there for their daughters, so they build up the habit for their daughters to contact them more. Results from paired sample t-tests showed that the undergraduates agreed that talking to mother on the phone had more satisfaction, felt more intimacy and supported than fathers.

Keywords: family ICT communication, parent-child ICT communication, FACEBOOK and LINE, gender differences

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Authors: Mukesh Ravi Raushan

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Despite consideration of obesity as a deadly public health issue contributing 2.6 million deaths worldwide every year developing country like India is facing malnutrition and it is more common than in Sub-Saharan Africa. About one in every three malnourished children in the world lives in India. The paper assess the nutritional health among children using data from total number of 43737 infant and young children aged 0-59 months (µ = 29.54; SD = 17.21) of the selected households by National Family Health Survey, 2005-06. The wasting was measured by a Z-score of standardized weight-for-height according to the WHO child growth standards. The impact of education with place of residence was found to be significantly associated with the complementary food diversity score (CFDS) in India. The education of mother was positively associated with the CFDS but the degree of performance was lower in rural India than their counterpart from urban. The result of binary logistic regression on wasting with WHO seven types of recommended food for children in India suggest that child who consumed the milk product food (OR: 0.87, p<0.0001) were less likely to be malnourished than their counterparts who did not consume, whereas, in case of other food items as the child who consumed food product of seed (OR: 0.75, p<0.0001) were less likely to be malnourished than those who did not. The nutritional status among children were negatively associated with the protein containing complementary food given the child as those child who received pulse in last 24 hour were less likely to be wasted (OR: 0.87, p<0.00001) as compared to the reference categories. The frequency to feed the indexed child increases by 10 per cent the expected change in child health outcome in terms of wasting decreases by 2 per cent in India when place of residence, education, religion, and birth order were controlled. The index gets improved as the risk for malnutrition among children in India decreases.

Keywords: CFDS, food diversity index, India, logistic regression

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Authors: Adrita Banerjee, Ajeet Kumar Singh

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Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

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Authors: Ashish Agarwal, Vaibhav Singh

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Harmful emissions from oil and gas processing facilities have long remained a matter of concern for governments and environmentalists throughout the world. This paper analyses Oil and Natural Gas Corporation (ONGC) gas processing plant in Hazira, Gujarat, India. It is the largest gas-processing complex in the country designed to process 41MMSCMD sour natural gas & associated sour condensate. The complex, sprawling over an area of approximate 705 hectares is the mother plant for almost all industries at Hazira and enroute Hazira Bijapur Jagdishpur pipeline. Various sources of pollution from each unit starting from Gas Terminal to Dew Point Depression unit and Caustic Wash unit along the processing chain were examined with the help of different emission data obtained from ONGC. Pollution discharged to the environment was classified into Water, Air, Hazardous Waste and Solid (Non-Hazardous) Waste so as to analyze each one of them efficiently. To protect air environment, Sulphur recovery unit along with automatic ambient air quality monitoring stations, automatic stack monitoring stations among numerous practices were adopted. To protect water environment different effluent treatment plants were used with due emphasis on aquaculture of the nearby area. Hazira plant has obtained the authorization for handling and disposal of five types of hazardous waste. Most of the hazardous waste were sold to authorized recyclers and the rest was given to Gujarat Pollution Control Board authorized vendors. Non-Hazardous waste was also handled with an overall objective of zero negative impact on the environment. The effect of methods adopted is evident from emission data of the plant which was found to be well under Gujarat Pollution Control Board limits.

Keywords: sulphur recovery unit, effluent treatment plant, hazardous waste, sour gas

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Authors: Musse Mohamud Ahmed, Tina Linda Achilles, Mohammad Kamrul Hasan

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Deterioration of the mother nature is evident these day with clear danger of human catastrophe emanating from greenhouses (GHG) with increasing CO2 emissions to the environment. PV technology can help to reduce the dependency on fossil fuel, decreasing air pollution and slowing down the rate of global warming. The objective of this paper is to propose, develop and design the production of clean water supply to rural communities using an appropriate technology such as Internet of Things (IOT) that does not create any CO2 emissions. Additionally, maximization of solar energy power output and reciprocally minimizing the natural characteristics of solar sources intermittences during less presence of the sun itself is another goal to achieve in this work. The paper presents the development of critical automated control system for solar energy power output optimization using several new techniques. water pumping system is developed to supply clean water with the application of IOT-renewable energy. This system is effective to provide clean water supply to remote and off-grid areas using Photovoltaics (PV) technology that collects energy generated from the sunlight. The focus of this work is to design and develop a submersible solar water pumping system that applies an IOT implementation. Thus, this system has been executed and programmed using Arduino Software (IDE), proteus, Maltab and C++ programming language. The mechanism of this system is that it pumps water from water reservoir that is powered up by solar energy and clean water production was also incorporated using filtration system through the submersible solar water pumping system. The filtering system is an additional application platform which is intended to provide a clean water supply to any households in Sarawak State, Malaysia.

Keywords: IOT, automated production and control system, water filtration, automated submersible water pump, solar energy

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Authors: Raghavi Janaswamy, Saraswathi K. Vasudev

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Music is ubiquitous in human lives. Ever since the fetus hears the sound inside the mother’s womb and later upon birth, the baby experiences alluring sounds, the curiosity of learning emanates and evokes exploration. Music is an education than mere entertainment. The intricate balance between music, education, and entertainment has well been recognized by the scientific community and is being explored as a viable tool to understand and improve human cognition. There are seven basic swaras (notes) Sa, Ri, Ga, Ma, Pa, Da, and Ni in the Carnatic music system that are analogous to C, D, E, F, G, A, and B of the western system. The Carnatic music builds on the conscious use of microtones, gamakams (oscillation), and rendering styles that evolved over centuries and established its stance. The complex but erudite raga system has been designed with elaborate experiments on srutis (musical sounds) and human perception abilities. In parallel, ‘rasa’- the emotions evoked by certain srutis and hence the ragas been solidified along with the power of language in combination with the musical sounds. The Carnatic music branches out as Kalpita sangeetam (pre-composed music) and Manodharma sangeetam (improvised music). This article explores the Manodharma sangeetam and its subdivisions such as raga alapana, swara kalpana, neraval, and ragam-tanam-pallavi (RTP). The intrinsic mathematical strategies in it’s practice methods toward improvising the music have been explored in detail with concert examples. The techniques on swara weaving for swara kalpana rendering and methods on the alapana development are also discussed at length with an emphasis on the impact on the human cognitive abilities. The articulation of the outlined conscious practice methods not only helps to leave a long-lasting melodic impression on the listeners but also onsets cognitive developments.

Keywords: Carnatic, Manodharmam, music cognition, Alapana

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Authors: Monika Michałowska, Anna Alichniewicz

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Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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Authors: Rojan Afrouz

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Introduction: The immigration is a complex process of transitioning and transformation. Immigrants are more likely to come from the patriarchal and hierarchical society with traditional gender roles and women’s stereotypes. Changing the perception of women’s gender roles may result in challenges between women and their family and community. In this article, Afghan women’s perspectives on gender roles and stereotypes have been investigated as well as their experience of changes in the new context of Australia. Australian initiatives of challenging gender roles have provided the opportunities for Afghan women to emancipate from the traditional gender roles and pursue the value of gender equality. In this process, they may face many challenges in intersectional levels within their family, community and wider society which is a complex conflate of oppressive factors that may not be addressed easily and straightforward. Methods: This qualitative study has been conducted among Afghan women who have lived in Australia less than ten years. Semi-structured interviews either face to face or by phone have been used to collect data for this study. The interviews have been audio-recorded and transcribed verbatim. Nvivo software has been used for data analysis. Findings: Many participants mentioned that they had been taught that a good Afghan woman is devoted, obedient and loyal to their family and community. They believed that for many Afghan families, Afghan women's natural place was inside the home as a housewife, mother, daughter involving so many responsibilities and expectation of making sacrifices. Many women stated that their attitudes toward gender roles and their feeling of being a woman had been changed since they came to Australia although the process of change for women was complex and diverse. Some had to deal with conflicts with their stereotypes, traditional gender roles as well as strong disagreement with their family and community. Conclusion: Moving to a different country with more gender equality is an opportunity for Afghan women to change their perceptions of gender roles and stereotypes. However, challenging traditional stereotypes and gender roles in the new context is a complex process comprising intersectional levels.

Keywords: stereotypes, gender role, immigration, Afghan women

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Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid

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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.

Keywords: acceptability, attitude, human milk bank, knowledge

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Authors: Nayomi Ranathunga, Priyantha Perera, Sumal Nandasena, Nalini Sathiakumar, Anuradhini Kasthuriratne, Rajitha Wikremasinghe

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Solid fuel combustion is an important source of indoor air pollution (IAP) in developing countries that has adverse health impacts particularly in children. This study was conducted to determine the effect of IAP due to solid fuel combustion on physical growth of children under five in a Sri Lankan setting. A prospective study was conducted in a mixed population comprising urban and semi urban residents. The study included 240 children under 5 who were permanent residents of the area. Physical growth was assessed by measuring anthropometric indices based on the World Health Organization (WHO) guidelines and standards. Exposure levels were defined according to the main type of fuel used for cooking at home: children residing in households using biomass fuel or kerosene as the main type of fuel for cooking were classified as the “high exposure” group and children resident in households using liquefied petroleum gas (LPG) or electricity for cooking were classified as the “low exposure” group. Sixty percent of the children were classified as from the “high” exposure group and 40% of the children were classified as from the “low” exposure group; 54% of the children were male. At baseline, the prevalence of wasting was 17.1% and the prevalence of stunting was 10.4%; the mean z-score for weight for height was - 0.85, weight for age was - 0.46 and height for age was -0.38. At baseline, children from the “high” exposure group had a significantly lower mean weight for height z-score (p=0.02) and a mean height for age z-score (p=0.001) as compared to children from the “low” exposure group after adjusting for confounding factors such as father’s education, mother’s education and family income. Poor maternal education was significantly associated with lower height for age z-scores (p=0.04) after adjusting for exposure status. IAP due to combustion of biomass fuel leads to chronic malnutrition.

Keywords: children, growth, indoor air pollution, solid fuel

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Authors: Koninika Mukherjee, Dilwar Hussain

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Introduction: One of the most prevalent psychopathologies among the youth is social anxiety. The presence of comorbid disorders further complicates diagnosis and treatment. One of the most commonly co-occurring disorders, along with social anxiety, is related to eating behavior. Objective: Identifying the risk and protective factors and the mechanism through which the effect of these disorders might help in treatment and prevention. So, the stated objective of the present study is to investigate the role of fear of negative evaluation and social appearance anxiety in the relationship of parental bonding with social anxiety and comorbid disordered eating. Method: A cross-sectional study was conducted with 411 Indian undergraduates. Data collection was done with the help of self-report measures like the social interaction anxiety scale, parental bonding instrument, brief fear of negative evaluation, social appearance anxiety scale, and the eating attitudes test. SPSS Amos 22.0 version was used for path analyses. Results: Out of the different dimensions of parental bonding, only maternal care and the father’s granting of behavioural freedom proved significant in the development and maintenance of social anxiety and disordered eating behaviour and symptoms. Fear of negative evaluation and social appearance anxiety mediated the impact of the mother’s care on social anxiety and comorbid disordered eating. However, only fear of negative evaluation seemed to mediate the effect of paternal granting of behavioral freedom on social anxiety and comorbid issues. Implications: One of the vital contributions of this study is looking at perceived maternal and paternal bonding separately in the path model. Identifying parenting dimensions significantly related to social anxiety and comorbid disorders can aid in establishing consensus around operational definitions and in the formulation of comprehensive assessments. Future Directions: Future research can include both participant and parental perceptions of parental bonding.

Keywords: social anxiety, disordered eating, fear of negative evaluation, social appearance anxiety

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Authors: Florina Magdalena Anichitoae, Anca Dobrean, Ionut Stelian Florean

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Due to the fact that cyberbullying victimization is an increasing problem nowadays, affecting more and more children and adolescents around the world, we wanted to take a step forward analyzing this phenomenon. So, we took a look at some variables which haven't been studied together before, trying to develop another way to view cyberbullying victimization. We wanted to test the effects of the mother, father, and peer attachment on adolescent involvement in cyberbullying as victims through unconditional self acceptance. Furthermore, we analyzed each subscale of the IPPA-R, the instrument we have used for parents and peer attachment measurement, in regards to cyberbullying victimization through unconditional self acceptance. We have also analyzed if gender and age could be taken into consideration as moderators in this model. The analysis has been performed on 653 adolescents aged 11-17 years old from Romania. We used structural equation modeling, working in R program. For the fidelity analysis of the IPPA-R subscales, USAQ, and Cyberbullying Test, we have calculated the internal consistency index, which varies between .68-.91. We have created 2 models: the first model including peer alienation, peer trust, peer communication, self acceptance and cyberbullying victimization, having CFI=0.97, RMSEA=0.02, 90%CI [0.02, 0.03] and SRMR=0.07, and the second model including parental alienation, parental trust, parental communication, self acceptance and cyberbullying victimization and had CFI=0.97, RMSEA=0.02, 90%CI [0.02, 0.03] and SRMR=0.07. Our results were interesting: on one hand, cyberbullying victimization is predicted by peer alienation and peer communication through unconditional self acceptance. Peer trust directly, significantly, and negatively predicted the implication in cyberbullying. In this regard, considering gender and age as moderators, we found that the relationship between unconditional self acceptance and cyberbullying victimization is stronger in girls, but age does not moderate the relationship between unconditional self acceptance and cyberbullying victimization. On the other hand, regarding the degree of cyberbullying victimization as being predicted through unconditional self acceptance by parental alienation, parental communication, and parental trust, this hypothesis was not supported. Still, we could identify a direct path to positively predict victimization through parental alienation and negatively through parental trust. There are also some limitations to this study, which we've discussed in the end.

Keywords: adolescent, attachment, cyberbullying victimization, parents, peers, unconditional self-acceptance

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Authors: Dharmendra Pratap

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Large Cardamom (Amomum subulatum), family Zingiberaceae is an aromatic spice crop and has rich medicinal value. Large Cardamom is as synonymous to Sikkim as Tea is to Darjeeling. Since Sikkim alone contributes up to 88% of India's large cardamom production which is the world leader by producing over 50% of the global yield. However, the production of large cardamom has declined almost to half since last two decade. The economic losses have been attributed to two viral diseases namely, chirke and Foorkey. Chirke disease is characterized by light and dark green streaks on leaves. The affected leaves exhibit streak mosaic, which gradually coalesce, turn brown and eventually dry up. Excessive sprouting and formation of bushy dwarf clumps at the base of mother plants that gradually die characterize the foorkey disease. In our surveys in Sikkim–Darjeeling hill area during 2012-14, 40-45% of plants were found to be affected with foorkey disease and 10-15% with chirke. Mechanical and aphid transmission study showed banana as an alternate host for both the disease. For molecular identification, total genomic DNA and RNA was isolated from the infected leaf tissues and subjected to Rolling circle amplification (RCA) and RT-PCR respectively. The DNA concatamers produced in the RCA reaction were monomerized by different restriction enzymes and the bands corresponding to ~1 kb genomes were purified and cloned in the respective sites. The nucleotide sequencing results revealed the association of Nanovirus with the foorkey disease of large cardamom. DNA1 showed 74% identity with Replicase gene of FBNYV, DNA2 showed 77% identity with the NSP gene of BBTV and DNA3 showed 74% identity with CP gene of BBTV. The finding suggests the presence of a new species of nanovirus associated with foorkey disease of large cardamom in Sikkim and Darjeeling hills. The details of their epidemiology and other factors would be discussed.

Keywords: RCA, nanovirus, large cardamom, molecular virology and microbiology

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Karen Armstrong

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This study is a narrative inquiry into the use of simulated person methodology (SPM) in teacher education classes. This methodology -often used in medical schools- has tremendous benefits in terms of enhancing experiential education in teacher education classes. Literacy education is a major focus in elementary schools. New teachers must work with parents to ensure that children learn to read and expand their literacy horizons. The classes used in this narrative inquiry research consist of one graduate class on family literacy and two pre-service teacher education classes: literacy and culture and early and family literacy. Two scenarios were devised, both of which simulated a parent-teacher interview. In the first scenario, the parent is a reluctant father who is ashamed of his lack of reading ability and does not understand why literacy is important. His seven-year-old son, wanting to emulate his father, has suddenly transformed from an eager student to one who rejects the value of reading in loyalty to his father who cannot read. In the second scenario, a father is called in by the teacher because his son has started acting out in class. The mother in this scenario is temporarily absent from the home, and the father is now the sole caregiver. In each of the scenarios, students are the teachers who are problem-solving these dilemmas in a safe environment with the 'parent' who is a specially trained simulated person. Teacher candidates enact, with the trained simulated person, their strategies for encouraging parents to engage in the literacy development of their children. Teacher candidates attempt to offer support and encouragement to parents. This simulation strategy offers both beginning and more experienced teachers the opportunity to practice an interview with two distinct and contrasting family situations with regard to the literacy of young children. The paper discusses the details of the scenarios enacted in class and the reflective discussion through which students learn from the simulation.

Keywords: experiential education, literacy, simulated person methodology, teacher education

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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