Search results for: clinical and patient outcomes

Authors: Wan-Chun Chang, Yi-Jung Lee

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Due to cultural factors, expressing emotions may not be encouraged in collectivist cultures, which emphasize the needs of the group over the needs of the individual. This phenomenon is more prominent for children of migratory families. Due to the absence of one parent, children were often parentified by adults, which then impacted on their self-differentiation process. It made them more difficult to express their needs and emotions freely and openly. This study aimed to investigate the meditation effect of self-differentiation between parentification, and ambivalence over emotional expression for children of migratory families in Taiwan. Participants included 460 (326 females, 134 males) Taiwanese adults (age 18-25 years). The data were collected through questionnaires and analyzed using descriptive statistics and multiple regression analysis. The questionnaire included informed consent form, 'Filial Responsibility Scale-Adult', 'Chinese version of the Differentiation of Self Inventory', 'Ambivalence over Emotion Expressiveness Questionnaire', and the demographic sheet. Results indicated that self-differentiation mediated the relationship between parentified experience and ambivalence over emotional expression. In other words, parentified experience itself does not have the power to affect ambivalence over emotional expression. Only by affecting self-differentiation can it make an actual difference. The results were as expected and confirmed the hypothesis. Implications for clinical practice, research, and training were discussed.

Keywords: ambivalence over emotional expression, children of migratory families, parentification, self-differentiation

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Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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Authors: Bih-O Lee, Hsiu-Wan Hsieh, Hsiu-Chen Liu, Mer Yu Pan

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Background: Illness perceptions are developed when people face health-threatening situations. Previous research suggests that understanding discrepancies between illness perceptions of patients and caregivers may need to improve quality of health care. Objective: This study examined the differences between illness perceptions of injured patients and those of their caregivers. Methods: Comparative study design was used. The study setting was the surgical wards of a teaching hospital in Taiwan. Participants were 127 pairs of injured patients and their caregivers. The participants completed socio-demographic data and completed the Chinese Illness Perception Questionnaire Revised-Trauma, which comprises eight subscales. Clinical data of the injured patients was obtained from medical records. Results: This study found that injured patients were more pessimistic than their caregivers about the injury. There were significant differences between patients and caregivers insofar as patients perceived more physical symptoms, scored higher in terms of reasons for their injury, had more negative emotions and experienced more consequences than caregivers. Elderly caregivers and caregivers for patients who were over 65, severely injured and admitted to an ICU perceived more negative perceptions about the injury. Conclusions: This study indicated that patients and caregivers had negative illness representations several months after injury although the intensity of their perceptions was different. The interventions should highlight the need to assist patients and caregivers after injury.

Keywords: illness representations, injury, caregivers, comparative study

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Authors: Abdulnasser Ahmed Haza’a, Marzoq Ali Odhah, Saddam Ahmed Al-Ahdal, Abdulfatah Saleh Al-Jaradi, Gamil Ghaleb Alrubaiee

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Patient safety in hospitals is an essential professional indicator that should be noticed. The threat of fires is potentially the most dangerous risk that could harm patients and personnel. The aim of the study is to assess the knowledge of operating room (OR) staff toward prevention and control sources of fires. Between March 1 and March 30, 2022, data collection was done. A descriptive cross-sectional study was conducted. The sample of the study consisted of 89 OR staff from different governmental hospitals. Convenient sampling was applied to select the sample size. Official approvals were obtained from selected settings for start collection data. Data were collected using a close-ended questionnaire and tested for knowledge. This study was conducted in four governmental hospitals in Sana'a, Yemen. Most of the OR staff were male. Of these, 50.6% of them were operation technician professionals. More than two-thirds of OR staff have less than ten years of experience; 93% of OR staff had inadequate knowledge of sources of fires, and inadequate knowledge of them toward controls and prevention of fires (73%, 79.8%), respectively; 77.5% of OR staff had inadequate knowledge of prevention and control sources of fires. The study concluded that most of OR staff had inadequate knowledge of sources, controls, and prevention of fires, while 22.5% of them had adequate knowledge of prevention and control sources of fires. We recommended the implementation of training programs toward sources, controls, and prevention of fires or related workshops in their educational planning for OR staff of hospitals.

Keywords: knowledge, operation rooms staff, fires, prevention

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Authors: Jun Hong Lee

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Background: Alzheimer`s disease (AD) I: creases with age and is characterized by the premature progressive loss of neuronal cell. In contrast, cancer cells have inappropriate cell proliferation and resistance to cell death. Objective: We evaluated the association between cancer and AD and also examined the specific types of cancer. Patients and Methods/Material and Methods: This retrospective, nationwide, longitudinal study used National Health Insurance Service – Senior cohort (NHIS-Senior) 2002-2013, which was released by the KNHIS in 2016, comprising 550,000 random subjects who were selected from over than 60. The study included a cohort of 4,408 patients who were first diagnoses as AD between 2003 and 2005. To match each dementia patient, 19,150 subjects were selected from the database by Propensity Score Matching. Results: We enrolled 4,790 patients for analysis in this cohort and the prevalence of AD was higher in female (19.29%) than in male (17.71%). A higher prevalence of AD was observed in the 70-84 year age group and in the higher income status group. A total of 540 cancers occurred within the observation interval. Overall cancer was less frequent in those with AD (12.25%) than in the control (18.46%), with HR 0.704 (95% Confidence Intervals (CIs)=0.0.64-0.775, p-Value < 0.0001). Conclusion: Our data showed a decreased incidence of overall cancers in patients with AD similar to previous studies. Patients with AD had a significantly decreased risk of colon & rectum, lung and stomach cancer. This finding lower than but consistent with Western countries. We need further investigation of genetic evidence linking AD to cancer.

Keywords: Alzheimer, cancer, nationwide, longitudinal study

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Authors: Aline Giardin

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Introduction: This review addresses the relationship between physical education and mental health and its main objective is to discuss the meanings that circulate in Psychiatric Hospitalization Units and Psychosocial Care Centers (CAPS) about the presence of physical education teachers and the practices developed by Them within these services. Material and methods: It is based on the theoretical contribution of the Psychiatric Reform and is methodologically inspired by the Bibliographic Review. Objectives: The objective of this review was to identify the main scientific evidence on the effects of physical activity on the main psychological aspects associated with mental health during the hospitalization process. Results: It was observed that physical activity has beneficial effects in the psychological, social and cognitive aspects, being thus a fundamental aspect of the lifestyle in promoting a healthy and successful treatment. In studies evaluating the effects of physical activity on mental health, the most frequently evaluated outcomes include anxiety, depression, and health-related quality of life (eg, self-esteem and self-efficacy). Evidence from epistemological studies indicates that the level of physical activity is positively associated with good mental health, when mental health is defined as good mood, general well-being and decreased symptoms. Conclusion: It is necessary to intervene and a greater interest of the professionals of physical education in the treatment with the people with mental disorders so that the negative symptoms are modified, through the aid of the physical activity, by better quality of life, physical condition, nutritional state and A healthy emotional appearance.

Keywords: health mental, physical activity, benefits, treatment

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: To describe a novel technique of trabeculectomy targeting triple modulation on wound healing to increase the overall success rate. Method: Ten eyes of 10 patients underwent trabeculectomy with subconjunctival mitomycin C (0.4mg/ml for 4 minutes) application combined with Ologen implantation subconjunctivally and subsclerally. Five of these patients underwent additional phacoemulsification with intraocular lens implantation. The Ologen implant was wet with 0.1 ml Bevacizumab. Result: All the eyes achieved target intraocular pressure (IOP), which was maintained until one year of follow-up. Two patients needed anterior chamber reformation at day two post surgery. One patient needed cataract surgery after four months of surgery and achieved target intraocular pressure on two topical antiglaucoma medicines. Conclusion: Vascular endothelial growth factor (VEGF) concentration has been seen to increase in the aqueous humor after filtration surgery. Ologen implantation helps in collagen remodelling, antifibroblastic response, and acts as a spacer. Bevacizumab augmented Ologen, in addition, targets the increased VEGF and helps in decreasing scarring. Anti-VEGF augmented Ologen in trabeculectomy with mitomycin C (MMC) hence appears to have encouraging short-term intraocular pressure control.

Keywords: ologen, anti-VEGF, trabeculectomy, scarring

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Authors: Sara Canas Pedrosa, Esther Moraleda SepuLveda

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Angelman Syndrome (AS) and Prader-Willi Syndrome (PWS) are considered rare genetic disorders that share the same chromosomal region: 15q11.2-q13. This is why both share some common characteristics, such as, delay in language development. However, there is still little research that specifically focuses on the linguistic profile in these populations. Therefore, the objective of this study was to know the characteristics of oral and written language that Angelman Syndrome and Prader-Willi Syndrome present from the point of view of parents. The sample consisted of 36 families (with children between 6 and 17 years old), of which 23 had children with AS and 13 had children with PWS. All of them answered the Language Assessment Scale of the standardized test CELF-4, Spanish Clinical Evaluation of Language Fundamentals-4 (Wiig, Secord & Semel, 2006). The scale is made up of 40 items that assesses the perception of parents in areas such as: difficulty of listening, speaking, reading and writing. The results indicate that the majority of parents manifest problems in almost all the sub-areas related to oral language and written language, taking into account that many do not achieve a literacy level, with similar results in comparison with both syndromes. These data support the importance of working on oral language delay and its relationship with the subsequent learning of literacy throughout its development.

Keywords: Angelman Syndrome , development, language, Prader-Willi Syndrome

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Authors: Disaphon Boobpachat, Nuttaset Manimmanakorn, Apiwan Manimmanakorn, Worrawut Thuwakum, Michael J. Hamlin

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Objectives: To evaluate effect of kinesio tape compared to placebo tape and static stretching on recovery of anaerobic power and maximal oxygen uptake (Vo₂max) after intensive exercise. Methods: Thirty nine untrained healthy volunteers were randomized to 3 groups for each intervention: elastic tape, placebo tape and stretching. The participants performed intensive exercise on the dominant quadriceps by using isokinetic dynamometry machine. The recovery process was evaluated by creatine kinase (CK), pressure pain threshold (PPT), muscle soreness scale (MSS), maximum voluntary contraction (MVC), jump height, anaerobic power and Vo₂max at baseline, immediately post-exercise and post-exercise day 1, 2, 3 and 7. Results: The kinesio tape, placebo tape and stretching groups had significant changes of PPT, MVC, jump height at immediately post-exercise compared to baseline (p < 0.05), and changes of MSS, CK, anaerobic power and Vo₂max at day 1 post-exercise compared to baseline (p < 0.05). There was no significant difference of those outcomes among three groups. Additionally, all experimental groups had little effects on anaerobic power and Vo₂max compared to baseline and compared among three groups (p > 0.05). Conclusion: Kinesio tape and stretching did not improve recovery of anaerobic power and Vo₂max after eccentric exercise compared to placebo tape.

Keywords: stretching, eccentric exercise, Wingate test, muscle soreness

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Authors: V. Hashim, P. N. Dileep

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Stent implantation is being seen as the most successful method to treat coronary artery diseases. Different types of stents are available in the market these days and the success of a stent implantation greatly depends on the proper selection of a suitable stent for a patient. Computer numerical simulation is the cost effective way to choose the compatible stent. Studies confirm that the design characteristics of stent do have great importance with regards to the pressure it can sustain, the maximum displacement it can produce, the developed stress concentration and so on. In this paper different designs of stent were analyzed together with balloon to optimize the stent and balloon system. Commercially available stent Palmaz-Schatz has been selected for analysis. Abaqus software is used to simulate the system. This work is the finite element analysis of the artery stent implant to find out the design factors affecting the stress and strain. The work consists of two phases. In the first phase, stress distribution of three models were compared - stent without balloon, stent with balloon of equal length and stent with balloon of extra length than stent. In second phase, three different design models of Palmaz-Schatz stent were compared by keeping the balloon length constant. The results obtained from analysis shows that, the design of the strut have strong effect on the stress distribution. A design with chamfered slots found better results. The length of the balloon also has influence on stress concentration of the stent. Increase in length of the balloon will reduce stress, but will increase dog boning effect.

Keywords: coronary stent, finite element analysis, restenosis, stress concentration

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Authors: Karen Cilliers, Benedict John Page

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The middle cerebral artery (MCA) is the most complex cerebral artery although few anomalies are found compared to the other cerebral arteries. The branches of the MCA cover a large part of each hemisphere, therefore it is exposed in various operations. Although the segments of the MCA are similarly described by most authors, there is some disagreement on the branching pattern of the MCA. The aim of this study was to review the available literature on the anatomy and variations of the MCA, and to compare this to a pilot study. For the pilot study, 20 hemispheres were perfused with coloured silicone and the MCA was dissected. According to the literature, the two most common branching configurations are the bifurcating and trifurcating patterns. In the pilot study, bifurcation was observed in 19 hemispheres, and in one hemisphere there was no branching (monofurcation). No trifurcation was observed. The most commonly duplicated branch was the anterior parietal artery in 30%, and most commonly absent was the common temporal artery in 65% and the temporal polar artery in 40%. Very few studies describe the origins of the branches of the MCA, therefore a detailed description is given. Middle cerebral artery variations that are occasionally reported in the literature include fenestration, and a duplicated or accessory MCA, although no variations were observed in the pilot study. Aneurysms can frequently be observed at the branching of cerebral vessels, therefore a thorough knowledge of the vascular anatomy is vital. Furthermore, knowledge of possible variations is important since variations can have serious clinical implications.

Keywords: anatomy, anomaly, description, middle cerebral artery, origin, variation

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Authors: Jugal Bhandari, K. Hari Priya

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The ECG signal provides important clinical information which could be used to pretend the diseases related to heart. Accordingly, delineation of ECG signal is an important task. Whereas delineation of P and T waves is a complex task. This paper deals with the Study of ECG signal and analysis of signal by means of Verilog Design of efficient filters and MATLAB tool effectively. It includes generation and simulation of ECG signal, by means of real time ECG data, ECG signal filtering and processing by analysis of different algorithms and techniques. In this paper, we design a basic particle filter which generates a dynamic model depending on the present and past input samples and then produces the desired output. Afterwards, the output will be processed by MATLAB to get the actual shape and accurate values of the ranges of P-wave and T-wave of ECG signal. In this paper, Questasim is a tool of mentor graphics which is being used for simulation and functional verification. The same design is again verified using Xilinx ISE which will be also used for synthesis, mapping and bit file generation. Xilinx FPGA board will be used for implementation of system. The final results of FPGA shall be verified with ChipScope Pro where the output data can be observed.

Keywords: ECG, MATLAB, Bayesian filtering, particle filter, Verilog hardware descriptive language

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Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

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Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

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Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90, and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of elbow flexion and extension task was investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76%, and 0.82% when using muscle relaxation periods of 60, 90, and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity, and knowing the optimal resting period will make the automation more effective.

Keywords: rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue

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Authors: Mona Hamdy, Iman Shaheen, Hadeel Seif Eldin, Basma Ali, Omnia Abdeldayem

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Summary: Bone involvement of sickle cell disease (SCD) patients varies from acute clinical manifestations of painful vaso-occlusive crises or osteomyelitis to more chronic affection of bone mineral density (BMD) and debilitating osteonecrosis and osteoporosis. Secreted klotho protein is involved in calcium (Ca) reabsorption in the kidney. This study aimed to measure serum klotho levels in children with SCD to determine the possibility of using it as a marker of low BMD in children with SCD in correlation with a dual-energy radiograph absorptiometry scan. This study included 60 sickle disease patients and 30 age-matched and sex-matched control participants without SCD. A highly statistically significant difference was found between patients with normal BMD and those with low BMD, with serum Ca and klotho levels being lower in the latter group. Klotho serum level correlated positively with both serum Ca and BMD. Serum klotho level showed 94.9% sensitivity and 95.2% specificity in the detection of low BMD. Both serum Ca and klotho serum levels may be useful markers for detection of low BMD related to SCD with high sensitivity and specificity; however, klotho may be a better indicator as it is less affected by the nutritional and endocrinal status of patients or by intake of Ca supplements.

Keywords: sickle cell disease, BMD, osteoporosis, DEXA, klotho

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Authors: Hatice Canan Gungor, Ahmet Akdemir

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The fields of engineering and technological sciences are increasing in quality and quantity day by day all over the world. Countries have to follow, implement and adapt these developments in order to economical empowerments. In our era, it's possible to follow the rapidly developing technology and to produce new technologies by inquisitive, curious, numerical thinking individuals who can show several approaches to problem solving. In this case, countries should develop te result oriented and need-focused curriculums in university education. As in the whole world, there are more space studies in our country as well. Universities should undertake the task of supply the need for staff of this technological race. In this context, questions about the purpose, content and learning outcomes of the space sciences and space engineering departments in our country will be researched answers to reveal the characteristic of this section. In this study, it was determined in which universities the space engineering and the departments of basic sciences educate with formal education and the contents of this education, and the universities were compared with each other as of 2017. In our country three universities provide Aeronautical and Aerospace Engineering, two universities provide Space Sciences and Technologies, two universities provide Aerospace Engineering, two universities provide Aeronautics and Astronautics Engineering education. In all universities, specialized courses are taught after basic engineering education. But the question that needs to be answered is, do the lessons benefit in practice? The answer of this question will reveal the quality of the education. This paper suggests that surveys be conducted to search for the answer to this question. It's thought to be the base for the next works.

Keywords: education, space engineering, space science, quality of systems

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Authors: Elif Ates, Naile Bilgili

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Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

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Authors: Maria Isabel Garcia-Planas, Maria Victoria Garcia-Camba

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Recent advances in cognitive neuroscience have allowed a step forward in perceiving the processes involved in learning from the point of view of the acquisition of new information or the modification of existing mental content. The evoked potentials technique reveals how basic brain processes interact to achieve adequate and flexible behaviours. The objective of this work, using evoked potentials, is to study if it is possible to distinguish if a patient suffers a specific type of learning disorder to decide the possible therapies to follow. The methodology used, is the analysis of the dynamics of different areas of the brain during a cognitive activity to find the relationships between the different areas analyzed in order to better understand the functioning of neural networks. Also, the latest advances in neuroscience have revealed the existence of different brain activity in the learning process that can be highlighted through the use of non-invasive, innocuous, low-cost and easy-access techniques such as, among others, the evoked potentials that can help to detect early possible neuro-developmental difficulties for their subsequent assessment and cure. From the study of the amplitudes and latencies of the evoked potentials, it is possible to detect brain alterations in the learning process specifically in dyscalculia, to achieve specific corrective measures for the application of personalized psycho pedagogical plans that allow obtaining an optimal integral development of the affected people.

Keywords: dyscalculia, neurodevelopment, evoked potentials, Learning disabilities, neural networks

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Authors: S. Rostami, S. H. Hosseini, A. A. Torabi, M. Bekhradi

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Introduction: Interest in the use of caffeine as an ergogenic aid has increased since the International Olympic Committee lifted the partial ban on its use. Caffeine has beneficial effects on various aspects of athletic performance, but its effects on training have been neglected. The purpose of this study was to investigate the acute effect of caffeine on testosterone and cortisole in young futsal players. Methods: Twenty-four professional futsal players with 18.3± 1.9 years ingested caffeine doses of 0, 200 and 800 mg in random order 1 hr before an anaerobic-exercise session (RAST test). Samples were taken at the time of caffeine ingestion and 30 min after the session. Data were log-transformed to estimate percent effects with mixed modeling, and effects were standardized to assess magnitudes. fects on training have been neglected. Results: Testosterone concentration showed a small increase of 15% (90% confidence limits, ± 19%) during exercise. Caffeine raised this concentration in a dose-dependent manner by a further small 21% (± 24%) at the highest dose. The 800-mg dose also produced a moderate 52% (± 44%) increase in cortisol. The effect of caffeine on the testosterone: cortisol ratio was a small decline (14%; ± 21%). Discussion and Conclusion: Caffeine has some potential to benefit training outcomes via the anabolic effects of the increase in testosterone concentration, but this benefit might be counteracted by the opposing catabolic effects of the increase in cortisol and resultant decline in the testosterone: cortisol ratio.

Keywords: anabolic, catabolic, performance, testosterone, cortisol ratio, RAST test

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Authors: Anthony Bawa, Konstantinos Banitsas

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Rheumatism is a muscular disorder that affects the muscles of the upper and lower limbs. This condition could potentially progress to impair the movement of patients. This study aims to investigate the hip muscular imbalance in patients with chronic rheumatism. A clinical trial involving a total of 15 participants, made up of 10 patients and 5 control subjects, took place in KATH Hospital between August and September. Participants recruited for the study were of age 54 ± 8years, weight 65± 8kg, and height 176 ± 8cm. Muscle signals were recorded from the rectus femoris, and vastus lateralis on the right and left hip of participants. The parameters used in determining the hip muscular imbalances were the maximum voluntary contraction (MVC%), the mean difference, and hip muscle fatigue levels. The mean signals were compared using a t-test, and the metrics for muscle fatigue assessment were based on the root mean square (RMS), mean absolute value (MAV) and mean frequency (MEF), which were computed between the hip muscles of participants. The results indicated that there were significant imbalances in the muscle coactivity between the right and left hip muscles of patients. The patients’ MVC values were observed to be above 10% when compared with control subjects. Furthermore, the mean difference was seen to be higher with p > 0.002 among patients, which indicated clear differences in the hip muscle contraction activities. The findings indicate significant hip muscular imbalances for patients with rheumatism compared with control subjects. Information about the imbalances among patients will be useful for clinicians in designing therapeutic muscle-strengthening exercises.

Keywords: muscular, imbalances, rheumatism, Hip

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Authors: Sabreen Al Shamli, Abdul Rahman Al azure

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Microscopic examination by histopathology is the gold standard for diagnosing many oral and maxillofacial pathologies. Current clinical guidelines and medicolegal regulations recommend the utilization of histopathology services for confirming pathologies being treated. The goal of this study was to determine the prevalence and distribution of oral and maxillofacial biopsies that had been histopathologically diagnosed at Anahdha Hospital (ANH). A total of 512 biopsies randomly selected from a ground total of 3310 biopsies, which were submitted for oral and maxillofacial histopathological specimens, were analyzed at Nahdha Hospital in Oman between January 2010 and December 2022. Data collected retrospectively selected from all case notes of patients who had oral histopathology examinations performed as part of their treatment. Data collected from the Shifa system was transferred to Microsoft Excel and analyzed using SPSS. Research ethics approval was obtained from the research committee of the hospital. This study provides background information on oral histopathology prevalence that could be helpful in future research in Oman. The findings of the present study are in agreement with the reported data from other investigations, even when it is taken into account how difficult it is to compare prevalence rates from different studies.

Keywords: oral biopsy, maxillofacial histopathology, oral disease, maxillofacial specimens

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Authors: Liaqat Ali, Khalid Farooq, Shafieullah Khan, Nasir Orakzai, Qudratullah

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Objectives: To determine the risk factors for high resistance of ciprofloxacin in complicated urinary tract infections. Materials and Methods: It is an analytical study that was conducted in the department of Urology (Team ‘C’) at Institute of Kidney Diseases Hayatabad Peshawar from 1st June 2012 till 31st December 2012. Total numbers of 100 patients with complicated UTI was selected in the study. Multivariate analysis and linear regression were performed for the detection of risk factors. All the data was recorded on structured Proforma and was analyzed on SPSS version 17. Results: The mean age of the patient was 55.6 years (Range 3-82 years). 62 patients were male while 38 patients were female. 66 isolates of E-Coli were found sensitive to ciprofloxacin while 34 isolates were found Resistant for ciprofloxacin. Using multivariate analysis and linear regression, an increasing age above 50 (p=0.002) History of urinary catheterization especially for bladder outflow obstruction (p=0.001) and previous multiple use of ciprofloxacin (p=0.001) and poor brand of ciprofloxacin were found to be independent risk factors for high resistance of ciprofloxacin. Conclusion: UTI is common illness across the globe with increasing trend of antimicrobial resistance for ciprofloxacin against E Coli in complicated UTI. The risk factors for emerging resistance are increasing age, urinary catheterization and multiple use and poor brand of ciprofloxacin.

Keywords: urinary tract infection, ciprofloxacin, urethral catheterization, antimicrobial resistance

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Authors: Renee Monchalin

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Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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Authors: Xiuguo Zhao, He Li, Alireza Yazdani, Xiaoning Zheng, Xinxi Xu

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Wound infected poses a serious threat to the surgery on the patient during the process of surgery. Understanding the bacteria-carrying particles (BCPs) transportation and deposition in the open surgical wound model play essential role in protecting wound against being infected. Therefore BCPs transportation and deposition in the surgical wound model were investigated using force-coupling method (FCM) based computational fluid dynamics. The BCPs deposition in the wound was strongly associated with BCPs diameter and concentration. The results showed that the rise on the BCPs deposition was increasing not only with the increase of BCPs diameters but also with the increase of the BCPs concentration. BCPs deposition morphology was impacted by the combination of size distribution, airflow patterns and model geometry. The deposition morphology exhibited the characteristic with BCPs deposition on the sidewall in wound model and no BCPs deposition on the bottom of the wound model mainly because the airflow movement in one direction from up to down and then side created by laminar system constructing airflow patterns and then made BCPs hard deposit in the bottom of the wound model due to wound geometry limit. It was also observed that inertial impact becomes a main mechanism of the BCPs deposition. This work may contribute to next study in BCPs deposition limit, as well as wound infected estimation in surgical-site infections.

Keywords: BCPs deposition, computational fluid dynamics, force-coupling method (FCM), numerical simulation, open surgical wound model

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Authors: Husham Bayazed

Abstract:

A growing number of studies indicate that atherosclerotic coronary artery disease (CAD) has a complex pathogenesis that extends beyond cholesterol intimal infiltration. The atherosclerosis process may involve an immune micro-environmental condition driven by local activation of the adaptive and innate immunity arrays, resulting in the formation of atherosclerotic plaques. Therefore, despite the wide usage of lipid-lowering agents, these devastating coronary diseases are not averted either at primary or secondary prevention levels. Many trials have recently shown an interest in the immune targeting of the inflammatory process of atherosclerotic plaques, with the promised improvement in atherosclerotic cardiovascular disease outcomes. This recently includes the immune-modulatory drug “Canakinumab” as an anti-interleukin-1 beta monoclonal antibody in addition to "Colchicine,” which's established as a broad-effect drug in the management of other inflammatory conditions. Recent trials and studies highlight the importance of inflammation and immune reactions in the pathogenesis of atherosclerosis and plaque formation. This provides an insight to discuss and extend the therapies from old lipid-lowering drugs (statins) to anti-inflammatory drugs (colchicine) and new targeted immune-modulatory therapies like inhibitors of IL-1 beta (canakinumab) currently under investigation.

Keywords: atherosclerotic plagues, immune microenvironment, lipid-lowering agents, and immunomodulatory drugs

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Authors: Emmanuel Kamal Aziz Saba, Sarah Sayed El-Tawab

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The present study was conducted to assess the involvement of ulnar sensory and/or motor nerve fibers in patients with carpal tunnel syndrome (CTS) and whether this affects the accuracy of the median versus ulnar comparative tests. The present study included 145 CTS hands and 71 asymptomatic control hands. Clinical examination was done. The following tests were done: Sensory conduction studies: median, ulnar and dorsal ulnar cutaneous nerves; and median versus ulnar digit (D) four sensory comparative study; and motor conduction studies: median nerve, ulnar nerve and median versus ulnar motor comparative study. It was found that 17 CTS hands (11.7%) had ulnar sensory abnormalities in 17 different patients. The median versus ulnar sensory and motor comparative studies were abnormal among all these 17 CTS hands. There were significant negative correlations between median motor latency and both ulnar sensory amplitudes recording D5 and D4. In conclusion, there is ulnar sensory nerve abnormality among CTS patients. This abnormality affects the amplitude of ulnar sensory nerve action potential. This does not affect the median versus ulnar sensory and motor comparative tests accuracy for use in CTS.

Keywords: median nerve, motor comparative study, sensory comparative study, ulnar nerve

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Authors: Aboozar Dehghan, S. Sharifi, A. Ardeshiri, F. Jafari, F. Samani

Abstract:

Ultrasonography is a safe, particular, available and easy to use method to evaluate soft tissues. Tendons play the main role to body locomotors system. Ultrasonography performed in tarsus and metatarsus region of rare limb of eight adult, Dromedary camels (camelus dromedaries) in both sex. Clinical examination and gate analysis was performed before slaughtering. From the tarsus to the 1st phalanx was divided to 4 equal region include 1a, 2a, 1b and 2b. Flexor surface was clipped and covered by enough ultrasonography gel. Ultrasonography was performed by linear phased array 8-12 Mhz transducer in transverse and longitudinal section and Superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT) and suspensory ligament (SL) were imaged. Echogenicity and diameter of these structures were recorded. Size of tendons and SL measured after necropsy too. statistical analysis obtained that SDFT diameter larger than others in all described regions and mean of DDFT diameter larger than suspensory ligament. Echogenicity of SL more than SDFT and DDFT. No Significant relationship was seen between left and right rare limb structures size. Between sex and tendons and SL diameter, significant relationship not seen.

Keywords: dromedary camel, tars and metatars, ultrasonography

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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Authors: A. I. A. Rahman, Sh-Hussain Salleh, K. Ahmad, K. Anuar

Abstract:

Analysis of vocal fold vibration is essential for understanding the mechanism of voice production and for improving clinical assessment of voice disorders. This paper presents a Dynamic Time Warping (DTW) based approach to analyze and objectively classify vocal fold vibration patterns. The proposed technique was designed and implemented on a Glottal Area Waveform (GAW) extracted from high-speed laryngeal images by delineating the glottal edges for each image frame. Feature extraction from the GAW was performed using Linear Predictive Coding (LPC). Several types of voice reference templates from simulations of clear, breathy, fry, pressed and hyperfunctional voice productions were used. The patterns of the reference templates were first verified using the analytical signal generated through Hilbert transformation of the GAW. Samples from normal speakers’ voice recordings were then used to evaluate and test the effectiveness of this approach. The classification of the voice patterns using the technique of LPC and DTW gave the accuracy of 81%.

Keywords: dynamic time warping, glottal area waveform, linear predictive coding, high-speed laryngeal images, Hilbert transform

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Authors: Gamalath M. B. P. Abeysekara

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Primary objective of any organization is to enhance the bottom line profit. Strategic procurement is one of the prominent aspects in view of receiving this ultimate objective. Strategic procurement is an activity used in each and every organization in their operations. Pharmaceutical procurement is an especially significant task for any organizations, particularly state sector concerned. The whole pharmaceutical procurement requirement of the country is procured through the State Pharmaceutical Corporation (SPC) of Sri Lanka. They follow Pharmaceutical Procurement Guideline of 2006 as the procurement principle. The main objective of this project is to identify the importance of State Pharmaceutical Corporation supplier selection criteria and critical analysis of pharmaceutical procurement procedure. State Pharmaceutical Corporations applied net price, product quality, past performance, and delivery of suppliers’ as main criteria for the selection suppliers. Data collection for this study was taken place through a questionnaire, given to fifty doctors within the Colombo district attached to five main state hospitals. Data analysis is carried out with mean and standard deviation functions. The ultimate outcomes indicated product quality, net price, and delivery of suppliers’ are the most important criteria behind the selection of suppliers. Critical analysis proved State Pharmaceutical Corporation should focus on net price reduction, improving laboratory testing facilities and effective communication between up and down stream of supply chain.

Keywords: government procurement procedure, pharmaceutical procurement supplier selection criteria, importance of SPC supplier selection criteria

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