Search results for: dietary adherence

Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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Authors: Yomna T. Abdou, Hala F. Zaki, Sanaa A. Kenawy

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Naringenin is a flavanone, a type of flavonoid, found in fruits such as grapefruit, oranges, and tomatoes, was found to possess antioxidant, anti-inflammatory and antitumor effects. The present study was conducted to investigate the protective effect of naringenin on iodoacetamide-induced ulcerative colitis (UC) in rats. Male Wistar rats were pretreated with sulfasalazine (300 mg/kg, p.o.) as standard anti-inflammatory drug or naringenin (50 mg/kg, p.o.) for 7 consecutive days then UC was induced by intracolon administration of 0.1 ml (2%) iodoacetamide dissolved in 1% methylcelluose. One week later, animals were scarificed and the colonic tissues were dissected. Colon inflammation was evident by elevation in colon tumor necrosis factor alpha (TNFα) and interleukin-8 (IL-8) as well as inducible nitric oxide synthase (iNOS) enzyme, prostaglandin- E2 (PG-E2) and myeloperoxidase (MPO) activities. Additionally, oxidative stress was manifested by increased colon lipoperoxidation (MDA), glutathione (GSH) depletion, elevated nitric oxide (NO) content and glutathione peroxidase (GPx) activity. Pretreatment with naringenin largely mitigated these alterations. The present study reinforces the hypothetical use of naringenin as an anti-inflammatory complement to conventional UC treatment and could be considered in the dietary prevention of intestinal inflammation and related disorders.

Keywords: iodoacetamide, naringenin, sulfasalazine, ulcerative colitis

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Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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Authors: Oluwafemi Ojo, Omotade Oloyede

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This study seeks to investigate the antioxidative properties and the ability of aqueous, ethanolic and ethyl acetate extracts from Ocimum gratissimum (OG) leaves to inhibit some pro-oxidants (Fe2+ and sodium nitroprusside) induced lipid peroxidation in rat’s liver homogenates in vitro. The ability of the extracts to inhibit 25 µM FeSO4 and 7.0 µM sodium nitroprusside induced lipid peroxidation in isolated rat’s liver was determined. The results of the study revealed that both pro-oxidants caused a significantly decrease in (p < 0.05) accumulation of lipid peroxides. However, aqueous extract of OG shows a high ability to inhibit lipid production in the liver induced with SNP than Fe2+. Ethanolic and ethyl acetate extract of OG which shows a high ability to inhibit lipid production more when induced with Fe2+ than SNP. However, ethyl acetate fraction of OG shows a higher inhibitory effect on both Fe2+ and SNP induced lipid peroxidation in rat’s liver. This applies to its significantly higher extractable phytochemicals. Therefore, Fe II and sodium nitroprusside induced oxidative stress could be managed by dietary intake of Ocimum gratissimum leaves.

Keywords: antioxidative, pro-oxidants, lipid peroxidation, Ocimum gratissimum

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Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Meida Laely Ramdani, Earmporn Thongkrajai, Dedy Purwito

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Lifestyle is one of the most important factors affecting health. Measurement of lifestyle behaviors is necessary for the identification of causal associations between unhealthy lifestyle and health outcomes. There was many instruments have been measured for lifestyle, but not specific for stroke recurrence. This study aimed to develop a new questionnaire of Lifestyle Adjustment Scale (LSAS) among recurrent stroke patients in Indonesia and to measure the reliability and validity of LSAS. The instrument consist of 33 items was developed from the responses of 30 recurrent stroke patients with the maximum age 60 years. Data was collected during October to November 2015. The properties of the instrument were evaluated by validity assessment and reliability measures. The content validity was judged adequate by a panel of five experts, with the result of I-CVI was 0.97. The Cronbach’s alpha analysis was carried out to measure the reliability of LSAS. The result showed that Cronbach’s alpha coefficient was 0.819. LSAS were classified under the domains of dietary habit, smoking habit, physical activity, and stress management. The results of Cronbach’s alpha coefficient for each subscale were 0.60, 0.39, 0.67, 0.65 and 0.76 respectively. LSAS instrument was valid and reliable therefore can be used as research tool among recurrent stroke patients. The development of this questionnaire has been adapted to the socio-cultural context in Indonesia.

Keywords: LSAS, recurrent stroke patients, lifestyle, Indonesia

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Maedeh Gharazi

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Adults with age 50 and older will include more than 70% of the diabetic populace by the year 2025. More established patients with diabetes are more inclined to have concurrent ceaseless conditions like hypertension, dyslipidemia, and cardiovascular sickness that may affect their nutritious necessities. The issue of achievement and support of an ideal body weight in elderly diabetic persons may not be as direct as in other age gatherings, and the risk-benefit ratio may be diverse too. Albeit expanded predominance of overweight and weight in the elderly adds to insulin resistance and hyperglycemia, more seasoned tenants of long haul care offices who experience the ill effects of diabetes have a tendency to be underweight. Both may mean insufficient nutritional status and lead to expanded grimness and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may influence the sort and amount of food devoured by elderly persons. Organized screening devices may recognize nutrition related issues that warrant proof based mediations. Despite the fact that glucose control and health concerns are essential calculates diet change in the more established populace, different contemplations incorporate personal satisfaction and individual inclinations. Redoing of nutritious rules to the needs of the more seasoned diabetic patient bodes well.

Keywords: diabetes, nutritious necessities, insulin resistance, glucose control

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Authors: H. Soltani, Kevin Laugero

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Obesity is becoming an increasingly critical issue in the United States due to the steady and substantial increase in prevalence over the last 30 years. Existing interventions have been able to help participants achieve short-term weight loss, but have failed to show long-term results. The complex nature of behavioral change remains one of the most difficult barriers in promoting sustainable weight-loss in overweight individuals. Research suggests that the 'intention-behavior gap' can be explained by a person’s ability to regulate higher-order thinking, or Executive Function (EF). A review of 63 research articles was completed in fall of 2017 to identify the role of EF in regulating eating behavior and to identify whether there is a potential for improving dietary quality by enhancing EF. Results showed that poor EF is positively associated with obesogenic behavior, namely increased consumption of highly palatable foods, eating in the absence of hunger, high saturated fat intake and low fruit and vegetable consumption. Recent research has indicated that interventions targeting an improvement in EF can be successful in helping promote healthy behaviors. Furthermore, interventions of longer duration have a more lasting and versatile effect on weight loss and maintenance. This may present an opportunity for the increasingly ubiquitous use of mobile application technology.

Keywords: eating behavior, executive function, nutrition, obesity, weight-loss

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Authors: Saeed Ahmed, Muhammad Imran, Yasir Allah Ditta, Shahid Mehmood, Zahid Rasool

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A study was conducted to investigate the effect of different levels of microencapsulated butyric (MEB) on growth performance, gut health and immunity in commercial broiler chickens. In total, 336 day-old Hubbard classic broilers chicks were randomly assigned to 4 dietary treatments (Control, 0.25, 0.35 and 0.45g/kg of butyric acid) under completely randomized design. Each treatment was replicated 3 times with 28 birds in each replicate. Feed intake, body weight gain, feed conversion ratio, intestinal morphology, apparent ileal digestibility of protein and immunity parameters were evaluated. At the end of the experiment (35-d) 3 birds/replicate in each group were randomly selected and slaughtered to collect blood, duodenal samples and ileal digesta. The data were analyzed by using ANOVA technique. The results indicated improved body weight gain (P = 0.0222), feed conversion ratio (P = 0.0056), duodenal villus height (P = 0.0512), AID (P = 0.0098) antibody titer against Newcastle disease improved (P = 0.0326). Treatments remained unresponsive with respect to feed intake (P = 0.9685).

Keywords: butyric acid, broilers, gut health, ileal digestibility

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Authors: Madhuresh Dwivedi, Navneet Singh Deora, H. N. Mishra

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In the context of bakery products, the gluten component of wheat has a crucial role in stabilizing the gas-cell and crumb structures, appearance, mouth feel and maintaining the rheological properties, thus the acceptability of these products. However, because of coeliac disease, some individuals cannot tolerate the protein gliadin present in the gluten fraction of wheat flour. Also termed as gluten-sensitive enteropathy, it is a common chronicle disorder in populations throughout the world with average prevalence of 0.37%. The safest way for celiac sufferers is to stay away from gluten-containing foods such as wheat, rye, barley as well as durum wheat, spelt wheat, and triticale. Thus, in view of the current increasing incidence of gluten intolerant sufferers (due to improved diagnostic procedures), the development of gluten-free cereal-based bakery products suitable for celiac patients represents a challenging and serious task, but also very demanding call for food technologists as well as for the bakers. The use of alternative cereal starches (like rice, soy, maize, potato and so on), gums, hydrocolloids, dietary fibres, alternative protein sources, prebiotics and combinations of them represent the most widespread approach used as replacement to mimic gluten in the manufacture of industrial processable gluten-free bakery products due to their structure-building and water binding properties.

Keywords: gluten-free, coeliac disease, alternative flour, hydrocolloid, crumb structure

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Authors: Monika Yadav

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The incorporation of a healthy lifestyle significantly contributes to the advancement of economic development. Urbanization, industrialization, and economic growth have enhanced living conditions, promoting sedentary behaviours among individuals with elevated socio-economic statuses. The prevalence of overweight and obesity has increased globally, along with the rise in living standards, posing a growing health risk. Overweight and obesity are known to be precursors to a range of modifiable and metabolic risk factors, contributing to the increase in lifestyle diseases. Unhealthy dietary choices and lifestyle practices primarily drive these diseases. Lifestyle diseases refer to chronic and non-communicable illnesses, encompassing conditions such as hypertension, heart disease, kidney disorders, infertility, polycystic ovary syndrome (PCOD), diabetes, respiratory diseases, and certain forms of cancer. This study examines the prevalence of lifestyle diseases among urban Indian women, explicitly differentiating between individuals with normal weight and those classified as obese. The main aim of this study is to investigate whether there is a correlation between a higher body mass index (BMI) in women and an increased vulnerability to lifestyle diseases when compared to women with a normal BMI. This research provides insights into the intricate relationship between lifestyle, health, and economic development within urban areas.

Keywords: urbanization, economic development, BMI, NCDs, urban, women, lifestyle practices

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Authors: Donald B. Enu, Clement O. Ukpor, Abigail E. Okon

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Unreliable scoring of students’ performance by lecturers short-chains students’ assessment in terms of underequipping the school authority with facts as intended by society through the curriculum hence, the learners, the school and the society are cheated because the usefulness of testing is defeated. This study, therefore, examined lecturers’ scoring objectivity of essay items in the Department of Social Science Education, University of Calabar, Nigeria. Specifically, it assessed lecturers’ perception of the relevance of scoring rubrics and its level of application. Data were collected from all the 36 lecturers in the Department (28 members and 8 non-members adjourned to the department), through a 20-item questionnaire and checklist instruments. A case-study design was adopted. Descriptive statistics of frequency counts, weighted means, standard deviations, and percentages were used to analyze data gathered. A mean score of 2.5 and or 60 percent and above formed the acceptance or significant level in decision taking. It was found that lecturers perceived the use of scoring rubrics as a relevant practice to ensure fairness and reliable treatment of examiners scripts particularly in marking essay items and that there is a moderately high level of adherence to the application of scoring rubrics. It was also observed that some criteria necessary for the scoring objectivity of essay items were not fully put in place in the department. It was recommended strongly that students’ identities be hidden while marking and that pre-determined marking scheme should be prepared centrally and strictly adhered to during marking and recording of scores. Conference marking should be enforced in the department.

Keywords: essay items, objective scoring, scorers reliability, scoring rubrics

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Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

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Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

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Authors: A. Mech

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Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).

Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes

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Authors: Aladdin Al-Tarawneh

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The Quran, as it is the sacred book of Islam and considered the literal word of God (Allah) in Arabic, is highly translated into many languages; however, the foreignising or the literal approach excessively stains the quality and discredits the final product in the eyes of its receptors. Such an approach fails to capture the intended meaning of the Quran and to communicate it in any language. Therefore, this study is conducted to propose a different approach that seeks involving other ones according to a hybrid model. Indeed, this study challenges the binary adherence that is highly used in Translation Studies (TS) in general and in the translation of the Quran in particular. Drawing on the genuine fact that the Quran can be communicated in any language in terms of meaning, and the translation is not sacred; this paper approaches the translation of the Quran by blending different methods like domestication or foreignisation in a systematic way, avoiding the binary choice made by many translators. To reach this aim, the paper has a conceptual part that seeks to elucidate and clarify the main methods employed in TS, and criticise and modify them to propose the new hybrid approach (the hybrid model) for translating the Quran – that is, the deductive method. To support and validate the outcome of the previous part, a comparative model is employed in order to highlight the differences between the suggested translation and other widely used ones – that is, the inductive method. By applying this methodology, the paper proves that there is a deficiency of communicating the original meaning of the Quran in light of the foreignising approach. In conclusion, the paper suggests producing a Quran translation has to take into account the adoption of many techniques to express the meaning of the Quran as understood in the original, and to offer this understanding in English in the most native-like manner to serve the intended target readers.

Keywords: Quran translation, hybrid approach, domestication, foreignization, hybrid model

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Authors: Muhammad Naziru Yahaya, Mustapha Bashir Ayinde

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Noise has been recognized as a major source of pollution in many urban and semi-urban settlements. Noise pollution causes by vehicular movement in urban cities has reaches an alarming proportion due to continuous increases in vehicles and industrialization. This research aim to determine the geo-physical characteristics of the study area and to determine the level of noise generation and volume intensity in areas where noise levels are high within the metropolis and compare with NESREA and WHO standards. This study identified the various sources of noise, compared noise levels in various parts of the study area with recommended standards and determined the geo-physical characteristic of noise generated. A sound level meter Gm 1352, was used for the noise measurements. The study showed that the noise pollution levels measured in minimum noise level of 63.75 dBA and average maximum of 95.175 dBA, at some locations in Birnin Kebbi metropolis the noise level have exceeded the standard limits set by the World Health Organization (WHO), Federal Environment Protection Agency (FEPA). Results revealed that there was a considerable increase in noise pollution in First Bank roundabout and Haliru Abdu roundabout, attribute to high numbers of vehicular movement and road congestion within Birnin Kebbi. The study therefore concluded that there should be an enforcement and adherence to the regulation regarding noise pollution limit. The minimum average day noise level recorded was 67.225 dBA, and average maximum of 96.6 dBA is an indication that the noise level of Birnin Kebbi metropolis was highly unsatisfactory. Based on this, it is suggested that taking adequate measures and following the laid-down recommendations will reduce traffic noise to the barest minimum.

Keywords: decibel, noise level, pollution, sound level, traffic, highway

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Authors: C. Minguez, J. Bueso-Rodenas, C. Ibanez, A. Calvo

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Mannan oligosaccharides (MOS) is one of the prebiotic most used in livestock nutrition. In this research, the effect of MOS dietary supplementation on growth performance and mortality in meat guinea pigs were studied. Three different experimental groups were compared: Control group (no additives); MOS 1 (1.5 g kg−1); MOS 2 (2 g kg−1). Guinea pigs were housed in 15 collective cages (n = 50 animals in each trial; 10 animals per cage). The young guinea pigs were weaning at day 28 and individually identified by a little ear tag. The fattening period was 49 days. Guinea pigs in both groups were fed ad libitum, with a standard commercial pellet diet (10 MJ of digestible energy/kg, 17% crude protein, 11% crude fiber, and 4.5% crude fat) and alfalfa (Medicago sativa) as forage. Growth traits, including body weight (BW), average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR), were measured weekly. On day 74, the animals were slaughtered. Contrasts between groups were obtained by calculated generalized least squares values. Mortality were evaluated by Fisher's exact test. Between MOS groups no significant differences were observed for growth traits and mortality. However, significant differences against the control group were observed for traits studied (pvalue < 0.05). In conclusion, the use of MOS could be a good prebiotic supplement to raise guinea pigs because it MOS has shown positive effects in growth traits and immune response in animals.

Keywords: guinea pig, growth, mannan oligosaccharides, mortality

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Authors: Wedad Azhar

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Vitamin D is an essential fat-soluble vitamin that is required for the maintenance of good health. It is obtained either through exposure to sunlight (ultraviolet B radiation) or through dietary sources. The role of vitamin D is beyond bone health. Indeed, it plays a critical role in the immune system and a broad range of organ functions such as the cardiovascular system. Moreover, vitamin D plays a critical role in the endothelial function, which is one of the main indicators of atherosclerosis. This study is investigating the correlation between vitamin D status and endothelial function in preventing and treating atherosclerosis especially in country that has ample of sunshine but yet, Saudis from suffering from this issue vitamin D deficiency and insufficiency. Ninety participants from both genders and aged 40 to 60will be involved. The participants will be categorised into three groups: the control group will be healthy persons, patients at risk of developing atherosclerosis, patients formally diagnosed atherosclerosis. Half of the participants in each group should already have been taking vitamin D supplementations. Fasting blood samples will be taken from the participants for biochemical assays. Endothelial function will be assist by flow-mediated dilation of the brachial artery. Participants will be asked to complete a questionnaire on their social and economic status, education level, daily exposure to sunlight, smoking status, consumption of supplements and medication, and a food frequency of vitamin D intake. The data will be analysed using SPSS.

Keywords: atherosclerosis, endothelial function, nutrition, vitamin D

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Authors: Choumous Mannoubi, Dahlia Kairy, Brigitte Vachon

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The use of technology allows clinicians to provide an individualized approach in a cost-effective manner and to reach a broader client base more easily. Such interventions can be effective in ensuring self-management and follow-up of people with diabetes, reducing the risk of complications by improving accessibility to care services, and better adherence to health recommendations. Consideration of users' opinions and fears to inform the design and implementation stages of these telehealth services seems to be essential to improve their acceptance and usability. The objective of this study is to describe the telepractice of nutritionists supporting the therapeutic management of diabetic patients and document the functional requirements of nutritionists for the design of a tele-nutrition platform. To best identify the requirements and constraints of nutritionists, we conducted individual semi-structured interviews with 10 nutritionists who offered tele-nutrition services. Using a qualitative design with a descriptive approach based on the Nutrition Care Process Model (mNCP) framework, we explored in depth the state of nutritionists' telepractice in public and private health care settings, as well as their requirements for teleconsultation. Qualitative analyses revealed that nutritionists primarily used telephone calls during the COVID 19 pandemic to provide teleconsultations. Nutritionists identified the following important features for the design of a tele-nutrition platform: it should support interprofessional collaboration, allow for the development and monitoring of a care plan, integrate with the existing IT environment, be easy to use, accommodate different levels of patient literacy, and allow for easy sharing of educational materials to support nutrition education.

Keywords: telehealth, nutrition, diabetes, telenutrition, teleconsultation, telemonitoring

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Authors: Noor Khan, Hira Waris

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This study was conducted on genetically male tilapia (GMT) fry reared in glass aquarium for three months to examine the synergetic effect of essential amino acids (EAA) supplementation on growth, body composition, and enzyme activities. Fish having average body weight of 16.56 ± 0.42g were fed twice a day on artificial feed (20% crude protein) procured from Oryza Organics (commercial feed) supplemented with EAA; methionine (M) and lysine (L) designated as T1 (0.3%M and 2%L), T2 (0.6%M and 4%L), T3 (0.9%M and 6%L) and control without EAA. Significantly higher growth performance was observed in T1, followed by T2, T3, and control. The results revealed that whole-body dry matter and crude protein were significantly higher (p ≤ 0.05) in T3 (0.9% and 6%) feeding fish, while the crude fat was lower (p ≤ 0.05) in a similar group of fish. Additionally, protease, amylase, and lipase activities were also observed maximum (p ≤ 0.05) in response to T3 than other treatments and control. However, the EAA, especially lysine and methionine, were found significantly higher (p ≤ 0.05) in T1 compared to other treatments. Conclusively, the addition of EAA, methionine, and lysine in the feed not only enhanced the growth performance of GMT fry but also improved body proximate composition and essential amino acid profile.

Keywords: genetically male tilapia, body composition, digestive enzyme activities, amino acid profile

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: S. Salari, M. A. Shirali, S. Tabatabaei, M. Sari, R. Jahanian

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This study was conducted to investigate the effect of different levels of vitamin E and L-carnitine on performance, blood parameters and immune responses of broilers under heat stress. For this purpose 396 one- day- old Ross 308 broiler chicks were randomly distributed between 9 treatments with 4 replicates (11 birds in each replicate). Dietary treatments consisted of three levels of vitamin E (0, 100 and 200 mg/ kg) and three levels of L-carnitine (0, 50 and 100 mg/ kg) that was done in completely randomized design with 3X3 factorial arrangement for 42 days. During the first three weeks, chickens were reared at normal temperature. From the beginning of the fourth week, all chickens were maintenance in a temperature range from 24-38 ° C for heat stress. Performance parameters including average feed intake, weight gain and feed conversion ratio were recorded weekly. The results showed that the levels of vitamin E had no significant effect on feed intake, weight gain and feed conversion ratio during the experiment. The use of L-carnitine decreased feed intake during the experiment (P < 0/05). But did not affect average daily gain and feed conversion ratio. Also, there was not significant interaction between vitamin E and L-carnitine for performance parameters except average daily gain during the starter period. The results of this study indicate that the use of different levels of vitamin E and L-carnitine under heat stress did not affected performance parameters of broiler chickens.

Keywords: broiler, heat stress, l-carnitine, performance

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Authors: Carolyn J. Ortega, Stephen E. Berger

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The role of the custody evaluator is perhaps one of the most controversial and risky endeavors in clinical practice. Complaints filed with licensing boards regarding a child-custody evaluation constitute the second most common reason for such an event. Although the evaluator is expected to answer for the family-law court what is in the “best interest of the child,” there is a lack of clarity on how to establish this in any empirically validated manner. Hence, practitioners must contend with a nebulous framework in formulating their methodological procedures that inherently places them at risk in an already litigious context. This study sought to qualitatively investigate patterns of practice among doctoral practitioners conducting child custody evaluations in the area of Southern California. Ten psychologists were interviewed who devoted between 25 and 100% of their California private practice to custody work. All held Ph.D. degrees with a range of eight to 36 years of experience in custody work. Semi-structured interviews were used to investigate assessment practices, ensure adherence to guidelines, risk management, and qualities of evaluators. Forty-three Specific Themes were identified using Interpretive Phenomenological Analysis (IPA). Seven Higher Order Themes clustered on salient factors such as use of Ethics, Law, Guidelines; Parent Variables; Child Variables; Psychologist Variables; Testing; Literature; and Trends. Evaluators were aware of the ever-present reality of a licensure complaint and thus presented idiosyncratic descriptions of risk management considerations. Ambiguity about quantifying and validly tapping parenting abilities was also reviewed. Findings from this study suggested a high reliance on unstructured and observational methods in child custody practices.

Keywords: forensic psychology, psychological testing, assessment methodology, child custody

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Ephrem Mebratu Dagnew, Mohammed Biset Ayalew, Gizework Alemnew Mekonnen, Alehegn Bishaw Geremew, Ousman Abubeker Abdela

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Objective: To assess the prevalence of drug-related problems and associated factors among adult psychiatric inpatients. Method: Hospital-based multicenter cross-sectional observational study was conducted from April to July 2021 at five randomly selected hospitals in North-west Ethiopia. A total of 325 consecutively sampled patients participated in the study. Clinical pharmacists assessed the DRPs based on clinical judgment supported by updated evidence-based diseases guidelines. A Medscape drug-interactions checker was used to check drug-drug interactions. The results were summarized using descriptive statistics, including frequency, mean, and standard deviation. Odds ratio (OR) with 95% confidence interval were also computed for each variable for the corresponding P-value. The value of P ≤ 0.05 was considered statistically significant. Result : From the total of 325 study participants, more than half of them (52.9%) were females and the mean age ± (standard deviation) was 30.8±11.3 years. At least one drug-related problem was recorded from 60.9%, 95% CI (55.7-65.8) of study participants with a mean of 0.6±0.49 per patient. Need additional drug therapy was the most common DRP (22.8%), followed by non-adherence to medicine (20.6%) and adverse drug reactions (11%), respectively. Factors independently associated with drug-related problems were rural residence [AOR=1.96,95%CI:1.01-2.84, P-value=0.046], self-employed [AOR=6.0 ,95% CI: 1.0-36.9, P-value=0.035] and alcohol drinkers [AOR=6.40,95%CI:1.12-37.5, p-value=0.034]. Conclusion: The prevalence of drug-related problems among adult psychiatric patients admitted to psychiatric wards was high. Healthcare providers give more attention to tackling these problems. Being a rural residence, self-employed, and Alcohol drinkers were associated with drug-related problems.

Keywords: psychiatric patients, drug-relatedproblems, multicenter, Ethiopia

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Authors: Aamina B. Hudaa, Rehana Akhtera, Massarat Hassana, Mir Monisab

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Mutton nuggets produced with the addition of apple pomace at the levels of 0% (Control), 5% (Treatment 1), 10% (Treatment 2), and 15% (Treatment 3) were evaluated for emulsion stability, cooking yield, pH, proximate composition, texture analysis and sensory properties. Apple pomace addition resulted in significantly higher (p ≤ 0.05) emulsion stability and cooking yield of treatments in comparison to control and pH values were significantly higher (p ≤ 0.05) for the control as compared to treatments. Among the treatments, the product with 15% apple pomace had significantly (p ≤ 0.05) highest moisture content, and protein, ash and fat contents were significantly (p ≤ 0.05) higher in control than treatment groups. Crude fiber content of control was found significantly (p ≤ 0.05) lower in comparison to nuggets formulated with 5%, 10% and 15% apple pomace and was found to increase significantly (p ≤ 0.05) with the increasing levels of apple pomace. Hardness of the products significantly (p ≤ 0.05) decreased with addition of apple pomace, whereas springiness, cohesiveness, chewiness and gumminess showed a non-significant (p ≥ 0.05) decrease with the levels of apple pomace. Sensory evaluation showed significant (p ≤ 0.05) reduction in texture, flavour and overall acceptability scores of treatment products; however the scores were in the range of acceptability and T-1 showed better acceptability among apple pomace incorporated treatments.

Keywords: Mutton nuggets, apple pomace, textural properties, sensory evaluation

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Muhammad Arsalan

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The efficiency of a financial intermediation system is assessed by its ability to achieve allocative efficiency, asset transformation, and the subsequent economic development. Islamic Banking and Finance (IBF) was conceived to serve as an alternate financial intermediation system adherent to the injunctions of Islam. A critical appraisal of the state of contemporary IBF reveals that it neither fulfills the aspirations of Islamic rhetoric nor is efficient in terms of asset transformation and economic development. This paper is an intuitive pursuit to explore the economic rationale of established principles of IBF, and the reasons of the persistent divergence of IBF being accused of ruses and sophistry. Disentangling the varying viewpoints, the underdevelopment of IBF has been attributed to misinterpretation of Riba, which has been explicated through a narrow fiqhi and legally deterministic approach. It presents a critical account of how incorrect conceptualization of the key injunction on Riba, steered flawed institutionalization of an Islamic Financial intermediation system. It also emphasizes on the wrong interpretation of the ontological and epistemological sources of Islamic Law (primarily Riba), that explains the perennial economic underdevelopment of the Muslim world. Deeming ‘a collaborative and dynamic Ijtihad’ as the elixir, this paper insists on the exigency of redefining Riba, i.e., a definition that incorporates the modern modes of economic cooperation and the contemporary financial intermediation ecosystem. Finally, Riba has been articulated in an agency theoretic framework to eschew expropriation of wealth, and assure protection of property rights, aimed at realizing the twin goals of a) Shari’ah adherence in true spirit, b) financial and economic development of the Muslim world.

Keywords: agency theory, financial intermediation, Islamic banking and finance, ijtihad, economic development, Riba, information asymmetry

Procedia PDF Downloads 128