Search results for: novel quarantine-adjusted incidence

Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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Authors: Shahrzad Yektatalab, Agrin Mohammadi, Ladan Zarshenas

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Background: Misophonia is a severe emotional response to repetitive sounds. This disorder may limit a person's communication, reduce their ability, or disrupt their social and personal life. This study aims to determine the prevalence of Misophonia and its relationship with obsessive-compulsive disorder, anxiety, and depression in undergraduate students of XXX University of Medical Sciences. Methods: The present study is an analytical descriptive study conducted in October 2020. The study samples are 390 undergraduate students of XXX University of medical sciences. A relative and systematic sampling method was used. In this study, a demographic questionnaire, misophonia questionnaire (A score of 7 or higher is considered as misophonia), Beck anxiety questionnaire, Beck depression questionnaire, and Maudsley questionnaire were used, and the data were analyzed using SPSS 24 software. Due to the non-normality of the data, the Spearman correlation coefficient was used for analyzing data. The significance level was considered less than 0.05. Results: 23.8% of students have misophonia. Of the 390 participants in the study, 93 had experienced misophonia. Among these 93 students, 37 (39.8%) had obsessive-compulsive disorder, 8 (8.6%) had anxiety and 9 (9.7%) had depression. There was a significant and direct relationship between all variables (p <0.001), which means that with the increase of each disorder, the probability of an increase in other disorders increases. Conclusion: Due to the high prevalence of misophonia in students and its direct relationship with obsessive-compulsive disorder, anxiety, and depression, It is recommended that future studies be conducted to identify ways to prevent and reduce the incidence of misophonia.

Keywords: misophonia, obsessive-compulsive disorder, anxiety, depression

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Authors: Aamna Tufail, Catherine Anyanwu

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Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.

Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars

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Authors: Zunnu Raen Akhtar

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Cotton Leaf Curl Disease (CLCuD) is from Gemini virus and is transmitted through whiteflies in cotton. Transgenic cotton containing Antisense Coat Protein (ACP) has been found to show better results against CLCuD in cotton. In current research, Antisense Coat Protein was inserted in cotton plants to observe resistance developed in the cotton plants against CLCuD. T1 generation of plants were observed for its expression in plants. Tests were carried out to observe the expression of Antisense Coat Protein using Polymerase Chain Reaction (PCR) technique and by southern blotting. Whiteflies showing positive Cotton Leaf Curl Virus (CLCV) were reared and released in bioassay on ACP expressing cotton plants under laboratory as well as confined semi-field conditions. Results confirmed the expression of AC protein in PCR and southern blotting. Further laboratory results showed that cotton plants expressing AC protein showed rare incidence of CLCuD infection as compared to control. In the confined semi-field, similar results were observed in AC protein expressing cotton as compared to control. These results explicitly show that ACP can help to tackle the CLCuD issue in the future and further studies on biochemical processes involved in these plants and effects of ACP induction on non-target organisms should also be studied for eco-system.

Keywords: cotton, white flies, antisense coat protein, CLCV

Procedia PDF Downloads 185

Authors: Shima Behzadi

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Background: In many human malignant tumors, microRNA expression is aberrant. This study investigates miR-141 as a prognostic marker in colorectal cancer with K-Ras mutation. Materials and methods: In this case-control study, 100 patients, mostly over the age of 50, who were diagnosed with colorectal cancer were selected. The pathology department of the Mostoufi Pathobiology and Genetics Laboratory in Tehran confirmed the presence of colorectal cancer in samples of paraffin-embedded colon tissue. The case group was composed of patients with codon 12 and 13 mutations in exon 2 of the K-Ras gene, while tumor samples of individuals without these mutations in exon 2 of the K-Ras gene were selected as the control group, with patient consent. The changes in the expression of miR-141 were examined in both groups. Results: The study found that 20% of the patients tested positive for codon 12 mutation, and 10% of patients had codon 13 mutation. As a result, in 30 cases, there was a higher level of miR-141 expression. The miR-141 gene expression level in K-Ras positive tumor samples was 1.5 times higher than its expression level in K-Ras negative samples. This increase in expression was statistically significant, with a p-value of less than 0.001, indicating that the observed results are highly statistically significant. Conclusion: The study revealed that the incidence of typical K-Ras gene mutations among the colorectal cancer patients in the sample matches the national average in Iran. Additionally, the expression of miR-141 can serve as a useful biomarker to aid in the prognosis of colorectal cancer.

Keywords: colorectal cancer, K-Ras gene, miR-141 marker, real time PCR, electrophoresis

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Authors: Saifullah K., Muhammad Naziruddin Saifullah, Muhammad N.

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The bio control potential and mechanism of P. chlamydosporia against Meloidogyne incognita was evaluated in the present study. Under invitro conditions, P. chlamydosporia was tested for parasitism of eggs and females of M. incognita. The results indicated that this fungus parasitized 87% eggs and 82% females. Culture filtrate (CF) of P. chlamydosporia was tested for its larvicide activity against M. incognita 2nd stage juvenile. The maximum mortality was 97.3% at 100% concentration of the culture filtrate while minimum mortality was 7.3% in 25% concentration after 24 hrs. The result of the pot experiment proved that P. chlamydosporia has reduced the incidence of RKN and improved all tested agronomic growth parameters. The treatment with inoculated M. incognita alone reduced plant height, fresh shoot, and fresh root weight by 44.7%, 29.8%, and 32.8% respectively over uninoculated healthy control. Histopathological studies on the interaction of Pochonia chlamydosporia and Meloidogyne incognita on tomato roots revealed anatomical changes among treatments. Less number of galls with small in size and scarcer abnormalities in the vascular cylinder was observed in plants inoculated with P. chlamydosporia and M. incognita than the plants treated with nematode only. The fungus was seen in in the intercellular spaces of cortical and epidermal cells while the vascular bundles of the plant remain intact, inoculated only with P. chlamydosporia. In the infected roots, many mature females were seen which feed on giant cells. The findings also revealed that control healthy plants were not affected and no histological changes were noted.

Keywords: histopathology, Pochonia chlamydosporia, Meloidogyne incognita, tomato

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Authors: Kevin Molina, Daniel Ortega, Manuel Martinez, Andres Gonzalez-Estrada, William Pinto

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Due to the increasing environmental impact, the wind energy is getting strong. This research studied the relationship between the power produced by a horizontal axis wind turbine (HAWT) and the aerodynamic profiles used for its construction. The analysis is studied using the Computational Fluid Dynamic (CFD), presenting the parallel between the energy generated by a turbine designed with selected profiles and another one optimized. For the study, a selection process was carried out from profile NACA 6 digits recommended by the National Renewable Energy Laboratory (NREL) for the construction of this type of turbines. The selection was taken into account different characteristics of the wind (speed and density) and the profiles (aerodynamic coefficients Cl and Cd to different Reynolds and incidence angles). From the selected profiles, was carried out a sensitivity analysis optimization process between its geometry and the aerodynamic forces that are induced on it. The 3D model of the turbines was realized using the Blade Element Momentum method (BEM) and both profiles. The flow fields on the turbines were simulated, obtaining the forces induced on the blade, the torques produced and an increase of 3% in power due to the optimized profiles. Therefore, the results show that the sensitivity analysis optimization process can assist to increment the wind turbine power.

Keywords: blade element momentum, blade, fluid structure interaction, horizontal axis wind turbine, profile design

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Authors: Niall Fennessy, Charlotte Yin, Vineet Gorolay, Michael Chan, Ilias Drivas

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Background: The aim of this study was to evaluate the effect of manual aspiration of air from the pleural cavity in mitigating the need for chest drain placement after a CT-guided lung biopsy. Method: This is a single institution retrospective review of CT-guided lung biopsies performed on 799 patients between September 2013 and May 2021 in a major tertiary hospital. Percutaneous manual aspiration of air was performed in 104/306 patients (34%) with pneumothoraxes as a preventative measure. Simple and multivariate analysis was performed to identify independent risk factors (modifiable and nonmodifiable) for the success of manual aspiration in mitigating the need for chest drain insertion. Results: The overall incidence of pneumothorax was 37% (295/799). Chest drains were inserted for 81/295 (27%) of the pneumothoraxes, representing 81/799 (10%) of all CT-guided lung biopsies. Of patients with pneumothoraces, 104 (36%) underwent percutaneous aspiration via either the coaxial guide needle or an 18 or 20G intravenous catheter attached to a three-way stopcock and syringe. Amongst this group, 13 patients (13%) subsequently required chest drain insertion. The success of percutaneous aspiration in avoiding subsequent pleural drain insertion decreased with aspiration volume >500mL, radial pneumothorax depth >3cm, increased subpleural depth of the lesion, and the presence of background emphysema.

Keywords: computed tomography, lung biopsy, pneumothorax, manual aspiration, chest drainage

Procedia PDF Downloads 176

Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

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Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

Procedia PDF Downloads 75

Authors: Donna L. Roberts

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2019 marked 23 years since Purdue Pharma launched its flagship drug, OxyContin, that unleashed an unprecedented epidemic touching both celebrities and common citizens, metropolitan, suburbia and rural areas and all levels of socioeconomic status. From rural Appalachia to East LA individuals, families and communities have been devastated by a trajectory of addiction that often began with the legitimate prescription of a pain killer for anything from a tooth extraction to a sports injury to recovery from surgery or chronic arthritis. Far from being a serendipitous progression of events, the proliferation of this new breed of 'miracle drug' was instead a carefully crafted marketing program aimed at both the medical community and common citizens. This research represents and in-depth investigation of the evolution of the marketing, distribution and promotion of prescription opioids by pharmaceutical companies and its relationship to the propagation of the opioid crisis. Specifically, key components of Purdue Pharma’s aggressive marketing campaign, including its bonus system and sales incentives, were analyzed in the context of the sociopolitical environment that essential created the proverbial 'perfect storm' for the changing manner in which pain is treated in the U.S. The analyses of these series of events clearly indicate their role in first, the increase in prescription of opioids for non-terminal pain relief and subsequently, the incidence of related addiction, overdose, and death. Through this examination of the conditions that facilitated and maintained this drug crisis, perhaps we can begin to chart a course toward its resolution.

Keywords: addiction, opioid, opioid crisis, Purdue Pharma

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Authors: Mbuzeni Mathenjwa

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Upon their independence, most African countries adopted constitutions that proclaim respect for the rule of law. The decision to constitutionalise the rule of law is basically informed by the countries’ experience during the colonial era which was characterised by discrimination on various grounds including race, gender and religion. Despite the promise to be bound by and adhere to the rule of law, disrespect for the rule of law has become a norm in the African continent. This is evident from the reported incidence of abuse of power, failure to perform obligations imposed by law and flagrant disregard of the law by the Executive including the heads of states in the continent. In some African countries including South Africa, the courts of law have been approached to rule on the legality of the decisions of the executives, taken contrary to the prescripts of the law. South African Courts have laid down a number of decisions wherein they found that the conduct of the executive contravenes the rule of law. Consequently decisions of the executive have been declared invalid by courts. In this regard courts have become a safety net in preserving the rule of law in. Accordingly, this paper discusses the role of the courts in preserving the rule of law in Africa. This it does by explaining the notion of judicial independence and the doctrine of the rule of law. The explanation on the notion of judicial independence is relevant because only an independent judiciary can effectively review and set aside the decision of the executive including the president of a country. Furthermore, a comparative overview of the enforcement of the rule of law in African countries is done. The methods used for this research is literature review, and study of legislation and case law in selected African countries relating to the independence of the judiciary and the rule of law. Finally, a conclusion is drawn on the role of the independent judiciary to preserve the rule of law in Africa.

Keywords: Africa, constitutions, independence, judiciary

Procedia PDF Downloads 293

Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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Authors: Sara Lamari, Toufik Madani

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This study aimed to explore the relationship between reproduction performances and coat characteristics of Montbéliarde cows born in Algeria or imported from Europe during the hot season in Algeria. Hair coat traits (hair coat color, Hair Weight, hair length, the number of hair per unit area, total hair diameters and hair medulla diameters) were estimated in 18 imported cattle and 49 locally born cows. These traits were measured in an area of 20cm below the dorsal line in the center of the thorax. Results showed that hair coats were significantly different between locally born and imported cows. Imported cows had whiter coats when compared to locally born cows for Montbéliarde cows. A significant effect of total hair diameter was observed on the interval from calving to conception (IC) for imported Montbéliarde cows, suggesting less incidence of heat stress on reproduction efficiency of cows with thin diameter hair coats. Montbéliarde cows with short hair coat registered significantly more number of mating per conception (2, 28±1, 93 Vs. 1,67±0,92) and IC (98,04±78,81Vs 74.53 ± 35.60 days) when compared to cows with long hairs. Hair works as a temperature regulator in association with muscles in the skin and may affect reproduction performances during hit stress season. It can be assumed that the length and a total diameter of hairs for the Montbeliarde breed appears to be related to their reproductive efficiency.

Keywords: hair coat, reproduction, Montbeliarde cow, hot season

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Authors: Nuria Vargas, Frances Rodriguez

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Neotropical medium cities have opportunities to develop in a good manner. Xalapa City (Veracruz capital, Mexico) and its metropolitan region, near to the Gulf of Mexico, has already <1 million inhabitants, a medium city size, but it’s growing rapidly as several cities in Latin America. Inside a landscape where it had been a forest cloud and coffee land, emerges the city with an irregular topography. The rapid grow of the urbanization and the loss of vegetation has result in a change on the climate parameters. Frequently warms spells, floods and landslides had been impacted last 2 decades, also a higher incidence of dengue and diarrhea is mentioned in the region. Therefore, the analysis of hydrometeorological events is crucial to understand the role they play in its problem. The urbanization and others radiative forces has created a modulation that can explain the decadal climate changes on the Xalapa region. The Atlantic Multidecadal Oscillation directly influences the temperature and precipitation of the region, even more than climate change does. The total effect of these drivers can create a significant context that origin more risk. However, the most policies frequently consider only the climate change as a principal factor, but other drivers are important to consider and evaluate for the implementation of actions that improve our ambient and cities, in a context of climate change. Medium-sized cities could create better conditions for future citizens, preventing with urban planning that considers possible risks associated with weather and climate.

Keywords: natural variability, urbanization, atlantic multidecadal oscillation, land use changes

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Authors: M. Elder, L. Beech, A. Mackie

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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

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Authors: Parvin Mirmiran, Zahra Bahadoran, Nazanin Moslehi, Fereidoun Azizi

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Background and aim: We aimed to investigate the effects of green fruits and vegetables (green FV) consumption on the 3-year changes of cardiometabolic risk factors. Methods: This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 2006-2008 and 2009-2011, on 1272 adults. Dietary intake of green FV, including green cabbage, broccoli, lettuce, celery, green beans, green peas, cucumber, leafy vegetables, zucchini, green chili and bell pepper, and kiwi fruit, has been assessed by a validated semi-quantitative food frequency questionnaire at baseline and second examination. Demographics, anthropometrics and biochemical measures were evaluated at baseline and 3 years later. The associations of cardiometabolic risk changes with mean intake of green FV were estimated. Results: The mean age of men and women at baseline was 39.8±12.7 and 37.3±12.1 years, respectively. Mean intake of green FV was 152±77 g/d. More intake from green FV was accompanied to more intake of vitamin A, α and β-carotene, lutein, β-criptoxanthine, potassium, magnesium and fiber. Consumption of green FV was inversely associated with 3-year change of waist circumference (β= -0.07, P=0.01), total cholesterol (β= -0.11, P=0.01) and triglycerides (β= -0.13, P=0.01). Each 25 g/d increase in consumption of green FV decreased the incidence of hyper-triglyceridemia by 12% (OR:0.88, 95%CI:0.71-0.99) in men. In women, no significant association was observed between consumption of green FV with cardiometabolic risk factors. Conclusion: Higher consumption of green FV could have preventive effects against abdominal fat gain and lipid disorders.

Keywords: cardiometabolic risk factors, abdominal obesity, lipid disorders, fruits, vegetables

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Authors: Lazhar Belkhiri, Ammar Tiri, Lotfi Mouni, Fatma Elhadj Lakouas

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This study evaluates the surface water quality in the Kebir Rhumel Basin by analyzing hydrochemical parameters. To assess spatial and temporal variations in water quality, we applied the Water Quality Index (WQI), Mann-Kendall (MK) trend analysis, and hierarchical cluster analysis (HCA). Monthly measurements of eleven hydrochemical parameters were collected across eight stations from January 2016 to December 2020. Calcium and sulfate emerged as the dominant cation and anion, respectively. WQI analysis indicated a high incidence of poor water quality at stations Ain Smara (AS), Beni Haroune (BH), Grarem (GR), and Sidi Khalifa (SK), where 89.5%, 90.6%, 78.2%, and 62.7% of samples, respectively, fell into this category. The MK trend analysis revealed a significant upward trend in WQI at Oued Boumerzoug (ON) and SK stations, signaling temporal deterioration in these areas. HCA grouped the dataset into three clusters, covering approximately 22%, 30%, and 48% of the months, respectively. Within these clusters, specific stations exhibited elevated WQI values: GR and ON in the first cluster, OB and SK in the second, and AS, BH, El Milia (EM), and Hammam Grouz (HG) in the third. Furthermore, approximately 38%, 41%, and 38% of samples in clusters one, two, and three, respectively, were classified as having poor water quality. These findings provide essential insights for policymakers in formulating strategies to restore and manage surface water quality in the region.

Keywords: surface water quality, water quality index (WQI), Mann-Kendall Trend Analysis, hierarchical cluster analysis (HCA), spatial-temporal distribution, Kebir Rhumel Basin

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Authors: Kemka Ihemelandu, Chukwuemeka Ihemelandu

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Melanoma remains a public health crisis, with incidence rates increasing rapidly in the past decades. Improving diagnostic accuracy to decrease misdiagnosis using Artificial intelligence (AI) continues to be documented. Unfortunately, unintended racially biased outcomes, a product of lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone, have increasingly been recognized as a problem.Resulting in noted limitations of the accuracy of the Convolutional neural network (CNN)models. CNN models are prone to biased output due to biases in the dataset used to train them. Our aim in this study was the optimization of convolutional neural network algorithms to mitigate bias in the automated diagnosis of melanoma. We hypothesized that our proposed training algorithms based on a data augmentation method to optimize the diagnostic accuracy of a CNN classifier by generating new training samples from the original ones will reduce bias in the automated diagnosis of melanoma. We applied geometric transformation, including; rotations, translations, scale change, flipping, and shearing. Resulting in a CNN model that provided a modifiedinput data making for a model that could learn subtle racial features. Optimal selection of the momentum and batch hyperparameter increased our model accuracy. We show that our augmented model reduces bias while maintaining accuracy in the automated diagnosis of melanoma.

Keywords: bias, augmentation, melanoma, convolutional neural network

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Authors: Renata Josipovic, Ante Cvitkovic

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Particulate matter belongs to pollutants that can lead to respiratory problems or premature death due to exposure (long-term, short-term) to these substances, all depending on the severity of the effects. The importance of the study is to determine whether the existing climatic conditions in the period from January 1st to August 31st, 2018 increased the number of emergency interventions in Slavonski Brod with regard to pollutants hydrogen sulfide and particles less than 10 µm (PM10) and less than 2.5 µm (PM2.5). Analytical data of the concentration of pollutants are collected from the Croatian Meteorological and Hydrological Service, which monitors the operation of two meteorological stations in Slavonski Brod, as well as climatic conditions. Statistics data of emergency interventions were collected from the Emergency Medicine Department of Slavonski Brod. All data were compared (air pollution, emergency interventions) according to climatic conditions (air humidity and air temperature) and statistically processed. Statistical significance, although weak positive correlation PM2.5 (correlation coefficient 0.147; p = 0.036), determined PM10 (correlation coefficient 0.122; p = 0.048), hydrogen sulfide (correlation coefficient 0.141; p = 0.035) with max. temperature (correlation coefficient 0.202; p = 0.002) with number of interventions. The association between mean air humidity was significant but negative (correlation coefficient - 0.172; p = 0.007). The values of the influence of air pressure are not determined. As the problem of air pollution is very complex, coordinated action at many levels is needed to reduce air pollution in Slavonski Brod and consequences that can affect human health.

Keywords: emergency interventions, human health, hydrogen sulfide, particulate matter

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Authors: Mirza Sultan Ahmad, Mubashra Ahmad, Ramlah Mehmood, Nazia Mahboob, Waqar Nasir

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Objective: To ascertain the prevalence of thrombocytopenia and study changes in MPV and PDW among cases of vivax malaria. Design: Descriptive analytic study. Place and duration of study: Department of pediatrics, Fazle Omar Hospital, from January to December 2012. Methodology: All patients from birth to 16 years age, who presented in Fazle- Omar hospital, Rabwah from January to December 2012 were included in this study. Hundred patients with other febrile illnesses were taken as control. Full blood counts were checked by Madonic CA 620 analyzer. Name, age, sex, weight, platelet counts. MPV, PDW, any evidence of bleeding, outcome of cases included in this study and taken as control were recorded on data sheets. Results: One hundred and forty-two patients were included in this study. There was no incidence of death or active bleeding. Median platelet count was 109000/mm3. Thrombocytopenia was present in 108 (76.1%) patients. Severe thrombocytopenia was present in 10(7%) patients. Minimum count was 27000/mm3 and maximum was 341000/mm3. Platelet counts of control group was significantly more as compared with study group.(p<.001) Median MPV was 8.70. Minimum value was 6.40 and maximum was 11.90. MPV of study group was significantly more than control group.(p<.001) Median PDW was 11.30. Minimum value was 8.5 and maximum was 16.70. There was no difference between PDW of study and control groups (p=0.246). Conclusions: Thrombocytopenia is a common complication among pediatric cases of vivax malaria. MPV of cases of vivax malaria is higher than control group.

Keywords: malaria vivax, platelet, mean platelet volume, thrombocytopenia

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Authors: D. Zahraddeen, N. M. Lemu, P. P. Barje, I. S. R. Butswat

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This study was conducted to investigate some of the factors affecting the optimum reproductive capacity of the indigenous breeds of sheep in Nigeria. A total of 767 sheep of different breeds were investigated. The reproductive indices considered were birth/weaning weights, litter size, parity, mortality, reproductive problems/disorders, body condition score (BCS), as well as growth traits. The results showed that litter size, parity, and BCS had significant (p < 0.05) effects on birth/weaning weights, mortality rates and growth traits of the sheep breeds studied. Similarly, the rearing method/system significantly (p < 0.05) influenced other reproductive traits such as birth/weaning weights, mortality, growth performance of lambs. However, the major reproductive problems/disorders in the ewes were dystocia (30.94%), retained placenta (16.91%), mastitis (15.83), pregnancy toxaemia (11.51%), uterine prolapse (6.48%) and vaginal prolapse (3.24%). In the rams, the incidence of reproductive problems included cryptorchidism (1.08%), orchitis (2.87%) and scrotal dermatophilosis (1.79%), among others. This study concludes that the four breeds of sheep (Balami, Yankasa, Uda, and West African Dwarf sheep) and their crosses exhibited varied genetic make-up and potentials. However, the large number of sheep farmers practicing the extensive production system might be responsible for the low reproductive performance of this species in the country. It is, therefore, recommended that significant improvement could be achieved through enhanced management practices of these animals.

Keywords: sheep, breeds, reproduction, disorders

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Authors: Mohammadreza Ashouria, Majid Motamedzadeb

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Rapid Entire Body Assessment (REBA) and Quick Exposure Check (QEC) are two general methods to assess the risk factors of work-related musculoskeletal disorders (WMSDs). This study aimed to compare ergonomic risk assessment outputs from QEC and REBA in terms of agreement in distribution of postural loading scores based on analysis of working postures. This cross-sectional study was conducted in an engine oil company in which 40 jobs were studied. A trained occupational health practitioner observed all jobs. Job information was collected to ensure the completion of ergonomic risk assessment tools, including QEC, and REBA. The result revealed that there was a significant correlation between final scores (r=0.731) and the action levels (r =0.893) of two applied methods. Comparison between the action levels and final scores of two methods showed that there was no significant difference among working departments. Most of the studied postures acquired low and moderate risk level in QEC assessment (low risk=20%, moderate risk=50% and High risk=30%) and in REBA assessment (low risk=15%, moderate risk=60% and high risk=25%).There is a significant correlation between two methods. They have a strong correlation in identifying risky jobs and determining the potential risk for incidence of WMSDs. Therefore, there is a possibility for researchers to apply interchangeably both methods, for postural risk assessment in appropriate working environments.

Keywords: observational method, QEC, REBA, musculoskeletal disorders

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Authors: Hyoung Seok Kim

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Purpose: To evaluate the clinical characteristics and surgical outcomes of retinal detachment associated with atopic dermatitis. Methods: A retrospective investigation of clinical notes of 37 patients with retinal detachment associated with atopic dermatitis was conducted from January 2019 to December 2023. Initial visual acuity, medical history, type of retinal detachment, number of tears, types of treatment, success rate of treatment, and presence of cataract were investigated. To evaluate the relationship with cataract, the patients were classified into three groups according to lens status: group A (eyes with clear lens), group B (eyes with cataract), and group C (pseudophakic eyes). Results: Of the 37 patients, 29 were male and 8 were female; 10 patients had bilateral retinal detachment (27.0%). The retinal breaks were often located temporally (89.4%), with only 5 cases (10.6%) involving nasal-side retinal breaks. No significant differ ences were noted in the ratio of males to females, age distribution, visual acuity before and after treatments, axial length, and lo cation of retina breaks among the three groups. After primary surgery, retinal detachment recurred in 12 patients (14 eyes), 5 of whom were initially diagnosed with bilateral retinal detachment. In addition, 12 of 14 eyes underwent a second operation, in which detachment recurred in 3 eyes. Conclusions: Incidence of bilateral retinal detachment was high in patients with atopic dermatitis, and the retinal breaks were of ten found on the temporal side. Retinal re-detachment was statistically high in patients with cataract or pseudophakic eyes com pared to patients with clear lens (p = 0.024).

Keywords: retinal detachment, atopic dermatitis, cataract, retina surgery

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Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal

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Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.

Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil

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Authors: Dipanshu Sur, Ratnabali Chakravorty

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Background: Striae result from rapid expansion of the underlying tissue, e.g. during puberty, pregnancy or rapid weight gain. Prior data indicate that the incidence of stretch marks in Indian women is 77%.The hormonal and genetic factors are associated with their appearance. Recently that has been found skin extensibility, elasticity and rupture were strongly influenced by the water content of dermis and epidermis cells. Objective: The objectives were to assess the effects of topical treatments applied during pregnancy on the later development of stretch marks. Materials and methods: An open, prospective, randomized study was done on 120 pregnant women in whom skin elasticity and hydration as well as striae presence or apparition were measured at baseline and periodically until delivery. Patients were randomly assigned to application in wet skin cream, or in dry skin conditions. Results: The average basal hydration was 42 ±13 IU and the final was 46 ± 6 IU (P = 0.0325; 95% CI: -7.66 to -0.34), which difference was statistically significant. By measuring the moisture in the control region (forearm) a basal reading of 40 ± 9 IU and end of study of 38 ± 6; (p = 0.1547; 95% CI: -0.77 to 4.77) and this difference was considered to be not statistically significant. It was observed that at the end of the study, 55% women without ridges; mild ridges 5%; 36% moderate, and 4%, severe ridges. The proportion of women without grooves was 54% when the cream was applied studied wet skin and 45% when the cream was applied on dry skin. Conclusion: It was shown that cream under study increased hydration and elasticity of abdominal skin consequently in all subjects. This effect is more significant (54%) when the cream is applied to damp skin.

Keywords: striae gravidarum, skin moisturizer, skin hydration, skin elasticity

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Authors: Jummai Sekinat Seriki-Mosadolorun, Oyebamiji John Okesoto

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School-aged children in Eti-Osa Local Government Area, Lagos State, were surveyed to determine their food habits, environmental exposures and nutritional status. The method used in this study was a descriptive survey. A systematic questionnaire and anthropometric measurement scales were utilized to compile the data. Information about the children's environment, diets, and demographics were collected using a questionnaire. The children's Body Mass Index (BMI) was calculated using anthropometric measuring scales. The sample size of 400 people was determined by a multi-stage sampling procedure. Chi-square test mean, and Analysis of Variance were used to examine the data. The study's findings suggested that the quality of the children’s natural environments was fairly satisfactory. The youngsters had an unhealthy diet consisting mostly of high-calorie items, including fufu/yam/Eba/pounded yam, biscuits, bread, vegetables, soups, meat, and sweetened drinks. The incidence of malnutrition among school-aged children varied dramatically. The children's environmental quality, eating pattern, and nutritional status were also significantly related to one another (p <0.005). The research came to the conclusion that historic structures should be updated with current technology to promote healthy growth in children, and it suggests that this be done as a matter of strategy.

Keywords: environmental quality, dietary pattern, nutritional status, school-aged children., dietary pattern, school-aged children, nutritional status

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Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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Authors: Teja Joshi

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Laterality has shown to play a role in performance as well as injuries especially in unilateral sports disciplines. Uniquely, Artistic Gymnastics involves combination of unilateral, bilateral and complex multi-planer elements as well as gymnastics specific rotational preference. Therefore, this study was conducted to explore if any such preferences are associated with number of injuries in artistic gymnasts. To explore the association between lateral preferences, rotational preferences and injuries incidence in artistic gymnastics. Artistic gymnasts above 16 years of age, were invited to participate in an online survey. The survey included consent, lateral preference inventory, injury data collection according to anatomical locations and rotational preference for selected gymnastics elements performed on the floor exercise. SPSS version 24 was used to analyse Non-parametric data using Kruskal-Wallis (K- independent test) test. Multiple regression was performed to identify the predictor for injuries and their side in gymnasts. Total number of injuries per gymnast was associated with handedness (p value-0.049) and no significant association was noted for footdness (p value-0.207), eyedness (p value-0.491) and eardness (p value-0.798). Additionally, rotational preferences did not influence number of injuries (p value-0.521). In multiple regression, eyedness was identified as a predicting factor to determine the number of injuries. Rotational preferences were neither determined as a national strategy nor a product of lateral preference. Dominant hand had higher number of injuries in artistic gymnasts. Rotational preference is independent of laterality, number of injuries and nationality.

Keywords: sports injury, rotational preference, gymnastics, handedness

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Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola

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Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.

Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection

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Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

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Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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