Search results for: sleep-disordered breathing syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 935

Search results for: sleep-disordered breathing syndrome

365 A Case Study of Kinesthetic Intelligence Development Intervention on One Asperger Child

Authors: Chingwen Yeh, I. Chen Huang

Abstract:

This paper aims to conduct a case study on kinesthetic intelligence development intervention with a child who has Asperger symptom identified by physician. First, the characteristics of Asperger were defined based on the related literature. Some Asperger's people are born with outstanding insight and are good at solving complex and difficult problems. In contrast to high-functioning autistic, Asperger children do not lose their ability to express themselves verbally. However in the cognitive function, they focus mainly on the things they are interested in instead of paying attention to the whole surrounding situation. Thus it is difficult for them not only to focus on things that they are not interesting in, but also to interact with people. Secondly, 8-weeks of kinesthetic intelligence development courses were designed within a series of physical action that including the following sections: limbs coordination, various parts of body rhythm changes, strength and space awareness and breathing practice. In classroom observations were recorded both on words and with video as the qualitative research data. Finally, in-depth interview with the case child’s teachers, parents and other in class observers were documented on a weekly base in order to examine the effectiveness of before and after the kinesthetic intelligence development course and to testify the usefulness of the lesson plan. This research found that the case child has improved significantly in terms of attention span and body movement creativity. In the beginning of intervention, the case child made less eyes contact with others. The instructor needed to face the case child to confirm the eyes contact. And the instructor also used various adjective words as guiding language for all kinds of movement sequence practice. The result can cause the case child’s attention and learning motivation. And the case child understand what to do to enhance kinesthetic intelligence. These authors hope findings of this study can contribute as reference for the further research on the related topic.

Keywords: asperger symptom, body rhythm, kinesthetic intelligence, space awareness

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364 Seroprevalence of Middle East Respiratory Syndrome Coronavirus (MERS-Cov) Infection among Healthy and High Risk Individuals in Qatar

Authors: Raham El-Kahlout, Hadi Yassin, Asmaa Athani, Marwan Abou Madi, Gheyath Nasrallah

Abstract:

Background: Since its first isolation in September 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) has diffused across 27 countries infecting more than two thousand individuals with a high case fatality rate. MERS-CoV–specific antibodies are widely found in Dromedary camel along with viral shedding of similar viruses detected in human at same region, suggesting that MERS epidemiology may be central role by camel. Interestingly, MERS-CoV has also been also reported to be asymptomatic or to cause influenza-like mild illnesses. Therefore, in a country like Qatar (bordered Saudi Arabia), where camels are widely spread, serological surveys are important to explore the role of camels in MERS-CoV transmission. However, widespread strategic serological surveillances of MERS-CoV among populations, particularly in endemic country, are infrequent. In the absence of clear epidemiological view, cross-sectional MERS antibody surveillances in human populations are of global concern. Method: We performed a comparative serological screening of 4719 healthy blood donors, 135 baseline case contacts (high risk individual), and four MERS confirmed patients (by PCR) for the presence of anti-MERS IgG. Initially, samples were screened using Euroimmune anti- MERS-CoV IgG ELISA kit, the only commercial kit available in the market and recommended by the CDC as a screening kit. To confirm ELISA test results, farther serological testing was performed for all borderline and positive samples using two assays; the anti MERS-CoV IgG and IgM Euroimmune indirect immunofluorescent test (IIFT) and pseudoviral particle neutralizing assay (PPNA). Additionally, to test cross reactivity of anti-MERS-CoV antibody with other family members of coronavirus, borderline and positive samples were tested for the presence of the of IgG antibody of the following viruses; SARS, HCoV-229E, HKU1 using the Euroimmune IIFT for SARS and HCoV-229E and ELISA for HKU1. Results: In all of 4858 screened 15 samples [10 donors (0.21%, 10/4719), 1 case contact (0.77 %, 1/130), 3 patients (75%, 3/4)] anti-MERS IgG reactive/borderline samples were seen in ELISA. However, only 7 (0.14%) of them gave positive with in IIFT and only 3 (0.06%) was confirmed by the specific anti-MERS PPNA. One of the interesting findings was, a donor, who was selected in the control group as a negative anti-MERS IgG ELISA, yield reactive for anti-MERS IgM IIFT and was confirmed with the PPNA. Further, our preliminary results showed that there was a strong cross reactivity between anti- MERS-COV IgG with both HCoV-229E or anti-HKU1 IgG, yet, no cross reactivity of SARS were found. Conclusions: Our findings suggest that MERS-CoV is not heavily circulated among the population of Qatar and this is also indicated by low number of confirmed cases (only 18) since 2012. Additionally, the presence of antibody of other pathogenic human coronavirus may cause false positive results of both ELISA and IIFT, which stress the need for more evaluation studies for the available serological assays. Conclusion: this study provides an insight about the epidemiological view for MERS-CoV in Qatar population. It also provides a performance evaluation for the available serologic tests for MERS-CoV in a view of serologic status to other human coronaviruses.

Keywords: seroprevalence, MERS-CoV, healthy individuals, Qatar

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363 Variation in the Morphology of Soft Palate

Authors: Hema Lattupalli

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Introduction: The palate forms a partition between the oral cavity and nasal cavity. The palate is made up of two parts hard palate and soft palate. The Hard palate forms the anterior part of the palate, the soft palate forms a movable muscular fold covered by mucous membrane that is suspended from the posterior border of a hard palate. Aim and Objectives: Soft palate morphological variations have a great paucity in the literature. It’s also believed that the soft palate has no such important anatomical variations. There is a variable presentation of the soft palate morphology in the lateral cephalograms. The aim of this study is to identify the velar morphology. Materials and Methods: 100 normal subjects between the age group of 20 – 35 were taken for the study. Method: Lateral Cephalogram (radiologic study). Results: Different shapes of the soft palate were observed in the lateral cephalograms. The morphology of soft palate was classified into six types 1.Leaf like (50 cases) most common type, 2.Straight line (20 cases), 3.S shaped (4 cases) very rare, 4.Butt like (10 cases), 5. Rat tail (6 cases), 6. Hook shaped (10 cases). Conclusion: This classification helps us to understand the better diversity of the velar morphology in mid-sagittal plane. These findings help us to understand the etiology of OSAS.

Keywords: soft palate, cephalometric radiographs, morphology, cleft palate, obstructive sleep apnoea syndrome

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362 Tracing the Courtyard Typology from the Past: Highlighting a Need for Conservation in Case of Historic Settlement in Historic Town of Gwalior

Authors: Shivani Dolas, A. Richa Mishra

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The existence of Courtyards in India can be traced back to ‘Indus valley civilization’ and various layers of history bearing implications like socio-cultural, traditional, religious, climatic, etc., moreover serving as a breathing space in case of historical core areas. Over time, with the overlay of various historic layers within the historic urban cores and the present high density populace, the cores are getting congested day by day. In this case, courtyards may emerge out as an efficient medium to provide quality of life through livable spaces. Presently, with the growing population of the historic town of Gwalior, town in Madhya Pradesh holds remarkable essence of courtyards with its multiple concepts over time. Its scale and function varies from an imposing grand appearance in palatial form, up to functional practices as residential. Its privilege can also be drawn in urban forms, in sharing single space by multiple dwellings and in temples which can be sketched specifically in the region. Moreover, the effectiveness of courtyards has proven balance and control of micro-climate in such composite climate region. The research paper aims to underline the concept of courtyards in case of a mixed use neighborhood, Naya bazar, in Lashkar area of Gwalior, which developed during 19th century, highlighting the need of its preservation. The paper also elaborates its various implications on user-space relationship as in the present context, and growing congestion in the area, user and space relationship is seen lost. The noticeable change in the behavioral context in buildings and users can be noticed with the downfall of courtyards, isolating users with land. Also, a concern has been expressed on negligence of courtyard planning in future development, suggesting recommendations on preserving the courtyard typology as heritage.

Keywords: courtyards, Gwalior, historic settlement, heritage

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361 Management of Recurrent Temporomandibular Joint True Bony Ankylosis : A Case Report

Authors: Mahmoud A. Amin, Essam Taman, Ahmed Omran, Mahmoud Shawky, Ahmed Mekawy, Abdallah M. Kotkat, Saber Younes, Nehad N. Ghonemy, Amin Saad, Ezz-Aleslam, Abdullah M. Elosh

Abstract:

Introduction: TMJ is a one-of-a-kind, complicated synovial joint that helps with masticatory function by allowing the mandible to open and close the mouth. True ankylosis is a situation in which condylar movement is limited by a mechanical defect in the joint, whereas false ankylosis is a condition in which there is a restriction in mandibular movement due to muscular spasm myositis ossificans, and coronoid process hyperplasia. Ankylosis is characterized by the inability to open the mouth due to fusion of the TMJ condyle to the base of the skull as a result of trauma, infection, or systemic diseases such as rheumatoid arthritis (the most common) and psoraisis. Ankylosis causes facial asymmetry and affects the patient psychologically as well as speech, difficult mastication, poor oral hygiene, malocclusion, and other factors. TMJ is a technically challenging joint; hence TMJ ankylosis management is complicated. Case presentation: this case is a male patient 25 years old reported to our maxillofacial clinic in Damietta faculty of medicine, Al-Azhar University with the inability to open the mouth at all, with a history of difficulty of mouth breathing and eating foods, there was a history of falling from height at 2006, and the patient underwent corrective surgery before with no improvement because the ankylosis was relapsed short period after the previous operations with that done out of our hospital inter-incisor distant ZERO so, this condition need mandatory management. Clinical examination and radiological investigations were done after complete approval from the patient and his brother; tracheostomy was done for our patient before the operation. The patient entered the operation in our hospital and drastic improvement in mouth opening was noticed, helping to restore the physical psychological health of the patient.

Keywords: temporomandibular joint, TMJ, Ankylosis, mouth opening, physiotherapy, condylar plate

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360 School-Related Variables and Adolescents Substance Use

Authors: Nicolas Meylan, Eric Tardif

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Many studies have highlighted the links between substance use and school difficulties. However, most of these studies address only the consumption in terms of frequency without considering the different types of behavior (use, abuse, dependence). Moreover, little is known about the associations between substance use and variables such as school engagement and school burnout recently described as a positive state of mind and an exhaustion syndrome related to school, respectively. Through this study, we wish to describe and compare school-related variables in adolescents with different type of substance use. Our study focuses on 402 Swiss adolescents, aged between 14 and 19 years old. They responded collectively and anonymously to a set of scales assessing substance use and several school variables (social support, stress, burnout, engagement and school climate). First, results on frequency and severity of substance use are relatively close to those observed in other studies. Second, it also appears that certain dimensions of stress, burnout, engagement and school climate are associated with the frequency of alcohol and cannabis consumption. Finally, adolescents’ substance abusers show particularly high scores of burnout, cynicism and stress related to workload, which can be understand as self-medication behavior. Additional analyzes are underway to clarify these associations. Results are discussed in terms of implications for research and clinical practice in academic burnout.

Keywords: school burnout, school engagement, adolescence, substance use, self-medication

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359 Moved by Music: The Impact of Music on Fatigue, Arousal and Motivation During Conditioning for High to Elite Level Female Artistic Gymnasts

Authors: Chante J. De Klerk

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The potential of music to facilitate superior performance during high to elite level gymnastics conditioning instigated this research. A team of seven gymnasts completed a fixed conditioning programme eight times, alternating the two variable conditions. Four sessions of each condition were conducted: without music (session 1), with music (session 2), without music (3), with music (4), without music (5), and so forth. Quantitative data were collected in both conditions through physiological monitoring of the gymnasts, and administration of the Situational Motivation Scale (SIMS). Statistical analysis of the physiological data made it possible to quantify the presence as well as the magnitude of the musical intervention’s impact on various aspects of the gymnasts' physiological functioning during conditioning. The SIMS questionnaire results were used to evaluate if their motivation towards conditioning was altered by the intervention. Thematic analysis of qualitative data collected through semi-structured interviews revealed themes reflecting the gymnasts’ sentiments towards the data collection process. Gymnast-specific descriptions and experiences of the team as a whole were integrated with the quantitative data to facilitate greater dimension in establishing the impact of the intervention. The results showed positive physiological, motivational, and emotional effects. In the presence of music, superior sympathetic nervous activation, and energy efficiency, with more economic breathing, dominated the physiological data. Fatigue and arousal levels (emotional and physiological) were also conducive to improved conditioning outcomes compared to conventional conditioning (without music). Greater levels of positive affect and motivation emerged in analysis of both the SIMS and interview data sets. Overall, the intervention was found to promote psychophysiological coherence during the physical activity. In conclusion, a strategically constructed musical intervention, designed to accompany a gymnastics conditioning session for high to elite level gymnasts, has ergogenic potential.

Keywords: arousal, fatigue, gymnastics conditioning, motivation, musical intervention, psychophysiological coherence

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358 Visual, Zoological Metaphors and 'Urtiin Duu' (Long Song) in Alshaa, Inner Mongolia

Authors: Oyuna Weina

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This study examines how musicians use visual and zoological metaphors for singing technique and voice quality in a genre of traditional music called urtiin duu (‘long song’) in Alshaa, Inner Mongolia, China. Previous studies have discussed melodic contour in Mongol music, but little study of the intersection of singing technique, visual and zoological metaphors has yet been undertaken. The purpose of this study is to address this lack by analysing urtiin duu itself, traditional pedagogy and performances, all of which have been inspired and are assessed by reference to nature and mobile pastoral herding practices. This study investigates the visual and zoological metaphors related to urtiin duu especially colour, the shape of the circle and animals in the Mongol community. Urtiin duu singing is associated with certain colours in song texts, in selection of repertoire and in the status of singers. Musicians also use colour to describe timbre. These colours in turn reference worship of nature, religions, and daily practices of most Mongols in Alshaa. Moreover, voice quality and singing technique are often related to the animals not only in song text but also in the approach to breathing and to melodic contour. Additionally, the concept of boronhoi (‘the shape of circle’), not only is applied to the melodic contour but also to the voice quality and singing technique. These three factors illustrate the connections among nature, spiritual world and everyday herding life of Mongols. These different connections provide evidence of multi-layered meanings. In contemporary Alshaa, urtiin duu singers received Western musical training from the city and returned to their homelands to perform urtiin duu. In doing so, they are also trying to reconnect with the history, nature and spiritual world in order to achieve their ideal sound. Within a multicultural society, singers negotiate amongst themselves, and with ethnic groups, audiences and government officials. The power of the metaphor therefore assists and reconnects the strength of regional identity and ethnic identity in Alshaa.

Keywords: Alshaa, urtiin duu, visual, zoological metaphors

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357 Application of Crude Palm Oil Liquid Sludge Sewage On Maize (Zea mays. L) as Re-Cycle Possibility to Fertilizer

Authors: Hasan Basri Jumin, Henni Rosneti, Agusnimar

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Crude palm oil liquid sludge sewage was treated to maize with 400 cc/plant could be increased mean relative growth rates, net assimilation rate, leaf area and dry weight of seed. There are indicated that 400 cc / plant treated to maize significantly increase the average of mean relative growth rates into 0.32 g.day-1. Net assimilation rates increase from 13.5 mg.m-2.day-1 into 34.5 mg.m-2.day-1, leaf area at 50 days after planting increase from 1419 cm-2 into 2458 cm-2 and dry weight of seed from 38 g per plant into 43 g per plant. Crude palm oil liquid sludge waste chemical analysis indicated that, there are no exceed threshold content of dangerous metals and biology effects. Cadmium content as heavy metal is lower than threshold of human healthy tolerance. Therefore, it has no syndrome effect to human health. Biological oxygen demands and chemical oxygen demands as indicators for micro-organism activities, there are under the threshold of human healthy tolerance.

Keywords: crude-palm-oil, fertilizer, liquid-sludge, maize, pollutant, waste

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356 Phytochemical and Biological Study of Chrozophora oblongifolia

Authors: Al-Braa Kashegari, Ali M. El-Halawany, Akram A. Shalabi, Sabrin R. M. Ibrahim, Hossam M. Abdallah

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Chemical investigation of Chrozophora oblongifolia resulted in the isolation of five major compounds that were identified as apeginin-7-O-glucoside (1), quercetin-3-O-glucuronic acid (2), quercetin-3-O-glacturonic acid (3), rutin (4), and 1,3,6-trigalloyl glucose (5). The identity of isolated compounds was assessed by different spectroscopic methods, including one- and two-dimensional NMR. The isolated compounds were tested for their antioxidant activity using different assays viz., DPPH, FRAP, ABTS, ORAC, and metal chelation effects. In addition, the inhibition of target enzymes involved in the metabolic syndrome, such as alpha-glucosidase and pancreatic lipase, were carried out. Moreover, the effect of the compounds on the advanced glycation end-products (AGEs) as one of the major complications of oxidative stress and hyperglycemia in metabolic syndromes were carried out using BSA‐fructose (bovine serum albumin), BSA-methylglyoxal, and arginine methylglyoxal models. The pure isolates showed a protective effect in metabolic syndromes as well as promising antioxidant activity. The results showed potent activity of compound 5 in all measured parameters meanwhile, none of the tested compounds showed activity against pancreatic lipase.

Keywords: Chrozophora oblongifolia, antioxidant, pancreatic lipase, metabolic syndromes

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355 System Dietadhoc® - A Fusion of Human-Centred Design and Agile Development for the Explainability of AI Techniques Based on Nutritional and Clinical Data

Authors: Michelangelo Sofo, Giuseppe Labianca

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In recent years, the scientific community's interest in the exploratory analysis of biomedical data has increased exponentially. Considering the field of research of nutritional biologists, the curative process, based on the analysis of clinical data, is a very delicate operation due to the fact that there are multiple solutions for the management of pathologies in the food sector (for example can recall intolerances and allergies, management of cholesterol metabolism, diabetic pathologies, arterial hypertension, up to obesity and breathing and sleep problems). In this regard, in this research work a system was created capable of evaluating various dietary regimes for specific patient pathologies. The system is founded on a mathematical-numerical model and has been created tailored for the real working needs of an expert in human nutrition using the human-centered design (ISO 9241-210), therefore it is in step with continuous scientific progress in the field and evolves through the experience of managed clinical cases (machine learning process). DietAdhoc® is a decision support system nutrition specialists for patients of both sexes (from 18 years of age) developed with an agile methodology. Its task consists in drawing up the biomedical and clinical profile of the specific patient by applying two algorithmic optimization approaches on nutritional data and a symbolic solution, obtained by transforming the relational database underlying the system into a deductive database. For all three solution approaches, particular emphasis has been given to the explainability of the suggested clinical decisions through flexible and customizable user interfaces. Furthermore, the system has multiple software modules based on time series and visual analytics techniques that allow to evaluate the complete picture of the situation and the evolution of the diet assigned for specific pathologies.

Keywords: medical decision support, physiological data extraction, data driven diagnosis, human centered AI, symbiotic AI paradigm

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354 Effects of Physical Activity on the Association of CETP Gene with HDL Cholesterol Levels in Korean Population

Authors: Jae Woong Sull, Sun Ha Jee

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High-density lipoprotein (HDL) cholesterol levels are associated with decreased risk of coronary artery disease. Several genome-wide association studies (GWAS) for HDL cholesterol levels have implicated cholesterol ester transfer protein (CETP) as possibly causal. We tested for the association between single nucleotide polymorphisms (SNPs) in CETP gene and HDL cholesterol levels in Korean population. Subjects were selected from the Korean Metabolic Syndrome Research Initiative study in the Bundang-Gu area. A total of 2,304 individuals from Bundang-Gu were recruited in 2008. Other subjects were selected from the Severance Hospital (N=4,294). SNP rs6499861 in the CETP gene was associated with mean HDL cholesterol levels (effect per allele -2.044 mg/dL, p=7.23×10-7). Subjects with the CG/GG genotype had a 1.46 -fold (range 1.24–1.72-fold) higher risk of having abnormal HDL cholesterol levels (<40 mg/dL) than subjects with the CC genotype. When analyzed by gender, the association of CETP was stronger in women than in men. When analyzed by physical activity behavior, the association with CETP was much stronger in male subjects with low physical activity (OR=1.54, 95% CI: 1.23-1.92, P=0.0001) than in male subjects with high physical activity. This study clearly demonstrates that genetic variants in CETP influence HDL cholesterol levels in Korean adults.

Keywords: CETP, HDL cholesterol, physical activity, polymorphisms

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353 Liminality in Early Career Academic Identities: A Life History Approach

Authors: C. Morris, W. Ashall, K. Telling, L. Kadiwal, J. Kirby, S. Mwale

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This paper addresses experiences of liminality in the early career phase of academia. Liminality is understood as a process moving from one state (in this case of being non-academic) to another (of being academic), caught between or moving in and out these modes of being. Drawing on life-history methods, a group of academics jointly reflected on experiences of the early career. Primarily focused on the theme of imposter syndrome at this career stage, the authors identified feelings of non-belonging and lack of fit with the academy, tracing the biographical, political, and affective dimensions of such responses. Uncertainty around status within seemingly impermeable hierarchies and barriers to progression in combination with our intersectional positionings shaped by sexism, racism, ableism, and classism, led to experiences of liminality, having not yet fully achieved the desired and potentially illusionary status of established academic. Findings are contextualised within the authors’ contrasting disciplinary, departmental, and institutional settings against a backdrop of neoliberalised academia. The paper thereby contributes nuanced understandings of early-career academic identities at a time when this career stage is ever more ill-defined, extended, precarious and uncertain, exposing ongoing impacts of inequities in the contemporary academic milieu.

Keywords: early career, identities, intersectionality, liminality

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352 Anxiety and Depression in Chronic Headache Patients: Major Concern for Community Mental Health

Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan

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The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.

Keywords: anxiety, chronic headaches, depression, HAM-A, HAM

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351 O2 Saturation Comparison Between Breast Milk Feeding and Tube Feeding in Very Low Birth Weight Neonates

Authors: Ashraf Mohammadzadeh, Ahmad Shah Farhat, Azin Vaezi, Aradokht Vaezi

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Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant (<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.

Keywords: Very low birth weight (V.L.B.W), O2 Saturation, Breast Feeding, Tube Feeding

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350 Impact of HLA-C*03:04 Allele Frequency Screening Test in Preventing Dapsone-induced SCARs in Thais

Authors: Pear-Rarin Leelakunakorn, Patompong Satapornpong

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Introduction: Dapsone is an anti-inflammatory and antibiotic drug that was widely used for the treatment of leprosy, acne fulminans, and dermatitis herpetiformis (DH). However, dapsone is the main cause that triggers severe cutaneous adverse reactions (SCARs), with a possibility of 0.4 to 3.6% of patients after initiating treatment. In fact, the mortality rate of dapsone-induced SCARs is approximately 9.9%. In previous studies, HLA-B*13:01 was strongly associated with dapsone-induced SCARs in Han Chinese, Thais, and Koreans. Nevertheless, the distribution of HLA-B*13:01 marker in each population might differ. Moreover, there were found that the association between HLA-C*03:04 and dapsone hypersensitivity syndrome in Han Chinese leprosy patients by OR = 9.00 and p-value = 2.23×10⁻¹⁹. Objective: The aim of this study was to investigate the distribution of HLA-C* 03:04 in Thailand's healthy population. Method: A total of 350 participants were HLA-C genotyping used sequence-specific oligonucleotides (PCR-SSOs). This study was approved by the Ethics Committee of Rangsit University Result : The most frequency of HLA -C alleles in Thais, consist of HLA -C* 01:02 (17.00 %), -C*08:01 (11.00%) , -C*07:02 (10.70%) , -C* 03:04 ( 9.10%) , -C* 03:02 (8.00%) , -C* 07:01 (6.30%), -C* 07:04 (4.60%), -C* 04:01 (4.40%) ,-C* 12:02 ( 4.30% ) ,and -C* 04:03(3.90%). Interestingly, HLA -C* 03:04 allele was similar to the distribution among Thais and other populations such as Eastern Europe (6.09%), Vietnam (7.42% ), East Croatia (2.25%), and Han Chinese (11.70%). Conclusion: Consequently, HLA-C*03:04 might serve as a pharmacogenetic marker for screening prior to initiation therapy with dapsone for prevention of dapsone-induced SCARs in Thai population.

Keywords: HLA-C*03:04, SCARs, thai population, allele frequency

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349 Inhibition and Breaking of Advanced Glycation End Products with Nuts and Polyphenols

Authors: Moon Ho Do, Sin-Hee Park, Jae Hyuk Lee, Kyo Hee Cho, Jae Kyung Chae, Sun Yeou Kim

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Long-term hyperglycemic conditions associated with diabetes lead to the formation of advanced glycation end-products (AGEs). Highly reactive glucose metabolites, methylglyoxal (MGO) and glyoxal (GO), induced carbonyl stress and it may induce cellular damage, cross-linking of proteins, and glycation, playing an important role in the impairment of kidney function. Small molecules that have the ability to inhibit AGE formation, and even break preformed AGEs have a beneficial impact on metabolic syndrome, diabetes, and cancer. We quantified contents of polyphenols in nuts and investigated the protective effect of nuts and polyphenols on MGO-induced cytotoxicity in porcine kidney epithelial cells (LLC-PK1). Moreover, we evaluated the inhibitory effect of AGEs formation in the presence of MGO or GO and possess the ability to break preformed AGEs. In this study, we confirmed twenty polyphenols in diverse nuts using LC-MS/MS system. Nuts and polyphenols play a protective role in LLC-PK1 cells by reducing MGO-induced cytotoxicity. They could also prevent the formation of MGO or GO-mediated AGEs and Break AGEs crosslink. It can be surmised that increased consumption of nuts would be an effective means of preventing diabetic diseases.

Keywords: advanced glycation end products, LLC-PK1, methylglyoxal, nut, polyphenol

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348 CFD Simulation of the Pressure Distribution in the Upper Airway of an Obstructive Sleep Apnea Patient

Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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347 Important role of HLA-B*58:01 Allele and Distribution Among Healthy Thais: Avoid Severe Cutaneous Adverse Reactions

Authors: Jaomai Tungsiripat, Patompong Satapornpong

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Allopurinol have been used to treat diseases that relating with the reduction of uric acid and be a treatment preventing the severity of, including gout, chronic kidney disease, chronic heart failure, and diabetes mellitus (type 2). However, allopurinol metabolites can cause a severe cutaneous adverse reaction (SCARs) consist of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) and Stevens-Johnson Syndrome(SJS)/Toxic Epidermal Necrolysis (TEN). Previous studies, we found only HLA-B*58:01 allele has a strongly association with allopurinol-induced SCARs in many populations: Han Chinese [P value = 4.7 x 10−24], European [P value <10−6], and Thai [P value <0.001].However, there was no update the frequency of HLA-B alleles and pharmacogenetics markers distribution in healthy Thais and support for screening before the initiation of treatment. The aim of this study was to investigate the prevalence of HLA-B*58:01 allele associated with allopurinol-induced SCARs in healthy Thai population. A retrospective study of 260 individual healthy subjects who living in Thailand. HLA-B were genotyped using sequence-specific oligonucleotides (PCR-SSOs).In this study, we identified the prevalence of HLA-B alleles consist ofHLA-B*46:01 (12.69%), HLA-B*15:02 (8.85%), HLA-B*13:01 (6.35%), HLA-B*40:01 (6.35%), HLA-B*38:02 (5.00%), HLA-B*51:01 (5.00%), HLA-B*58:01 (4.81%), HLA-B*44:03 (4.62%), HLA-B*18:01 (3.85%) and HLA-B*15:25 (3.08%). Therefore, the distribution of HLA-B*58:01 will support the clinical implementation and screening usage of allopurinol in Thai population.

Keywords: allopurinol, HLA-B*58: 01, Thai population, SCARs

Procedia PDF Downloads 133
346 Clinical Outcomes of Neonates Born to COVID-19 Positive Mothers in a Tertiary Level Private Hospital

Authors: Patricia Abigail B. Miranda, Imelda A. Luna

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Introduction: COVID-19 infection is a novel viral illness that began as a local epidemic in December 2019 in Wuhan, China which quickly emerged into a pandemic by February 2020. The virus causes a spectrum of signs and symptoms, ranging from mild upper respiratory symptoms to acute respiratory distress syndrome, which may lead to death. Among children and neonates, those afflicted with the disease may present asymptomatically or with mild symptoms. To date, there has been limited local data that describes the outcomes of the growing number of COVID-19 cases, specifically in neonates. Methods: A cross-sectional study was conducted to determine the outcomes of neonates born to COVID-19 Positive Mothers from March 2020 until June 2022. The prevalence of COVID-19 among these neonates was also determined. Results: COVID-positive prevalence after 24 hours of life is at 8%, while prevalence after 48 hours among those who still underwent testing was at 13.51%. Moreover, among those COVID-19-negative neonates who had symptoms, they mostly presented with tachypnea (5.7%). The prevalence of complications among COVID-19-negative neonates delivered to COVID-19-positive mothers is 22.7%. Conclusion: Neonates born to COVID-19-positive mothers who yielded positive COVID-19 results are generally asymptomatic. Moreover, there are no associated mortalities among those who yielded positive results.

Keywords: COVID-19, neonates, outcomes, clinical profile

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345 Phenotype and Psychometric Characterization of Phelan-Mcdermid Syndrome Patients

Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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344 Database of Pharmacogenetics HLA-A*31:01 Allele in Thai Population and Carbamazepine-Induced SCARs

Authors: Watchawin Ekphinitphithaya, Patompong Satapornpong

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Introduction: Carbamazepine (CBZ) is one of the most prescribed antiepileptic drugs (AEDs) by neurologists and non-neurologist worldwide. CBZ is usually prescribed along with other drugs, leading to the possibility of severe cutaneous adverse drug reactions (SCARs). The HLA-B*15:02 is strongly associated with CBZ-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS–TEN) in the Han Chinese and other Asian populations but not in European populations, while HLA-A*31:01 allele has been reported to be associated with CBZ-induced SCARs in European population and Japanese. Objective: The aim of this study is to investigate the distribution of pharmacogenetics HLA-A*31:01 marker in a healthy Thai population associated with Carbamazepine-induced SCARs. Materials and Methods: Prospective study, 350 unrelated healthy Thais were recruited in this study. Human leukocyte antigen-A alleles were genotyped using PCR-sequence specific oligonucleotides (PCR-SSOs). Results: The frequency of HLA-A alleles were HLA-A*11:01 (190 alleles, 27.14%), HLA-A*24:02 (82 alleles, 11.71%), HLA-A*02:03 (80 alleles, 11.43%), HLA-A*33:03 (76 alleles, 10.86%), HLA-A*02:07 (58 alleles, 8.29%), HLA-A*02:01 (35 alleles, 5.00%), HLA-A*24:07 (29 alleles, 4.14%), HLA-A*02:06 – HLA-A*30:01 (15 alleles, 2.14%), and HLA-A*01:01 (14 alleles, 2.00%). Particularly, the number of HLA-A*31:01 alleles was 6 of 700 (0.86%) in the healthy Thai population. Many research presented varying distributions of HLA-A*31:01 in Asians, including 2% of Han Chinese, 9% of Japanese and 5% of Koreans. In addition, this allele was found approximately 2-5% in the Caucasian population. Conclusions: Thus, the pharmacogenetics database is vital to support in many populations, especially in Thais, for screening HLA-A*31:01 allele to avoid CBZ-induced SCARs before initiating treatments in each population.

Keywords: Carbamazepine, HLA-A*31:01, Thai population, pharmacogenetics

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343 Kluyveromyces marxianus ABB S8 as Yeast-Based Technology to Manufacture Low FODMAP Baking Good

Authors: Jordi Cuñé, Carlos de Lecea, Laia Marti

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Small molecules known as fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) are quickly fermented in the large intestine after being poorly absorbed in the small intestine. There is proof that individuals suffering from functional gastrointestinal disorders, like irritable bowel syndrome (IBS), observe an improvement while following a diet low in FODMAPs. Because wheat has a relatively high fructan content, it is a key source of FODMAPs in our diet. A yeast-based method was created in this study to lower the amounts of FODMAP in (whole wheat) bread. In contrast to fermentation by regular baker yeast, the combination of Kluyveromyces marxianus ABB S7 with Saccharomyces cerevisiae allowed a reduction of fructan content by 60% without implying the appearance of other substrates categorized as FODMAP (excess fructose or polyols). The final FODMAP content in the developed whole wheat bread would allow its classification as a safe product for sensitive people, according to international consensus. Cocultures of S. cerevisiae and K. marxianus were established in order to ensure sufficient CO₂ generation; larger quantities of gas were produced due to the strains' synergistic relationship. Thus, this method works well for lowering the levels of FODMAPs in bread.

Keywords: Kluyveromyces marxianus, bakery, bread, FODMAP, IBS, functional gastro intestinal disorders

Procedia PDF Downloads 47
342 Haemoperitoneum in a Case of Dengue Fever

Authors: Sagarjyoti Roy

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Dengue is an arboviral infection, belonging to family flaviviridae, comprising of four serotypes; DENV1, DENV2, DENV3 and DENV4. All four serotypes are capable of causing full-spectrum of clinical features, ranging from self-limiting fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Complications may affect any organ system, including those involving gastrointestinal system and serositis. We report a case, of a 28 years, non-alcoholic male, presenting with a 7 day history of fever and malaise followed by abdominal pain and distension, from 4th day of fever. He was admitted in medicine department of RG KAR medical college hospital. Dengue fever was confirmed by NS1 and dengue IgM positivity. Platelet count was 30,000/cc (1.5- 4 lac/cc) and haematocrit was 52% (38- 50% for men). Clinicoradiological findings revealed bilateral pleural effusion, ascites and splenomegaly. Ascitic fluid was hemorrhagic in nature, with a high protein and RBC content. Liver function tests revealed mild transaminitis with normal coagulation profile. Patient was managed conservatively. A diagnosis of dengue fever complicated by serositis and spontaneous haemoperitoneum was made. The symptoms subsided after a hospital stay of 10 days. The case highlights haemorrhage into peritoneal cavity as a possible complication of dengue fever. Although a definite explanation requires more detailed studies, platelet or endothelial cell dysfunction might be contributory.

Keywords: ascites, dengue, haemoperitoneum, serositis

Procedia PDF Downloads 257
341 Impact of Dairy Polysaccharides on Caloric Intake and Postprandial Metabolic Responses in Young Adults

Authors: Muhammad Umair Arshad, Saima Ishtiaq, Ali Imran

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Different polysaccharides contribute towards the management of glycemic and satiety and consequently manage the metabolic syndrome. In the present study, we compared the postprandial glycemic and satiety responses of different dietary polysaccharides when added to milk (2% Milk Fat). The objective of this study was to evaluate different polysaccharides against postprandial glucose, appetite responses, and food intake at subsequent meals. In a repeated measures crossover design, 30 females (18–30 years) consumed 250 ml milk with 2% M.F. (control), or milk with carrageenan (2.5 g), guar gum (2.5 g) and alginate (2.5 g), followed by an ad libitum pizza meal after 120 min. Alginate and guar gum addition resulted in lower caloric intake at subsequent pizza meal. The post-treatment (0–120 min) glucose and average appetite were suppressed by alginate and guar gum (p < 0.0001), with a more pronounced effect of guar gum. However, alginate resulted in lower blood glucose (p < 0.0001) compared with control and carrageenan during post-treatment. Alginate and guar gum, added milk, and other beverages would be beneficial in the short-term regulation of postprandial glycemia and satiety.

Keywords: satiety, glycemic control, milk polysaccharides, food intake

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340 Vapochromism of 3,3’,5,5’-Tetramethylbenzidine-Tetrasilisicfluormica Intercalation Compounds with High Selectivity for Water and Acetonitrile

Authors: Reira Kinoshita, Shin'ichi Ishimaru

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Vapochromism is a type of chromism in which the color of a substance changes when it is exposed to the vapor of volatile materials, and has been investigated for the application of chemical sensors for volatile organic compounds causing sick building syndrome and health hazards in workspaces. We synthesized intercalation compounds of 3,3',5,5'-tetramethylbenzidine (TMB), and tetrasilisicfluormica (TSFM) by the commonly used cation-exchange method with the cation ratio TMB²⁺/CEC of TSFM = 1.0, 2.0, 2.7 and 5.4 to investigate the vapochromism of these materials. The obtained samples were characterized by powder XRD, XRF, TG-DTA, N₂ adsorption, and SEM. Vapochromism was measured for each sample under a controlled atmosphere by a handy reflectance spectrometer directly from the outside of the glass sample tubes. The color was yellow for all specimens vacuum-dried at 50 °C, but it turned green under H₂O vapor exposure for the samples with TMB²⁺/CEC = 2.0, 2.7, and 5.4 and blue under acetonitrile vapor for all cation ratios. Especially the sample TMB²⁺/CEC = 2.0 showed clear chromism both for water and acetonitrile. On the other hand, no clear color change was observed for vapors of alcohols, acetone, and non-polar solvents. From these results, this material can be expected to apply for easy detection of humidity and acetonitrile vapor in the environment.

Keywords: chemical sensor, intercalation compound, tetramethylbenzidine, tetrasilisicfluormica, vapochromism, volatile organic compounds

Procedia PDF Downloads 106
339 Nutrient Foramina of the Lunate Bone of the Hand – an Anatomical Study

Authors: P.J. Jiji, B.V. Murlimanju, Latha V. Prabhu, Mangala M. Pai

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Background: The lunate bone dislocation can lead to the compression of the median nerve and subsequent carpal tunnel syndrome. The dislocation can interrupt the vasculature and would cause avascular necrosis. The objective of the present study was to study the morphology and number of the nutrient foramina in the cadaveric dried lunate bones of the Indian population. Methods: The present study included 28 lunate bones (13 right sided and 15 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the lunate bones. The foramen ranged between 2 and 10. The foramina were more in number over the dorsal surface (average number 3.3) in comparison to the palmar surface (average number 2.4). Conclusion: We believe that the present study has provided important data about the nutrient foramina of the lunate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the lunatomalacia and Kienbock’s disease.

Keywords: avascular necrosis, foramen, lunate, nutrient

Procedia PDF Downloads 241
338 Methodical Approach for the Integration of a Digital Factory Twin into the Industry 4.0 Processes

Authors: R. Hellmuth

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The orientation of flexibility and adaptability with regard to factory planning is at machine and process level. Factory buildings are not the focus of current research. Factory planning has the task of designing products, plants, processes, organization, areas and the construction of a factory. The adaptability of a factory can be divided into three types: spatial, organizational and technical adaptability. Spatial adaptability indicates the ability to expand and reduce the size of a factory. Here, the area-related breathing capacity plays the essential role. It mainly concerns the factory site, the plant layout and the production layout. The organizational ability to change enables the change and adaptation of organizational structures and processes. This includes structural and process organization as well as logistical processes and principles. New and reconfigurable operating resources, processes and factory buildings are referred to as technical adaptability. These three types of adaptability can be regarded independently of each other as undirected potentials of different characteristics. If there is a need for change, the types of changeability in the change process are combined to form a directed, complementary variable that makes change possible. When planning adaptability, importance must be attached to a balance between the types of adaptability. The vision of the intelligent factory building and the 'Internet of Things' presupposes the comprehensive digitalization of the spatial and technical environment. Through connectivity, the factory building must be empowered to support a company's value creation process by providing media such as light, electricity, heat, refrigeration, etc. In the future, communication with the surrounding factory building will take place on a digital or automated basis. In the area of industry 4.0, the function of the building envelope belongs to secondary or even tertiary processes, but these processes must also be included in the communication cycle. An integrative view of a continuous communication of primary, secondary and tertiary processes is currently not yet available and is being developed with the aid of methods in this research work. A comparison of the digital twin from the point of view of production and the factory building will be developed. Subsequently, a tool will be elaborated to classify digital twins from the perspective of data, degree of visualization, and the trades. Thus a contribution is made to better integrate the secondary and tertiary processes in a factory into the added value.

Keywords: adaptability, digital factory twin, factory planning, industry 4.0

Procedia PDF Downloads 148
337 Free Fibular Flaps in Management of Sternal Dehiscence

Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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336 Osteoporosis and Weight Gain – Two Major Concerns for Menopausal Women - a Physiotherapy Perspective

Authors: Renu Pattanshetty

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The aim of this narrative review is to highlight the impact of menopause on osteoporosis and weight gain. The review also aims to summarize physiotherapeutic strategies to combat the same.A thorough literature search was conducted using electronic databases like MEDline, PUBmed, Highwire Press, PUBmed Central for English language studies that included search terms like menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies from the year 2000 till date. Out of 157 studies that included metanalyses, critical reviews and randomized clinical trials, a total of 84 were selected that met the inclusion criteria. Prevalence of obesity is increasing world - wide and is reaching epidemic proportions even in the menopausal women. Prevalence of abdominal obesity is almost double than that general obesity with rates in the US with 65.5% in women ages 40-59 years and 73.8 in women aged 60 years or more. Physical activities and exercises play a vital role in prevention and treatment of osteoporosis and weight gain related to menopause that aim to boost the general well-being and any symptoms brought about by natural body changes. Endurance exercises lasting about 30 minutes /day for 5 days/ week has shown to decrease weight and prevent weight gain. In addition, strength training with at least 8 exercises of 8-12 repetitions working for whole body and for large muscle groups has shown to result positive outcomes. Hot flashes can be combatted through yogic breathing and relaxation exercises. Prevention of fall strategies and resistance training are key to treat diagnosed cases of osteoporosis related to menopause. One to three sets with five to eight repetitions of four to six weight bearing exercises have shown positive results. Menopause marks an important time for women to evaluate their risk of obesity and osteoporosis. It is known fact that bone benefit from exercises are lost when training is stopped, hence, practicing bone smart habits and strict adherence to recommended physical activity programs are recommended which are enjoyable, safe and effective.

Keywords: menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies

Procedia PDF Downloads 299