Search results for: young patients

Authors: Veera J. Allu, Shreya Pal, Anang Pangeni

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Introduction: Adhesive small bowel obstruction (ASBO) is usually managed conservatively. Failed conservative management leads to operative intervention by an open approach. However, laparoscopic management of ASBO is increasingly being reported in the literature. We report an unusual case of ASBO secondary to a band from the appendicular tip which was managed laparoscopically. Case Description: This patient was a 61-year-old female, otherwise fit and healthy, presenting with abdominal pain and mild distension with vomiting of 3 days duration. She had undergone ultrasound-guided drainage of an appendicular abscess three months ago and laparoscopic right inguinal hernia repair (TEP) in the past. CTAP showed small bowel obstruction with a transition point in the pelvis and the possible cause being adhesions. She was initially managed conservatively; however, as she was not improving for two days, she was consented to diagnostic laparoscopy. Intraoperatively, an adhesive band was found between the appendicular tip and distal ileum around 100cm proximal to the ileocolic junction, resulting in mechanical bowel obstruction. Laparoscopic division of band was performed, followed by appendicectomy, and the patient had an uneventful recovery and was discharged on postoperative day 1. Conclusion: In highly selected patients and with appropriate expertise, laparoscopic management of ASBO is feasible and safe.

Keywords: bowel obstruction, adhesions, laparoscopy, open procedure

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Authors: Natasha Goh, Sebastian Brown

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Purpose: This case report describes an unusual presentation of uveal melanoma. Method: Case notes, imaging, and histopathological specimen were reviewed for this case report. Result: The patient is a 62-year-old lady of Chinese heritage who had been receiving follow-up at the eye clinic of a tertiary hospital. She had a longstanding history of poor vision in her right eye after sustaining trauma to the eye at age 3. She was found to have a carotid-cavernous sinus fistula in the right eye in 2009 and underwent stenting in China. Unfortunately, this was unsuccessful and resulted in a painful blind eye. She had represented with headaches, worsening eye pain, and ptosis in Sydney in 2016. Her CT angiogram showed a calcified vascular structure in the orbit and globe, and she was offered a digital subtraction angiography by the neurosurgical team, which she ultimately declined. She had since been followed up at the eye clinic for the pthisical eye. Due to chronic ocular pain and recurrent conjunctivitis, the decision was made for an evisceration in 2021. The specimen was sent for routine histopathological examination and returned positive for uveal melanoma. The patient was subsequently referred to a melanoma center for further follow-up, which comprised serial imaging and radiotherapy treatment. Conclusion: Clinicians should bear in mind that uveal melanomas may present in a longstanding phthisical eye and in patients with no or little apparent risk factors.

Keywords: uveal melanoma, pthisical eye, carotid cavernous fistula, uveal melanoma risk factors

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Authors: Bencharif Meriem, Sersar Ibrahim, Djaafri Zineb

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Introduction and purpose of the study: Education plays a fundamental role in the lives of young people, but what about their physical well-being as they spend long hours sitting at school? School inactivity is a problem that deserves particular attention because it can have significant repercussions on the health and development of students. The aim of this study was to describe and evaluate the physical activity of students in different practices in class, at recess and in the canteen. Material and methods: A physical activity diary and an anthropometric measurement sheet (weight, height) were provided to 123 school-aged adolescents. The measurements were carried out according to international recommendations. The statistical tests were carried out with the R software. 3.2.4. The significance threshold retained was 0.05. Results and Statistical Analysis: One hundred and twenty-three students agreed to participate in the study. Their average age was 16.5±1.60 years. Overweight was present in 8.13% and obesity in 4.06%. For the practice of physical activity, during physical education and sports classes, all students played sports with an average of 1.94±1.00 hours/week, of which 74.00% sweated or were out of breath during these hours of physical activity. It was also noted that boys practiced sports more than girls (p<0.0001). Each day, on average, students spent 39.78±37.85 min walking or running during recess. On the other hand, they spent, on average 4.25±2.65 hours sitting per day in class, at recess, in the canteen, etc., without counting the time spent in front of a screen. The increasing use of screens has become a major concern for parents and educators. On average, students spent approximately 42.90±38.41 min per day using screens in class, at recess, in the canteen and at home. (computer, tablet, telephone, video games, etc.) and therefore to a prolonged sedentary lifestyle. On average, students sat for more than 1.5 hours without moving for at least 2 minutes in a row approximately 1.72±0.71 times per day. Conclusion: These students spent many hours sitting at school. This prolonged inactivity can have negative consequences on their health, including problems with posture and cardiovascular health. It is crucial that schools, educators and parents collaborate to promote more active learning environments where students can move more and thus contribute to their overall well-being. It's time to rethink how we approach education and student health to give them a healthier, more active future.

Keywords: physical acivity, sedentarity, adolescents, school

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Authors: Manjunath A. P., Al-Ajmi G. M., Al Shukri M., Girija S

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Introduction: This study aimed to compare the ability of hysteroscopy and ultrasonography to diagnose uterine polyps. To correlate the ultrasonography and hystroscopic findings with various clinical factors and histopathology of uterine polyps. Methods: This is a retrospective study conducted at the Department of Obstetrics and Gynaecology at Sultan Qaboos University Hospital from 2014 to 2019. All women undergoing hysteroscopy for suspected uterine polyps were included. All relevant data were obtained from the electronic patient record and analysed using SPSS. Results: A total of 77 eligible women were analysed. The mean age of the patients was 40 years. The clinical risk factors; obesity, hypertension, and diabetes mellitus, showed no significant statistical association with the presence of uterine polyps (p-value>0.005). Although 20 women (52.6%) with uterine polyps had thickened endometrium (>11 mm), however, there is no statistical association (p-value>0.005). The sensitivity and specificity of ultrasonography in the detection of uterine polyp were 39% and 65%, respectively. Whereas for hysteroscopy, it was 89% and 20%, respectively. The prevalence of malignant and premalignant lesions were 1.85% and 7.4%, respectively. Conclusion: This study found that obesity, hypertension, and diabetes mellitus were not associated with the presence of uterine polyps. There was no association between thick endometrium and uterine polyps. The sensitivity is higher for hysteroscopy, whereas the specificity is higher for sonography in detecting uterine polyps. The prevalence of malignancy was very low in uterine polyps.

Keywords: endometrial polyps, hysteroscopy, ultrasonography, premalignant, malignant

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Authors: Amir Feily, Hazhir Shahmoradi Akram, Mojtaba Ghaedi, Farshid Javdani, Naser Hatami, Navid Kalani, Mohammad Zarenezhad

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Background: Filler-induced facial skin ischemia is a potential complication of dermal filler injections that can result in tissue damage and necrosis. Nitroglycerin has been suggested as a treatment option due to its vasodilatory effects, but its efficacy in this context is unclear. Methods: A narrative review was conducted to examine the available evidence on the efficacy of nitroglycerin in filler-induced facial skin ischemia. Relevant studies were identified through a search of electronic databases and manual searching of reference lists. Results: The review found limited evidence supporting the efficacy of nitroglycerin in this context. While there were case reports where the combination of nitroglycerin and hyaluronidase was successful in treating filler-induced facial skin ischemia, there was only one case report where nitroglycerin alone was successful. Furthermore, a rat model did not demonstrate any benefits of nitroglycerin and showed harmful results. Conclusion: The evidence regarding the efficacy of nitroglycerin in filler-induced facial skin ischemia is inconclusive and seems to be against its application. Further research is needed to determine the effectiveness of nitroglycerin alone and in combination with other treatments for this condition. Clinicians should consider limited evidence bases when deciding on treatment options for patients with filler-induced facial skin ischemia.

Keywords: nitroglycerin, facial, skin ischemia, fillers, efficacy, narrative review

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Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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Authors: Buse Bahitli, Samiye Mete

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The aim of the study was to evaluate the quality of sexual life of women with diagnosed gynecological cancer and receive treatment. The study was a descriptive and cross-sectional type, and it was carried out with 276 women. Information Form and Sexual Quality of Life Scale-Female (SQOL) form was used in the study. The data was evaluated using Mann-Whitney U and Kruskal-Wallis test. In the study, Sexual Quality of Life Scale-Female average score was 68.83 ± 21.17. The %43.1 of women was endometrial cancer, %30.8 was cervical cancer, %24.6 was ovarian cancer, and %1.4 was vulvar cancer. The average time to diagnosis of patients is 41.80 ± 47.64 months. There was no significant difference mean SQOL according to individual/sociodemographic characteristics like age, education. Gynecological cancer-related characteristics like gynaecological cancer type, treatment type, surgery type were found not to affect the mean score of SQOL. However, it was found that the difference was due to the higher SQOL score in the group with a diagnosis time of 25 months and over (X²KW= 6.356, p= 0.046). The reason of significant difference means SQOL according to diagnosis over time might be that women adapted to cancer diagnosis. While women with gynaecologic cancer are evaluating their sexual lives, it is necessary to evaluate them with good evaluation tools.

Keywords: gynecological cancers, sexuality, quality of sexual life, SQOL

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Authors: Nayer Mofidtabatabaei

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Advancements in artificial intelligence (AI) have transformed various fields, including psychology and behavioral sciences. This paper explores the diverse ways in which AI is applied to enhance research, diagnosis, therapy, and understanding of human behavior and mental health. We discuss the potential benefits and challenges associated with AI in these fields, emphasizing the ethical considerations and the need for collaboration between AI researchers and psychological and behavioral science experts. Artificial Intelligence (AI) has gained prominence in recent years, revolutionizing multiple industries, including healthcare, finance, and entertainment. One area where AI holds significant promise is the field of psychology and behavioral sciences. AI applications in this domain range from improving the accuracy of diagnosis and treatment to understanding complex human behavior patterns. This paper aims to provide an overview of the various AI applications in psychological and behavioral sciences, highlighting their potential impact, challenges, and ethical considerations. Mental Health Diagnosis AI-driven tools, such as natural language processing and sentiment analysis, can analyze large datasets of text and speech to detect signs of mental health issues. For example, chatbots and virtual therapists can provide initial assessments and support to individuals suffering from anxiety or depression. Autism Spectrum Disorder (ASD) Diagnosis AI algorithms can assist in early ASD diagnosis by analyzing video and audio recordings of children's behavior. These tools help identify subtle behavioral markers, enabling earlier intervention and treatment. Personalized Therapy AI-based therapy platforms use personalized algorithms to adapt therapeutic interventions based on an individual's progress and needs. These platforms can provide continuous support and resources for patients, making therapy more accessible and effective. Virtual Reality Therapy Virtual reality (VR) combined with AI can create immersive therapeutic environments for treating phobias, PTSD, and social anxiety. AI algorithms can adapt VR scenarios in real-time to suit the patient's progress and comfort level. Data Analysis AI aids researchers in processing vast amounts of data, including survey responses, brain imaging, and genetic information. Privacy Concerns Collecting and analyzing personal data for AI applications in psychology and behavioral sciences raise significant privacy concerns. Researchers must ensure the ethical use and protection of sensitive information. Bias and Fairness AI algorithms can inherit biases present in training data, potentially leading to biased assessments or recommendations. Efforts to mitigate bias and ensure fairness in AI applications are crucial. Transparency and Accountability AI-driven decisions in psychology and behavioral sciences should be transparent and subject to accountability. Patients and practitioners should understand how AI algorithms operate and make decisions. AI applications in psychological and behavioral sciences have the potential to transform the field by enhancing diagnosis, therapy, and research. However, these advancements come with ethical challenges that require careful consideration. Collaboration between AI researchers and psychological and behavioral science experts is essential to harness AI's full potential while upholding ethical standards and privacy protections. The future of AI in psychology and behavioral sciences holds great promise, but it must be navigated with caution and responsibility.

Keywords: artificial intelligence, psychological sciences, behavioral sciences, diagnosis and therapy, ethical considerations

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Authors: Farhaz Amyn Rajabali, Collins Odour

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Mathematics has been there for over 4000 years and has been one of the very first educational topics explored by human civilization. Throughout the years, it has become a complex study and has derived so many other subjects. With advancements in ICT, most of the computation in mathematics is done using powerful computers. In many different countries, the children in primary and secondary schools face difficulties in learning mathematics, and this has many reasons behind it, one being the students don’t engage much with the mathematical concepts hence failing to understand them deeply. The objective of this system is to help the students understand this mathematical concept interactively, which in return will encourage the love for learning and increase thorough understanding of many concepts. Research was conducted among a group of samples and about 50% of respondents replied that they had never used an augmented reality application before. This means that the chances for this system to be accepted in the market are high due to its innovative idea. Around 60% of people did recommend the use of this system to learn mathematics. The study also showed several challenges in an educational system, including but not limited to lack of resources which was chosen by 30% of respondents, the challenge to read from textbooks (34.6%) and how hard it is to visualize concepts (46.2%). The survey question asked what benefits the users see using augmented reality to learn mathematics. The responses that were picked the most were increased student engagement and using real-world examples to understand concepts, both being 65.4% and followed by easy access to learning material at 61.5%, and increased knowledge retention at 50%. This shows that there are plenty of issues with an education system that can be addressed by software applications; now that the newer generation is so enthusiastic about electronic devices, it can actually be used to deliver good knowledge and skills to the upcoming students and mitigate most of the challenges faced currently. The study concludes that the implementation of the system is a best practice for the educational system especially leveraging a new technology that has the ability to attract the attention of many young students and use it to deliver information. It will also give rise to awareness of new technology and on multiple ways it can be implemented. Addressing the educational sector in developing countries using information technology is an imperative task since these kids studying now is the future of the country and will use what they learn and understand during their childhood will help them to make decisions about their lives in the future which will not only affect them personally but also affect the whole society in general.

Keywords: AR, mathematics, system development, augmented reality

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Authors: Ghazi Chabchoub, Mouna Feki, Mohamed Abid, Hammadi Ayadi

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Autoimmune thyroid diseases (AITDs), including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT), are inherited as complex traits. Genetic factors associated with AITDs have been tentatively identified by candidate gene and genome scanning approaches. We analysed three intragenic microsatellite markers in the thyroid hormone receptor associated protein 2 gene (THRAP2), mapped near D12S79 marker, which have a potential role in immune function and inflammation [THRAP2-1(TG)n, THRAP2-2 (AC)n and THRAP2-3 (AC)n]. Our study population concerned 12 patients affected with AITDs belonging to a multiplex Tunisian family with high prevalence of AITDs. Fluorescent genotyping was carried out on ABI 3100 sequencers (Applied Biosystems USA) with the use of GENESCAN for semi-automated fragment sizing and GENOTYPER peak-calling software. Statistical analysis was performed using the non parametric Lod score (NPL) by Merlin software. Merlin outputs non-parametric NPLall (Z) and LOD scores and their corresponding asymptotic P values. The analysis for three intragenic markers in the THRAP2 gene revealed strong evidence for linkage (NPL=3.68, P=0.00012). Our results suggested the possible role of THRAP2 gene in AITDs susceptibility in this family.

Keywords: autoimmunity, autoimmune disease, genetic, linkage analysis

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Authors: M. J. Pourvaghar, M. E. Bahram, Sh. Khoshemehry

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Hyperlipidemia or an increase in blood lipids is a condition that has been rising, especially during the last decade, with the advancement of the life-span of the car, as an important disease. In fact, it is one of the complications of industrial life and semi-industrial. Hyperlipidemia alone is not a disease, but it is recognized as an important risk factor for coronary artery disease. The methodology of this review article is the use of research to provide the best solution for physical activity and exercise in relation to lowering blood lipids and lowering blood pressure. Also, factors that contribute to improving the health status of humans should be introduced. Research findings in this article show that physical activity with a specific duration and severity can keep a person away from the cardiovascular disease. The result shows that regular physical activity with low intensity and long periods of time is essential for human health. Physical mobility reduces blood pressure, reduces the harmful fats and does not cause cardiovascular disease. More than half of the patients suffering from cardiovascular problems are afflicted with blood lipids. On the other hand, high blood pressure is one of the serious health hazards in the world today, which causes a large number of cardiovascular problems and mortality in the world. Undoubtedly, the second most common risk factor for heart disease is high blood pressure after cigarette smoking.

Keywords: blood pressure, cardiovascular, hyperlipidemia, risk factor

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Data integration of health through connected services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. Such integration will support all wind of change in healthcare by being predictive, pre-emptive, personalized, problem-oriented and participatory. Prototyping a healthcare system that enables data integration has been a big challenge for healthcare for a long time. However, an innovative solution started to emerge by focusing on problem lists where everything can connect the problem list forming a growing graph. This notion was introduced by Dr. Lawrence Weed in early 70’s, but the enabling technologies weren’t mature enough to provide a successful implementation prototype. In this article, we are describing our efforts in prototyping Dr. Lawrence Weed's problem-oriented medical record (POMR) and his patient case schema (SOAP) to shape a prototype for connected health. For this, we are using the TypeGraphQL API and our enterprise-based QL4POMR to describe a Web-Based gateway for healthcare services connectivity. Our prototype has reported success in connecting to the HL7 FHIR medical record and the OpenTarget biomedical repositories.

Keywords: connected health, problem-oriented healthcare record, SOAP, QL4POMR, typegraphQL

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Authors: Yousif Mohamed Y. Abdallah

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This is an experimental study deals with detection, measurement and analysis of the periodic physiological organ motion during external beam radiotherapy; to improve the accuracy of the radiation field placement, and to reduce the exposure of healthy tissue during radiation treatments. The importance of this study is to detect the maximum path of the mobile structures during radiotherapy delivery, to define the planning target volume (PTV) and irradiated volume during both inspiration and expiration period and to verify the target volume. In addition to its role to highlight the importance of the application of Intense Guided Radiotherapy (IGRT) methods in the field of radiotherapy. The results showed (body contour was equally (3.17 + 0.23 mm), for left lung displacement reading (2.56 + 0.99 mm) and right lung is (2.42 + 0.77 mm) which the radiation oncologist to take suitable countermeasures in case of significant errors. In addition, the use of the image registration technique for automatic position control is predicted potential motion. The motion ranged between 2.13 mm and 12.2 mm (low and high). In conclusion, individualized assessment of tumor mobility can improve the accuracy of target areas definition in patients undergo Sterostatic RT for stage I, II and III lung cancer (NSCLC). Definition of the target volume based on a single CT scan with a margin of 10 mm is clearly inappropriate.

Keywords: respiratory motion, external beam radiotherapy, image processing, lung

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Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau

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Background: Preparing in the stress field (SF) is, increasingly, a concern for doctors of different specialties. Aims: The aim was to evaluate the importance of an e-learning program for doctors postgraduate courses, in SF. Methods: Doctors (n= 40 male, 40 female) of different specialties and ages (31-71 years), who attended postgraduate courses in SF, voluntarily responded to a questionnaire that included the following themes: Importance of SF courses for specialty practiced by each respondent doctor (using visual analogue scale, VAS); What SF themes would be indicated as e-learning (EL); Preferred form of SF information assimilation: Classical lectures (CL), EL or a combination of these methods (CL+EL); Which information on the SF course are facilitated by EL model versus CL; In their view which are the first four advantages and the first four disadvantages of EL compared to CL, for SF. Results: To most respondents, the SF courses are important for the specialty they practiced (VAS by an average of 4). The SF themes suggested to be done as EL were: Stress mechanisms; stress factor models for different medical specialties; stress assessment methods; primary stress management methods for different specialties. Preferred form of information assimilation was CL+EL. Aspects of the course facilitated by EL versus CL model: Active reading of theoretical information, with fast access to keywords details; watching documentaries in everyone's favorite order; practice through tests and the rapid control of results. The first four EL advantages, mentioned for SF were: Autonomy in managing the time allocated to the study; saving time for traveling to the venue; the ability to read information in various contexts of time and space; communication with colleagues, in good times for everyone. The first three EL disadvantages, mentioned for SF were: It decreases capabilities for group discussion and mobilization for active participation; EL information accession may depend on electrical source or/and Internet; learning slowdown can appear, by temptation of postponing the implementation. Answering questions was partially influenced by the respondent's age and genre. Conclusions: 1) Post-graduate courses in SF are of interest to doctors of different specialties. 2) The majority of participating doctors preferred EL, but combined with CL (CL+EL). 3) Preference for EL was manifested mainly by young or middle age men doctors. 4) It is important to balance the proper formula for chosen EL, to be the most efficient, interesting, useful and agreeable.

Keywords: stress field, doctors’ postgraduate courses, classical lectures, e-learning lecture

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Authors: Mohammad Karimizadehardakani, Hooman Minoonejad, Reza Rajabi, Ali Sharifnejad

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Background: Ankle sprain is one of the most important risk factor of anterior cruciate ligament (ACL) injury. Also, functional ankle instability (FAI) population has alterations in lower extremity sagittal plane biomechanics during landing task. We want to examine whether biomechanical alterations demonstrated by FAI patients are associated with the mechanism of ACL injury during high risk and sport related tasks. Methods: Sixteen basketball player with FAI and 16 non-injured control performed a single-leg cross drop landing. Knee sagittal and frontal (ATSF) was calculated. Independent t-tests, multiple linear regression, and Pearson correlation were used for analysis data. Result: Subject with FAI showed more peak ATFS, posterior ground reaction force (GRF) and less knee flexion, compared to the controls (P= 0.001, P= 0.004, P= 0.011). Knee flexion (r= −0.824, P = 0.011) and posterior GRF (r= 0.901, P = .001) were correlated with ATSF; Posterior GRF was factor that most explained the variance in ATSF (R2= 0.645; P = .001) in the FAI group. Conclusions: Result of our study showed there is a potential biomechanical relationship between the presence of FAI and risk factors associated with ACL injury mechanism.

Keywords: functional ankle instability, anterior cruciate ligament, biomechanics, risk factor

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Authors: Divyani Redhu, Manisha Rathaur

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India has emerged as a very lucrative market for the smartphones in a very short span of time. The number of smartphone users here is growing massively with each passing day. Also, the expansion of internet services to far corners of the nation has also given a push to the smartphone revolution in India. Millennial, also known as Generation Y or the Net Generation is the generation born between the early 1980s and mid-1990s (some definitions extending further to early 2000s). Spanning roughly over 15 years, different social classes, cultures, and continents; it is irrational to imagine that millennial have a unified identity. But still, it cannot be denied that the growing millennial population is not only young but is highly tech-savvy too. It is not just the appearance of the device that today; we call it ‘smart’. Rather, it is the numerous tasks and functions that it can perform which has led its name to evolve as that of a ‘smartphone’. From usual tasks that were earlier performed by a simple mobile phone like making calls, sending messages, clicking photographs, recording videos etc.; today, the time has come where most of our day – to – day tasks are being taken care of by our all-time companion, i.e. smartphones. From being our alarm clock to being our note-maker, from our watch to our radio, our book-reader to our reminder, smartphones are present everywhere. Smartphone has now become an essential device for particularly the millennial to communicate not only with their friends but also with their family, colleagues, and teachers. The study by the researchers would be quantitative in nature. For the same, a survey would be conducted in particularly the capital of India, i.e. Delhi and the National Capital Region (NCR), which is the metropolitan area covering the entire National Capital Territory of Delhi and urban areas covering states of Haryana, Uttarakhand, Uttar Pradesh and Rajasthan. The tool of the survey would be a questionnaire and the number of respondents would be 200. The results derived from the study would primarily focus on the increasing reach of smartphones in India, smartphones as technological innovation and convergent tools, smartphone usage pattern of millennial in India, most used applications by the millennial, the average time spent by them, the impact of smartphones on the personal interactions of millennial etc. Thus, talking about the smartphone technology and the millennial in India, it would not be wrong to say that the growth, as well as the potential of the smartphones in India, is still immense. Also, very few technologies have made it possible to give a global exposure to the users and smartphone, if not the only one is certainly an immensely effective one that comes to the mind in this case.

Keywords: Delhi – NCR, India, millennial, smartphone

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Authors: Fakunle Egbo, Kammalchukwu A., Akinremi T.

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Physical activity and nutritional status influence the health status and cognition of young adults. Lack of physical activity increases the likelihood of developing obesity which leads to the risk of heart diseases and other risk factors like high blood pressure, high blood cholesterol, diabetes etc. The study employed a cross-sectional study design. The study used a multi stage sampling technique multi- stage sampling technique; Purposive, for the selection of colleges that would be used, stratified random sampling for stratifying the colleges into departments and the simple random sampling for the selection of each respondent from the departments. Structured questionnaires were used to obtain data from the respondents and pre-tested anthropometric instruments were used to get the weight and height of the respondents and statistically analyzed using SPSS version 22.0 and the TDA (Total dietary allowance) software which was used to analyze the nutrient intake of the respondents. This study showed that they comprised of 50.1% males and 40.9% females. Slightly above average 51.8% were between ages of 15-19 with mean age being 19.57 years; ages 20-24 were slightly below average at 45.7%. The male students 58.7% had vigorous physical activity, whereas majority of females 76.5% had light physical activity level. 39.1% of the male students carried out physical activity 2-3 times per week while One third of the female students (38.3%) carried out physical activity 6-7 times per week. Majority of the respondents had Inadequate Protein- 63.8%, Carbohydrate- 60.2%, and Dietary fiber- 88.8. 36% eat rice 4-6 times per week. Majority of the respondents had inadequate fruit and vegetables (Efo, Banana,) at 47.7%, 40.6% respectively. Using Body mass index, (63.2%) have normal weight. 22.9% are overweight, 6.8% are underweight, 5.4% have grade 1 obesity and 1.6% have grade II obesity. There was a statistically significant association between the physical activity of the respondents with their nutritional status (p=0.037), physical activity and sex (p=0.000), nutritional status and amount spent on food daily (p=0.007). The study concluded that the physical activity level of the respondents, most especially the females were low; One third of the students were malnourished therefore, there should be an urgent need for improving the overall health status of students by providing the students with well-equipped gyms and other sporting equipment’s that would make them participate actively and keep fit.

Keywords: physical activity, nutritional status, undergraduates, dietary pattern

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Authors: Komal Fizza

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All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

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Authors: A. Saimen, E. Armstrong, C. Manitshana

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Intimate partner violence (IPV) has been recognised as a global human rights violation. It is universally under diagnosed and the institution of timeous multi-faceted interventions has been noted to benefit IPV victims. Currently, the concept of using a screening tool to detect IPV has not been widely explored in a primary healthcare setting in South Africa, and it was for this reason that this study has been undertaken. A systematic random sampling of 1 in 8 women over a period of 3 months was conducted prospectively at the OPD of a Level 1 Hospital. Participants were asked about their experience of IPV during the past 12 months. The WAST-short, a two-question tool, was used to screen patients for IPV. To verify the result of the screening, women were also asked the remaining questions from the WAST. Data was collected from 400 participants, with a response rate of 99.3%. The prevalence of IPV in the sample was 32%. The WAST-short was shown to have the following operating characteristics: sensitivity 45.2%, specificity 98%,positive predictive value 98%, negative predictive value 79%. The WAST-short lacks sufficient sensitivity and therefore is not an ideal screening tool for this setting. Improvement in the sensitivity of the WAST-short in this setting may be achieved by lowering the threshold for a positive result for IPV screening, and modification of the screening questions to better reflect IPV as understood by the local population.

Keywords: domestic violence, intimate partner violence, screening, screening tools

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Authors: Novutry Siregar, Afdal, Emilzon Taslim

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Hyaline Membrane Disease (HMD) is the main cause of respiratory failure in preterm neonates caused by surfactant deficiency. Nasal Continuous Positive Airway Pressure (NCPAP) is the therapy for HMD. The success of therapy is determined by gestational age, birth weight, HMD grade, time of NCAP administration, and time of breathing frequency recovery. The aim of this research is to identify the predictive factor of NCPAP therapy success in preterm neonates with HMD. This study used a cross-sectional design by using medical records of patients who were treated in the Perinatology of the Pediatric Department of Dr. M. Djamil Padang Central Hospital from January 2015 to December 2017. The samples were eighty-two neonates that were selected by using the total sampling technique. Data analysis was done by using the Chi-Square Test and the Multiple Logistic Regression Prediction Model. The results showed the success rate of NCPAP therapy reached 53.7%. Birth weight (p = 0.048, OR = 3.34 95% CI 1.01-11.07), HMD grade I (p = 0.018, OR = 4.95 CI 95% 1.31-18.68), HMD grade II (p = 0.044, OR = 5.52 95% CI 1.04-29.15), and time of breathing frequency recovery (p = 0,000, OR = 13.50 95% CI 3.58-50, 83) are the predictive factors of NCPAP therapy success in preterm neonates with HMD. The most significant predictive factor is the time of breathing frequency recovery.

Keywords: predictive factors, the success of therapy, NCPAP, preterm neonates, HMD

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Authors: Eliott Guérin, Remi Daudin, Georges Kalepsi, Alexis Lenain, Sebastien Gravier, Benoit Ter-Ovanessian, Damien Fabregue, Jean-Jacques Blandin

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Due to interesting compromise between mechanical and corrosion properties, Zr-based BMGs are attractive for biomedical applications. However, the enhancement of their glass forming ability (GFA) is often achieved by addition of toxic elements like Ni or Be, which is of course a problem for such applications. Consequently, the development of Ni-free Be-free Zr-based BMGs is of great interest. We have developed a Zr-based (Ni and Be-free) amorphous metallic alloy with an elastic limit twice the one of Ti-6Al-4V. The Zr56Co28Al16 composition exhibits a yield strength close to 2 GPa and low Young’s modulus (close to 90 GPa) [1-2]. In this work, we investigated Niobium (Nb) addition through substitution of Zr up to 8 at%. Cobalt substitution has already been reported [3], but we chose Zr substitution to preserve the glass forming ability. In this case, we show that the glass forming ability for 5 mm diameters rods is maintained up to 3 at% of Nb substitution using suction casting in cooper moulds. Concerning the thermal stability, we measure a strong compositional dependence on the glass transition (Tg). Using DSC analysis (heating rate 20 K/min), we show that the Tg rises from 752 K for 0 at% of Nb to 759 K for 3 at% of Nb. Yet, the thermal range between Tg and the crystallisation temperature (Tx) remains almost unchanged from 33 K to 35 K. Uniaxial compression tests on 2 mm diameter pillars and 3 points bending (3PB) tests on 1 mm thick plates are performed to study the Nb addition on the mechanical properties and the plastic behaviour. With these tests, an optimal Nb concentration is found, improving both plasticity and fatigue resistance. Through interpretations of DSC measurements, an attempt is made to correlate the modifications of the mechanical properties with the structural changes. The optimized chemical, structural and mechanical properties through Nb addition are encouraging to develop the potential of this BMG alloy for biomedical applications. For this purpose, we performed polarisation, immersion and cytotoxicity tests. The figure illustrates the polarisation response of Zr56Co28Al16, Zr54Co28Al16Nb2 and TA6V as a reference after 2h of open circuit potential. The results show that the substitution of Zr by a small amount of Nb significantly improves the corrosion resistance of the alloy.

Keywords: metallic glasses, amorphous metal, medical, mechanical resistance, biocompatibility

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Authors: Madhumita Sahu, S. S. Tiwary

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The Radiotherapy of Carcinoma Lung has always been difficult and a matter of great concern. The significant movement due to fractional motion caused due to non-rhythmic respiratory motion poses a great challenge for the treatment of Lung cancer using Ionizing Radiation. The present study compares the accuracy in the measurement of Target Volume using Slow-CT and 4DCT Imaging in SBRT for Lung Tumor. The experimental samples were extracted from patients with Lung Cancer who underwent SBRT. Slow-CT and 4DCT images were acquired under free breathing for each patient. PTV were delineated on Slow CT images. Similarly, ITV was also delineated on each of the 4DCT volumes. Volumetric and Statistical analysis were performed for each patient by measuring corresponding PTV and ITV volumes. The study showed (1) The Maximum Deviation observed between Slow-CT-based PTV and 4DCT imaging-based ITV is 248.58 cc. (2) The Minimum Deviation observed between Slow-CT-based PTV and 4DCT imaging-based ITV is 5.22 cc. (3) The Mean Deviation observed between Slow-CT-based PTV and 4DCT imaging-based ITV is 63.21 cc. The present study concludes that irradiated volume ITV with 4DCT is less as compared to the PTV with Slow-CT. A better and more precise treatment could be given more accurately with 4DCT Imaging by sparing 63.21 CC of mean body volume.

Keywords: CT imaging, 4DCT imaging, lung cancer, statistical analysis

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Authors: Michael Aupetit, Mahmoud Al-ismail, Khaled Mohamed

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Cancer is a major public health problem all over the world. Breast cancer has the highest incidence rate over all cancers for women in Qatar making its study a top priority of the country. Human cancer is a dynamic disease that develops over an extended period through the accumulation of a series of genetic alterations. A Darwinian process drives the tumor cells toward higher malignancy growing the branches of a progression tree in the space of genes expression. Although it is not possible to track these genetic alterations dynamically for one patient, it is possible to reconstruct the progression tree from the aggregation of thousands of tumor cells’ genetic profiles from thousands of different patients at different stages of the disease. Analyzing the progression tree is a way to detect pivotal molecular events that drive the malignant evolution and to provide a guide for the development of cancer diagnostics, prognostics and targeted therapeutics. In this work we present the development of a Visual Analytic web platform CanVis enabling users to upload gene-expression data and analyze their progression tree. The server computes the progression tree based on state-of-the-art techniques and allows an interactive visual exploration of this tree and the gene-expression data along its branching structure helping to discover potential driver genes.

Keywords: breast cancer, progression tree, visual analytics, web platform

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Authors: Paris Binos

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The present work investigates developmental aspects of the duration of isolated vowels in infants with normal hearing compared to those who received cochlear implants (CIs) before two years of age. Infants with normal hearing produced shorter vowel duration since this find related with more mature production abilities. First isolated vowels are transparent during the protophonic stage as evidence of an increased motor and linguistic control. Vowel duration is a crucial factor for the transition of prelexical speech to normal adult speech. Despite current knowledge of data for infants with normal hearing more research is needed to unravel productions skills in early implanted children. Thus, isolated vowel productions by two congenitally hearing-impaired Greek infants (implantation ages 1:4-1:11; post-implant ages 0:6-1:3) were recorded and sampled for six months after implantation with a Nucleus-24. The results compared with the productions of three normal hearing infants (chronological ages 0:8-1:1). Vegetative data and vocalizations masked by external noise or sounds were excluded. Participants had no other disabilities and had unknown deafness etiology. Prior to implantation the infants had an average unaided hearing loss of 95-110 dB HL while the post-implantation PTA decreased to 10-38 dB HL. The current research offers a methodology for the processing of the prelinguistic productions based on a combination of acoustical and auditory analyses. Based on the current methodological framework, duration measured through spectrograms based on wideband analysis, from the voicing onset to the end of the vowel. The end marked by two co-occurring events: 1) The onset of aperiodicity with a rapid change in amplitude in the waveform and 2) a loss in formant’s energy. Cut-off levels of significance were set at 0.05 for all tests. Bonferroni post hoc tests indicated that difference was significant between the mean duration of vowels of infants wearing CIs and their normal hearing peers. Thus, the mean vowel duration of CIs measured longer compared to the normal hearing peers (0.000). The current longitudinal findings contribute to the existing data for the performance of children wearing CIs at a very young age and enrich also the data of the Greek language. The above described weakness for CI’s performance is a challenge for future work in speech processing and CI’s processing strategies.

Keywords: cochlear implant, duration, spectrogram, vowel

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Authors: Monica Trifitriana, Rido Mulawarman

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Introduction: Androgenetic alopecia (AGA) is a genetically predetermined disorder due to an excessive response to dihydrotestosterone (DHT). Currently, non-surgical treatment of androgenetic alopecia is more in demand by the patient. There are many non-surgical treatments, ranging from topical treatments oral medications, and procedure treatments. Objective: We aim to assess the latest evidence of the efficacy of non-surgical treatments of androgenetic alopecia in men in comparison to placebo for improving hair density, thickness, and growth. Method: We performed a comprehensive search on topics that assess non-surgical treatments of androgenetic alopecia in men from inception up until November 2021. Result: There were 24 studies out of a total of 2438 patients divided into five non-surgical treatment groups to assess the effectiveness of hair growth, namely: minoxidil 2% (MD: 8.11 hairs/cm²), minoxidil 5% (MD: 12.02 hairs/cm²), low-level laser light therapy/LLLT (MD: 12.35 hairs/cm²), finasteride 1mg (MD: 20.43 hairs/cm²), and Platelete-Rich Plasma/PRP with microneedling (MD: 26.33 hairs/cm²). All treatments had significant results for increasing hair growth, particularly in cases of androgenetic alopecia in men (P<0.00001). Conclusion: From the results, it was found that the five non-surgical treatment groups proved to be effective and significant for hair growth, particularly in cases of androgenetic alopecia in men. In order of the best non-surgical treatment for hair growth is starting from PRP with microneedling, Finasteride 1mg, LLLT, minoxidil 5%, to minoxidil 2%.

Keywords: androgenetic alopecia, non-surgical, men, meta-analysis, systematic review

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Authors: Zhan Dong, Qiu Jianrong, Li Qinghui, Zhang Lei

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The quantity and quality of the papers published on sport science from 2001 to 2013 had been counted and analysed and compared with the papers published on the journal from 1990 to 2000. The result showed that: 1. In the sports medicine field, the proportion of basic/application was abnormal. Basic research was far more than the application research. The papers on researching of imitating altitude training was the main part. Gene research made great progress.The research on sport injury and medical supervision were lower and lower. Research on sports prescription had made much progress, especially in the patients of heart infarction. 2. In building up people’s health field, the research on the old people had been more and more compared with the 10 years before, but it was not enough. 3. In the field of sports psychology, the research on disable people had been more compared with the 10 years before. Solved the problem of the sportmen before the game. 4. In the field of sports biomechanics, it showed that methods had made great progress compared with the 10 years before. Sport biomechanics combined with sports medicine, helped the sportsmen in good condition in the game. 5. In the exercise training field, the experts pay more attention to the outstanding sportsmen, and the researches emphasized that biology knowledge is the main basic for them to the research.

Keywords: sport medicine, sport injury, medical supervision

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Authors: Maedeh Gharazi

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

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

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Authors: Rim Frikha, Maha Ben Jema, Moez Elloumi, Tarek Rebai

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Background: Acute lymphoblastic leukemia (ALL); a common blood cancer characterized by the interaction between genetic and environmental factors. Methylenetetrahydrofolate reductase (MTHFR) is an essential folate metabolic enzyme in the processes of DNA synthesis and methylation. A common functional variant of the MTHFR gene, the A1298C, which induces disturbances in folate metabolism, may affect susceptibility to ALL. Objective: The present study aimed to assess the prevalence of MTHFR polymorphism A1298 > C in Tunisian children with ALL. Materials and Methods: A total of 28 Tunisian ALL children were enrolled in this study. Genomic DNA was extracted from whole venous blood collected in ethylenediaminetetraacetic acid (EDTA). Genotyping was carried out with restriction fragment length polymorphism (RFLP) using MboII restriction enzyme. Genotype distribution and allele frequency of MTHFR A1298C was calculated in ALL patients. Results: The A1298C variant of MTHFR was found in 11(19.6%) heterozygous and one homozygous patient (3.5%). Conclusions: This result highlights that A1298C polymorphism of MTHFR is common in Tunisian childhood ALL and suggests that this variant may have a potential role in leukemogenesis. Genotyping of large samples and different ethnicities are required to validate these findings.

Keywords: methylenetetrahydrofolate reductase, acute lymphoblastic leukemia, A1298C variant, prevalence

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Authors: Mohamed Bakry Mohamed Ali, Mohamed Ehab El-Din Mustafa, Joseph Naiem Sabet Aziz, Sarah Mahmoud Ali Kaooh

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Background: Acute lung injury (ALI) is one of the major challenges in intensive care medicine. The most common extrapulmonary cause of ALI is sepsis, accounting more than 30% of the cases in humans. Lipopolysaccharide (LPS) has gained wide acceptance as a clinically relevant model of ALI. Lipopolysaccharide is a glycoprotein forming the major constituent of bacterial endotoxin. Losartan is angiotensin II type 1 (AT1) receptor antagonists. It is widely used for management of hypertension. It was recently suggested that losartan protects against septic ALI. It would thereby prevent LPS-induced ALI. Aim of the work and design of the experiment: This work investigated the injurious effect of lipopolysaccharide (LPS) and ALI on adult male albino rat at 24 hours and 14 days of LPS administration and the possible protective role of losartan pretreatment. LPS has deteriorated animal survival and behavior. It increased lung weight and induced lung histological damage. These changes could be much reduced by the losartan pretreatment. Conclusion: Administration of losartan before LPS could largely reduce these LPS/ ALI induced short and long term alterations. It could be recommended that patients susceptible to developing ALI, as in ICU, should receive a protective dose of angitensin II type 1 (AT1) receptor blocker as losartan.

Keywords: acute lung injury (ALI), lipopolysaccharide (LPS), losartan

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Authors: Adriana B. Ribeiro, Camila B. Araujo, Frank L. Bueno, Luiz Eduardo V. Silva, Caroline V. Fortes, Helio C. Salgado, Rubens Fazan Jr., Claudia H. L. da Silva

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Denture-related stomatitis (DRS) has recently been associated with deleterious cardiovascular effects, including hypertension. This study evaluated salivary parameters, blood pressure (BP) and heart rate variability (HRV), before and after DRS treatment in edentulous patients (n=14). Collection of unstimulated and stimulated saliva, as well as blood pressure (BP) measurements and electrocardiogram recordings were performed before and after 10 days of DRS treatment. The salivary flow (mL/min) was found similar at both times while pH was smaller (more neutral) after treatment (7.3 ± 2.2 vs. 7.1 ± 0.24). Systolic BP (mmHg) showed a trend, but not a significant reduction after DRS treatment (158 ± 25.68 vs. 148 ± 16,72, p=0,062) while diastolic BP was found similar in both times (86 ± 13.93 and 84 ± 9.38). Overall HRV, measured by standard deviation of RR intervals was not affected by DRS treatment (24 ± 4 vs 18 ± 2 ms), but differences of successive RR intervals (an index of parasympathetic cardiac modulation) increased after the treatment (26 ± 4 vs 19 ± 2 ms). Moreover, another index of vagal modulation of the heart, the power of RR interval spectra at high-frequency, was also markedly higher after DRS treatment (236 ± 63 vs 135 ± 32 ms²). Such findings strongly suggest that DRS is linked to an autonomic imbalance with sympathetic overactivity, which is markedly deleterious, increasing cardiovascular risk and the incidence of diseases such as hypertension. Acknowledgment: This study is supported by FAPESP, CNPq.

Keywords: biofilm, denture stomatitis, HRV, blood pressure

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