Search results for: young patients

Authors: Khaliun Nyambayar, Nomindari Azzaya, Batkhuyag Purevjav

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Pharmacovigilance was officially introduced in Mongolia in 2003, in accordance with the Health Minister Order 183 for the registry of adverse drug reactions (ADR), approved in 2006 and was reviewed in 2010. This study was designed to evaluate the incidence and common types of adverse drug reactions among hospitalized children, the frequency of adverse drug reaction reported by health care providers, and the follow-up processes resulting from adverse drug reactions. A retrospective study of paediatric patients who experienced an adverse drug reaction from 2015 to 2019, extracted from the “yellow” card at the State Research Center for Maternal and Child Health, (city). A total of 417 adverse drug reactions were reported with an overall incidence was 80 (21.5%). Adverse reactions resulting from the use of antibiotics (particularly gentamycin, cephalosporins, and vancomycin) were usually mild. ADR’s were reported by physicians and nurses (93.8%), pharmacists (6.25%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patient's medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. Measures to improve the detection and reporting of adverse drug reactions by all health care professionals should be improved, to enhance our understanding of the nature and impact of these reactions in children.

Keywords: adverse drug reaction, pediatric, yellow card, Mongolia

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Authors: Laila Ozola, Evita Straumite

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Celiac disease is a permanent enteropathy caused by the ingestion of gluten, a protein occurring in wheat, rye and barley. The only way of the effective daily treatment is a strict gluten-free diet. From the investigation of products available in the local market, it was found that Latvian producers do not offer gluten-free products. The aim of this research was to study and analyze changes of celiac patient’s attitude to gluten-free product quality and availability in the Latvian market and purchasing habits. The survey was designed using website www.visidati.lv, and a questionnaire was sent to people suffering from celiac disease. The first time the respondents were asked to fill in the questionnaire in 2011, but now repeatedly from the beginning of September 2013 till the end of January 2014. The questionnaire was performed with 75 celiac patients, respondents were from all Latvian regions and they answered 16 questions. One of the most important questions was aimed to find out consumers’ opinion about quality of gluten-free products, consumption patterns of gluten-free products, and, moreover, their interest in products made in Latvia. Respondents were asked to name gluten-free products they mainly buy and give specific purchase locations, evaluate the quality of products and necessity for products produced in Latvia. The results of questionnaire show that the consumers are satisfied with the quality of gluten-free flour, flour blends, sweets and pasta, but are not satisfied with the quality of bread and confectionery available in the Latvian markets.

Keywords: consumers, gluten-free products, quality, survey

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Authors: Andreas Kornmaaler Hansen, Carlos Gomez Cubero, Elizabeth Jochum

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The use of the arts in therapy and rehabilitation is well established, and there is growing recognition of the value of the arts for improving health and well-being across diverse populations. Combining arts with socially assistive robots is a relatively under-explored research area. This paper presents the results of a feasibility study conducted within an existing arts and health program to scope the possibility of combining visual arts with socially assistive robots to promote mental health and well-being. Using a participatory research design with participant-led perspectives, we present the results of our feasibility study with a collaborative drawing robot among an adult population with mild to severe mental illness. We identify key methodological challenges and advantages of working with participatory and human-centered approaches. Based on the results of three pilot workshops with participants and lay health workers, we outline suggestions for authentic engagement with real stakeholders toward the development of socially assistive robots in community health contexts. Working closely with a patient population at all levels of the research process is key for developing tools and interventions that center patient experience and priorities while minimizing the risks of alienating patients and communities.

Keywords: arts and health, visual art, health promotion, mental health, collaborative robots, creativity, socially assistive robots

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Authors: Mohamed El Kory Yacoub, Ahmed Bezeid El Mamy Beyatt, Djibril Barry, Yanogo Pauline, Nicolas Meda

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Introduction: Rift Valley Fever is a zoonotic arbovirosis that severely affects ruminants, as well as humans. It causes abortions in pregnant females and deaths in young animals. The disease occurs during heavy rains followed by large numbers of mosquito vectors. The objective of this work is to evaluate the surveillance system for Rift Valley Fever. Methods: We conducted an evaluation of the Rift Valley Fiver surveillance system. Data were collected from the analysis of the national database of the Mauritanian Network of Animal Disease Epidemiological Surveillance at the Ministry of Rural Development, of RVF cases notified from the whole national territory, of questionnaires and interviews with all persons involved in RVF surveillance at the central level. The quality of the system was assessed by analyzing the quantitative attributes defined by the Centers for Disease Control and Prevention. Results: In 2019, 443 cases of RVF were notified by the surveillance system, of which 36 were positive. Among the notified cases of Rift Valley Fever, the 0- to the 3-year-old age group of small ruminants was the most represented with 49.21% of cases, followed by 33.33%, which was recorded in large ruminants in the 0 to 7-year-old age group, 11.11% of cases were older than seven years. The completeness of the data varied between 14.2% (age) and 100% (species). Most positive cases were recorded between October and November 2019 in seven different regions. Attribute analysis showed that 87% of the respondents were able to use the case definition well, and 78.8% said they were familiar with the reporting and feedback loop of the Rift Valley Fever data. 90.3% of the respondents found it easy, while 95% of them responded that it was easy for them to transmit their data to the next level. Conclusions: The epidemiological surveillance system for Rift Valley Fever in Mauritania is simple and representative. However, data quality, stability, and responsiveness are average, as the diagnosis of the disease requires laboratory confirmation and the average delay for this confirmation is long (13 days). Consequently, the lack of completeness of the recorded data and of description of cases in terms of time-place-animal, associated with the delay between the stages of the surveillance system can make prevention, early detection of epidemics, and the initiation of measures for an adequate response difficult.

Keywords: evaluation, epidemiological surveillance system, rift valley fever, mauritania, ruminants

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Authors: Amanda de Oliveira Ferreira Leite, Ana Luiza del Pino Ferreira, Bruna Garcez Correa, Janaíne de Souza Mello, Marla Manquevich, Mirna Wetters Portuguez

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Objective: We sought to investigate a neuropsychological intervention focused on improving cognition, psychological aspects, and quality of life of elderly people with mild cognitive impairment. Method: A controlled and randomized study, blind to the evaluator, was executed. We evaluated 78 elderly people, divided into the neuropsychological and control groups, through a semi-structured interview, Addenbrooke’s Cognitive Examination, Katz Index, Lawton and Brody Scale, Geriatric Depression Scale, Beck Anxiety Inventory, Personal Development Scale, WHOQOL-bref and WHOQOL--old. Results: After the intervention, the neuropsychological group showed improvement in the cognitive subtests and in the total score, reduction in the frequency of symptoms associated with anxiety and depression, better psychological well-being, and quality of life. The research highlights useful intervention strategies for improving the general condition of these patients and rehabilitating damaged areas. Conclusion: We concluded that there is a relationship between neuropsychological intervention and improvement in cognitive and psychological performance, as well as in the quality of life in elderly people with mild cognitive impairment.

Keywords: aging, mild cognitive impairment, neuropsychology, quality of life

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Authors: Muhammad Mustaqeem, Musa Kaleem Baloch, Irfan Ullah, Ammarah Luqman, Afshan Ahmad

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Flurbiprofen is one of the most potent nonsteroidal anti-inflammatory drugs. It is widely used for relief of pain in patients suffering from rheumatic diseases, migraine, sore throat and primary dysmenorrhea. However, its aqueous solubility is very low and hinders the skin permeation. Thus, it is imperative to develop such a drug delivery systems which can improve its aqueous solubility and hence improve the skin permeation and therapeutic compliance. Microemulsions have been also proven to increase the cutaneous absorption of lipophilic drugs as compared to conventional vehicles. Micro-emulsion is thermodynamically stable emulsion that has the capacity to ‘hide/solubilize’ water-insoluble molecules within a continuous oil phase. Therefore, flurbiprofen was converted to Easters through chemical reactions with alcohols such as methanol, ethanol, propanol and butanol. The product was further treated with hydrazine to get hydrazide. The solubility of the parent drug Flurbiprofen and the products were solubilized in microemulsions formed using various surfactants like ionic, non-ionic and zwitterions. It has been concluded that the product was more soluble than the parent compound. The biological activities of these were also investigated. The outcome was very promising and the product was more active than the parent compound. It, therefore, concluded that in this way, we can not only enhance the solubility of the drug and increase its bioactivity, but also reduce the risk of stomach cancer.

Keywords: Flurbiprofen, microemulsion, surfactants, hyrazides

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Authors: Sulaiman A. Alrumman, Abd El-Latif Hesham

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Despite medical progress worldwide, dental caries are still widespread. Miswak is derived from the plant arak (Salvadora persica). It is used by Muslim people as a natural product for the cleansing of teeth, to ensure oral and dental hygiene. This study was designed to evaluate the antimicrobial effects of ethanol, methanol, and ethanol/methanol extracts of miswak against three bacterial pathogens of the oral cavity. The pathogens were isolated from the oral cavity of volunteers/patients and were identified on the basis of 16S rRNA gene amplification data. Sequence comparisons were made with 16S rRNA gene sequences available in the GenBank database. The results of sequence alignment and phylogenetic analysis identified the three pathogens as being Staphylococcus aureus strain KKU-020, Enterococcus faecalis strain KKU-021 and Klebsiella pneumoniae strain KKU-022. All miswak extracts showed powerful antimicrobial activity against the three pathogens. The maximum zone of inhibition (40.67±0.88 mm) was observed against E. faecalis with ethanolic extracts whilst methanolic extracts showed the minimum zone of inhibition (10.33±0.88 mm) against K. pneumonia KKU-022. Based on the significant effects of the miswak extracts against the oral cavity pathogens in our study, we recommend that miswak is to be used as a dental hygiene method to prevent tooth caries.

Keywords: antibacterial, miswak, Salvadora persica, oral cavity pathogens

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Authors: Evangelia-Chrysanthi Kouklari, Evdokia Tagkouli, Vassiliki Ntre, Artemios Pehlivanidis, Stella Tsermentseli, Gerasimos Kolaitis, Katerina Papanikolaou

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Executive Function (EF) is a set of goal-directed cognitive skills essentially needed in problem-solving and social behavior. Developmental EF research has indicated that EF emerges early in life and marks dramatic changes before the age of 5. Research evidence has suggested that it may continue to develop up to adolescence as well, following the development of the prefrontal cortex. Over the last decade, research evidence has suggested distinguished domains of cool and hot EF, but traditionally the development of EF in Autism Spectrum Disorder (ASD) has been examined mainly with tasks that address the “cool” cognitive aspects of EF. Thus, very little is known about the development of “hot” affective EF processes and whether the cross-sectional developmental pathways of cool and hot EF present similarities in ASD. Cool EF has also been proven to have a strong correlation with Theory of Mind (ToM) in young and middle childhood in typical development and in ASD, but information about the relationship of hot EF to ToM skills is minimal. The present study’s objective was to explore the age-related changes of cool and hot EF in ASD participants from middle childhood to adolescence, as well as their relationship to ToM. This study employed an approach of cross-sectional developmental trajectories to investigate patterns of cool and hot EF relative to chronological age within ASD. Eighty-two participants between 7 and 16 years of age were recruited to undertake measures that assessed cool EF (working memory, cognitive flexibility, planning & inhibition), hot EF (affective decision making & delay discounting) and ToM (false belief and mental state/emotion recognition). Results demonstrated that trajectories of all cool EF presented age-related changes in ASD (improvements with age). With regards to hot EF, affective decision-making presented age-related changes, but for delay discounting, there were no statistically significant changes found across younger and older ASD participants. ToM was correlated only to cool EF. Theoretical implications are discussed as the investigation of the cross-sectional developmental trajectories of the broader EF (cool and hot domains) may contribute to better defining cognitive phenotypes in ASD. These findings highlight the need to examine developmental trajectories of both hot and cool EF in research and clinical practice as they may aid in enhancing diagnosis or better-informed intervention programs.

Keywords: autism spectrum disorder, developmental trajectories, executive function, theory of mind

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Authors: Mohammed Qutishat, Loai Abu Sharour, Kholoud Al-Damery, Ibtisam Al Harthy, Sulaiman Al-Sabei

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Background: The 2019 coronavirus outbreak (COVID-19) has been declared a pandemic and has greatly affected both patients and healthcare workers. This study was conducted to explore the extent of posttraumatic stress disorder (PTSD) experiences among nurses as a result of the COVID-19 pandemic in Jordan. Method: This study used a cross-sectional study design with a convenience sampling approach. A sample of 259 participants completed the study questionnaires, including a sociodemographic questionnaire and the posttraumatic stress disorder checklist for DSM‐5, between May and July 2020. Result: The prevalence of PTSD among the study participants was 37.1%. The majority of study participants who exhibited PTSD symptoms presented the lowest level of PTSD (17%). The results indicated significant differences in overall COVID-19-related PTSD according to the participant’s age (F = 14.750, P = .000), gender (F = 30.340, P = .000), level of education (F = 51.983, P =.000), years of experience (F = 52.33, P = .000), place of work (F = 19.593, P = .000), and working position (F = 11.597, P = .000), as determined by one-way ANOVA. Conclusion: Nurses must be qualified and accredited to cope with reported PTSD cases and their consequences in relation to COVID-19 outbreaks. Close collaboration with a multidisciplinary team is required to recognise, manage, and encourage safety literacy among health care professionals and individuals diagnosed with or suspected of PTSD due to COVID-19 outbreaks or any other viral outbreaks.

Keywords: PTSD, nursing, coronavirus, pandemic, infectious disease

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Authors: M. Simon, O. Peillon, R. Seijas, P. Alvarez, A. Pérez-Bellmunt

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Introduction: Myofascial trigger points (MTrPs) are defined as hyperirritable areas within taut bands of skeletal muscle and classified as either active or latent. Although they could be present in any muscle, the triceps surae is one of the most affected of the lower limb. The aim of this study was described which treatments are more used and their principal results. Study design: We performed a systematic literature search using strategies for the concepts of “Trigger Points and Gastrocnemius and Soleus not Trapezius” in Medline. Articles were screened by authors and included if they contained a rehabilitation intervention of MTrPs in healthy subjects or patients. Results: The treatments used were mostly invasive interventions and only a small part of the studies used non-invasive treatments. The methodology (time o type of intervention, characteristics of treatment, etc.) used in these treatments were frequently undefined. Overall, examination variables varied significantly among the included studies, but they were improving their parameters when the MTrPs were treated. Conclusions: There are a high variety of physical therapy treatments to improve the symptomatology of MTrPs when affect triceps surae muscle. Even so, not a single study analyzing the skeletal muscle contractile parameters (as maximal displacement or delay time) change with MTrPS therapy has been found. The treatments have to better specificity the methodology used in the futures investigation.

Keywords: fascia, myofascial trigger points, physical therapy, triceps surae

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Authors: M. K. Yusuf, W. O. Hamman, U. E. Umana, S. B. Oladele

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Background: Dilatation of the inferior vena cava (IVC) is used as the ultrasonic diagnostic feature in patients suspected of congestive heart failure. The IVC diameter has been reported to vary among the various body mass indexes (BMI) and body shape indexes (ABSI). Knowledge of these variations is useful in precision diagnoses of CHF by imaging scientists. Aim: The study aimed to establish an equation for predicting the ultrasonic mean diameter of the IVC among the various BMI/ABSI of inhabitants of Azare, Bauchi State-Nigeria. Methodology: Two hundred physically healthy adult subjects of both sexes were classified into under, normal, over, and obese weights using their BMIs after selection using a structured questionnaire following their informed consent for an abdominal ultrasound scan. The probe was placed on the midline of the body, halfway between the xiphoid process and the umbilicus, with the marker on the probe directed towards the patient's head to obtain a longitudinal view of the IVC. The maximum IVC diameter was measured from the subcostal view using the electronic caliper of the scan machine. The mean value of each group was obtained, and the results were analysed. Results: A novel equation {(IVC Diameter = 1.04 +0.01(X) where X= BMI} has been generated for determining the IVC diameter among the populace. Conclusion: An equation for predicting the IVC diameter from individual BMI values in apparently healthy subjects has been established.

Keywords: equation, ultrasonic, IVC diameter, body adiposities

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Authors: Nandhana Vivek, Bhaskar Gogoi, Ayyavu Mahesh

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Breast cancer metastasis plays a key role in cancer progression and fatality. The present study examines the potential causes of metastasis in breast cancer by investigating the novel interactions between genes and their pathways. The gene expression profile of GSE99394, GSE1246464, and GSE103865 was downloaded from the GEO data repository to analyze the differentially expressed genes (DEGs). Protein-protein interactions, target factor interactions, pathways and gene relationships, and functional enrichment networks were investigated. The proliferation pathway was shown to be highly expressed in breast cancer progression and metastasis in all three datasets. Gene Ontology analysis revealed 11 DEGs as gene targets to control breast cancer metastasis: LYN, DLGAP5, CXCR4, CDC6, NANOG, IFI30, TXP2, AGTR1, MKI67, and FTH1. Upon studying the function, genomic and proteomic data, and pathway involvement of the target genes, DLGAP5 proved to be a promising candidate due to it being highly differentially expressed in all datasets. The study takes a unique perspective on the avenues through which DLGAP5 promotes metastasis. The current investigation helps pave the way in understanding the role DLGAP5 plays in metastasis, which leads to an increased incidence of death among breast cancer patients.

Keywords: genomics, metastasis, microarray, cancer

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Authors: Alsulami H., Alghamdi N., Alasker A., Almohen N., Shome D.

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Most conventional chemotherapeutic agents which are used for the treatment of cancers not only eradicate cancer cells but also affect normal hematopoietic Stem cells (HSCs) that leads to severe pancytopenia during treatment. Therefore, a need exists for novel approaches to treat cancer without or with minimum effect on normal HSCs. Parthenolide (PTL), a herbal product occurring naturally in the plant Feverfew, is a potential new chemotherapeutic agent for the treatment of many cancers such as acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL). In this study we investigated the effect of different PTL concentrations on the viability of normal HSCs and also on the ability of these cells to form colonies after they have been treated with PTL in vitro. Methods: In this study, 24 samples of bone marrow and cord blood were collected with consent, and mononuclear cells were separated using density gradient separation. These cells were then exposed to various concentrations of PTL for 24 hours. Cell viability after culture was determined using 7ADD in a flow cytometry test. Additionally, the impact of PTL on hematopoietic stem cells (HSCs) was evaluated using a colony forming unit assay (CFU). Furthermore, the levels of NFҝB expression were assessed by using a PE-labelled anti-pNFκBP65 antibody. Results: this study showed that there was no statistically significant difference in the percentage of cell death between untreated and PTL treated cells with 5 μM PTL (p = 0.7), 10 μM PTL (p = 0.4) and 25 μM (p = 0.09) respectively. However, at higher doses, PTL caused significant increase in the percentage of cell death. These results were significant when compared to untreated control (p < 0.001). The response of cord blood cells (n=4) on the other hand was slightly different from that for bone marrow cells in that the percentage of cell death was significant at 100 μM PTL. Therefore, cord blood cells seemed more resistant than bone marrow cells. Discussion &Conclusion: At concentrations ≤25 μM PTL has a minimum or no effect on HSCs in vitro. Cord blood HSCs are more resistant to PTL compared to bone marrow HSCs. This could be due to the higher percentage of T-lymphocytes, which are resistant to PTL, in CB samples (85% in CB vs. 56% in BM. Additionally, CB samples contained a higher proportion of CD34+ cells, with 14.5% of brightly CD34+ cells compared to only 1% in normal BM. These bright CD34+ cells in CB were mostly negative for early-stage stem cell maturation antigens, making them young and resilient to oxidative stress and high concentrations of PTL.

Keywords: stem cell, parthenolide, NFKB, CLL

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Authors: B. O. Olawale, C. R. Chatwin, R. C. D. Young, P. M. Birch, F. O. Faithpraise, A. O. Olukiran

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Ortho-rectification is the process of geometrically correcting an aerial image such that the scale is uniform. The ortho-image formed from the process is corrected for lens distortion, topographic relief, and camera tilt. This can be used to measure true distances, because it is an accurate representation of the Earth’s surface. Ortho-rectification and geo-referencing are essential to pin point the exact location of targets in video imagery acquired at the UAV platform. This can only be achieved by comparing such video imagery with an existing digital map. However, it is only when the image is ortho-rectified with the same co-ordinate system as an existing map that such a comparison is possible. The video image sequences from the UAV platform must be geo-registered, that is, each video frame must carry the necessary camera information before performing the ortho-rectification process. Each rectified image frame can then be mosaicked together to form a seamless image map covering the selected area. This can then be used for comparison with an existing map for geo-referencing. In this paper, we present a four-step ortho-rectification procedure for real-time geo-referencing of video data from a low-cost UAV equipped with multi-sensor system. The basic procedures for the real-time ortho-rectification are: (1) Decompilation of video stream into individual frames; (2) Finding of interior camera orientation parameters; (3) Finding the relative exterior orientation parameters for each video frames with respect to each other; (4) Finding the absolute exterior orientation parameters, using self-calibration adjustment with the aid of a mathematical model. Each ortho-rectified video frame is then mosaicked together to produce a 2-D planimetric mapping, which can be compared with a well referenced existing digital map for the purpose of georeferencing and aerial surveillance. A test field located in Abuja, Nigeria was used for testing our method. Fifteen minutes video and telemetry data were collected using the UAV and the data collected were processed using the four-step ortho-rectification procedure. The results demonstrated that the geometric measurement of the control field from ortho-images are more reliable than those from original perspective photographs when used to pin point the exact location of targets on the video imagery acquired by the UAV. The 2-D planimetric accuracy when compared with the 6 control points measured by a GPS receiver is between 3 to 5 meters.

Keywords: geo-referencing, ortho-rectification, video frame, self-calibration

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Authors: Aminu Yakubu Umar

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X-ray is the major contributor to the effective dose of both the patient and the personnel. Because of the radiological risks involved, it is usually recommended that dose to patient from X-ray be kept as low as reasonably achievable (ALARA) with adequate image quality. The implementation of quality assurance in diagnostic radiology can help greatly in achieving that, as it is a technique designed to reduce X-ray doses to patients undergoing radiological examination. In this study, quality control was carried out in six hospitals, which involved KVp test, evaluation of total filtration, test for constancy of radiation output, and check for mA linearity. Equipment used include KVp meter, Rad-check meter, aluminum sheets (0.1–1.0 mm) etc. The results of this study indicate that, the age of the X-ray machines in the hospitals ranges from 3-13 years, GHI and GH2 being the oldest and FMC being the newest. In the evaluation of total filtration, the HVL of the X-ray machines in the hospitals varied, ranging from 2.3-5.2 mm. The HVL was found to be highest in AHC (5.2 mm), while it was lowest in GH3 (2.3 mm). All HVL measurements were done at 80 KVp. The variation in voltage accuracy in the hospitals ranges from 0.3%-127.5%. It was only in GH1 that the % variation was below the allowed limit. The test for constancy of radiation output showed that, the coefficient of variation ranges from 0.005–0.550. In GH3, FMC and AHC, the coefficient of linearity were less than the allowed limit, while in GH1, GH2 and GH4 the coefficient of linearity had exceeded the allowed limit. As regard to mA linearity, FMC and AHC had their coefficients of linearity as 0.12 and 0.10 respectively, which were within the accepted limit, while GH1, GH3 and GH4 had their coefficients as 0.16, 0.69 and 0.98 respectively, which exceeded the allowed limit.

Keywords: radiation, X-ray output, quality control, half-value layer, mA linearity, KVp variation

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Authors: Mahmoud Tarek, Alaa Obeida, Mai Magdy, Khalid Hussein, Aly Shalaby

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Background: More doctors are complaining of burnout than before, Burnout is a state of physical and mental exhaustion caused by the doctor’s lifestyle, unfortunately, Medical errors are also more likely in those suffering from burnout and these may result in malpractice suits. Methodology: It is a retrospective audit of burnout response on all neonatologists over a 9 months period. We gathered data using burnout questionnaire, it was obtained from 23 physicians, the physicians divided into 5 categories according to the final score of the 28 questions in the questionnaire. Category 1 with score from 28-38 with almost no work stress, category 2 with score (38-50) who express a low amount of job related stress, category 3 with score (51-70) with moderate amount of stress, category 4 with score (71-90) those express a high amount of job stress and begun to burnout, category 5 with score (91 and above) who are under a dangerous amount of stress and advanced stage of burnout. Results: 33 neonatologists have received the questionnaire, 23 responses were sent back with a response rate of 69.6%. The results showed that 61% of physicians fall in category 4, 31% of the physician in category 5, while 8% of physicians equally distributed between category 2 and 3 (4% each of them). On the other hand, there is no physician present in category 1. Conclusion: Burnout is prevalent in SNICUs, So interventions to minimize burnout prevalence may be of greater importance as this may be reflected indirectly on medical conditions of the patients and physicians, efforts should be done to decrease this high rate of burnout.

Keywords: Cairo, work overload, exhaustion, surgery, neonatal ICU

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Authors: Gezahegn Bekele Welldgiyorgise

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It is obvious that the economics, politics and social conditions of a country are determined by the quality and standard of its education. Indeed, education plays a vital role in changing the consciousness and awareness of society and transforming it on a large scale. Moreover, education contributes a lot to the advancement of science and technology, information and communication, and above all, it speeds up its progress in no time if it focuses mainly on the qualitative approach to education. Education brings about universal change and transformation and lightens mankind in all dimensions. It creates an educated, enlightened and brightened generation in society. The generation will be sharped, sharpened and well-oriented if it gets modern, sophisticated and standardized education in its field of study. The main goal of education is to produce well-qualified, well-trained and disciplined young offers in a given community. If the youth is well trained and well-mannered, he will certainly be enlightened, problem solvers and solution seekers, researchers, and innovators. In this respect, we have to provide the youth with modern education, a teaching-learning process led by active learning and a participatory approach with a new curriculum preparation for the age of children supported by modern facilities (ICT).In addition to that, the curriculum should have to give attention to mathematics and science lessons that include international experience in a comfortable school and classrooms. Therefore, the generation that will be created through such kinds of the guided education system will make the students active participants, self-confident, researchers and problem solvers, besides that result in changed life standards and a developed country. Similarly, our country, Ethiopia, has aimed to get such change in youth (generation) through modern education, designing a new educational policy and curriculum which was implemented for many years, although the goal of education has not reached the required level. To get the main idea of the article, I should have answered the question of why our country's educational goal had not reached the desired level because it is necessary to lay the foundation for research in finding out problems seen through students learning performance, the first task is selecting primary-school as a sample. Therefore, we selected “Dilla primary school (5-8)” which is a workplace for a teacher and gives me a chance to recognize students’ learning performance to recognize their learning grades (internal and external) and measure performance (achievement) of students easily’.

Keywords: curriculum, performance, innovation, learning

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Authors: Adriana De Serio, Donato Forenza

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Aims. In this experimental research the Authors present the methodological plan “Musictherapy and Gardentherapy” that they created interconnected with the garden landscape ecosystems and aimed at PsychoPhysical Disability (MusGarPPhyD). In the context of the environmental education aimed at spreading the landscape culture and its values, it’s necessary to develop a solid perception of the environment sustainability to implement a multidimensional approach that pays attention to the conservation and enhancement of gardens and natural environments. The result is an improvement in the life quality also in compliance with the objectives of the European Agenda 2030. The MusGarPPhyD can help professionals such as musictherapists and environmental and landscape researchers strengthen subjects' motivation to learn to deal with the psychophysical discomfort associated with disability and to cope with the distress and the psychological fragility and the loneliness and the social seclusion and to promote productive social relationships. Materials and Methods. The MusGarPPhyD was implemented in multiple spaces. The musictherapy treatments took place first inside residential therapeutic centres and then in the garden landscape ecosystem. Patients: twenty, set in two groups. Weekly-sessions (50’) for three months. Methodological phases: - Phase P1. MusicTherapy treatments for each group in the indoor spaces. - Phase P2. MusicTherapy sessions inside the gardens. After each Phase, P1 and P2: - a Questionnaire for each patient (ten items / liking-indices) was administrated at t0 time, during the treatment and at tn time at the end of the treatment. - Monitoring of patients' behavioral responses through assessment scales, matrix, table and graph system. MusicTherapy methodology: pazient Sonorous-Musical Anamnesis, Musictherapy Assessment Document, Observation Protocols, Bodily-Environmental-Rhythmical-Sonorous-Vocal-Energy production first indoors and then outside, sonorous-musical instruments and edible instruments made by the Author/musictherapist with some foods; Administration of Patient-Environment-Music Index at time to and tn, to estimate the patient’s behavior evolution, Musictherapeutic Advancement Index. Results. The MusGarPPhyD can strengthen the individual sense of identity and improve the psychophysical skills and the resilience to face and to overcome the difficulties caused by the congenital /acquired disability. The multi-sensory perceptions deriving from contact with the plants in the gardens improve the psychological well-being and regulate the physiological parameters such as blood pressure, cardiac and respiratory rhythm, reducing the cholesterol levels. The secretions of the peptide hormones endorphins and the endogenous opioids enkephalins increase and bring a state of patient’s tranquillity and a better mood. The subjects showed a preference for musictherapy treatments within a setting made up of gardens and peculiar landscape systems. This resulted in greater health benefits. Conclusions. The MusGarPPhyD contributes to reduce psychophysical tensions, anxiety, depression and stress, facilitating the connections between the cerebral hemispheres, thus also improving intellectual performances, self-confidence, motor skills and social interactions. Therefore it is necessary to design hospitals, rehabilitation centers, nursing homes, surrounded by gardens. Ecosystems of natural and urban parks and gardens create fascinating skyline and mosaics of landscapes rich in beauty and biodiversity. The MusGarPPhyD is useful for the health management promoting patient’s psychophysical activation, better mood/affective-tone and relastionships and contributing significantly to improving the life quality.

Keywords: musictherapy, gardentherapy, disability, life quality

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Authors: Hussein Alahmer, Amr Ahmed

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Liver cancer is one of the common diseases that cause the death. Early detection is important to diagnose and reduce the incidence of death. Improvements in medical imaging and image processing techniques have significantly enhanced interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate.  This paper presents an automated CAD system consists of three stages; firstly, automatic liver segmentation and lesion’s detection. Secondly, extracting features. Finally, classifying liver lesions into benign and malignant by using the novel contrasting feature-difference approach. Several types of intensity, texture features are extracted from both; the lesion area and its surrounding normal liver tissue. The difference between the features of both areas is then used as the new lesion descriptors. Machine learning classifiers are then trained on the new descriptors to automatically classify liver lesions into benign or malignant. The experimental results show promising improvements. Moreover, the proposed approach can overcome the problems of varying ranges of intensity and textures between patients, demographics, and imaging devices and settings.

Keywords: CAD system, difference of feature, fuzzy c means, lesion detection, liver segmentation

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Authors: Rahimah Saimin

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Previous research has shown that young children can learn from educational television programmes, videos or other technological media. However, the blending of any of these with traditional printed-based text appears to be omitted. Repeated viewing is an important factor in children's ability to comprehend the content or plot. The present study combined videos with traditional printed-based text and required repeated viewing and is original and distinctive. The first study was a pilot study to explore whether the intervention is implementable in ordinary classrooms. The second study explored whether the curricular embedding is important or whether the video with curricular embedding is effective. The third study explored the effect of “dosage”, i.e. whether a longer/ more intense intervention has a proportionately greater effect on outcomes. Both measured outcomes (comprehension, word sounds, and early word recognition) and unmeasured outcomes (engagement to reading traditional printed-based texts or/and multimodal texts) were obtained from this study. Observation indicated degree of engagement in reading. The theoretical framework was multimodality theory combined with Piaget’s and Vygotsky’s learning theories. An experimental design was used with 4-5-year-old children in nursery schools and primary schools. Six links to video clips exploring non-fiction science content were provided to teachers. The first session is whole-class and subsequent sessions small-group. The teacher then engaged the children in dialogue using supplementary materials. About half of each class was selected randomly for pre-post assessments. Two assessments were used the British Picture Vocabulary Scale (BPVSIII) and the York Assessment of Reading for Comprehension (YARC): Early Reading. Different programme fidelity means were deployed- observations, teacher self-reports attendance logs and post-delivery interviews. Data collection is in progress and results will be available shortly. If this multiphase study show effectiveness in one or other application, then teachers will have other tools which they can use to enhance vocabulary, letter knowledge and word reading. This would be a valuable addition to their repertoire.

Keywords: language skills, literacy skills, multimodality, video

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Authors: Wangxu Xia

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BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

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Authors: Shalini Tripathi, Pardeep Kumar

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The method of translating observed symptoms into disease names is known as disease diagnosis. The ability to solve clinical problems in a complex manner is critical to a doctor's effectiveness in providing health care. The accuracy of his or her expertise is crucial to the survival and well-being of his or her patients. Artificial Intelligence (AI) has a huge economic influence depending on how well it is applied. In the medical sector, human brain-simulated intellect can help not only with classification accuracy, but also with reducing diagnostic time, cost and pain associated with pathologies tests. In light of AI's present and prospective applications in the biomedical, we will identify them in the paper based on potential benefits and risks, social and ethical consequences and issues that might be contentious but have not been thoroughly discussed in publications and literature. Current apps, personal tracking tools, genetic tests and editing programmes, customizable models, web environments, virtual reality (VR) technologies and surgical robotics will all be investigated in this study. While AI holds a lot of potential in medical diagnostics, it is still a very new method, and many clinicians are uncertain about its reliability, specificity and how it can be integrated into clinical practice without jeopardising clinical expertise. To validate their effectiveness, more systemic refinement of these implementations, as well as training of physicians and healthcare facilities on how to effectively incorporate these strategies into clinical practice, will be needed.

Keywords: Artificial Intelligence, medical diagnosis, virtual reality, healthcare ethical implications 

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Authors: Huma Naqeeb

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Epidemiological studies have shown the robust link between breast cancer and dietary pattern. There has been no previous study conducted in Pakistan, which specifically focuses on dietary patterns among breast cancer women. This study aims to examine the association of breast cancer with dietary patterns among Pakistani women. This case-control research was carried in multiple tertiary care facilities. Newly diagnosed primary breast cancer patients were recruited as cases (n = 408); age matched controls (n = 408) were randomly selected from the general population. Data on required parameters were systematically collected using subjective and objective tools. Factor and Principal Component Analysis (PCA) techniques were used to extract women’s dietary patterns. Four dietary patterns were identified based on eigenvalue >1; (i) veg-ovo-fish, (ii) meat-fat-sweet, (iii) mix (milk and its products, and gourds vegetables) and (iv) lentils - spices. Results of the multiple regressions were displayed as adjusted odds ratio (Adj. OR) and their respective confidence intervals (95% CI). After adjusted for potential confounders, veg-ovo-fish dietary pattern was found to be robustly associated with a lower risk of breast cancer among women (Adj. OR: 0.68, 95%CI: (0.46-0.99, p<0.01). The study findings concluded that attachment to the diets majorly composed of fresh vegetables, and high quality protein sources may contribute in lowering the risk of breast cancer among women.

Keywords: breast cancer, dietary pattern, women, principal component analysis

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Authors: I. Stacher, B. Schrank, K. Stiehl, K. A. Woodcock

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Background: The need and desire for connectedness and belonging to a peer group is a major concern in middle childhood. This is particularly true for the period of school transition when making and maintaining friendships is put to the test. Social relations are important for enhancing self-esteem, confidence, and mental health. Conflicts with peers and victimization mark challenges in the complex social environment of early adolescents. Thus, the promotion of supportive peer relationships is an important social goal. The current literature lacks an in-depth analysis of young people’s experiences connected to making and maintaining friendships. Aim: This qualitative study aims to understand the factors that facilitate and hinder friendship and peer relations within the complex context of school transition. Methods: Youth engagement workshops at primary and secondary schools were conducted with 53 classes (N = 906 pupils; M age = 10.44; SD = .912) in 29 different schools across lower Austria. A big poster was created with the entire class, collecting early adolescents’ ideas on ways they can support each other in the school environment. Then, students were divided into smaller groups and encouraged to share their personal experiences of friendship. Verbatim quotes from students were collected on observation sheets and sticky notes during the activities. A thematic analysis was conducted. Results: Early adolescents describe facilitating factors that allow them to connect with peers. These descriptions are mainly on a behavioral level and are relevant for face-to-face and digital contact, e.g., practical and emotional support, spending time together, pleasure and fun. Specific challenges such as offensive actions, betrayal, and lack of emotion regulation exist and need to be addressed if aiming to reduce barriers between peers. Conclusion: Knowing first-hand experiences, desires, and barriers for making and maintaining friends at the time of school transition will help researchers to develop preventive health programs that adequately address the needs and preferences of today’s youth.

Keywords: youth voice, experts by experience, friendship, peer relations, primary-secondary school, transition

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Authors: Zahra Mila Elmi, Mahsa Khanekheshi

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Almost half of the population and potential manpower in the country and rural areas are women. Manpower especially educated people, plays an important role in the production and economic growth. Also, the potential of rural areas to create employment should not be overlooked. In this research, the effects of socio-economic and demographic factors on women's economic participation in rural areas of Iran's provinces will be studied. Therefore, this study was performed by using the results of the rural households income and expenditure surveys -has been taken in 2016- in the framework of pseudo panel data. This study used the logit model and the maximum likelihood method to study the rural women's participation, with 28,265 observations. Results show the inverted U-shaped relationship between age and the probability of female participation; In other words, young women are more likely to participate in labor markets more than the other groups. Divorced and single woman has more chance of participation in comparison with who was being married. With increasing the divorce rate and singleness in Iran, economic policymakers must provide appropriate solutions for this challenge in the coming years. On the base of the results, being a student and the presence of an infant under the age of 6 in the household has a negative effect on the possibility of women's participation in the labor market. The women's education level has a U-shaped relationship with their participation rate. Illiteracy and high education have a strong positive effect on the economic participation of rural women. This shows the dual labor market for women in Iran. Illiterate women are attracted to service jobs, and educated woman are more attracted to education and health jobs. Increasing household income has a small but positive and significant effect on the probability of rural female participation. In the overlook, due to the frequency of the women population in the age group of 25 to 35 years, and more willingness of women in the age 35 to 44 years to participate in the labor market, and studying ofa significant portion of the rural women, the increase of rural female participation is expected in the years ahead. Thus, it is expected policy maker to create new job opportunities for the employment of educated women and take the necessary plan to improve the current situation for women.

Keywords: female participation rate, rural area, provincial data, pseudo-panel data method

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Authors: A. V. Belousov, Yakushenko

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One of the main problems of modern dentistry is development a reliable method to detect inflammation in the gums on the stages of diagnosis and assessment of treatment efficacy. We have proposed a method of gingival fluid intake, which successfully combines accessibility, excluding the impact of the annoying and damaging the gingival sulcus factors and provides reliable results (patent of RF№ 2342956 Method of gingival fluid intake). The objects of the study were students - volunteers of Dentistry Faculty numbering 75 people aged 20-21 years. Cellular composition of gingival fluid was studied using microscope "Olympus CX 31" (Japan) with the calculation of epithelial leukocyte index (ELI). Assessment of gingival micro circulation was performed using the apparatus «LAKK–01» (Lazma, Moscow). Cytological investigation noted the highly informative of epithelial leukocyte index (ELI), which demonstrated changes in the mechanisms of protection gums. The increase of ELI occurs during inhibition mechanisms of phagocytosis and activation of epithelial desquamation. The cytological data correlate with micro circulation indicators obtained by laser Doppler flowmetry. We have identified and confirmed the correlations between parameters laser Doppler flowmetry and data cytology gingival fluid in patients with gingivitis.

Keywords: gingivitis, laser doppler flowmetry, gingival fluid cytology, epithelial leukocyte index (ELI)

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Authors: Siriniya Siribrahmanakul

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Introduction:SARsCOVID-19 is rapidly spreading, and some people may exhibit severe symptoms. Mortality rate of 2.0–3.0% with COVID-19 infection atworldwide. Human leukocyte antigen (HLA), located on chromosome 6, consist of HLA class I and class II. HLA are used by the immune system to attach self-antigens. Previous studies, HLA-DRB1*01:01,HLA-DRB1*12:01and HLA-DRB1*14:04 were, showed significant difference with severe COVID-19 in the Chinese population by p-value < 0.05. Objective: We investigated the prevalence of HLA-DRB1 alleles associated with severe COVID-19 in Thai population. Materials and Methods:200 DNA samples were isolated from EDTA blood using the MagNAprue Compact Nucleic Acid Isolation kits.HLA-DRB1alleles were genotyped using sequence-specific oligonucleotides (PCR-SSOs). Results:The frequency of HLA-DRB1 alleles in Thai population wereHLA-DRB1*12:02 (15.75%), HLA-DRB1*15:02 (14.50%), HLA-DRB1*09:01 (11.50%), HLA-DRB1*07:01 (9.50%), HLA-DRB1*03:01,HLA-DRB1*05:01 (5.75%), HLA-DRB1*14:01 (5.50%), HLA-DRB1*16:02 (4.50%), HLA-DRB1*04:05 (4.00%), HLA-DRB1*14:03 (3.25%), HLA-DRB1*10:01 (2.25%) and HLA-DRB1*13:02 (2.00%). Particularly, HLA-DRB1*12:02 allele was the highest allele frequency presented in the four regions groups of Thai population. Furthermore, the HLA-DRB1* alleles associated with severe COVID-19, which consists ofHLA-DRB1*14:04(2.00 %) and HLA-DRB1*12:01(0.50%) in Thai population, whereas HLA-DRB1*01:01 allele was not found in this population. HLA-DRB1*14:04 and HLA-DRB1*12:01alleles were similarly distributed in four regions populations in Thailand (p-value > 0.05). The alleles frequencies of HLA-DRB1*14:04 and HLA-DRB1*12:01, which associated with severe COVID-19, had no significant differences between Thai population, South China population, South Africa population, and South Koreapopulation (p-value > 0.05). Conclusions: Particularly, this study has focused on allele frequency of HLA-DRB1*14:04in a healthy Thai population to evaluating their impact on the severe COVID-19. Furthermore, our research needs to be done in larger numbers of Thai patients.

Keywords: HLA-DRB1, allele frequency, Thai population, COVID-19 marker

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: B. Shukir, L. Szivos, D. Kis, P. Barzo

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Glioblastoma is the most malignant brain tumor. In general, the survival rate varies between (14-18) months. Glioblastoma consists a solid and infiltrative part. The standard therapeutic management of glioblastoma is maximum safe resection followed by chemo-radiotherapy. It’s hypothesized that the pretumoral hyperintense region in fluid attenuated inversion recovery (FLAIR) images includes both vasogenic edema and infiltrated tumor cells. In our study, we aimed to define the sensitivity and specificity of hyperintense FLAIR images preoperatively to examine how well it can define the true extent of glioblastoma. (16) glioblastoma patients included in this study. Hyperintense FLAIR region were delineated preoperatively as tumor mask. The infiltrative part of glioblastoma considered the regions where the tumor recurred on the follow up MRI. The recurrence on the CE-T1 images was marked as the recurrence masks. According to (AAL3) and (JHU white matter labels) atlas, the brain divided into cortical and subcortical regions respectively. For calculating specificity and sensitivity, the FLAIR and the recurrence masks overlapped counting how many regions affected by both . The average sensitivity and specificity was 83% and 85% respectively. Individually, the sensitivity and specificity varied between (31-100)%, and (100-58)% respectively. These results suggest that despite FLAIR being as an effective radiologic imaging tool its prognostic value remains controversial and probabilistic tractography remain more reliable available method for identifying the true extent of glioblastoma.

Keywords: brain tumors, glioblastoma, MRI, FLAIR

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Authors: Dan Richard D. Fernandez

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This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

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