Search results for: cerebral injury

Authors: Christopher Muhawe, Masooda Bashir

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With increased Internet Communication Technology(ICT), the virtual world has become the new normal. At the same time, there is an unprecedented collection of massive amounts of data by both private and public entities. Unfortunately, this increase in data collection has been in tandem with an increase in data misuse and data breach. Regrettably, the majority of data breach and data misuse claims have been unsuccessful in the United States courts for the failure of proof of direct injury to physical or economic interests. The requirement to express data privacy harms from an economic or physical stance negates the fact that not all data harms are physical or economic in nature. The challenge is compounded by the fact that data breach harms and risks do not attach immediately. This research will use a descriptive and normative approach to show that not all data harms can be expressed in economic or physical terms. Expressing privacy harms purely from an economic or physical harm perspective negates the fact that data insecurity may result into harms which run counter the functions of privacy in our lives. The promotion of liberty, selfhood, autonomy, promotion of human social relations and the furtherance of the existence of a free society. There is no economic value that can be placed on these functions of privacy. The proposed approach addresses data harms from a psychological and social perspective.

Keywords: data breach and misuse, economic harms, privacy harms, psychological harms

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Authors: Feng Zhang, Li Chen, Desong Kong, Xiaoping Zhang, Xiaojing Zhu, Yin Lu, Shizhong Zheng

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Sinusoidal pathological angiogenesis is a novel therapeutic target for liver fibrosis. We demonstrated that curcumin ameliorated fibrotic injury and sinusoidal angiogenesis in rat liver with fibrosis caused by carbon tetrachloride. Curcumin reduced the expression of angiogenic markers in fibrotic liver. Experiments in vitro showed that the viability and vascularization of rat liver sinusoidal endothelial cells (LSECs) were not impaired by curcumin. Further investigations showed that curcumin inhibited VEGF expression in hepatic stellate cells (HSCs) by disrupting PDGF-βR/ERK and mTOR pathways. HSC motility and vascularization were also suppressed by curcumin via blocking PDGF-βR/FAK/RhoA cascade. Gain- or loss-of-function analyses revealed that activation of PPARγ was required for curcumin to inhibit angiogenic properties of HSCs. We concluded that curcumin attenuated sinusoidal angiogenesis in liver fibrosis possibly by targeting HSCs via a PPARγ activation-dependent mechanism. PPARγ could be a target molecule for reducing pathological angiogenesis during liver fibrosis.

Keywords: angiogenesis, hepatic stellate cell, curcumin, peroxisome proliferator-activated receptor-γ

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Authors: Olarinde Olaniran, Oluyomi A. Sowemimo

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Toxoplasmosis is frequently misdiagnosed or underdiagnosed, and it is the third most common cause of hospitalization due to food-borne infection. Intra-uterine infection with Toxoplasma gondii due to active parasitaemia during pregnancy can cause severe and often fatal cerebral damage, abortion, and stillbirth of a fetus. The aim of the study was to investigate the prevalence of T. gondii infection in women of childbearing age in selected communities of Osun State with a view to determining the risk factors which predispose to the T. gondii infection. Five (5) ml of blood was collected by venopuncture into a plain blood collection tube by a medical laboratory scientist. Serum samples were separated by centrifuging the blood samples at 3000 rpm for 5 mins. The sera were collected with Eppendorf tubes and stored at -20°C analysis for the presence of IgG and IgM antibodies against T. gondii by commercially available enzyme-linked immunosorbent assay (ELISA) kit (Demeditec Diagnostics GmbH, Germany) conducted according to the manufacturer’s instructions. The optical densities of wells were measured by a photometer at a wavelength of 450 nm. Data collected were analysed using appropriate computer software. The overall seroprevalence of T. gondii among the women of child-bearing age in selected seven communities in Osun state was 76.3%. Out of 76.3% positive for Toxoplasma gondii infection, 70.0% were positive for anti- T. gondii IgG, and 32.3% were positive for IgM, and 26.7% for both IgG and IgM. The prevalence of T. gondii was lowest (58.9%) among women from Ile Ife, a peri-urban community, and highest (100%) in women residing in Alajue, a rural community. The prevalence of infection was significantly higher (P= 0.000) among Islamic women (87.5%) than in Christian women (70.8%). The highest prevalence (86.3%) was recorded in women with primary education, while the lowest (61.2%) was recorded in women with tertiary education (p =0.016). The highest prevalence (79.7%) was recorded in women that reside in rural areas, and the lowest (70.1%) was recorded in women that reside in peri-urban area (p=0.025). The prevalence of T. gondii infection was highest (81.4%) in women with one miscarriage, while the prevalence was lowest in women with no miscarriages (75.9%). The age of the women (p=0.042), Islamic religion (p=0.001), the residence of the women (p=0.001), and water source were all positively associated with T. gondii infection. The study concluded that there was a high seroprevalence of T. gondii recorded among women of child-bearing age in the study area. Hence, there is a need for health education and create awareness of the disease and its transmission to women of reproductive age group in general and pregnant women in particular to reduce the risk of T. gondii in pregnant women.

Keywords: seroepidemiology, Toxoplasma gondii, women, child-bearing, age, communities, Ile -Ife, Nigeria

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Authors: Ezekiel Ejiofor Nnadi

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Nigeria construction industry is known for its active construction activities. This has earmarked the industry to be the key to economic growth of the nation. It has largest employer of labour and gives sustenance to other industries like manufacturing industry. While this is a sign of growth and prosperity; the waste generated by the industry has always been a problem and a serious concern. It results in wastage of economic gain and has resultant health effect on the populace apart from injury being sustained on sites. This work provides a platform to learn more about construction waste, its management strategy and how to reduce waste production in Nigeria construction industry. Construction sites, waste management authority and public health institutions in Lagos as the centre of most construction activities in Nigeria were selected, and a set of questionnaire was administered to using the systematic sampling technique. Descriptive statistics and relative importance index (RII) technique were employed for the analysis of the data gathered. The findings of the analysis show that excessive wastes reduce contractors’ profit margin and also that some construction wastes contain hazardous and toxic elements such as lead, asbestos or radioactive materials which required proper handling and effective disposal. The conclusion was drawn that the check on waste on construction sites starts with the designers to the contractors who execute on site.

Keywords: construction cost, construction industry, economic growth, materials wastes

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Authors: Chaudhary Muhammad Aqdus Ilyas, Matthias Rehm, Kamal Nasrollahi, Thomas B. Moeslund

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This paper presents the investigation of data collection procedures, associated with robots when placed with traumatic brain injured (TBI) patients for rehabilitation purposes through facial expression and mood analysis. Rehabilitation after TBI is very crucial due to nature of injury and variation in recovery time. It is advantageous to analyze these emotional signals in a contactless manner, due to the non-supportive behavior of patients, limited muscle movements and increase in negative emotional expressions. This work aims at the development of framework where robots can recognize TBI emotions through facial expressions to perform rehabilitation tasks by physical, cognitive or interactive activities. The result of these studies shows that with customized data collection strategies, proposed framework identify facial and emotional expressions more accurately that can be utilized in enhancing recovery treatment and social interaction in robotic context.

Keywords: computer vision, convolution neural network- long short term memory network (CNN-LSTM), facial expression and mood recognition, multimodal (RGB-thermal) analysis, rehabilitation, robots, traumatic brain injured patients

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Authors: Maryam Savari, Mohamad Nizam Ayub, Ainuddin Wahid Abdul Wahab

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Game-based Learning (GBL) is an alternative that provides learners with an opportunity to experience a volatile environment in a safe and secure place. A volatile environment requires a different technique to facilitate learning and prevent injury and other hazards. Subjects involving elasticity are always considered hazardous and can cause injuries,for instance a bouncing ball. Elasticity is a topic that necessitates hands-on practicality for learners to experience the effects of elastic objects. In this paper the scope is to investigate the natural interaction between learners and elastic objects in a safe environment using GBL. During interaction, the potentials of natural contact in the process of learning were explored and gestures exhibited during the learning process were identified. GBL was developed using Kinect technology to teach elasticity to primary school children aged 7 to 12. The system detects body gestures and defines the meanings of motions exhibited during the learning process. The qualitative approach was deployed to constantly monitor the interaction between the student and the system. Based on the results, it was found that Natural Interaction GBL (Ni-GBL) is engaging for students to learn, making their learning experience more active and joyful.

Keywords: elasticity, Game-Based Learning (GBL), kinect technology, natural interaction

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Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne

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A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.

Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD

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Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni

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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.

Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm

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Authors: Maryam Tijjani Kolo

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Lack of refuse dumping points has made the residents of Shagari low-cost well armed with some health and environmental related hazards. These studies investigate the effect of household refuse on the resident of Shagari low-cost. A well structured questionnaire was administered to elicit views of the respondent in the study area through adopting cluster sampling method. A total of 100 questionnaires were selected and divided into 50, each to both sections of the study area. Interview was conducted to each household head. Data obtained were analyzed using simple parentages to determine the major hazard in the area. Result showed that majority of the household are civil servant and traders, earning reasonable monthly income. 68% of the respondent has experienced the effect of living close to waste dumping areas, which include unpleasant smell and polluted smoke when refuse is burnt, which causes eye and respiratory induction, human injury from broken bottles or sharp objects as well as water, insect and air borne diseases. Hence, the need to urgently address these menace before it overwhelms the capacities of the community becomes paramount. Thus, the community should be given more enlightenment and refuse dumping sites should be created by the local government area.

Keywords: household, refuse, refuse dumping points, Shagari low-cost

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Authors: Humaira M. Khan, Kanwal Asif

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Ischemic stroke is a neurological disorder with a complex pathophysiology associated with motor, sensory and cognitive deficits. Major approaches developed to treat acute ischemic stroke fall into two categories, thrombolysis and neuroprotection. The objectives of this study were to evaluate the neuroprotective and anti-thrombolytic effects of Olea europaea (olive oil) and Malus domestica (apple cider vinegar) and their combination in rat stroke model. Furthermore, histopathological analysis was also performed to assess the severity of ischemia among treated and reference groups. Male albino rats (12 months age) weighing 300- 350gm were acclimatized and subjected to middle cerebral artery occlusion method for stroke induction. Olea europaea and Malus domestica was administered orally in dose of 0.75ml/kg and 3ml/kg and combination was administered at dose of 0.375ml/kg and 1.5ml/kg prophylactically for consecutive 21 days. Negative control group was dosed with normal saline whereas piracetam (250mg/kg) was administered as reference. Neuroprotective activity of standard piracetam, Olea europaea, Malus domestica and their combination was evaluated by performing functional outcome tests i.e. Cylinder, pasta, ladder run, pole and water maize tests. Rats were subjected to surgery after 21 days of treatment for analysis from stroke recovery. Olea europaea and Malus domestica in individual doses of 0.75ml/kg and 3ml/kg respectively showed neuroprotection by significant improvement in ladder run test (121.6± 0.92;128.2 ± 0.73) as compare to reference (125.4 ± 0.74). Both test doses showed significant neuroprotection as compare to reference (9.60 ± 0.50) in pasta test (8.40 ± 0.24;9.80 ± 0.37) whereas with cylinder test, experimental groups showed significant increase in movements (6.60 ± 0.24; 8.40 ± 0.24) in contrast to reference (7.80 ± 0.37).There was a decrease in percentage time taken f to reach the hidden maize in water maize test (56.80 ± 0.58;61.80 ± 0.66) at doses 0.75ml/kg and 3ml/kg respectively as compare to piracetam (59.40 ± 1.07). Olea europaea and Malus domestica individually showed significant reduction in duration of mobility (127.0 ± 0.44; 123.0 ± 0.44) in pole test as compare to piracetam (124.0 ± 0.70). Histopathological analysis revealed the significant extent of protection from ischemia after prophylactic treatments. Hence it is concluded that Olea europaea and Malus domestica are effective neuroprotective agents alone as compare to their combination.

Keywords: ischemia, Malus domestica, neuroprotection, Olea europaea

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Authors: Valerie Isaak

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Background: This study explores the effectiveness of refresher training sessions of an intervention program at reducing the employees’ risk of injury due to patient violence in a forensic psychiatric hospital. Methods: The original safety intervention program that consisted of a 3 days’ workshop was conducted in the maximum-security ward of a psychiatric hospital in Israel. Ever since the original intervention, annual refreshers were conducted, highlighting one of the safety elements covered in the original intervention. The study examines the effect of the intervention program along with the refreshers over a period of 10 years in four wards. Results: Analysis of the data demonstrates that beyond the initial reduction following the original intervention, refreshers seem to have an additional positive long-term effect, reducing both the number of violent incidents and the number of actual employee injuries in a forensic psychiatric hospital. Conclusions: We conclude that such an intervention program followed by refresher training would promote employees’ wellbeing. A healthy work environment is part of management’s commitment to improving employee wellbeing at the workplace.

Keywords: wellbeing, violence at work, intervention program refreshers, public sector mental healthcare

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Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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Authors: Abdelbary Prince, Said Moussa, Hyungkyu Kim, Eman Gouda, Jin Han

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We compared the dynamic alterations of mitochondrial proteome of control, ischemia-reperfusion (IR) and ischemic preconditioned (IPC) rabbit hearts. Using 2-DE, we identified 29 mitochondrial proteins that were differentially expressed in the IR heart compared with the control and IPC hearts. For two of the spots, the expression patterns were confirmed by Western blotting analysis. These proteins included succinate dehydrogenase complex, Acyl-CoA dehydrogenase, carnitine acetyltransferase, dihydrolipoamide dehydrogenase, Atpase, ATP synthase, dihydrolipoamide succinyltransferase, ubiquinol-cytochrome c reductase, translation elongation factor, acyl-CoA dehydrogenase, actin alpha, succinyl-CoA Ligase, dihydrolipoamide S-succinyltransferase, citrate synthase, acetyl-Coenzyme A dehydrogenase, creatine kinase, isocitrate dehydrogenase, pyruvate dehydrogenase, prohibitin, NADH dehydrogenase (ubiquinone) Fe-S protein, enoyl Coenzyme A hydratase, superoxide dismutase [Mn], and 24-kDa subunit of complex I. Interestingly, most of these proteins are associated with the mitochondrial respiratory chain, antioxidant enzyme system, and energy metabolism. The results provide clues as to the cardioprotective mechanism of ischemic preconditioning at the protein level and may serve as potential biomarkers for detection of ischemia-induced cardiac injury.

Keywords: ischemic preconditioning, mitochondria, proteome, cardioprotection

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Authors: Chien-Lin Wang, Cha-Ling Ko, Tainsong Chen

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Pulse Blood pressure (BP) is one of the vital signs, and is an index that helps determining the stability of life. In this respect, some spinal cord injury patients need to take the tilt table test. While doing the test, the posture changes abruptly, and may cause a patient’s BP to change abnormally. This may cause patients to feel discomfort, and even feel as though their life is threatened. Therefore, if a continuous non-invasive BP assessment system were built, it could help to alert health care professionals in the process of rehabilitation when the BP value is out of range. In our research, BP assessed by the pulse transit time technique was developed. In the system, we use a self-made photoplethysmograph (PPG) sensor and filter circuit to detect two PPG signals and to calculate the time difference. The BP can immediately be assessed by the trend line. According to the results of this study, the relationship between the systolic BP and PTT has a highly negative linear correlation (R2=0.8). Further, we used the trend line to assess the value of the BP and compared it to a commercial sphygmomanometer (Omron MX3); the error rate of the system was found to be in the range of ±10%, which is within the permissible error range of a commercial sphygmomanometer. The continue blood pressure measurement from pulse transit time technique may have potential to become a convenience method for clinical rehabilitation.

Keywords: continous blood pressure measurement, PPG, time transit time, transit velocity

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Authors: Sophio Kalmakhelidze, Eka Shekiladze, Tamar Sanikidze, Mikheil Gogebashvili, Nazi Ivanishvili

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Radiation-induced various degrees of brain injury and cognitive impairment have been described after cranial radiotherapy of brain tumors. High doses of ionizing radiation have a severe impact on the central nervous system, resulting in morphological and behavioral impairments. Structures of the limbic system are especially sensitive to radiation exposure. Hence, compounds or drugs that can reduce radiation-induced impairments can be used as promising antioxidants or radioprotectors. In our study Mice whole-body irradiation with 137Cs was performed at a dose rate of 1,1 Gy/min for a total dose of 5 Gy with a “Gamma-capsule-2”. Irradiated mice were treated with Herniarin (20 mg/kg) for five days before irradiation and the same dose was administrated after one hour of irradiation. The immediate and delayed effects of ionizing radiation, as well as, protective effect of Herniarin was evaluated during early and late post-irradiation periods. The results reveal that ionizing radiation (5 Gy) alters the structure of the hippocampus in adult mice during the late post-irradiation period resulting in the decline of memory formation and learning process. Furthermore, Simple Coumarin-Herniarin reveals a radiosensitizing effect reducing morphological and behavioral alterations.

Keywords: ionizing radiation, cognitive impairments, hippocampus, limbic system, Herniarin

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Authors: Nikhat Iqbal Tamboli

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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.

Keywords: ocular morbidity, eye trauma, RTA, eye injury

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Authors: Danish Farooq, Janos Juhasz

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Car-motorcycle accidents have been observed higher in recent years, which caused mainly riders’ fatalities and serious injuries. In-depth crash investigation methods aim to investigate the main factors which are likely involved in fatal road accidents and injury outcomes. The main objective of this study is to investigate the involved factors in car-motorcycle accidents in Budapest city. The procedure included statistical analysis and data sampling to identify car-motorcycle accidents by dominant accident types based on collision configurations. The police report was used as a data source for specified accidents, and simulation models were plotted according to scale (M 1:200). Car-motorcycle accidents were simulated in Virtual Crash software for 5 seconds before the collision. The simulation results showed that the main involved factors to car-motorcycle accidents were human behavior and view obstructions. The comprehensive, in-depth analysis also found that most of the car drivers and riders were unable to perform collision avoidance manoeuvres before the collision. This study can help the traffic safety authorities to focus on simulated involved factors to solve road safety issues in car-motorcycle accidents. The study also proposes safety measures to improve safe movements among road users.

Keywords: car motorcycle accidents, in-depth analysis, microscopic simulation, safety measures

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Authors: Divya Pathak, James Sloane

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Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

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Authors: Muhamad Ammar Bin Mohd Asri, Muhammad Hamizan Bin Yusof, Muhammad Haziq Bin Abdul Khalil, Esman Hanief Bin Khairul Anuar, Muhammad Fikri Bin Ishak, Amril Azim Bin Mohd Norrahim, Muhammad Danial Fakhri Bin Fakhruddin, Muhammad Khairul Nizam in Hosnodin, Muhammad Ezzat Hariz Bin Norhisam

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Ergonomics is the science of creating and arranging workplaces, products, and systems to increase human performance, comfort, and safety. This study researched ergonomics as a solution for preventing workplace injuries, specifically musculoskeletal disorders, among employers and employees. The method will be used in this project is a literature review which means conducting a study about ergonomics with peer-reviewed journal articles and books. It focuses on employees and employers who are in one company on other departments under the protection of Occupational Safety and Health (OSHA). These solutions include ergonomic assessments, workplace design improvements, effective training and education, and the use of ergonomic tools and equipment. Employers can build workplaces that are safer and more productive by putting these solutions in place, and employees can work comfortably and prevent accidents from bad ergonomics. Overall, the paper highlights how crucial it is to take injury prevention measures and consider ergonomics at work.

Keywords: occupational safety and health, musculoskeletal disorders, ergonomic, ergonomic risk

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Riteesh Bookun

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Patients with carotid stenosis, which may be asymptomatic or symptomatic in the form of transient ischaemic attack (TIA), amaurosis fugax, or stroke, often require an endarterectomy to reduce stroke risk. Risks of this procedure include stroke, death, myocardial infarction, and cranial nerve damage. Carotid endarterectomy is most commonly performed under general anaesthetic, however, it can also be undertaken with a regional anaesthetic approach. Our tertiary centre generally performs carotid endarterectomy under regional anaesthetic. Our major tertiary hospital mostly utilises regional anaesthesia for carotid endarterectomy. We completed a cross-sectional analysis of all cases of carotid endarterectomy performed under regional anaesthesia across a 10-year period between January 2010 to March 2020 at our institution. 350 patients were included in this descriptive analysis, and demographic details for patients, indications for surgery, procedural details, length of surgery, and complications were collected. Data was cross tabulated and presented in frequency tables to describe these categorical variables. 263 of the 350 patients in the analysis were male, with a mean age of 71 ± 9. 172 patients had a history of ischaemic heart disease, 104 had diabetes mellitus, 318 had hypertension, and 17 patients had chronic kidney disease greater than Stage 3. 13.1% (46 patients) were current smokers, and the majority (63%) were ex-smokers. Most commonly, carotid endarterectomy was performed conventionally with patch arterioplasty 96% of the time (337 patients). The most common indication was TIA and stroke in 64% of patients, 18.9% were classified as asymptomatic, and 13.7% had amaurosis fugax. There were few general complications, with 9 wound complications/infections, 7 postoperative haematomas requiring return to theatre, 3 myocardial infarctions, 3 arrhythmias, 1 exacerbation of congestive heart failure, 1 chest infection, and 1 urinary tract infection. Specific complications to carotid endarterectomy included 3 strokes, 1 postoperative TIA, and 1 cerebral bleed. There were no deaths in our cohort. This analysis of a large cohort of patients from a major tertiary centre who underwent carotid endarterectomy under regional anaesthesia indicates the safety of such an approach for these patients. Regional anaesthesia holds the promise of less general respiratory and cardiac events compared to general anaesthesia, and in this vulnerable patient group, calls for comparative research between local and general anaesthesia in carotid surgery.

Keywords: anaesthesia, carotid endarterectomy, stroke, carotid stenosis

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Authors: Ninomyslaw Jakubczyk, Anna Zwierzchowska, Adam Maszczyk

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Background: Central stabilisation training aims to improve neuromuscular coordination. It is used in the form of injury prevention and completing the swimmers' process. The aim of the study was to access the impact of this training on the results by disabled swimmers at 50 and 100 meters’ freestyle. Material/Method: 20 competitors with similar dysfunctions of the musculoskeletal system, randomly assigned to the experimental and control group, participated in the study. Each group consisted of 7 swimmers started in competitions from the standing starting position, and 3 started from the water. The study included a 4-week set of stabilization exercises, 4 times a week instead of pulling by legs. Exercises were held under specialist swimming conditions and involved controlled circuit muscle movements while maintaining a floating stable position in the water. Results: All groups improved their 'best times' besides swimmers started from standing position in the control group. There were no significant differences between intergroup and intra-group results, both at distance 50 and 100 meters’ freestyle. Conclusions: Better improvements in the experimental group were noted, but this effect cannot be attributed to 4-week stabilisation training. However, this investigation might suggest that this type of training could be beneficial for junior disabled swimmers.

Keywords: athletes, swimming, trunk exercises, youth

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Authors: Sarah Nasr, Maha M. A. Nasra, Ossama Y. Abdallah

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The present work aimed to prepare Silymarin loaded MCM-41 type mesoporous silica nanoparticles (MSNs) and to assess the system’s solubility enhancement ability on the pharmacodynamic performance of Silymarin as a hepatoprotective agent. MSNs prepared by soft-templating technique, were loaded with Silymarin, characterized for particle size, zeta potential, surface properties, DSC and XRPD. DSC and specific surface area data confirmed deposition of Silymarin in an amorphous state in MSNs’ pores. In-vitro drug dissolution testing displayed enhanced dissolution rate of Silymarin upon loading on MSNs. High dose Acetaminophen was then used to inflict hepatic injury upon albino male Wistar rats simultaneously receiving either free Silymarin, Silymarin loaded MSNs or blank MSNs. Plasma AST, ALT, albumin and total protein and liver homogenate content of TBARs or LDH as measures of antioxidant drug action were assessed for all animal groups. Results showed a significant superiority of Silymarin loaded MSNs to free drug in almost all parameters. Meanwhile prolonged administration of blank MSNs had no evident toxicity on rats.

Keywords: mesoporous silica nanoparticles, safety, solubility enhancement, silymarin

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Authors: Jyoti Agrawal

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Introduction: Renal diseases in children and young adult can be difficult to diagnose early as it may present only with few symptoms, tends to have different course than adult and respond variously to different treatment. The pattern of renal disease in children is different from developing countries as compared to developed countries. Methods: This study was a hospital based prospective observational study carried from March, 2014 to February 2015 at BP Koirala institute of health sciences. Patients with renal disease, both inpatient and outpatient from birth to 14 years of age were enrolled in the study. The diagnosis of renal disease was be made on clinical and laboratory criteria. Results: Total of 120 patients were enrolled in our study which contributed to 3.74% % of total admission. The commonest feature of presentation was edema (75%), followed by fever (65%), hypertension (60%), decreased urine output (45%) and hematuria (25%). Most common diagnosis was acute glomerulonephritis (40%) followed by Nephrotic syndrome (25%) and urinary tract infection (25%). Renal biopsy was done for 10% of cases and most of them were steroid dependent nephrotic syndrome. 5% of our cases expired because of multiorgan dysfunction syndrome, sepsis and acute kidney injury. Conclusion: Renal disease contributes to a large part of hospital pediatric admission as well as mortality and morbidity to the children.

Keywords: glomerulonephritis, nephrotic syndrome, renal disease, urinary tract infection

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Authors: Suat Erel, Gozde Gur

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Background: Recently a supramalleolar type of dynamic ankle foot orthosis (DAFO) has been increasingly used to support all of the dynamic arches of the foot and redistribute the pressure under the plantar surface of the foot to reduce the muscle tone. DAFO helps to maintain balance and postural control by providing stability and proprioceptive feedback in children with disease like Cerebral Palsy, Muscular Dystrophies, Down syndrome, and congenital hypotonia. Aim: The aim of this study was to investigate the role of Dynamic ankle foot orthosis (DAFO) on temporo-spatial parameters of gait and balance in three children with hereditary spastic paraparesis (HSP). Material Method: 13, 14, and 8 years old three children with HSP were included in the study. To provide correction on weight bearing and to improve gait, DAFO was made. Lower extremity spasticity (including gastocnemius, hamstrings and hip adductor muscles) using modified Ashworth Scale (MAS) (0-5), The temporo-spatial gait parameters (walking speed, cadence, base of support, step length) and Timed Up & Go test (TUG) were evaluated. All of the assessments about gait were compared with (with DAFO and shoes) and without DAFO (with shoes only) situations. Also after six months follow up period, assessments were repeated by the same physical therapist. Results: MAS scores for lower extremity were between “2-3” for the first child, “0-2” for the second child and “1-2” for the third child. TUG scores (sec) decreased from 20.2 to 18 for case one, from 9.4 to 9 for case two and from 12,4 to 12 for case three in the condition with shoes only and also from 15,2 to 14 for case one, from 7,2 to 7,1 for case two and from 10 to 7,3 for case three in the condition with DAFO and shoes. Gait speed (m/sec) while wearing shoes only was similar but while wearing DAFO and shoes increased from 0,4 to 0,5 for case one, from 1,5 to 1,6 for case two and from 1,0 to 1,2 for case three. Base of support scores (cm) wearing shoes only decreased from 18,5 to 14 for case one, from 13 to 12 for case three and were similar as 11 for case two. While wearing DAFO and shoes, base of support decreased from 10 to 9 for case one, from 11,5 to 10 for case three and was similar as 8 for case two. Conclusion: The use of a DAFO in a patient with HSP normalized the temporo-spatial gait parameters and improved balance. Walking speed is a gold standard for evaluating gait quality. With the use of DAFO, walking speed increased in this three children with HSP. With DAFO, better TUG scores shows that functional ambulation improved. Reduction in base of support and more symmetrical step lengths with DAFO indicated better balance. These encouraging results warrant further study on wider series.

Keywords: dynamic ankle foot orthosis, gait, hereditary spastic paraparesis, balance in patient

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Authors: Yun-An Chen, Hung-Jun Lin, Tai-Horng Young, Der-Zen Liu

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Decellularized brain extracellular matrix had been shown that it has the ability to influence on cell proliferation, differentiation and associated cell phenotype. However, this scaffold is thought to have poor mechanical properties and rapid degradation, it is hard for cell recellularization. In this study, we used decellularized brain extracellular matrix combined with chitosan, which is naturally occurring polysaccharide and non-cytotoxic polymer, forming a 3-D scaffold for neural stem/precursor cells (NSPCs) regeneration. HE staining and DAPI fluorescence staining confirmed decellularized process could effectively vanish the cellular components from the brain. GAGs and collagen I, collagen IV were be showed a great preservation by Alcain staining and immunofluorescence staining respectively. Decellularized brain extracellular matrix was well mixed in chitosan to form a 3-D scaffold (DB-C scaffold). The pore size was approximately 50±10 μm examined by SEM images. Alamar blue results demonstrated NSPCs had great proliferation ability in DB-C scaffold. NSPCs that were cultured in this complex scaffold differentiated into neurons and astrocytes, as reveled by NSPCs expression of microtubule-associated protein 2 (MAP2) and glial fibrillary acidic protein (GFAP). In conclusion, DB-C scaffold may provide bioinformatics cues for NSPCs generation and aid for CNS injury functional recovery applications.

Keywords: brain, decellularization, chitosan, scaffold, neural stem/precursor cells

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Authors: Lorena GóMez Escorcia, Gustavo Aroca MartíNez, Jose Luiz Villarreal, Elkin Navarro Quiroz

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Lupus nephritis (LN) is a high-cost disease, occurring in about half of patients with Systemic Lupus Erythematosus (SLE). Renal biopsy constitutes the only protocol that, to date, allows a correct diagnosis of the level of renal involvement in these patients. However, this procedure can have various adverse effects such as kidney bleeding, muscle bleeding, infection, pain, among others. Therefore, the development of new diagnostic alternatives is required. The neutrophil gelatinase-associated lipocalin (NGAL) has been emerging as a novel biomarker of acute kidney injury. The aim of this study was to assess urinary NGAL levels as a marker for disease activity in patients with lupus nephritis. For this work included 50 systemic lupus erythematosus (SLE) patients, 50 with active lupus nephritis (LN), and 50 without autoimmune and renal disease as controls. TNGAL in urine samples was measured by enzyme-linked immunosorbent assay (ELISA). The results revealed that patients with kidney damage had an elevated urinary NGAL as compared to patients with lupus without kidney damage and controls (p <0.005), and the mean of uNGAL was (28.72 ± 4.53), (19.51 ± 4.72), (8.91 ± 3.37) respectively. Measurement of urinary NGAL levels showed a very good diagnostic performance for discriminating patients with Lupus nephritis from SLE without renal damage and of control individuals.

Keywords: lupus nephritis, biomarker, NGAL, urine samples

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Authors: Alanna Goodman, Kayla Murray, Keith Warriner

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The following reports on a comparative study on the efficacy of different decontamination technologies to decrease Listeria monocytogenes inoculated onto white sliced mushrooms and assesses the fate of residual levels during posttreatment storage under aerobic conditions at 8uC. The treatments were chemical (hydrogen peroxide, peroxyacetic acid, ozonated water, electrolyzed water, chitosan, lactic acid), biological (Listeria bacteriophages), and physical (UV-C, UV:hydrogen peroxide). None of the treatments achieved .1.2 log CFU reduction in L. monocytogenes levels; bacteriophages at a multiplicity of infection of 100 and 3% (vol/vol) hydrogen peroxide were the most effective of the treatments tested. However, growth of residual L. monocytogenes during posttreatment storage attained levels equal to or greater than levels in the nontreated controls. The growth of L. monocytogenes was inhibited on mushrooms treated with chitosan, electrolyzed water, peroxyacetic acid, or UV. Yet, L. monocytogenes inoculated onto mushrooms and treated with UV:hydrogen peroxide decreased during posttreatment storage, through a combination of sublethal injury and dehydration of the mushroom surface. Although mushrooms treated with UV:hydrogen peroxide became darker during storage, the samples were visually acceptable relative to controls. In conclusion, of the treatments evaluated, UV:hydrogen peroxide holds promise to control L. monocytogenes on mushroom surfaces.

Keywords: listeria monocytogenes, sliced mushrooms, bacteriophages, UV, sanitizers

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Authors: Galawezh Obaid Othman

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The present investigation was undertaken to evaluate the germ cell toxicity induced by ciprofloxacin antibiotic and the Protective effect of grape seed oil, Ciproflaxin uses include treatment of genitor-urinary and some reproductive tract bacterial infections. One of the most attractive approaches to disease prevention involves the use of natural antioxidants to protect tissue against toxic injury, the possible protective effect of grape seed oil, against ciprofloxacin induced reproductive toxicity on mouse .the animals were randomly divided into four groups consisting of five mice. Group (1) was orally given distilled water (solvent of the used drugs) and kept as a control. Group (2) was administered 6ml/kg. b.w of grape seed oil orally 15 days .Group (3) was administered 206mg/kg. b.w of ciprofloxacin orally for 15 days.. Last group was treated orally with Grape seed oil (6mg/kg b.w. /day) prior to an orally administered ciprofloxacin (CPX) at a dose of 206 mg⁄kg. b.w. by three hours for fifteen days. Ciproflaxin have ability to induce various types of sperm abnormalities such as (Sperm without head, sperm without tail, defective head spearm,swollen head sperm ), The results explored that Grape seed oil possesses statistically significant (p<0.05) protective potential against Ciproflaxin by decreasing sperm abnormalities frequency in mouse.

Keywords: antimutagen, ciprofloxacin, grape seed oil, germ cell

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Authors: Yi Tse Wang, Che Hsiu Chen, Zih Jian Huang, Hon Wen Cheng

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Stretching treatments enhanced flexibility. On the other hand, decreases in hamstrings strength have been reported after stretching, especially with static stretching or passive stretching. Stretching has been shown to be more effective than static stretching to improve muscle performance, but a clear consensus for the effect of dynamic stretching on muscle performance has not been achieved. The purpose of this study was to compare the acute effect of a dynamic stretching, static stretching and eccentric exercise protocol on hamstrings stiffness, flexibility and muscle strength. Forty-five healthy active men (height 179.9 cm; weight 71.5 kg; age 22.5 years) were participated in 3 randomly ordered testing sessions: dynamic stretching (DS), active static stretching (ASS), and passive static stretching (PSS). All the stretch were performed 30 seconds and repeated 6 times. There was a 30-second interval between repetitions. The outcome measures were isokinetic concentric contraction (60°/s), eccentric contraction (30°/s) peak torque, muscle flexibility after stretching. The results showed that the muscle flexibility (3.6%, 3.9% and 1.59%, respectively) increased significantly after DS, PSS and ASS. Hamstring isokinetic concentric peak torque (-6.4%, -8.0% and -5.8%, respectively) and eccentric peak torque (-5.8%, -4.5% and -5.4%, respectively) decreased significantly after DS, PSS and ASS. Hence, although the stretching protocols improve hamstrings flexibility immediately, reduced hamstring muscle eccentric and concentric peak torque.

Keywords: hamstrings injury, warm-up, muscle performance, muscle stretching

Procedia PDF Downloads 367