Search results for: oral health prevention

Authors: Alhage Drammeh

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The research is on the occurrence of certain diseases among children in rural and far-flung parts of the Gambia and the extent to which they are caused by lack of access to clean water. A baseline survey was used to discover, describe, and explain the actual processes. The paper explains the purpose of the research, which is majorly to improve the health condition of children, especially those living in rural communities. The paper also gives a brief overview of the socio-economic situation of The Gambia, emphasizing its status as a Least Developed Country (LDC) and the majority of its population living below the poverty line, with women and children hardest hit. The research used as case studies of two rural communities in the Gambia -Basse Dampha Kunda Village and Foni Besse. Data was collected through oral interviews and medical tests conducted among people in both villages, with an emphasis on children. The demographic detail of those tested is tabulated for a clearer understanding. The results were compared, revealing that skin rashes, hepatitis, and certain other diseases are more prevalent in communities lacking access to safe drinking water. These results were also presented in a tabular form. The study established how some policy failures and neglect on the part of the Government of The Gambia are imperiling the health of many rural dwellers in the country, the most glaring being that the research team was unable to test water samples collected from the two communities, as there are no laboratory reagents for testing water anywhere in The Gambia. Many rural communities lack basic amenities, especially clean and potable water, as well as health facilities. The study findings also highlighted the need for healthcare providers and medical NGOs to voice the plight of rural dwellers and collaborate with the government to set up health facilities in rural areas of The Gambia.

Keywords: jaundice, skin rashes, children, rural communities, the Gambia, causes

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Authors: Fakhr Eddin Alnaal, Angela Dahdal, Duaa Aladib, Sabeen Ibrahim, Ibrahim Ghoraibi, Bissan Ahmed

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Dementia is one of the diseases which had several stages and Alzheimer’s term was selected in respect for the first doctor Alzheimer who defined the first symptoms of this diseases in a woman whom was well treated by him. The fact that this is a type of a silent disease on which you have a long-term process of neurological degradation and suddenly gives symptoms which are most often irreversible, on clinical level likely we can consider it as a malignancy, one in terms of that it is sudden shocking irreversible and on the level of behavior and some mortality beside the lack of early detection tools for diagnosis. Therefore, the goal of our project is to test the concept of the ability of Statin in prevention of such disease and we investigated that both on experimental level and most importantly on clinical one, the clinical part was performed in a recognized house of aged people who had accidently a high cholesterol and were for years given Statin to treat that elevation, however after the symptoms of Alzheimer’s appeared and when diagnosed, they were well treated and rapidly recovered compared to Alzheimer’s patients in the same house who did not receive Statin had a mild improvement in their symptoms after the therapy, on the other hand we confirmed such observation by a well-organized experimental work.

Keywords: Alzheimer's, dementia, silent disease, statin

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Mohamed S. Selim, Nesreen A. Fatthallah, Shimaa A. Higazy, Zhifeng Hao, Xiang Chen

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After the prohibition of tin-based fouling-prevention coatings in 2003, the researchers were directed toward eco-friendly coatings. Because of their nonstick, environmental, and economic benefits, foul-release nanocoatings have received a lot of attention. They use physical anti-adhesion terminology to deter any fouling attachment.Natural bioinspired surfaces have micro/nano-roughness and low surface free energy features, which may inspire the design of dynamic antifouling coatings. Graphene-based nanocomposite surfaces were designed to combat marine-fouling adhesion with ecological as well as eco-friendly effects rather than biocidal solutions. Polymer–graphenenanofiller hybrids are a novel class of composite materials in fouling-prevention applications. The controlled preparation of nanoscale orientation, arrangement, and direction along the composite building blocks would result in superior fouling prohibition. This work representsfoul-release nanocomposite top coats for marine coating applications with superhydrophobicity, surface inertness against fouling adherence, cost-effectiveness, and increased lifetime.

Keywords: foul-release nanocoatings, graphene-based nanocomposite, polymer, nanofillers

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Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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Authors: Jamal A. Mayouf, Hashim Salih Al Bayati, Eltayeb M. Emmima

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Green tea is one of the most common drinks in all cities of Libyan. Heavy metal contents such as cadmium (Cd), lead (Pb), nickel (Ni) and zinc (Zn) were determined in four green tea samples collected from Libyan market and their tea infusions by using atomic emission spectrophotometry after acid digestion. The results obtained indicate that the concentrations of Cd, Pb, Ni and Zn in tea infusions samples ranged from 0.07-0.12, 0.19-0.28, 0.09-0.15, 0.18-0.43 mg/l after boiling for 5 min., 0.06-0.08, 0.18-0.23, 0.08-0.14, 0.17-0.27 mg/l after boiling for 10 min., 0.07-0.11, 0.18-0.24, 0.08-0.14, 0.21-0.34 mg/l after boiling for 15 min. respectively. On the other hand, the concentrations of the same element mentioned above obtained in tea leaves ranged from 6.0-18.0, 36.0-42.0, 16.0-20.0, 44.0-132.0 mg/kg respectively. The concentrations of Cd, Pb, Ni and Zn in tea leaves samples were higher than Prevention of Food Adulteration (PFA) limit and World Health Organization(WHO) permissible limit.

Keywords: boiling, infusion, metals, tea

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Authors: J. Burlakovs, Y. Jani, L. Grinberga, M. Kriipsalu, O. Anne, I. Grinfelde, W. Hogland

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The worldwide future sustainable economies are oriented towards the sea: the maritime economy is becoming one of the strongest driving forces in many regions as population growth is the highest in coastal areas. For hundreds of years sea resources were depleted unsustainably by fishing, mining, transportation, tourism, and waste. European Sustainable Development Strategy is identifying and developing actions to enable the EU to achieve a continuous, long-term improvement of the quality of life through the creation of sustainable communities. The aim of this paper is to provide insight in Baltic Sea Region case studies on implemented actions on tourism industry waste and beach wrack management in coastal areas, hazardous contaminants and plastic flow treatment from waste, wastewaters and stormwaters. These projects mentioned in study promote successful prevention of contaminant flows to the sea environments and provide perspectives for creation of valuable new products from residuals for future circular economy are the step forward to green innovation winning streak.

Keywords: resilience, hazardous waste, phytoremediation, water management, circular economy

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Authors: Amanda R. R. Oliveira, Caio F. F. C. Cunha, Juan C. L. Junior, Amorim H. P. Junior

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Children deaths are traumatic events that most often can be prevented. The technology of prevention and intervention in cases of infant deaths is available at low cost and with solid evidence and favorable results, however, with low access cover. Weight is one of the main factors related to death in the neonatal period, so the newborns of low birth weight are a population at high risk of death in the neonatal period, especially early neonatal period. This paper describes the development of a model based in neural network analysis to predict the mortality risk rating in the early neonatal period for newborns of low birth weight to identify the individuals of this population with increased risk of death. The neural network applied was trained with a set of newborns data obtained from Brazilian health system. The resulting network presented great success rate in identifying newborns with high chances of death, which demonstrates the potential for using this tool in an integrated manner to the health system, in order to direct specific actions for improving prognosis of newborns.

Keywords: low birth weight, neonatal death risk, neural network, newborn

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Women with disabilities are largely missing from global research on violence prevention, yet research shows that women with disabilities are a particularly marginalised group who experience heightened levels and unique forms of violence than men with disabilities, and women without disabilities. They face heightened stigma, discrimination, and violence due to their gender and their disability. Including women with disabilities in violence, research helps inform policy and prevention interventions that are relevant and inclusive. To ensure their inclusion in violence research, we need ethical guidelines that are sensitive to their heightened risk and vulnerability, that recognize the diversity in the disabled population, but that also promote disabled people’s agency in defining their own violence prevention needs and agendas. Objective: To highlight pertinent ethical issues around women with disabilities’ inclusion and participation in violence research. Methodology: Considering the lack of formalized guidelines for research of people with disabilities, we draw from the literature on international ethics guidelines for researching violence against women, and the Emancipatory Disability Research paradigm, as well as drawing from our own experiences from the field in applying the guidelines when doing research with disabled women. Findings: Following the guiding ethical principles of respect, benefit, justice, and do no harm, we argue that reasonable accommodation, capacity, and equal participation need to be considered in conceptualizing and conducting ethical violence research with women with disabilities. We conclude that disability research in the area of violence is highly politicized and must be carefully scrutinized to ensure justice and the contribution of women with disabilities to their own welfare. Implications: We suggest that these issues are practically applied in the field and tested and critiqued to enhance best practice for undertaking ethical research with this particular group. It is important that not only researchers and ethics committees, but also disabled women and disabled organizations, are involved in enhancing and formalizing ethical research guidelines for marginalized populations.

Keywords: capacity, emancipatory disability research paradigm equal participation, reasonable accommodation, research ethics, violence against women with disabilities

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Authors: A. M. Gadanya, M. S. Sule

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Effect of oral administration of Gadagi tea on some antioxidant enzymes was assessed in healthy male albino rats. The rats were grouped and administered with standard doses of the 3 types of Gadagi tea i.e. Sak, Sada and Magani for a period of four weeks. Animals that were not administered with the tea constituted the control group. At the end of fourth week, the animals were sacrificed and their serum superoxide dismutase (SOD), glutathione reductase (GR) and catalase (CAT) activities were determined. The activities of the enzymes were also determined in the brain, liver, kidney and intestine homogenates of the rats. Mean SOD activity in brain of rats orally administered with “sada” was found to be significantly higher (P < 0.05) than that of the control group. Mean CAT activity in the intestine of rats orally administered with “magani” was found to be significantly higher (P < 0.05) than that of the control group and the experimental groups of Sak and Sada at standard dose level. Thus, all the “Gadagi” tea preparations studied at standard dose level could stimulate antioxidant enzymes, especially SOD in brain and CAT in intestine (by Sada) and CAT in intestine (by Magani).

Keywords: “Gadagi” tea, superoxide dismutase, catalase, glutathione reductase

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Authors: Joseph Bamidele Minari

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The anti-jaundice properties of the methanolic extract of Carica papaya leaves on albino rat was evaluated. In order to achieve this, the phytochemical screening of the extract was carried out, and carbon tetrachloride (CCl4) (i.p) was injected into albino rats to induce jaundice. The rats were simultaneously given oral doses of 20 mg/kg, 40 mg/kg, 60 mg/kg, 80 mg/kg and 100 mg/kg (p.o) of methanolic extract of C. papaya. The effects of these extract on total bilirubin concentration, liver ALT AST, GGT activities of the jaundice-induced rats were studied after seven days period of the experiment. Administration of CCl4 alone to the rats significantly increased (p<0.05) total bilirubin concentration while the activities of ALT, AST, and GGT in the liver when compared to controls which received distilled water (p.o) was significantly lower (p<0.05). Simultaneous treatment of CCl4 injection, and oral administration of different doses of the C. papaya extract significantly reduced (p<0.05) total bilirubin concentration in the serum while the liver ALT AST, GGT activities significantly increased (p < 0.05). However, the lowest significant reduction (p<0.05) of bilirubin concentration was observed with simultaneous administration of 60mg/kg of the extract on the rats. This study suggests that the extract of C. papaya leaves possess the phytochemicals that have anti-jaundice properties.

Keywords: carica papaya, jaundice, herbal medicine, liver, rat

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Authors: Gramza-Michalowska Anna, Skrety Joanna, Anna Zywica, Kobus-Cisowska Joanna, Kmiecik Dominik, Korczak Jozef

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Background: Modern consumer highly appreciates the positive influence of consumed products on well-being and overall health. High acceptance of new food is a result of intensified research showing many proofs confirming that food offers significant prophylactic and therapeutic potential, next to its basic nutritional function. Objective: Proposition of the technology of unsweetened oat drinks enriched with plant extracts for pro-health oriented individuals. We investigated the effects of selected plant extracts addition on antioxidative capacity and consumer’s acceptance of drinks as representative of all day diet product. Methods: The analysis of the basic composition and antioxidant properties of the drinking product was conducted. Basic composition included protein, lipids and fiber content. Antioxidant capacity of drink was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and FRAP. Proposed drink as new product was also characterized with sensory analysis, which included color, aroma, taste, consistency and overall acceptance. Results: Results showed that addition of plant extracts into a oat drink allowed to enhance its antioxidant potential and influenced significantly its sensory values. The preferred composition and properties of designed beverage permit claim that it can have a positive impact on the health of the consumers. Conclusion: Designed oat drink would be an answer for pro-healthy life style of the consumers. Results showed that product with plant extracts addition would be accepted by the consumers and because of its antioxidative potential could be an important factor in prevention of free radicals influence on human organism.

Keywords: phytonutrients, pro-health, well-being, antioxidant potential, sensory value

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Authors: Andi Intan Purnamasari, Supriyadi, Sulbadana, Aminuddin Kasim

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Law functions as social control. Providing arrangements not only for legal certainty, but also in the scope of justice and expediency. The three values ​​achieved by law essentially function to bring comfort to each individual in carrying out daily activities. However, it is undeniable that global conditions have changed the orientation of people's lifestyles. Some people want to ensure their existence in the digital world which is popularly known as the metaverse. Some countries even project their city to be a metaverse city. The order of life is no longer limited to the real space, but also to the cyber world. Not infrequently, legal events that occur in the cyber world also force the law to position its position and even prevent crime in cyberspace. Through this research, conceptually it provides a view of the legal position in crime prevention in the Metaverse world. when the law acts to regulate the situation in the virtual world, of course some people will feel disturbed, this is due to the thought that the virtual world is a world in which an avatar can do things that cannot be done in the real world, or can be called a world without boundaries. Therefore, when the law is present to provide boundaries, of course the concept of the virtual world itself becomes no longer a cyber world that is not limited by space and time, it becomes a new order of life. approach, approach, approach, approach, and approach will certainly be the method used in this research.

Keywords: crime, cyber, metaverse, law

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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: Kamsiah Jaarin, Yusof Kamisah, Faizah Othman Nurul Akmal Muhammad, Zakiah Jubri, Qodriyah Mohd Saad, Srijit Das

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Forty (40) normotensive adult male Sprague-Dawley rats aged three months weighing 180-200 g were divided into 4 groups with 10 rats per group: (1) normotensive control; (2) hypertensive rats; (3) hypertensive rats treated with Nigella sativa (2.5 ml/kg/day); and (4) hypertensive rats treated with nicardipine (5 mg/kg/day). After acclimatization, the hypertensive rats of the group 2, 3 and 4 were induced to be hypertensive by giving NW–nitro-L-arginine methyl ester (L-NAME; 30 mg/kg/day) in their drinking water for consecutive 7 days. After one week, rats in the group 3 were given a daily oral dose of 2.5 ml/kg/day of Nigella sativa (NS) by oral gavage. Rats in the group 4 were given nicardipine (5 mg/kg/day) via oral gavages. All rats in this study received L-NAME continuously throughout the treatment duration. The blood pressure will be measured pre-treatment and weekly for 8 weeks using power lab. Blood was taken before and at the end of study for measurement of nitric oxide. At the end of 8 weeks, the rats are sacrificed and descending thoracic aorta was disserted for measurement of vascular reactivity, and intracellular adhesion molecules (ICAM-1) and vascular cell adhesion molecules (VCAM-1). Nigella sativa reduced both systolic and diastolic BP compared to control and L-name group. The BP lowering effect of NS was comparable to nicardipine a calcium antagonist. The blood pressure lowering effect of NS was accompanied with an increasing relaxation response to nitroprusside and acetylcholine and reducing vasoconstriction response to epinephrine. L-NAME and nicardipine on the other hand, reduced plasma nitric oxide concentration. In contrast, NS increased NO concentration. However, Nigella sativa had no significant effect on aortic VCAM- 1 and ICAM-1 expression. In conclusion; Nigella sativa oil reduces both systolic and diastolic blood pressure in L-NAME treated rats. The antihypertensive effect of NS was comparable to nicardipine. The BP lowering effect may be mediated via stimulating nitric oxide release from vascular endothelium.

Keywords: Nigella sativa, ICAM, VCAM, blood pressure, vascular reactivity

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: Shrestha Sharma, Jasjeet K. Sahni, Javed Ali, Sanjula Baboota

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Introduction: Rutin is a naturally occurring strong antioxidant molecule belonging to bioflavonoid category. Due to its free radical scavenging properties, it has been found to be beneficial in the treatment of various diseases including inflammation, cancer, diabetes, allergy, cardiovascular disorders and various types of microbial infections. Despite its beneficial effects, it suffers from the problem of low aqueous solubility which is responsible for low oral bioavailability. The aim of our study was to optimize and characterize self-nanoemulsifying drug delivery system (SNEDDS) of rutin using Box-Behnken design (BBD) combined with a desirability function. Further various antioxidant, pharmacokinetic and pharmacodynamic studies were performed for the optimized rutin SNEDDS formulation. Methodologies: Selection of oil, surfactant and co-surfactant was done on the basis of solubility/miscibility studies. Sefsol+ Vitamin E, Solutol HS 15 and Transcutol P were selected as oil phase, surfactant and co-surfactant respectively. Optimization of SNEDDS formulations was done by a three-factor, three-level (33)BBD. The independent factors were Sefsol+ Vitamin E, Solutol HS15, and Transcutol P. The dependent variables were globule size, self emulsification time (SEF), % transmittance and cumulative percentage drug released. Various response surface graphs and contour plots were constructed to understand the effect of different factor, their levels and combinations on the responses. The optimized Rutin SNEDDS formulation was characterized for various parameters such as globule size, zeta potential, viscosity, refractive index , % Transmittance and in vitro drug release. Ex vivo permeation studies and pharmacokinetic studies were performed for optimized formulation. Antioxidant activity was determined by DPPH and reducing power assays. Anti-inflammatory activity was determined by using carrageenan induced rat paw oedema method. Permeation of rutin across small intestine was assessed using confocal laser scanning microscopy (CLSM). Major findings:The optimized SNEDDS formulation consisting of Sefsol+ Vitamin E - Solutol HS15 -Transcutol HP at proportions of 25:35:17.5 (w/w) was prepared and a comparison of the predicted values and experimental values were found to be in close agreement. The globule size and PDI of optimized SNEDDS formulation was found to be 16.08 ± 0.02 nm and 0.124±0.01 respectively. Significant (p˂0.05) increase in percentage drug release was achieved in the case of optimized SNEDDS formulation (98.8 %) as compared to rutin suspension. Furthermore, pharmacokinetic study showed a 2.3-fold increase in relative oral bioavailability compared with that of the suspension. Antioxidant assay results indicated better efficacy of the developed formulation than the pure drug and it was found to be comparable with ascorbic acid. The results of anti-inflammatory studies showed 72.93 % inhibition for the SNEDDS formulation which was significantly higher than the drug suspension 46.56%. The results of CLSM indicated that the absorption of SNEDDS formulation was considerably higher than that from rutin suspension. Conclusion: Rutin SNEDDS have been successfully prepared and they can serve as an effective tool in enhancing oral bioavailability and efficacy of Rutin.

Keywords: rutin, oral bioavilability, pharamacokinetics, pharmacodynamics

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Authors: Nareshkumar Harale, B. B. Meshram

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The continued exponential growth of successful cyber intrusions against today’s businesses has made it abundantly clear that traditional perimeter security measures are no longer adequate and effective. We evolved the network trust architecture from trust-untrust to Zero-Trust, With Zero Trust, essential security capabilities are deployed in a way that provides policy enforcement and protection for all users, devices, applications, data resources, and the communications traffic between them, regardless of their location. Information exchange over the Internet, in spite of inclusion of advanced security controls, is always under innovative, inventive and prone to cyberattacks. TCP/IP protocol stack, the adapted standard for communication over network, suffers from inherent design vulnerabilities such as communication and session management protocols, routing protocols and security protocols are the major cause of major attacks. With the explosion of cyber security threats, such as viruses, worms, rootkits, malwares, Denial of Service attacks, accomplishing efficient and effective intrusion detection and prevention is become crucial and challenging too. In this paper, we propose a design and analysis model for next generation network intrusion detection and protection system as part of layered security strategy. The proposed system design provides intrusion detection for wide range of attacks with layered architecture and framework. The proposed network intrusion classification framework deals with cyberattacks on standard TCP/IP protocol, routing protocols and security protocols. It thereby forms the basis for detection of attack classes and applies signature based matching for known cyberattacks and data mining based machine learning approaches for unknown cyberattacks. Our proposed implemented software can effectively detect attacks even when malicious connections are hidden within normal events. The unsupervised learning algorithm applied to network audit data trails results in unknown intrusion detection. Association rule mining algorithms generate new rules from collected audit trail data resulting in increased intrusion prevention though integrated firewall systems. Intrusion response mechanisms can be initiated in real-time thereby minimizing the impact of network intrusions. Finally, we have shown that our approach can be validated and how the analysis results can be used for detecting and protection from the new network anomalies.

Keywords: network intrusion detection, network intrusion prevention, association rule mining, system analysis and design

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Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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Authors: Nada Alqadri, Omaima Nasir

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Natural compounds are an important source of potential inhibitors; they have a lot of pharma potential with less adverse effects. The effective antiviral activities of natural products have been proved in different studies. The outbreak of COVID-19 in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. Based on previous studies, natural products can be introduced as preventive and therapeutic agents in the fight against COVID-19; considering that no food or supplement has been authorized to prevent COVID-19, individuals continue to search for and consume specific herbs, foods, and commercial supplements for this purpose. This study will be aimed to estimate the uses of herbal and natural products during the COVID-19 infection to determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of different participants will be conducted and will be a focus on respondents’ chronic disease histories, socio-dmographic characteristics, and frequency and trends of using these products. Descriptive and univariate analyses will be performed to determine prevalence and associations between various products used and respondents’ socio-demographic data. Relationships will be tested using Pearson’s chi-square test or an exact probability test. Our main findings will give evidence of beneficial uses of natural products and herbal medicine as prophylactic and will be a vigorous approach to stop or at least slow down COVID-19 infection and transmission. This will be of great interest of public health, and the results of our study will lend health officials better control on the current pandemic.

Keywords: COVID-19, herbs, natural products, saudi arabia

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Galila Aisyah Latif Amini, Husnul Khatimah, Citra Amelia

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Smoking among women is of particular concern for the maternal and child health community due to the strong association between prenatal smoking and adverse birth outcomes. Pregnancy is perceived to be a unique reason for smoking cessation, as motivation to care for the unborn fetus. This study aimed to find out the determinants of smoking cessation among pregnant women. Method that we use in this study is systematic review. We identified relevant studies by searching on science database online through SAGE journals, Proquest, Scopus, Emerald, JSTOR, and Springerlink. Journals were screened by title and abstract according to the research topic then filtered using the criteria exclusion and inclusion. And then we did critical appraisal. The results of the four studies reviewed were found that the determinant of smoking cessation are parity, the level of education, socioeconomic status, household SHS exposure, smoking habits of both parents, partner smoking status, psychological factors, antenatal care, intervention for health care provider, age smoking duration. The factor most strongly associated with smoking cessation is parity (OR 2,55; Cl 2,34-2,77). The results of this study are expected to give advice for developing future smoking cessation and relapse prevention programs.

Keywords: pregnancy, smoking cessation, tobacco use cessation, smoking

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Authors: Ladda Thiamwong, Renata Komalasari

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Falls are the leading cause of disability and hospitalization in low-income older adults. Fear of falling is present in 20% to 85 % of older adults and has been identified as an independent risk factor of fall risk, activity restriction, and loss of independence. About 12% of American older adults have subjective cognitive decline. Cognitive impairment is also an established factor of fall risk. However, it is unclear whether measures of fear of falling and subjective cognitive decline have the greatest association with fall risk in low-income older adults. The aim of this study was to evaluate the association between fear of falling, subjective cognitive decline-functional performance (SCD-FP), and fall risk using simple screening tools. In this cross-section study, we collected data from community-dwelling older adults 60 years or older in low-income settings in Central Florida, and 86 participants were included in the data analysis. Fear of falling was assessed by the Short Fall Efficacy Scale- International (Short FES-I) with seven items. Subjective cognitive decline-functional performance (SCD-FP) was assessed by a self-reported experience of worsening or more frequent confusion or memory loss in the past 12 months and its functional implications. Fall risk was evaluated by the Centers for Disease Control and Prevention (CDC)'s Stay Independent checklist with 12 items. The majority of participants were female, and more than half of the participants were African American. More than half of the participants had a higher school degree or higher, and less than 20% had no financial problems. Less than 30% of the participants perceived their general health as very good- excellent. More than half of the participants lived alone, and less than 15% lived with a partner or spouse. About 60% of the participants had hypertension, 40% had diabetes, 16% had cancer, and 50% had arthritis. About 30% of the participants had difficulty walking up ten steps without resting, more than 40% felt unsteady when walking, and 30% had been advised to use a cane or walker to get around safely. Regression analysis showed that fall risk was associated with fear of falling ( = .524, p <.001) and subjective cognitive decline-functional performance ( = .465, p =.027). The structure coefficient showed that fear of falling (rs2 = .922) was a stronger predictor of fall risk than subjective cognitive decline-functional performance (rs2= .200). Fear of falling and subjective cognitive decline-functional performance are growing public health issues, and addressing those issues is a public priority. Proactive screening for fear of falling and subjective cognitive decline-functional performance is critical in fall prevention. A combination of all three self-reported tools (Short FES-I, SCD-FP, and CDC's Stay Independent checklist) takes less than 5 minutes to complete. Primary care providers or public health professionals should consider including these tools to screen fear of falling and subjective cognitive decline-functional performance as part of fall risk assessment, especially in low-income settings. Thus, encouraging older adults and healthcare professionals to discuss fear of falling, subjective cognitive decline, and fall risk during routine medical office visits.

Keywords: falls, fall risk, fear of falling, cognition, subjective cognitive decline, low-income, older adults, community, screening, nursing, primary care

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Authors: T. Almutairi, K. Naudi, N. Nairn, X. Ju, B. Eng, J. Whitters, A. Ayoub

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Purpose: At present Cone Beam Computed Tomography (CBCT) imaging does not record dental morphology accurately due to the scattering produced by metallic restorations and the reported magnification. The aim of this pilot study is the development and validation of a new method for the replacement of the distorted dentition of CBCT scans with the dental image captured by the digital intraoral camera. Materials and Method: Six dried skulls with orthodontics brackets on the teeth were used in this study. Three intra-oral markers made of dental stone were constructed which were attached to orthodontics brackets. The skulls were CBCT scanned, and occlusal surface was captured using TRIOS® 3D intraoral scanner. Marker based and surface based registrations were performed to fuse the digital intra-oral scan(IOS) into the CBCT models. This produced a new composite digital model of the skull and dentition. The skulls were scanned again using the commercially accurate Laser Faro® arm to produce the 'gold standard' model for the assessment of the accuracy of the developed method. The accuracy of the method was assessed by measuring the distance between the occlusal surfaces of the new composite model and the 'gold standard' 3D model of the skull and teeth. The procedure was repeated a week apart to measure the reproducibility of the method. Results: The results showed no statistically significant difference between the measurements on the first and second occasions. The absolute mean distance between the new composite model and the laser model ranged between 0.11 mm to 0.20 mm. Conclusion: The dentition of the CBCT can be accurately replaced with the dental image captured by the intra-oral scanner to create a composite model. This method will improve the accuracy of orthognathic surgical prediction planning, with the final goal of the fabrication of a physical occlusal wafer without to guide orthognathic surgery and eliminate the need for dental impression.

Keywords: orthognathic surgery, superimposition, models, cone beam computed tomography

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Authors: Ziyad S. Haidar

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Background: Saliva plays a major role in maintaining oral and dental health (consequently, general health and well-being). Where it normally bathes the oral cavity and acts as a clearing agent. This becomes more apparent when the amount and quality of salivare significantly reduced due to medications, salivary gland neoplasms, disorders such as Sjögren’s syndrome, and especially ionizing radiation therapy for tumors of the head and neck, the fifth most common malignancy worldwide, during which the salivary glands are included within the radiation field or zone. Clinically, patients affected by salivary gland dysfunction often opt to terminate their radiotherapy course prematurely because they become malnourished and experience a significant decrease in their quality of life. Accordingly, the development of an alternative treatment to restore or regenerate damaged salivary gland tissue is eagerly awaited. Likewise, the formulation of a radioprotection modality and early damage prevention strategy is also highly desirable. Objectives: To assess the pre-clinical radio-protective effect as well as the reparative/regenerative potential of layer-by-layer self-assembled lipid-polymer-based core-shell nanocapsules designed and fine-tuned in this experimental work for the sequential (ordered) release of dual cytokines, following a single local administration (direct injection) into a murine sub-mandibular salivary gland model of irradiation. Methods: The formulated core-shell nanocapsules were characterized by physical-chemical-mechanically pre-/post-loading with the drugs (in solution and powder formats), followed by optimizing the pharmaco-kinetic profile. Then, nanosuspensions were administered directly into the salivary glands, 24hrs pre-irradiation (PBS, un-loaded nanocapsules, and individual and combined vehicle-free cytokines were injected into the control glands for an in-depth comparative analysis). External irradiation at an elevated dose of 18Gy (revised from our previous 15Gy model) was exposed to the head-and-neck region of C57BL/6 mice. Salivary flow rate (un-stimulated) and salivary protein content/excretion were regularly assessed using an enzyme-linked immunosorbent assay (3-month period). Histological and histomorphometric evaluation and apoptosis/proliferation analysis followed by local versus systemic bio-distribution and immuno-histochemical assays were then performed on all harvested major organs (at the distinct experimental end-points). Results: Monodisperse, stable, and cytocompatible nanocapsules capable of maintaining the bioactivity of the encapsulant within the different compartments with the core and shell and with controlled/customizable pharmaco-kinetics, resulted, as is illustrated in the graphical abstract (Figure) below. The experimental animals demonstrated a significant increase in salivary flow rates when compared to the controls. Herein, salivary protein content was comparable to the pre-irradiation (baseline) level. Histomorphometry further confirmed the biocompatibility and localization of the nanocapsules, in vivo, into the site of injection. Acinar cells showed fewer vacuoles and nuclear aberration in the experimental group, while the amount of mucin was higher in controls. Overall, fewer apoptotic activities were detected by a Terminal deoxynucleotidyl Transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay and proliferative rates were similar to the controls, suggesting an interesting reparative and regenerative potential of irradiation-damaged/-dysfunctional salivary glands. The Figure below exemplifies some of these findings. Conclusions: Biocompatible, reproducible, and customizable self-assembling layer-by-layer core-shell delivery system is formulated and presented. Our findings suggest that localized sequential bioactive delivery of dual cytokines (in specific dose and order) can prevent irradiation-induced damage via reducing apoptosis and also has the potential to promote in situ proliferation of salivary gland cells; maxSALIVA is scalable (Good Manufacturing Practice or GMP production for human clinical trials) and patent-pending.

Keywords: saliva, head and neck cancer, nanotechnology, controlled drug delivery, xerostomia, mucositis, biopolymers, innovation

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Authors: Bennasser Samira

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Meningitis, especially the meningococcal one, is a serious problem of public health. A system of vigilanceand surveillance is in place to allow effective actions to be taken on actual or potential health problems caused by all forms of meningitis. Objectives: 1. Describe the epidemiological surveillance system for meningitis in the province of Taza. 2. Evaluate the quality and responsiveness of the epidemiological surveillance system for meningitis in the province of Taza. 3. Propose measures to improve this system at the provincial level. Methods: This was a descriptive study with a purely quantitative approach by evaluating the quality and responsiveness of the system during 5 years between January 2016 and December 2020. We usedfor that the investigation files of meningitis cases and the provincial database of meningitis. We calculated some quality indicators of surveillance system already defined by the National Program for the Prevention and Control of Meningitis. Results: The notification is passive, the completeness of the data is quite good (94%), and the timeliness don’t exceed 71%. The quality of the data is acceptable (91% agreement). The systematic and rapid performance of lumbar punctures increases the diagnostic capabilities of the system. The local response actions are effected in 100%. Conclusion: The improvement of this surveillance system depends on strengthening the staff skills in diagnostic, reviewing surveillance tools, and encouraging judicious use of the data.

Keywords: evaluation, meningitis, system, taza, morocco

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Authors: Razieh Zarei, Hassan zm, Abolghasem Ajami, Darush Moslemi, Narges Afsary, Amrollah Mostafa-zade

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Introduction: IL-23 is responsible for the differentiation and expansion of Th17/ThIL-17 cells from naive CD4+ T cells. Therefore, may be IL-23/IL17 axis involve in a variety of allergic and autoimmune diseases, such as RA, MS, inflammatory bowel disease (IBD), and asthma. TGF-β is also share for the differentiation Th17 producing IL-17 and CD4+CD25+Foxp3hiT regulatory cells from naïve CD4+ T cells which are involved in the regulation of immune response, maintaining immunological self-tolerance and immune homeostasis ,and the control of autoimmunity and cancer surveillance. Therefore, T regulatory cells play a key role in autoimmunity, allergy, cancer, infectious disease, and the induction of transplantation tolerance. Vitamin A and it's derivatives (retinoids) inhibit or reverse the carcinogenic process in some types of cancers in oral cavity,head and neck, breast, skin, liver, and blood cells. Shark is a murine organism and its cartilage has antitumor peptides to prevent angiogenesis, in vitro. Our purpose is whether simultaneous oral treatment vitamin A and shark cartilage can modulate IL-23/IL-17 and CD4CD25Foxp3 T regulatory cell/TGF-β pathways and Th1/Th2 immunity in patients with gastric cancer. Materials and Methods: First investigated an imbalanced supernatant of cytokines exist in patients with gastric cancer by ELISA. Associated with cytokines measuring such as IL-23,IL-17,TGF-β,IL-4 and γ-IFN, then flow cytometry was employed to determine whether the peripheral blood mononuclear cells such as CD4+CD25+Foxp3highT regulatory cells in patients with gastric cancer were changed correspondingly. Results: An imbalance between IL-17 secretion and TGF-β/Foxp3 t regulatory cell pathway and so, Th1 immunity (γ-IFN production) and TH2 immunity (IL-4 secretion) was not seen in patients with gastric cancer treated by vitamin A and shark cartilage. But, the simultaneously presented down-regulation of IL-23 indicated, at least cytokine level. Conclusion: Il-23, as a pro-angiogenesis cytokine, probably, help to tumor growth. Hence, suggested that down-regulation of IL-23, at least cytokine level, is useful for anti-tumor immune responses in patients with gastric cancer.

Keywords: IL-23/IL17 axis, TGF-β/CD4CD25Foxp3 T regulatory pathway, γ-IFN, IL-4, shark cartilage and gastric cancer

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Authors: Arghavan Tonkaboni, Shamsolmolouk Najafi, Mohmmad Taghi Kiani, Mehrzad Gholampour, Touraj Goli

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Introduction: Recurrent aphthous stomatitis (RAS) is a multifactorial recurrent oral lesion; which is an autoimmune disease. TH1 cytokines are the most important etiological factors. Autoimmune thyroid disease (ATD) is one of the most common autoimmune diseases and generally coexists with other autoimmune diseases. This study assessed the prevalence of thyroid disease in patients with recurrent aphthous stomatitis. Materials and Methods: This case control study assessed 100 known RAS patients who were diagnosed clinically by oral medicine specialists; venous blood samples were analyzed for thyroid stimulating hormone (TSH), free triiodothyronine (fT3), total thyroxine (fT4), thyroglobulin, anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (anti-TG) levels. Results: Fifty patients with RAS aged between 18-42 years (28.5±5.8) and 50 healthy volunteers aged 19-45 years (27.3±5.4) participated. In RAS patients, fT3 and TSH levels were significantly higher (P=0.031, P=0.706); however, fT4 level was lower in the RAS group (P=0.447). Anti TG and anti-TPO levels were significantly higher in the RAS group (P=0.008, P=0.067). Conclusion: Our study showed that ATD prevalence was significantly higher in RAS patients. Based on this study, we recommend assessment of thyroid hormones and antibodies in RAS patients.

Keywords: recurrent aphthous stomatitis, thyroid antibodies, thyroid hormone, thyroid autoimmune disease

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Authors: Ayşe Coban, Orhan Coban, Haldun Soydal, Sükrü Sürücü

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While health is a source of prosperity for individuals, it is also one of the most important determinants of economic growth for a country. Health, by increasing the productivity of labor, contributes to economic growth. Therefore, countries should give the necessary emphasis to health services. The primary aim of this study is to analyze the changes occurring in health services in Turkey by examining the developments in the sector. In this scope, the second aim of the study is to reveal the place of health expenditures in the Turkish economy. As a result of the analysis in the dataset, in which the 1999-2013 periods is considered, it was determined that some increase in health expenditures took place and that the increase in the share of health expenditures in GDP was too small. Furthermore, analysis of the results points out that in financing health expenditures, the public sector is prominent compared to the private sector.

Keywords: health, health service, health expenditures, Turkey

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Authors: Aulina R. Rahmi, Farid Yuristiawan, Annisa Ibifadillah, Ummu H. Amri, Hidayati Gunawan

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Glass ionomer cement is one of the filling material that often used on the field of dentistry because it is relatively less expensive and mostly available. Restoration materials could undergo changes in their clinical properties such as changes in roughness of the restoration`s surface. An increase of surface roughness accelerates bacterial colonization and plaque maturation. In the oral cavity, GIC was exposed to various substances, such as toothpaste, an oral care product used during toothbrushing. One of the popular toothpaste is whitening toothpaste. Abrasive and chemical agents such as hydrogen peroxide in whitening toothpaste could increase the surface roughness of restorative materials. Objective: To determine the differences on the surface roughness of glass ionomer cement that was brushed with whitening and conventional toothpaste. Method: This study was done using experimental laboratory method with pre and post test design. There were 36 samples which were divided into 2 groups. The first group was brushed with whitening toothpaste and the second group was brushed with conventional toothpaste, each for 2 minutes. Surface roughness value of the specimens was measured by using Roughness Tester test. Result: The data was analyzed by using independent t-test and the result of this study showed there was a significant difference between the surface of glass ionomer cement which was brushed with whitening and conventional toothpaste (p=0,000). Conclusion: Glass ionomer cement that was brushed with whitening toothpaste produced more roughness than conventional toothpaste.

Keywords: glass ionomer cement, surface roughness, toothpaste, roughness tester

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