Search results for: prevention of infection

Authors: Yang-Ho Jang, Soon-Ok Jee, Hae-Chul Park, Jeong-Woo Kang, Byung-Jae So, Sung-Shik Shin, Kyu-Sung Ahn, Kwang-Jick Lee

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Introduction: Antibiotics have been used as feed additives for the growth promotion and performance in food-producing animals. However, the possibility of selection of antimicrobial resistance and the concerns of residue in animal products led to ban the use of antibiotics in farm animals at 2011 in Korea. This strategy is also adjusted to anticoccidial drugs soon but these are still allowed for the time being to use in a diet for the treatment and control for the enteric necrosis in poultry. Therefore substantial focus has been given to find alternatives to antimicrobial agents. Several phytogenic materials have been reported to have positive effects on coccidiosis. This study was to evaluate the effects on anti-coccidial effect of oregano oil based herb mixture on Eimeria spp. in poultry. Materials and Methods: A total of one day-old boiler chickens divided into six groups (each group=30 chkckens) were used in this study. The herbal mixture was fed with water freely as follows: two groups, one infected with Eimeria spp. and the other group served as controls without herbal mixture respectively; 0.2ml/L of oregano oil; 0.2ml/L of oregano oil and Sanguisorbae radix; 0.2ml/L of Sanguisorbae radix; last group was fed with dichlazuril diet as positive control. Sporulated Eimeria spp. was infected at 14 day-old. Following infection, survival rate, bloody diarrhea, OPG (oocyst per gram) and feed conversion ratios were determined. The experimental period was lasted for 4 weeks. Results: Herbal mixture feeding groups (Group 3,4,5) showed low feed conversion ratio comparing with negative control. Oregano oil group and positive control group recorded the highest survival rate. The grade of bloody diarrhea was scored 0 to 5. Herbal mixture feeding groups showed 2, 3 and 1 score respectively however, group 2 (infection and no-treatment) showed 4. OPG results in herbal mixture feeding group were 3 to 4 times higher than diclazuril diet feeding group. Conclusions: These results showed that oregano oil and Sanguisorbae radix mixture may have an anti-coccidial effect and also affect chick performance.

Keywords: anticoccidial effects, oregano oil based herb mixture, herbal mixture, antibiotics

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Authors: K. P. v. R. de Silva, R. W. Senevirathna, M. M. A. J. Kumara, J. P. M. Kumarasinghe, R. L. Gunawardana, S. M. Uluwitiya, G. C. P. Jayawickrama, W. K. T. I. Madushani

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Introduction: The limited literature supporting the utilization of mechanical bowel preparation (MBP) for patients undergoing laparoscopic anterior resection (LAR) remains a notable issue. This study was conducted to examine the clinical consequences of anastomosis in colorectal surgery with MBP compared to cases where MBP was not utilized (no-MBP) in the context of LAR. Methods: This was a retrospective comparative study conducted in the professorial surgical wards of the teaching hospital karapitiya (THK). Colorectal cancer patients(n=306) participated in the study, including 151 MBP patients and 155 no-MBP patients, where the postoperative complications and mortality rates were compared. Results: The anastomotic leakage rate was 2.6%(n=4) in the no-MBP group and 6.0%(n=9) in the MBP group (p=0.143). The postoperative paralytic ileus rate was 18.5%(n=28) and 5.8%(n=9) in the MBP group and no-MBP group, respectively, displaying a statistically significant difference (p=0.001). Wound infection, pneumonia, urinary tract infection, and cardiac complication rates also were higher in the MBP group. The overall mortality rate was 1.3%(n=3) in the no-MBP group and 2.0%(n=2) in the MBP group. Conclusions: The evidence concludes that MBP increases post-operative complications. Therefore, prophylactic MBP in LAR has not been proven to benefit patients. However, further research is necessary to understand the comparative effects of MBP versus no preparation comprehensively.

Keywords: MBP, anastomosis, LAR, paralytic ileus

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Authors: Mohammadjavad Mehrabanpour, Maryam Ranjbar Bushehri, Dorsa Mehrabanpour

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Respiratory diseases are the most important problems in the country’s poultry industry, particularly when it comes to broiler flocks. Ornithobacterium rhinotracheale (ORT) is a species that causes poor performance in growth rate, egg production, and mortality. This pathogen causes a respiratory infection including pulmonary alveolar inflammation, and pneumonia of birds throughout the world. Newcastle disease (ND) is a highly contagious disease in poultry, and also, it causes considerable losses to the poultry industry. The aim of this study was to evaluate the simultaneous occurrence of ORT and ND and NDV isolation by inoculation in embryonated eggs and confirmed by RT-PCR in broiler chicken flocks in Fars province. In this study, 318 blood and 85 tissue samples (brain, trachea, liver, and cecal tonsils) were collected from 15 broiler chicken farms. Survey serum antibody titers against ORT by using a commercial enzyme-linked immunosorbent assay (ELISA) kit performed. Evaluation of antibody titer against ND virus is performed by hemagglutination inhibition test. Virus isolation with chick embryo eggs 9-11 and RT-PCR method were carried out. A total of 318 serum samples, 135 samples (42.5%) were positive for antibodies to ORT and titer of HI antibodies against NDV in 122 serum samples (38/4%) were 7-10 (log2) and 61 serum samples (19/2%) had occurrence antibody titer against Newcastle virus and ORT. Results of the present study indicated that 20 tissue samples were positive in embryonated egg and in rapid hemagglutination (HA) test. HI test with specific ND positive serum confirmed that 6 of 20 samples. PCR confirmed that all six samples were positive and PCR products of samples indicated 535-base pair fragments in electrophrosis. Due to the great economic importance of these two diseases in the poultry industry, it is necessary to design and implement a comprehensive plan for prevention and control of these diseases.

Keywords: ELISA, Ornithobacterium rhinotracheale, newcastle disease, seroprevalence

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Authors: Imeobong Joseph Inyang, Aniekan-Augusta Okon Eyo, Abel William Essien

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Hepatitis B virus (HBV) is one of the known human carcinogens. The presence of HBsAg in liver tissues indicates active viral replication. More than 85% of Hepatocellular Carcinoma (HCC) cases occur in countries with increased rates of chronic HBV infection. An evaluation study to determine the relationship between positivity for HBsAg and development of HCC and its distribution between age and gender of subjects was done. Shikata Orcein and Haematoxylin and Eosin (H&E) staining techniques were performed on liver sections. A total of 50 liver tissue specimens comprising 38 biopsy and 12 post-mortem specimens were processed. Thirty-five of the 50 specimens were positive for HBsAg with Orcein stain whereas only 16 were positive with H&E stain, and these were also positive with Orcein stain, giving an HBsAg prevalence of 70.0% (35/50). The prevalence of HCC in the study was 56.0% (28/50), of which 21 (75.0%) cases were positive for HBsAg, 18 (64.3%) were males while 10 (35.7%) were females distributed within the age range of 20-70 years. The highest number of HBsAg positive HCC cases, 7/21 (33.3%) occurred in the age group 40-49 years. There was no relationship in the pattern of distribution of HCC between age and gender using the Pearson correlation coefficient (r = 0.0474; P < 0.05). HBV infection predisposed to HCC. Orcein technique was more specific and is therefore recommended for screening of liver tissues where facilities for immunohistochemistry are inaccessible.

Keywords: Hepatitis B. surface antigen, hepatocellular carcinoma, orcein, pathology

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Authors: A. Alyami, S. Christmas, K. Neeltje, G. Pollakis, B. Paxton, Z. Al-Bayati

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The Human leukocyte antigen-G (HLA-G) molecule plays an important role in immunomodulation. To date, 16 untranslated regions (UTR) HLA-G haplotypes have been previously defined by sequenced SNPs in the coding region. From these, UTR-1, UTR-2, UTR-3, UTR-4, UTR-5, UTR-6 and UTR-7 are the most frequent 3’UTR haplotypes at the global level. UTR-1 is associated with higher levels of soluble HLA-G and HLA-G expression, whereas UTR-5 and UTR-7 are linked with low levels of soluble HLA-G and HLA-G expression. Human immunodeficiency virus type 1 (HIV-1) infection results in the progressive loss of immune function in infected individuals. The virus escape mechanism typically includes T lymphocytes and NK cell recognition and lyses by classical HLA-A and B down-regulation, which has been associated with non-classical HLA-G molecule up-regulation, respectively. We evaluated the haplotypes of the HLA-G 3′ untranslated region frequencies observed in three HIV-1 groups from the Netherlands and their susceptibility to develop infection. The three groups are made up of mainly men who have sex with men (MSM), injection drug users (IDU) and a high-risk-seronegative (HRSN) group. DNA samples were amplified with published primers prior sequencing. According to our results, the low expresser frequencies show higher in HRSN compared to other groups. This is indicating that 3’UTR polymorphisms may be identified as potential prognostic biomarkers to determine susceptibility to HIV.

Keywords: Human leukocyte antigen-G (HLA-G) , men who have sex with men (MSM), injection drug users (IDU), high-risk-seronegative (HRSN) group, high-untranslated region (UTR)

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Authors: Sheikha Turki Alketbi

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Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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Authors: Saekil Yun, Sib Sankar Giri, Jin Woo Jun, Hyoun Joong Kim, Sang Guen Kim, Sang Wha Kim, Jung Woo Kang, Se Jin Han, Se Chang Park

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In aquaculture, vaccination is important to control and prevent diseases. In the study, we utilized poly D,L-lactide-co-glycolic acid (PLGA) microparticles (MPs) for encapsulating formalin-killed Aeromonas hydrophila cells. To assess the innate and adaptive immune responses, carps and loaches were used for the experiments. Fish were divided into three groups (A, B, C). Total antigen of 0.1 ml vaccine was adjusted by 2 x 108 CFU and injected via intraperitoneal route. Group A was vaccinated with 0.1 ml of PLGA vaccine, group B was with 0.1 ml of FKC vaccine and group C was with 0.1 ml of sterile PBS. All three groups were challenged with A. hydrophila and challenge dose was lethal dose (LD50). Loaches and carp were then challenged with A. hydrophila at 12 and 20 weeks post vaccination (wpv), and 10 and 14 wpv, respectively, and relative survival rates were calculated. For both fish species, the curve of antibody titer over time was shallower in the PLGA group than the FKC group and the PLGA groups demonstrated higher survival rates at all time-points. In the groups of PLGA-MP, relative mRNA levels of IL-1β, TNF-α, lysozyme C and IgM were significantly upregulated than FKC treated groups. Biodegradable PLGA microparticle vaccine could induce longer immune responses than original FKC vaccines to protect from A. hydrophila infection.

Keywords: PLGA, microparticles, Aeromonas hydrophila, vaccine

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Authors: Siriniya Siribrahmanakul

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

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

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Authors: Sachiko Hosoya

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Objectives: The purpose of this paper is to investigate the social policy of preventive genetic medicine in Iran, by following the legalization process of abortion law and the factors affecting the process in wider Iranian contexts. In this paper, ethical discussions of prenatal diagnosis and selective abortion in Iran will be presented, by exploring Iranian social policy to control genetic diseases, especially a genetic hemoglobin disorder called Thalassemia. The ethical dilemmas in application of genetic medicine into social policy will be focused. Method: In order to examine the role of the policy for prevention of genetic diseases and selective abortion in Iran, various resources have been sutudied, not only academic articles, but also discussion in the Parliament and documents related to a court case, as well as ethnographic data on living situation of Thalassemia patients. Results: Firstly, the discussion on prenatal diagnosis and selective abortion is overviewed from the viewpoints of ethics, disability rights activists, and public policy for lower-resources countries. As a result, it should be noted that the point more important in the discussion on prenatal diagnosis and selective abortion in Iran is the allocation of medical resources. Secondly, the process of implementation of national thalassemia screening program and legalization of ‘Therapeutic Abortion Law’ is analyzed, through scrutinizing documents such as the Majlis record, government documents and related laws and regulations. Although some western academics accuse that Iranian policy of selective abortion seems to be akin to eugenic public policy, Iranian government carefully avoid to distortions of the policy as ‘eugenic’. Thirdly, as a comparative example, discussions on an Iranian court case of patient’s ‘right not to be born’ will be introduced. Along with that, restrictive living environments of people with Thalassemia patients and the carriers are depicted, to understand some disabling social factors for people with genetic diseases in the local contexts of Iran.

Keywords: abortion, Iran, prenatal diagnosis, public health ethics, Thalassemia prevention program

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Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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Authors: Mohammad Hossein Modarressi, Mozhgan Mondeali, Khabat Barkhordari, Ali Etemadi

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The COVID-19 pandemic, caused by SARS-CoV-2, has led to significant concerns worldwide due to its catastrophic effects on public health. The SARS-CoV-2 infection is initiated with the binding of the receptor-binding domain (RBD) in its spike protein to the ACE2 receptor in the host cell membrane. Due to the error-prone entity of the viral RNA-dependent polymerase complex, the virus genome, including the coding region for the RBD, acquires new mutations, leading to the appearance of multiple variants. These variants can potentially impact transmission, virulence, antigenicity and evasive immune properties. S477N mutation located in the RBD has been observed in the SARS-CoV-2 omicron (B.1.1. 529) variant. In this study, we investigated the consequences of S477N mutation at the molecular level using computational approaches such as molecular dynamics simulation, protein-protein interaction analysis, immunoinformatics and free energy computation. We showed that displacement of Ser with Asn increases the stability of the spike protein and its affinity to ACE2 and thus increases the transmission potential of the virus. This mutation changes the folding and secondary structure of the spike protein. Also, it reduces antibody neutralization, raising concern about re-infection, vaccine breakthrough and therapeutic values.

Keywords: S477N, COVID-19, molecular dynamic, SARS-COV2 mutations

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Authors: Marzieh Nojomi, Azadeh Mottaghi, Arghavan Haj-Sheykholeslami, Narjes Khalili, Arash Tehrani Banihashemi

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Background and objectives: Domestic violence is a global problem with severe consequences throughout the life of the victims. Iran’s Ministry of Health has launched an intimate partner violence (IPV) prevention program, integrated in the primary health care services since 2016. The present study is a part of this national program’s evaluation. In this section, we aimed to examine spousal abuse victims’ knowledge and attitude towards domestic violence before and after receivingthese services. Methods: To assess the knowledge and attitudes of victims, a questionnaire designed by Ahmadzadand colleagues in 2013 was used. This questionnaire includes 15 questions regarding knowledge in the fields of definition, epidemiology, and effects on children, outcomes, and prevention of domestic violence. To assess the attitudes, this questionnaire has 10 questions regarding the attitudes toward the causes, effects, and legal or protective support services of domestic violence. To assess the satisfaction and the effect of the program on prevention or reduction of spousal violence episodes, two more questions were also added. Since domestic violence prevalence differs in different parts of the country, we chose nine areas with the highest, the lowest, and moderate prevalence of IPVfor the study. The link to final electronic version of the questionnaire was sent to the randomly selected public rural or urban health centers in the nine chosen areas. Since the study had to be completed in one month, we used newly identified victims as pre-intervention group and people who had at least received one related service from the program (like psychiatric consultation, education about safety measures, supporting organizations and etc.) during the previous year, as our post- intervention group. Results: A hundred and ninety-two newly identified IPV victims and 267 victims who had at least received one related program service during the previous year entered the study. All of the victims were female. Basic characteristics of the two groups, including age, education, occupation, addiction, spouses’ age, spouses’ addiction, duration of the current marriage, and number of children, were not statistically different. In knowledge questions, post- intervention group had statistically better scores in the fields of domestic violence outcomes and its effects on children; however, in the remaining areas, the scores of both groups were similar. The only significant difference in the attitude across the two groups was in the field of legal or protective support services. From the 267 women who had ever received a service from the program, 91.8% were satisfied with the services, and 74% reported a decrease in the number of violent episodes. Conclusion: National IPV prevention program integrated in the primary health care services in Iran is effective in improving the knowledge of victims about domestic violence outcomes and its effects on children. Improving the attitude and knowledge of domestic violence victims about its causes and preventive measures needs more effective interventions. This program can reduce the number of IPV episodes between the spouses, and satisfaction among the service users is high.

Keywords: intimate partner violence, assessment, health services, efficacy

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Authors: Gbone Akou Sophie

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Lome state in Togo is considered to have the highest HIV prevalence in Togo according to NAIIS 2023, with the prevalence of 5.5%, Female Sex Workers (FSW) are one of the most vulnerable population, and they are vital in HIV programming. They have the highest HIV prevalence compared to others such as HRM, PWID and Transgender in lome State, Togo. Evidence from Integrated Biological Behavioral Surveillance Survey shows increasing burden of HIV infection from 13.7% in 20018 to 17.2% in 2020 and now 22.9% in 2021 among Female Sex Workers (FSW). This shows their HIV prevalence has been rising over time. The vulnerability status of the FSW in the riverine areas of lome is heightened because of cultural and economic issues where there is exchange of sex for commodities with cross border traders as well as limited access to HIV prevention information. Methods:A cross sectional study which recruited 120 FSW from two Riverine LGAs of Agoe and Kpehenou LGA of Lome State using both snowballing and simple random sampling technique. While semi-structured questionnaire was used as an instrument for data collection among the 120 FSW respondents. Additional information was also elicited from 10 FSW key opinion leaders and community members through in-depth interviews (IDI). Results: 44(36%) of respondents were willing to receive regular HIV care and services as well as visit for STI check-ups at any service point. However, 47(40%) were willing to receive services at private facilities alone, 10 (8%) were willing to receive services at public facilities, 6 (5%) were willing to access services in their homes rather than in the health facility. 13 (11%) were also willing to have peers assist in getting HIV testing services. Conclusion: integrated differentiated model of care for HIV services helps improve HIV services uptake among FSW community especially in the hard- to reach riverine areas which will further lead to epidemic control. Also targeted HIV information should be designed to suit the learning needs of the hard-to reach communities like the riverine areas. More peer educators should be engaged to ensure information and other HIV services reach the riverine communities.

Keywords: female sex workers ( FSW), human immuno-deficiency virus(HIV), prevanlence, service delivery

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Authors: B. Baran, S. N. Kaptanoglu, M. Ocal, Y. Kagnici, E. Esen, E. Siyez, D. M. Siyez

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Infertility is the fact that couples cannot have children despite 1 year of unprotected sexual life. Infertility can be considered as an important problem affecting not only sexual life but also social and psychological conditions of couples. Learning about information about preventable factors related to infertility during university years plays an important role in preventing a possible infertility case in older ages. The possibility to facilitate access to information with the internet has provided the opportunity to reach a broad audience in the diverse learning environments and educational environment. Moreover, the internet has become a basic resource for the 21st-century learners. Providing information about infertility over the internet will enable more people to reach in a short time. When studies conducted abroad about infertility are examined, interactive websites and online education programs come to the fore. In Turkey, while there is no comprehensive online education program for university students, it seems that existing studies are aimed to make more advertisements for doctors or hospitals. In this study, it was aimed to design and develop online infertility prevention education for university students. Mayer’s Multimedia Learning Theory made up the framework for the online learning environment in this study. The results of the needs analysis collected from the university students in Turkey who were selected with sampling to represent the audience for online learning contributed to the design phase. In this study, an infertility prevention online education environment designed as a 4-week education was developed by explaining the theoretical basis and needs analysis results. As a result; in the development of the online environment, different kind of visual aids that will increase teaching were used in the environment of online education according to Mayer’s principles of extraneous processing (coherence, signaling, spatial contiguity, temporal contiguity, redundancy, expectation principles), essential processing (segmenting, pre-training, modality principles) and generative processing (multimedia, personalization, voice principles). For example, the important points in reproductive systems’ expression were emphasized by visuals in order to draw learners’ attention, and the presentation of the information was also supported by the human voice. In addition, because of the limited knowledge of university students in the subject, the issue of female reproductive and male reproductive systems was taught before preventable factors related to infertility. Furthermore, 3D video and augmented reality application were developed in order to embody female and male reproductive systems. In conclusion, this study aims to develop an interactive Online Infertility Prevention Education in which university students can easily access reliable information and evaluate their own level of knowledge about the subject. It is believed that the study will also guide the researchers who want to develop online education in this area as it contains design-stage decisions of interactive online infertility prevention education for university students.

Keywords: infertility, multimedia learning theory, online education, reproductive health

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Authors: Muhammad Imran Hussain, Ramisha Ibtisam, Tayyaba Fatima, Huba Khalid, Ayesha Aziz, Khansa, Adan Sitara, Anam Shahzad, Aymen Jabeen

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Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.

Keywords: tuberculosis, vitamin D, interferon gamma, protein, infection

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Authors: Isaac Makundi, Kazuo Nishigaki

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The Tsushima leopard cat (TLC) Prionailurus bengalensis euptilurus, designated a National Natural Monument of Japan, inhabits Tsushima Island, Nagasaki Prefecture, Japan. TLC is considered a subspecies of P. bengalensis, and lives only on Tsushima Island. TLCs are threatened by various infectious diseases. Feline leukemia virus (FeLV) causes a serious infectious disease with a poor prognosis in cats. Therefore, the transmission of FeLV from Tsushima domestic cats (TDCs) to TLCs may threaten the TLC population. We investigated the FeLV infection status of both TDCs and TLCs on Tsushima Island by screening blood samples for FeLV p27 antigen and using PCR to amplify the full-length FeLV env gene. The prevalence of FeLV was 6.4% in TDCs and 0% in TLCs. We also demonstrated that the virus can replicate in the cells of TLCs, suggesting its potential cross-species transmission. The viruses in TDCs were classified as genotype I/clade 3, which is prevalent on a nearby island, based on previous studies of FeLV genotypes and FeLV epidemiology. The FeLV viruses identified on Tsushima Island can be further divided into two lineages within genotype I/clade 3, which are geographically separated in Kamijima and Shimojima, indicating that FeLV may have been transmitted to Tsushima Island at least twice. Monitoring FeLV infection in the TDC and TLC populations is highly recommended as part of the TLC surveillance and management strategy.

Keywords: epidemiology, Feline leukemia virus, Tsushima Island, wildlife management

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Authors: S. Pathak, R. Lazarus

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A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

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Authors: J. J. Mathew

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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

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Authors: Angie M. Wolf, DeVone Boggan

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This paper highlights an innovative and nontraditional violence prevention program that is making a noticeable impact in what was once one of the country’s most violent communities. With unique and tailored strategies, the Operation Peacemaker Fellowship, established in Richmond, California, combines components of evidence-based practices with a community-oriented focus on relationships and mentoring to fill a gap in services and increase community safety. In an effort to highlight these unique strategies and provide a blueprint for other communities with violent crime problems, the authors of this paper hope to clearly delineate how one community is moving forward with vanguard approaches to invest in the lives of young men who once were labeled the communities’ most violent, even the most deadly, youth. The impact of this program is evidenced through the fellows’ own voices as they illuminate the experience of being in the Fellowship. In interviews, fellows’ describe how participating in this program has transformed their lives, and the lives of those they love. The authors of this article spent more than two years researching this Fellowship program in order to conduct an evaluation of it and, ultimately, to demonstrate how this program is a testament to the power of relationship and love combined with evidence-based practices, consequently enriching the lives of youth and the community that embraces them.

Keywords: gun violence prevention, high risk youth, law, policing justice

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Authors: Pintu Modak

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The core strength is essential not only for athletes but also for everyone to perform everyday's household chores with ease and efficiency. Core strength means to strengthen the muscles deep within the abdomen which connect to the spine and pelvis which control the position and movement of the central portion of the body. Strengthening of core muscles is important for injury prevention (lower back pain) and performance enhancement in sports. The purpose of the study was to review the literature and findings on the effects of Yoga exercise as a part of sports training method and fitness programs. Fifteen papers were found to be relevant for this review. There are five simple yoga poses: Ardha Phalakasana (Low plank), Vasisthasana (side plank), Purvottanasana (inclined plane), Sarvangasana (shoulder stand), and Virabhadrasana (Warrior) are found to be very effective for strengthening core muscles. They are the most effective poses to build core strength and flexibility to the core muscles. The study suggests that sports and fitness trainers should include these yoga exercises in their programs to strengthen core muscles.

Keywords: core strength, yoga, injuries, lower back

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Authors: Robert O'Mochain

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Over seven years have passed since the #MeToo movement first became prominent in Japan. Opinions vary on the degree of success of the movement along with its offshoot campaigns. This chapter suggests that a range of historical factors help to account for the relative lack of success of #MeToo in Japan, but that the gains achieved should also be highlighted. Our interviews with a range of activists provide insights into the nature of #MeToo in Japan and how it should be contextualized in the contemporary landscape of feminist movements here. In spite of the gains that have been made, it remains clear that levels of abuse and of non-reporting remain worryingly high and calls for well-resourced campaigns for ‘Awareness, Prevention, and Response’ are as timely as ever. Surprisingly, a case of sexual abuse involving boys and young men who were the victims of the sexual predator and entertainment mogul, Johnny Kitagawa, may be the clearest sign of change in Japanese society regarding victims of sexual abuse. In the post-#MeToo era, it was possible for these victims to come forward and attain some measure of justice. It was also possible for members of the public to strongly condemn the failures of the mass media journalists who ignored the evidence of sexual abuse for many years. Nevertheless, the case itself does not constitute reliable evidence that conditions have changed significantly for all victims of abuse or that media outlets will live up to their promises about reporting abuse.

Keywords: #MeToo, significance, Japan, prevention, response

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Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: Muhammad Munir, Riffat Mehboob, Samina Naeem, Muhammad Salman, Shehryar Ahmed, Irshad Hussain Qureshi, Tahira Murtaza Cheema, Ashraf Sultan, Akmal Laeeq, Nakhshab Choudhry, Asad Aslam Khan, Fridoon Jawad Ahmad

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A dengue outbreak in Lahore, Pakistan during 2011 was unprecedented in terms of severity and magnitude. This research aims to determine the serotype distribution of dengue virus during this outbreak and classify the patients demographically. 5ml of venous blood was drawn aseptically from 166 patients with dengue-like signs to test for the virus between the months of August to November 2011. The samples were sent to the CDC, Atlanta, Georgia for the purpose of molecular assays to determine their serotype. RT-PCR protocol was performed targeting at the 4 dengue serotypes. Out of 166 cases, dengue infection was detected with RT-PCR in 95 cases, all infected with same serotype DEN-2. 75% of positive cases were males while 25% were females. Most positive patients were in the age range of 16-30 years. 33% positive cases had accompanying bleeding. This is first study during the 2011 dengue epidemic in Lahore that reports DEN-2 as the only prevalent serotype. It also indicates that more infected patients were males, adults, within age range of 16-30 years, peaked in the month of November, Dengue hemorrhagic fever (DHF) is manifested more in females, Ravi town was heavily hit by dengue virus infection.

Keywords: dengue, serotypes, Pakistan, DEN 2, Lahore, demography, serotype distrbution, 2011 epidemic

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Authors: T. Varazi, M. Pruidze, M. Kurashvili, N. Gagelidze, M. Sutton

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The complex phytoremediation approach given in the presented work implies joint application of natural sorbents, microorganisms, natural biosurfactants and plants. The approach is based on using the natural mineral composites, microorganism strains with high detoxification abilities, plants-phytoremediators and natural biosurfactants for enhancing the uptake of intermediates of pollutants by plant roots. In this complex strategy of phytoremediation technology, the sorbent serves to uptake and trap the pollutants and thus restrain their emission in the environment. The role of microorganisms is to accomplish the first stage biodegradation of organic contaminants. This is followed by application of a phytoremediation technology through purposeful planting of selected plants. Thus, using of different tools will provide restoration of polluted environment and prevention of toxic compounds’ dissemination from hotbeds of pollution for a considerable length of time. The main idea and novelty of the carried out work is the development of a new approach for the ecological safety. The wide spectrum of contaminants: Organochlorine pesticide – DDT, heavy metal –Cu, oil hydrocarbon (hexadecane) and wax have been used in this work. The presented complex biotechnology is important from the viewpoint of prevention, providing total rehabilitation of soil. It is unique to chemical pollutants, ecologically friendly and provides the control of erosion of soils.

Keywords: bioremediation, phytoremediation, pollutants, soil contamination

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Authors: Jason Maffia, Maria D’urso, Robert Crupi, Margaret Cartmell

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The emotional aspects of traumatic events such as workplace violence are often ignored, causing low productivity, disillusionment, and resentment within an organization. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. This review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. It is essential that health care organizations are prepared physically and emotionally for traumatic situations. This study explores the theoretical nature of addressing work-related violence in healthcare settings as well as traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social, and organizational influences on response are identified and used to tentatively offer explanations for identifying security risks, development, and implementation of de-escalation teams, CISM programs and training staff in violence prevention are among strategies hospitals are employing to keep workers and patients safe. General conclusion regarding the implications for intervention effectiveness and design are discussed.

Keywords: healthcare settings, stress reactions, traumatic events, workplace violence

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Authors: B. K. Umesh Kumar, Waleed Al Shukaili

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Air travel is one of the safest modes of travel. Inflight injuries occur due to various factors such as air turbulence, spillage of hot liquids, and fall of improperly stowed overhead baggage. Injuries occur not only to passengers but also to the flight attendants who are handling the passengers throughout the flight. A retrospective study of all records of crew safety report by the captain of the aircraft for all the flights from 01 Mar 2015 to 31 Mar 2019 in a National Carrier of Middle Eastern country, were analyzed. There was one injury to Flight attendant every 1200 flights. Commonest aircraft involved was Boeing. Inflight phase had 82% of all injuries. 63% of accidents involved female Attendants. Commonest age group involved was from 25-30 years. Cart and container injuries were the commonest and accounted for nearly 62% of the total injuries followed by turbulence. Back injuries were the commonest injuries followed by ankle, shoulder, and burns. Mean days of absence from work seen in shoulder injuries 40 days followed by injuries to back, which accounted for 38 Days. Reduction in injuries to flight attendants can be brought about by proper selection of crew, reduction in cart load. Proper maintenance of cart and container plays a major role in prevention of occupational accidents.

Keywords: flight attendants, in-flight injuries, types of injuries, work related injury prevention

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Authors: Adaobi Anakwe, Wilson Majee, Kari White, Rhonda BeLue

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Background: Black men in the U.S. have overall poorer health, are more likely to experience unintended pregnancies, and have pregnancies (with their partner) at younger ages than other racial/ethnic groups. These factors increase the likelihood that pregnancies among Black fathers will occur at suboptimal paternal health. Although several community-based programs exist to support low-income Black fathers’ involvement with their families, little is known about the sexual and reproductive health, and family planning needs of fathers enrolled in these programs. The objective of this study was to quantitatively examine the relationship between Black fathers’ fertility desires and pregnancy prevention strategies and qualitatively explore the nuances of this relationship. Methods: A concurrent mixed-methods approach was used to survey 36 and interview 13 Black fathers from low-income backgrounds, who were participating in a community-based fatherhood program in a Midwestern urban area. Fathers in this study were ≥18 years old with at least one child. Differences between groups were compared using Fisher’s Exact tests and thematic analyses to examine the relationship between participants' fertility desires and reproductive planning practices. Results: Participants had a median age of 33 years, and 72% were non-residential biological parents. About 40% of men desired pregnancy, and 69% reported they or their partner always used contraception. In bivariate analysis, participants’ fertility desires were not associated with pregnancy prevention (p=0.251). Although most interview participants desired pregnancies, several factors contributed to their ability to plan for a pregnancy. Men felt that using contraception to prevent pregnancies was dependent on navigating trust with a partner. Health before pregnancy and financial stability were also important. Overall, participants thought that using an adult mindset, in which they considered the consequences of unprotected sex, was key to family planning. Conclusion: Black fathers may not desire pregnancy and consider a variety of factors, but this does not always result in active pregnancy prevention/contraceptive use. Community-based organizations already working with Black fathers can be leveraged to increase reproductive health awareness and facilitate reproductive planning for fathers.

Keywords: reproductive planning, reproductive health, preconception health, Black fathers, fertility desires, pregnancy

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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: N. Hadthamard, P. Chaumpluk, M. Buanong, P. Boonyaritthongchai, C. Wongs-Aree

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Ripe ‘Nam Dok Mai’ mango (Mangifera indica L.) is an important exported fruit of Thailand, but rapidly declined in the quality attributes mainly by infection of anthracnose and stem end rot diseases. Multilayer coating is considered as a developed technique to maintain the postharvest quality of mangoes. The utilization of alternated coating by matching oppositely electrostatic charges between 0.1% chitosan and 0.1% polystyrene sulfonate (PSS) was studied. A number of the coating layers (layer by layer) were applied on mature green ‘Nam Dok Mai No.4’ mangoes prior to storage at 25 ^oC, 65-70% relative humidity (RH). There were significant differences in some quality attributes of mangoes coated by 3½ layers, 4½ layers and 5½ layers. In comparison to coated mangoes, uncoated fruits were higher in weight loss, total soluble solids, respiration rate, ethylene production and disease incidence except the titratable acidity. Coating fruit at 3½ layers exhibited the ripening delay and reducing disease infection without off flavour. On the other hand, fruit coated with 5½ layers comprised the lowest acceptable score, caused by exhibiting disorders from fermentation at the end of storage. As a result, multilayer coating between chitosan and PSS could effectively maintain the postharvest quality of mango, but number of coating layers should be thoroughly considered.

Keywords: multilayer, chitosan, polystyrene sulfonate, Nam Dok Mai No.4

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