Search results for: late complications
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1755

Search results for: late complications

1035 Comparison of the Effectiveness of Neisseria gonorrhea Crude Protein Injections with Intravenous, Intracutaneous, and Subcutaneous

Authors: Annisa Amalina, Lintang Sekar Sari, Khairunnisa Salsabila, Astya Gema Ramadhan, M. Fatkhi, Andani Eka Putra

Abstract:

Gonorrhea is one of the sexually transmitted diseases by genito-genital, oro-genital and anogenital. Gonorrhea disease will cause complications if not treated properly. The diagnostic tool that has been used nowadays is microscopic. Thus a rapid diagnostic tool for gonorrhea is required, using polyclonal antibodies. The purpose of this study was to determine the effectiveness of injections of intravenous, subcutaneous and intracutaneous crude protein gonorrhea. The research method used in this research is experimental explorative. This research was conducted in Molecular Microbiology Laboratory of Faculty of Medicine, Andalas University for 3 months from April to June 2017. This study used 3 groups of rabbit with intravenous, subcutaneous, and intracutaneous injections. Each group was treated on days 1, 7, 21, and 28 with crude protein injection. After that, the examination of antibody levels held by using ELISA, followed by the antibody comparative tests contained in all three groups. The results examined by One Way ANOVA test on SPSS 21 and showed that there is no significant difference between intravenous, subcutaneous, and intracutaneous use p=0.69 (p < 0.05). However, there is an increased level (0.047 to 1.171) in antibodies from day 1 to day 14. In addition, subcutaneous use is preferred because it has minimal side effects compared to intravenous and intracutaneous use.

Keywords: crude protein, Neisseria gonorrhea, polyclonal antibodies, subcutaneous

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1034 Maternal Health Outcome and Economic Growth in Sub-Saharan Africa: A Dynamic Panel Analysis

Authors: Okwan Frank

Abstract:

Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: economic growth, maternal mortality, pool mean group, Sub-Saharan Africa

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1033 Territorial Disputes behind the Declaration of Independence of Abkhazia and South Ossetia by Some Latin American States

Authors: Besik Goginava

Abstract:

Several days later after the end of 2008 Russo-Georgian War, Venezuela and Nicaragua formally recognized the independence of Abkhazia and South Ossetia. In 2009-10 both countries established diplomatic relations with self-declared republics. It is a paradoxical fact that after neighboring Russia-Georgian conflict territories were internationally recognized by two Latin American states with ongoing territorial disputes. The Venezuela-Guyana territorial dispute which officially began in the early XIX century became conflict-ridden again in the late 1990s and 2000s. Venezuela has long claimed the land which comprises 40% of Guyana’s current territory. Territorial disputes of Nicaragua include dispute with Colombia over Caribbean Islands, with Costa Rica over the San Juan River and maritime dispute with Honduras. Based on historical and analytical research methods the purpose of this paper is to establish the relationship between the recognition of Abkhazia and South Ossetia by Venezuela and Nicaragua and Venezuela’s territorial dispute with Guyana, as well as Nicaragua’s with Colombia, Costa Rica and Honduras. The objective of the study is to investigate the factors that led Venezuela and Nicaragua to formally recognize Georgian conflict territories and how could their own territorial disputes affect on their decision.

Keywords: Latin America, Georgia, Venezuela, Nicaragua, Abkhazia, South Ossetia

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1032 B Spline Finite Element Method for Drifted Space Fractional Tempered Diffusion Equation

Authors: Ayan Chakraborty, BV. Rathish Kumar

Abstract:

Off-late many models in viscoelasticity, signal processing or anomalous diffusion equations are formulated in fractional calculus. Tempered fractional calculus is the generalization of fractional calculus and in the last few years several important partial differential equations occurring in the different field of science have been reconsidered in this term like diffusion wave equations, Schr$\ddot{o}$dinger equation and so on. In the present paper, a time-dependent tempered fractional diffusion equation of order $\gamma \in (0,1)$ with forcing function is considered. Existence, uniqueness, stability, and regularity of the solution has been proved. Crank-Nicolson discretization is used in the time direction. B spline finite element approximation is implemented. Generally, B-splines basis are useful for representing the geometry of a finite element model, interfacing a finite element analysis program. By utilizing this technique a priori space-time estimate in finite element analysis has been derived and we proved that the convergent order is $\mathcal{O}(h²+T²)$ where $h$ is the space step size and $T$ is the time. A couple of numerical examples have been presented to confirm the accuracy of theoretical results. Finally, we conclude that the studied method is useful for solving tempered fractional diffusion equations.

Keywords: B-spline finite element, error estimates, Gronwall's lemma, stability, tempered fractional

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1031 Shunt Placement in Treatment of Hydrocephalus in Patients with Myelomeningocele

Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

Abstract:

Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

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1030 Children in Opera: Sociological and Musicological Trends

Authors: Andrew Sutherland

Abstract:

In many ways, opera is not a natural domain for children. It is hardly surprising that from the thousands of works, comparatively few include roles for children. There are several possibilities for this, the dramatic themes in opera are often about the human condition from the adult perspective; the need for developed voices to project in large, theatrical spaces underpinned by orchestral accompaniment does not naturally suit the child’s voice, and enabling children to cope with long runs of performances on top of their education requires vocal and physical stamina. In more recent times, the involvement of children contributes another layer of difficulty in terms of having access to young singers while adhering to laws that protect their working rights. Despite these points, children have been in opera since its inception in a variety of ways, but their contribution is often undervalued or ignored by musicologists and even the industry itself. In this paper, the phenomenon of children in opera from the late 16th century to the present day is explored through empirical, socio-musicological observations with reference to score analysis. Conclusions are drawn regarding the changing attitudes of composers when scoring for children’s voices in relation to societal developments. From the use of ‘kindertruppen’ in the pre-enlightenment period to Handel’s virtuosic writing for William Savage, to the darkness of the inter-war eras which saw a proliferation of operatic characters for children and the post-war era which saw children as the new frontier of building audiences for opera, the links between changes in society and the inclusion, portrayal and scoring for children in opera are largely congruent.

Keywords: children, musical analysis, opera, sociology

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1029 The Effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions

Authors: Pramote Thangkratok

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The aims of this experimental study were to investigate the effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions. In addition, to compare bleeding and hematoma occurrences at the Access site between experimental and control groups. The randomized controlled trial (RCT) was conducted in 70 patients who underwent Cardiovascular Angiography and Interventions via the femoral artery and received post procedural care at the intermediate cardiac care unit, Bangkok Heart Hospital. From December 2015 to February 2016. The control group (35 patients) was to get standard care after the intervention, whereas the experimental group (35 patients) was Reverse Trendelenburg Position 30-45 degrees. The groups were not significantly different in terms of demographic characteristics, Age, Gender, BMI, blood pressure, heart rate. While not significantly different from each other, the intensity of back pain control group had a significantly higher pain score than experimental group. Vascular complications in terms of bleeding and hematoma were not significantly different between the control and experimental groups. The findings show that Reverse Trendelenburg Position after Cardiovascular Angiography and Interventions would reduce or prevent the back pain without increasing the chance of bleeding and hematoma.

Keywords: reverse trendelenburg position, back pain, cardiovascular angiography, cardiovascular interventions

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1028 Trauma after Childbirth: The Mediating Effects of Subjective Experience

Authors: Grace Baptie, Jackie Andrade, Alison Bacon, Alyson Norman

Abstract:

Background: Many women experience their childbirth as traumatic, and 4-6% of mothers present with postnatal posttraumatic stress disorder (PTSD) as a result of their birth. Aims: To measure the relationship between obstetric and subjective experience of childbirth on mothers’ experience of postnatal trauma and identify salient aspects of the birth experience considered traumatic. Methods: Women who had given birth within the last year completed an online mixed-methods survey reporting on their subjective and obstetric birth experience as well as symptoms of postnatal trauma, depression and anxiety. Findings: 29% of mothers experienced their labour as traumatic and 15% met full or partial criteria for PTSD. Feeling supported and in control mediated the relationship between obstetric intervention and postnatal trauma symptoms. Five key themes were identified from the qualitative data regarding aspects of the birth considered traumatic including: obstetric complications; lack of control; concern for baby; psychological trauma and lack of support. Conclusion: Subjective birth experience is a significantly stronger predictor of postnatal trauma than level of medical intervention, the psychological consequences of which can be buffered by an increased level of support and control.

Keywords: birth trauma, perinatal mental health, postnatal PTSD, subjective experience

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1027 Etiological Factors for Renal Cell Carcinoma: Five-Year Study at Mayo Hospital Lahore

Authors: Muhammad Umar Hassan

Abstract:

Renal cell carcinoma is a subset of kidney cancer that arises in the lining of DCT and is present in parenchymal tissue. Diagnosis is based on lab reports, including urinalysis, renal function tests (RFTs), and electrolyte balance, along with imaging techniques. Organ failure and other complications have been commonly observed in these cases. Over the years, the presentation of patients has varied, so carcinoma was classified on the basis of site, shape, and consistency for detailed analysis. Lifestyle patterns and occupational history were inquired about and recorded. Methods: Data from 100 patients presenting to the oncology and nephrology department of Mayo Hospital in the year 2015-2020 were included in this retrospective study on a random basis. The study was specifically focused on three risk factors. Smoking, occupational exposures, and Hakim medicine are taken by the patient for any cause. After procurement of data, follow-up contacts of these patients were established, resulting in a detailed analysis of lifestyle. Conclusion: The inference drawn is a direct causal link between smoking, industrial workplace exposure, and Hakim medicine with the development of Renal Cell Carcinoma. It was shown in the majority of the patients and hence confirmed our hypothesis.

Keywords: renal cell carcinoma, kidney cancer, clear cell carcinoma

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1026 Use of a Laparoscopic Approach in Urgent Adhesive Small Bowel Obstructions

Authors: Nuhi Arslani, Aleks Brumec

Abstract:

Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

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1025 Anagliptin: A Japanese Made Dipeptidyl Peptidase-4 Inhibitor That Naturally Lowers LDL-Cholesterol in Type 2 Diabetes

Authors: C. Iitake, K. Iitake

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Background and Aims: The number of diabetic patients based on obesity is increasing drastically in Asia. Since most patients have multiple complications, if one medicine can treat those at the same time, it would contribute to financial savings and patients’ compliance. A Japanese-made DPP-4 inhibitor, Anagliptin is only sold in Japan and South Korea. It is said to have its unique aspect of lowering LDL-cholesterol (LDL-C) levels together with lowering blood glucose. We have assessed 63 patients in our faculty to investigate this fact clinically and statistically. Method: Patients with type 2 diabetes who has been treated with Anagliptin for the first time was investigated changes in HbA1c, fasting and random blood glucose and LDL-C levels from the baseline at 1 month, 6 months and 1 year. Results: 29 patients (46.1%) were given DPP-4 inhibitors for the first time (original group), and 34 patients (53.9%) were using other DPP-4 inhibitors before Anagliptin (exchanged group). The change in HbA1c and fasting glucose from the baseline were -2.0% (P < 0.001) and -38.3mg/dl (P < 0.01) respectively with original group, -0.5% (P < 0.01) and -29.4mg/dl (P < 0.01) respectively with exchanged group. 23 patients (36.5%) were using statins or fibrates and 28 patients (44.4%) were using none, and its LDL-C change were -8.1mg/dl (P = 0.2582) and -10.1mg/dl(P < 0.05) respectively. 16 patients(25%) with LDL-C level ≥ 140mg/dl, change were -21.7mg/dl(P < 0.05). LDL-C change did not have a correlation coefficient (=-0.03238) with change in HbA1c and was not affected by other diabetic drugs. Conclusion: These findings indicate that Anagliptin is a potential treatment option for type 2 diabetes complicated by hyperlipidemia.

Keywords: DPP-4 inhibitors, anagliptin, LDL-cholesterol, type 2 diabetes

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1024 Spatial Practice Towards Urban Identity: The Shift, Limitation and Contemporary Value of Christopher

Authors: Botao Zhao, Hong Jiang

Abstract:

Christopher Alexander's urban design theory challenges the technical rationality of the empiricism that prevailsin the first half of the 20th century. Alexander emphasizes the wholeness of the city through progressive design, conceptual-based participation, shaping of centrality, and other principles. Based on Christopher Alexander’s comprehensive book “a new theory of urban design” and by combining with other major works, this paper puts Alexander into the history of the post-modern shift of architecture and urban planning in the middle and late 20th century and analyzes the uniqueness of Alexander’s systematization of spatial context. Despite the overemphasis on the initiative of design, Alexander's attempt to discover the “objectivity” of good space -the ability to generate people's urban identity-through an expanded concept of space, and a systematic approach to design restructures the visceral connection between urban space and human. The concept of urban identity is then decomposed into the identity of the physical setting, identity of process, and identity of meaning. Professionals need to learn from the reality and history of urban space to construct spatial“vocabulary libraries” and create the wholeness of the city, and in which process strengthen the subjectivity of the discipline simultaneously, to generate living structures in which urban identity could be ultimately cultivated.

Keywords: christopher alexander, a new theory of urban design, Urban identity, pattern language, urban design

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1023 An Atlantic Canadian Case of Disseminated Streptococcus equi Subspecies zooepidemicus Infection

Authors: Albert Chang, Duncan Webster

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Streptococcus equi subspecies zooepidemicus infections in humans can be contracted through contact with domestic animals or unpasteurized dairy products. Although infection in humans is rare, the course can be fulminant. We describe the case of a 75-year-old, immunocompetent male, who developed disseminated disease with bacteremia, native aortic valve endocarditis, suppurative pericarditis with cardiac tamponade, meningitis and bilateral endopthalmitis. Despite treatment with pericardial drain placement, intravenous ceftriaxone and rifampin the patient, unfortunately, did not survive. To date, reported cases of disseminated infection by S. zooepidemicus are few. Furthermore, with the review of the literature, this case demonstrates the broadest organ system involvement reported. Of interest, previous studies have suggested an affinity of this organism for certain organ systems and this case corroborates an emerging association of S. zooepidemicus with endopthalmitis. In addition, this is the second Canadian case of documented human infection with both cases being similar in clinical features, presentation, and geographical location. A discussion regarding previous S. zooepidemicus outbreaks and the potential for zoonotic outbreaks to occur is included. In short, this case report should serve to warn clinicians regarding complications and sites of haematogenous seeding in the setting of disseminated S. zooepidemicus infections.

Keywords: endopthalmitis, endocarditis, meningitis, Streptococcus equi subspecies zooepidemicus

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1022 Risk Factors for Fall in Elderly with Diabetes Mellitus Type 2 in Jeddah Saudi Arabia 2022: A Cross-Sectional Study

Authors: Rami S. Alasmari, Abdullah Al Zahrani, Hattan A. Hassani, Hattan A. Hassani, Nawwaf A. Almalky, Abdullah F. Bokhari, Alwalied A. Hafez

Abstract:

Diabetes mellitus type 2 (DMT2) is a major chronic condition that is considered common among elderly people, with multiple potential complications that could contribute to falls. However, this concept is not well understood, thus, the aim of this study is to determine whether diabetes is an independent risk factor for falls in elderly. In this observational cross-sectional study, 309 diabetic patients aged 60 or more who visited the primary healthcare centers of the Ministry of National Guard Health Affairs in Jeddah were chosen via convenience sampling method. To collect the data, Semi-structured Fall Risk Assessment questionnaire and Fall Efficacy Score scale were used. The mean age of the participants was estimated to be 68.5 (SD:7.4) years. Among the participants, 48.2% experienced falling before, and 63.1% of them suffered falls in the past 12-months. The results showed that gait problems were independently associated with a higher likelihood of fall among the elderly patients (OR = 1.98, 95%CI, 1.08 to 3.62, p = 0.026. This paper suggests that diabetes mellitus is an independent fall risk factor among elderly. Therefore, identifying such patients as being at higher risk and prompt referral to a specialist falls clinic is recommended.

Keywords: diabetes, fall, elderly, risk factors

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1021 3D Scanning Documentation and X-Ray Radiography Examination for Ancient Egyptian Canopic Jar

Authors: Abdelrahman Mohamed Abdelrahman

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Canopic jars are one of the vessels of funerary nature used by the ancient Egyptian in mummification process that were used to save the viscera of the mummified body after being extracted from the body and treated. Canopic jars are made of several types of materials like Limestone, Alabaster, and Pottery. The studied canopic jar dates back to Late period, located in the Grand Egyptian Museum (GEM), Giza, Egypt. This jar carved from limestone with carved hieroglyphic inscriptions, and it filled and closed by mortar from inside. Some aspects of damage appeared in the jar, such as dust, dirts, classification, wide crack, weakness of limestone. In this study, we used documentation and investigation modern techniques to document and examine the jar. 3D scanning and X-ray Radiography imaging used in applied study. X-ray imaging showed that the mortar was placed at a time when the jar contained probably viscera where the mortar appeared that not reach up to the base of the inner jar. Through the three-dimensional photography, the jar was documented, and we have 3D model of the jar, and now we have the ability through the computer to see any part of the jar in all its details. After that, conservation procedures have been applied with high accuracy to conserve the jar, including mechanical, wet, and chemical cleaning, filling wide crack in the body of the jar using mortar consisting of calcium carbonate powder mixing with primal E330 S, and consolidation, so the limestone became strong after using paraloid B72 2% concentrate as a consolidate material.

Keywords: vessel, limestone, canopic jar, mortar, 3D scanning, X-ray radiography

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1020 Numerical Pricing of Financial Options under Irrational Exercise Times and Regime-Switching Models

Authors: Mohammad Saber Rohi, Saghar Heidari

Abstract:

In this paper, we studied the pricing problem of American options under a regime-switching model with the possibility of a non-optimal exercise policy (early or late exercise time) which is called an irrational strategy. For this, we consider a Markovmodulated model for the dynamic of the underlying asset as an alternative model to the classical Balck-Scholes-Merton model (BSM) and an intensity-based model for the irrational strategy, to provide more realistic results for American option prices under the irrational behavior in real financial markets. Applying a partial differential equation (PDE) approach, the pricing problem of American options under regime-switching models can be formulated as coupled PDEs. To solve the resulting systems of PDEs in this model, we apply a finite element method as the numerical solving procedure to the resulting variational inequality. Under some appropriate assumptions, we establish the stability of the method and compare its accuracy to some recent works to illustrate the suitability of the proposed model and the accuracy of the applied numerical method for the pricing problem of American options under the regime-switching model with irrational behaviors.

Keywords: irrational exercise strategy, rationality parameter, regime-switching model, American option, finite element method, variational inequality

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1019 Influence of HbA1c on Nitric Oxide Level in Patients with Type 2 Diabetes Mellitus

Authors: Dara Kutsyk, Olga Bondarenko, Mariya Sorochka

Abstract:

In 21-century type 2 diabetes (T2D) has become a global health and social problem in the whole world. The goal of treatment for patients with T2D is to prevent complications of diabetes - macrovascular diseases (heart disease, stroke, and peripheral vascular disease) and microvascular diseases (retinopathy, neuropathy and nephropathy). Nitric oxide (NO) plays an important role in maintaining vascular homeostasis. Loss of NO function is one of the earliest indicators of disease and its progression especially in patients with T2D. Aim: To compare NO level between patients with well and bad controlled glycemia in T2D. Methods: The study included 32 patients with T2D. The diagnosis of T2D was confirmed due to International Diabetes Federation (IDF) criteria 2015. Patients were divided into two groups: with well controlled glycaemia (HbA1c < 7%) and bad controlled glycaemia (HbA1c > 7%). The control group consists of 15 healthy subjects. Results: NO level in patients with T2D is significantly higher (27,2 ±3,1 µmol), compared to controls (18,86±0,9 µmol; p < 0,001). A significant difference in NO level was found between patients with bad controlled glycaemia (25,9±2,2 µmol) and well controlled glycaemia (28,7 ± 3,0 µmol; p<0,01). The study showed a moderate negative correlation between NO level and HbA1c (-0,399; р< 0,05). Conclusions: Production of NO is impaired in patients with T2D, especially with badly controlled glycaemia. With the increase in HbAc serum NO decreases. This can be the main target for prevention vascular complication in T2D.

Keywords: type 2 diabetes, glycated hemoglobin, nitric oxide, Diabetes mellitus

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1018 The Admitting Hemogram as a Predictor for Severity and in-Hospital Mortality in Acute Pancreatitis

Authors: Florge Francis A. Sy

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Acute pancreatitis (AP) is an inflammatory condition of the pancreas with local and systemic complications. Severe acute pancreatitis (SAP) has a higher mortality rate. Laboratory parameters like the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV) have been associated with SAP but with conflicting results. This study aims to determine the predictive value of these parameters on the severity and in-hospital mortality of AP. This retrospective, cross-sectional study was done in a private hospital in Cebu City, Philippines. One-hundred five patients were classified according to severity based on the modified Marshall scoring. The admitting hemogram, including the NLR, RDW, and MPV, was obtained from the complete blood count (CBC). Cut-off values for severity and in-hospital mortality were derived from the ROC. Association between NLR, RDW, and MPV with SAP and mortality were determined with a p-value of < 0.05 considered significant. The mean age for AP was 47.6 years, with 50.5% being male. Most had an unknown cause (49.5%), followed by a biliary cause (37.1%). Of the 105 patients, 23 patients had SAP, and 4 died. Older age, longer in-hospital duration, congestive heart failure, elevated creatinine, urea nitrogen, and white blood cell count were seen in SAP. The NLR was associated with in-hospital mortality using a cut-off of > 10.6 (OR 1.133, 95% CI, p-value 0.003) with 100% sensitivity, 70.3% specificity, 11.76% PPV and 100% NPV (AUC 0.855). The NLR was not associated with SAP. The RDW and MPV were not associated with SAP and mortality. The admitting NLR is, therefore, an easily accessible parameter that can predict in-hospital mortality in acute pancreatitis. Although the present study did not show an association of NLR with SAP nor RDW and MPV with both SAP and mortality, further studies are suggested to establish their clinical value.

Keywords: acute pancreatitis, mean platelet volume, neutrophil-lymphocyte ratio, red cell distribution width

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1017 Craniopharyngiomas: Surgical Techniques: The Combined Interhemispheric Sub-Commissural Translaminaterminalis Approach to Tumors in and Around the Third Ventricle: Neurological and Functional Outcome

Authors: Pietro Mortini, Marco Losa

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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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1016 Effect of Heat Stress on the Physiology of the Cork Oak

Authors: J. Zekri, N. Souilah, W. Abdelaziz, D. Alatou

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Our study shall focus on the ability of trees cork oak that showed vis-à-vis sensitivity to climate change, including late spring frosts. The combination of these factors resulted in damage alarmed, therefore forest ecosystems weakened trees that can affect their ability to support other abiotic and biotic stresses, For this we tested its tolerance to thermal variations and cold weather conditions by estimating some stress markers (quantification of proteins, RNA, soluble sugars) that are quantified to evaluate the cold tolerance of seedlings. Sowing of cork oak (Quercus suber L.) is grown in controlled conditions at 25° C ± 2° C in long days 16h. These seedlings are transferred at low temperatures between 5° C and -6° C for a period of 3 hours. Biochemical analyzes were performed in the various organs of the cork oak seedlings. Cool temperatures induced a significant accumulation of proline in different organs of seedlings and the optimum concentrations were observed in the roots with very high concentrations (4 times larger than those of the control). The accumulation of soluble sugars is significantly in stems and roots at 0° C. Protein concentrations are very high in leaves of both growth and high waves in rod at -4° C to -2° C. Tolerance cork oak seems to be at the thermal limit of -2°C. The concentration of these metabolites in the various organs showed the ability oak cork hardening during the winter.

Keywords: climate change, thermal change, semi-aride, biochemical markers, heat stress

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1015 Nursing Care Experience for a Patient with Type2 Diabetes Mellitus and Hyperglycemic Hyperosmolar State

Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

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This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

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1014 The Role of Physical Activity on Some Factors Affecting Cardiovascular Disease

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

Abstract:

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

Keywords: blood pressure, cardiovascular, hyperlipidemia, risk factor

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1013 Triangulations via Iterated Largest Angle Bisection

Authors: Yeonjune Kang

Abstract:

A triangulation of a planar region is a partition of that region into triangles. In the finite element method, triangulations are often used as the grid underlying a computation. In order to be suitable as a finite element mesh, a triangulation must have well-shaped triangles, according to criteria that depend on the details of the particular problem. For instance, most methods require that all triangles be small and as close to the equilateral shape as possible. Stated differently, one wants to avoid having either thin or flat triangles in the triangulation. There are many triangulation procedures, a particular one being the one known as the longest edge bisection algorithm described below. Starting with a given triangle, locate the midpoint of the longest edge and join it to the opposite vertex of the triangle. Two smaller triangles are formed; apply the same bisection procedure to each of these triangles. Continuing in this manner after n steps one obtains a triangulation of the initial triangle into 2n smaller triangles. The longest edge algorithm was first considered in the late 70’s. It was shown by various authors that this triangulation has the desirable properties for the finite element method: independently of the number of iterations the angles of these triangles cannot get too small; moreover, the size of the triangles decays exponentially. In the present paper we consider a related triangulation algorithm we refer to as the largest angle bisection procedure. As the name suggests, rather than bisecting the longest edge, at each step we bisect the largest angle. We study the properties of the resulting triangulation and prove that, while the general behavior resembles the one in the longest edge bisection algorithm, there are several notable differences as well.

Keywords: angle bisectors, geometry, triangulation, applied mathematics

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1012 Use of Nutritional Screening Tools in Cancer-Associated Malnutrition

Authors: Meryem Saban Guler, Saniye Bilici

Abstract:

Malnutrition is a problem that significantly affects patients with cancer throughout the course of their illness, and it may be present from the moment of diagnosis until the end of treatment. We searched electronic databases using key terms such as ‘malnutrition in cancer patients’ or ‘nutritional status in cancer’ or ‘nutritional screening tools’ etc. Decline in nutritional status and continuing weight loss are associated with an increase in number and severity of complications, impaired quality of life and decreased survival rate. Nutrition is an important factor in the treatment and progression of cancer. Cancer patients are particularly susceptible to nutritional depletion due to the combined effects of the malignant disease and its treatment. With increasing incidence of cancer, identification and management of nutritional deficiencies are needed. Early identification of malnutrition, is substantial to minimize or prevent undesirable outcomes throughout clinical course. In determining the nutritional status; food consumption status, anthropometric methods, laboratory tests, clinical symptoms, psychosocial data are used. First-line strategies must include routine screening and identification of inpatients or outpatients at nutritional risk with the use of a simple and standardized screening tool. There is agreement among international nutrition organizations and accredited health care organizations that routine nutritional screening should be a standard procedure for every patient admitted to a hospital. There are f management of all cancer patients therefore routine nutritional screening with validated tools can identify cancer patients at risk.

Keywords: cancer, malnutrition, nutrition, nutritional screening

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1011 A Real Time Development Study for Automated Centralized Remote Monitoring System at Royal Belum Forest

Authors: Amri Yusoff, Shahrizuan Shafiril, Ashardi Abas, Norma Che Yusoff

Abstract:

Nowadays, illegal logging has been causing much effect to our forest. Some of it causes a flash flood, avalanche, global warming, and etc. This comprehensibly makes us wonder why, what, and who has made it happened. Often, it already has been too late after we have known the cause of it. Even the Malaysian Royal Belum forest has not been spared from land clearing or illegal activity by the natives although this area has been gazetted as a protected area preserved for future generations. Furthermore, because of its sizeable and wide area, these illegal activities are difficult to monitor and to maintain. A critical action must be called upon to prevent all of these unhealthy activities from recurrence. Therefore, a remote monitoring device must be developed in order to capture critical real-time data such as temperature, humidity, gaseous, fire, and rain detection which indicates the current and preserved natural state and habitat in the forest. Besides, this device location can be detected via GPS by showing the latitudes and longitudes of its current location and then to be transmitted by SMS via GSM system. All of its readings will be sent in real-time for data management and analysis. This result will be benefited to the monitoring bodies or relevant authority in keeping the forest in the natural habitat. Furthermore, this research is to gather a unified data and then will be analysed for its comparison with an existing method.

Keywords: remote monitoring system, forest data, GSM, GPS, wireless sensor

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1010 Variation of Hedonic Capacity of People According to Age and Its Correlation with Chronotype

Authors: T. Hojageldiyev, Y. Bolmammedov

Abstract:

Increasing evidence suggests late chronotype individuals are at increased risk of developing psychopathological conditions. Our previously conducted study aimed to know the distribution of chronotypes according to age revealed that evening-types reaching a peak at age 14. While there is growing number of studies evaluating associations between chronotype and affective symptoms, to our best knowledge there are no studies addressing the issue of prevalence of anhedonia according to age groups of people. The sample included 545 healthy students between 13-21 years old from secondary schools and universities of Turkmenistan. Self-report 14 item Snaith-Hamilton Pleasure Scale (SHAPS) was used to assess hedonic tone of students. SHAPS score of 3 or higher indicates the criteria for the anhedonia. According to similarity of hedonic capacity participants divided into three age groups. Group I (age 13-14-15) includes 206 students (92 female), group II (age 16-17) includes 256 students (111 female) and group III (age 18-19-20-21) includes 83 (37 female). Statistical analysis was performed using Microsoft Excel 2013 and GraphPad Prism 7.0 programs. According to results average SHAPS scores of group I is 1.93 ± 1.94, group II 1.08 ± 1.43 and group III 1.29 ± 1.62. Students with anhedonia in group I consisted 30.5%, in group II 13,2% and in group III 12.04%. There are no gender differences. According to questionnaire results, higher prevalence of anhedonia is at the age between 13-15 than other age groups, and hedonic capacity increases as the age of students increases (p < 0.05). As a result, distribution of evening-types according to age correlates with hedonic capacity which is evening-types tends to have lower hedonic capacity.

Keywords: anhedonia, age, chronotype, hedonic capacity

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1009 Bilateral Retinitis in Q Fever

Authors: Carl Eiselen, Stephen O’Hagan

Abstract:

Background: Q fever, caused by the obligate intracellular bacterium Coxiella burnetii, is an infectious disease with variable systemic manifestations. Its potential to cause ocular complications has not been reported before in Australia. This case study explores the unusual presentation of asymptomatic acute multifocal retinitis (AMR) in a patient with acute Q fever endocarditis and hepatitis in rural Queensland, Australia. Case Presentation: A 48-year-old male gardener presented with flu-like symptoms, weight loss, and encephalopathy. Despite systemic malaise, he had no ocular symptoms. Laboratory investigations confirmed acute Q fever, and imaging studies identified hepatic involvement and endocarditis. The retinal screening revealed asymptomatic AMR, corroborated by fundus examination and SD-OCT. Following treatment with Doxycycline and hydroxychloroquine, both systemic and ocular manifestations improved. Discussion: This is the first documented case of asymptomatic AMR associated with Q fever. The patient’s lack of autoantibodies challenges the established understanding of Q fever endocarditis and suggests potential alternative mechanisms. Conclusion: This case report expands our understanding of the multi-systemic impact of Q fever, highlighting the need for comprehensive clinical evaluation and including retinal screening in the setting of acute infection. The disease's underlying mechanism for ocular involvement is not yet established.

Keywords: Coxiella Burnetti, Q fever, ocular manifestation, acute multifocal retintis, endocarditis

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1008 Data Disorders in Healthcare Organizations: Symptoms, Diagnoses, and Treatments

Authors: Zakieh Piri, Shahla Damanabi, Peyman Rezaii Hachesoo

Abstract:

Introduction: Healthcare organizations like other organizations suffer from a number of disorders such as Business Sponsor Disorder, Business Acceptance Disorder, Cultural/Political Disorder, Data Disorder, etc. As quality in healthcare care mostly depends on the quality of data, we aimed to identify data disorders and its symptoms in two teaching hospitals. Methods: Using a self-constructed questionnaire, we asked 20 questions in related to quality and usability of patient data stored in patient records. Research population consisted of 150 managers, physicians, nurses, medical record staff who were working at the time of study. We also asked their views about the symptoms and treatments for any data disorders they mentioned in the questionnaire. Using qualitative methods we analyzed the answers. Results: After classifying the answers, we found six main data disorders: incomplete data, missed data, late data, blurred data, manipulated data, illegible data. The majority of participants believed in their important roles in treatment of data disorders while others believed in health system problems. Discussion: As clinicians have important roles in producing of data, they can easily identify symptoms and disorders of patient data. Health information managers can also play important roles in early detection of data disorders by proactively monitoring and periodic check-ups of data.

Keywords: data disorders, quality, healthcare, treatment

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1007 High-Resolution ECG Automated Analysis and Diagnosis

Authors: Ayad Dalloo, Sulaf Dalloo

Abstract:

Electrocardiogram (ECG) recording is prone to complications, on analysis by physicians, due to noise and artifacts, thus creating ambiguity leading to possible error of diagnosis. Such drawbacks may be overcome with the advent of high resolution Methods, such as Discrete Wavelet Analysis and Digital Signal Processing (DSP) techniques. This ECG signal analysis is implemented in three stages: ECG preprocessing, features extraction and classification with the aim of realizing high resolution ECG diagnosis and improved detection of abnormal conditions in the heart. The preprocessing stage involves removing spurious artifacts (noise), due to such factors as muscle contraction, motion, respiration, etc. ECG features are extracted by applying DSP and suggested sloping method techniques. These measured features represent peak amplitude values and intervals of P, Q, R, S, R’, and T waves on ECG, and other features such as ST elevation, QRS width, heart rate, electrical axis, QR and QT intervals. The classification is preformed using these extracted features and the criteria for cardiovascular diseases. The ECG diagnostic system is successfully applied to 12-lead ECG recordings for 12 cases. The system is provided with information to enable it diagnoses 15 different diseases. Physician’s and computer’s diagnoses are compared with 90% agreement, with respect to physician diagnosis, and the time taken for diagnosis is 2 seconds. All of these operations are programmed in Matlab environment.

Keywords: ECG diagnostic system, QRS detection, ECG baseline removal, cardiovascular diseases

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1006 The Fadama Initiative: Implications for Human Security and Sustainable Development in Nigeria

Authors: Albert T. Akume, Yahya M. Abdullahi

Abstract:

The impact of poverty on individual and society is grave, hence the efforts by the government to eradicate or alleviate. In Nigeria the various efforts to reduce rural poverty by empowering them and making the process of their development self-sustaining have ended dismally. That notwithstanding, government determination to conquer poverty has not diminish as in the early 1990s the government with financial collaboration from the World Bank and African Development Bank introduced the fadama project. It is against this backdrop that this paper uses the documentary and analytical research methods to examine the implication the fadama development project has for community capacity development and human security in Nigeria. From the analysis it was discovered the fadama project improved household income of fadama farmers, community empowerment, participatory development planning and support for demand driven productive investment in farm and non-farm activities including community infrastructures. Despite this impressive result the fadama project is challenged by conflict especially in northern Nigeria and late delivery of necessary farm consumables that aid improved productivity. It was therefore recommended that the government should strengthen her various state security institutions to proactively mitigate conflicts and to ensure that farm consumables and other support services reach farmers timely.

Keywords: capacity development, empowerment, fadama, human security, poverty reduction, theory of change, sustainable development

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