Search results for: obstructive sleep apnoea syndrome

Authors: Bassam Band, Simon Freeman, Rohan Munir, Hisham Band

Abstract:

Objective: To determine efficacy of facial physiotherapy provided for patients with facial nerve palsy. Design: Retrospective study Subjects: 54 patients diagnosed with Facial nerve palsy were included in the study after they met the selection criteria including unilateral facial paralysis and start of therapy twelve months after the onset of facial nerve palsy. Interventions: Patients received the treatment offered at a facial physiotherapy clinic consisting of: Trophic electrical stimulation, surface electromyography with biofeedback, neuromuscular re-education and myofascial release. Main measures: The Sunnybrook facial grading scale was used to evaluate the severity of facial paralysis. Results: This study demonstrated the positive impact of physiotherapy for patient with facial nerve palsy with improvement of 24.2% on the Sunnybrook facial grading score from a mean baseline of 34.2% to 58.2%. The greatest improvement looking at different causes was seen in patient who had reconstructive surgery post Acoustic Neuroma at 31.3%. Conclusion: The therapy shows significant improvement for patients with facial nerve palsy even when started 12 months post onset of paralysis across different causes. This highlights the benefit of this non-invasive technique in managing facial nerve paralysis and possibly preventing the need for surgery.

Keywords: facial nerve palsy, treatment, physiotherapy, bells palsy, acoustic neuroma, ramsey-hunt syndrome

Procedia PDF Downloads 516

Authors: Rakesh Kumar Soni

Abstract:

Under free living conditions, human biological clocks show a periodicity of 24 hour for numerous physiological, behavioral and biochemical variables. However, this period is not the original period; rather it merely exhibits synchronization with the solar clock. It is, therefore, most important to investigate characteristics of human circadian clock, essentially in shift workers, who normally confront with contrasting social clocks. Aim of the present study was to investigate rest-activity rhythm and to vouch for the best technique for the computation of periods in this rhythm in subjects randomly selected from different groups of shift workers. The rest-activity rhythm was studied in forty-eight shift workers from three different organizations, namely Newspaper Printing Press (NPP), Chhattisgarh State Electricity Board (CSEB) and Raipur Alloys (RA). Shift workers of NPP (N = 20) were working on a permanent night shift schedule (NS; 20:00-04:00). However, in CSEB (N = 14) and RA (N = 14), shift workers were working in a 3-shift system comprising of rotations from night (NS; 22:00-06:00) to afternoon (AS; 14:00-22:00) and to morning shift (MS; 06:00-14:00). Each subject wore an Actiwatch (AW64, Mini Mitter Co. Inc., USA) for 7 and/or 21 consecutive days, only after furnishing a certificate of consent. One-minute epoch length was chosen for the collection of wrist activity data. Period was determined by using Actiware sleep software (Periodogram), Lomb-Scargle Periodogram (LSP) and Spectral analysis software (Spectre). Other statistical techniques, such as ANOVA and Duncan’s multiple-range test were also used whenever required. A statistically significant circadian rhythm in rest-activity, gauged by cosinor, was documented in all shift workers, irrespective of shift work. Results indicate that the efficiency of the technique to determine the period (τ) depended upon the clipping limits of the τs. It appears that the technique of spectre is more reliable.

Keywords: biological clock, rest activity rhythm, spectre, periodogram

Procedia PDF Downloads 147

Authors: Yongrong Liu, Xin Tang

Abstract:

Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

Procedia PDF Downloads 54

Authors: Jyotismita Talukdar

Abstract:

In this paper, a study has been made on the possibility and accuracy of early prediction of several Heart Disease using Artificial Neural Network. (ANN). The study has been made in both noise free environment and noisy environment. The data collected for this analysis are from five Hospitals. Around 1500 heart patient’s data has been collected and studied. The data is analysed and the results have been compared with the Doctor’s diagnosis. It is found that, in noise free environment, the accuracy varies from 74% to 92%and in noisy environment (2dB), the results of accuracy varies from 62% to 82%. In the present study, four basic attributes considered are Blood Pressure (BP), Fasting Blood Sugar (FBS), Thalach (THAL) and Cholesterol (CHOL.). It has been found that highest accuracy(93%), has been achieved in case of PPI( Post-Permanent-Pacemaker Implementation ), around 79% in case of CAD(Coronary Artery disease), 87% in DCM (Dilated Cardiomyopathy), 89% in case of RHD&MS(Rheumatic heart disease with Mitral Stenosis), 75 % in case of RBBB +LAFB (Right Bundle Branch Block + Left Anterior Fascicular Block), 72% for CHB(Complete Heart Block) etc. The lowest accuracy has been obtained in case of ICMP (Ischemic Cardiomyopathy), about 38% and AF( Atrial Fibrillation), about 60 to 62%.

Keywords: coronary heart disease, chronic stable angina, sick sinus syndrome, cardiovascular disease, cholesterol, Thalach

Procedia PDF Downloads 159

Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

Abstract:

Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

Procedia PDF Downloads 280

Authors: A. Jafarzadeh, G. R. Hashemi Tabar

Abstract:

Campylobacteriosis is caused by Campylobacter organisms. This is most commonly caused by C. jejuni, It is among the most common bacterial infections of humans, often a foodborne illness. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, mostly including cramps, fever and pain. It is found in cattle, swine, and birds, where it is non-pathogenic. But the illness can also be caused by C. coli (also found in cattle, swine, and birds) C. upsaliensis (found in cats and dogs) and C. lari (present in seabirds in particular). Infection with a Campylobacter species is one of the most common causes of human bacterial gastroenteritis. For instance, an estimated 2 million cases of Campylobacter enteritis occur annually in the U.S., accounting for 5-7% of cases of gastroenteritis. Furthermore, in the United Kingdom during 2000 Campylobacter jejuni was involved in 77.3% in all cases of foodborne illness. 15 out of every 100,000 people are diagnosed with campylobacteriosis every year, and with many cases going unreported, up to 0.5% of the general population may unknowingly harbor Campylobacter in their gut annually. A large animal reservoir is present as well, with up to 100% of poultry, including chickens, turkeys, and waterfowl, having asymptomatic infections in their intestinal tracts. An infected chicken may contain up to 109 bacteria per 25 grams, and due to the installations, the bacteria is rapidly spread to other chicken. This vastly exceeds the infectious dose of 1000-10,000 bacteria for humans. In this article this disease is fully discussed in human and animals.

Keywords: campylobacteriosis, human, animal, zoonosis

Procedia PDF Downloads 496

Authors: Dušica L. Marić, Mirela Erić, Dušan M. Maić, Nebojša T. Milošević, Dragana Radošević, Nikola Vučinić

Abstract:

The anatomical existence of transforaminal ligaments has been studied widely. The crucial anatomic study of these structures describes the transforaminal ligaments as an anomalous structure. The ligaments associated with the intervertebral foramen were classified in the external, intraforaminal and internal foraminal ligaments. The external ligaments are the most frequently reported type of transforaminal ligaments in adult spine. The purpose of this study was to examine the appearance of the ligaments within the external space of the intervertebral foramen in adult cadavers. External transforaminal ligaments branch out forward from the root of the transverse process toward the vertebral body with superior, transverse and inferior directions. The ligament detected in the study was different from the other reported descriptions of L1 foraminal ligaments. This ligament extends from the root of the pedicle to the inferior border of the vertebral body below the level of the disc and forms the compartment through which pass the ventral root of the spinal nerve and a small branch of the spinal artery. The results of this study show that the external ligaments can be clearly macroscopic visualized, and it is very important to have prior knowledge of the cadaveric specimens, to identify these structures. The presence of these ligaments is clinically important. These ligaments could be the cause of nerve root compression and the low back syndrome.

Keywords: anatomy, ligaments, lumbar spine, spinal nerve roots

Procedia PDF Downloads 317

Authors: Teresita Castillo, Concepción Campo, Carlos Carrillo

Abstract:

Attention, comprehension and solution of poverty can be worked considering a socioeconomic approach; but it also can be attended from a multidimensional perspective that allows considering other dimensions including psychological variables manifested in behaviors, thoughts and feelings concerning this phenomenon. Considering the importance of research regarding psychology and poverty, this paper presents results about psychosocial impacts of poverty on young people related to mental health issues and its relation to fatalism. These results are part of a bigger transcultural study done in collaboration with the Federal University of Ceará, in Brazil. Participants were 101 young men and women, between 12 and 29 years old, living in two emarginated suburbs in Mérida, Mexico, located in the southeastern zone of the country. Participants responded the Self Report Questionnaire (SRQ- 20), with 20 items dichotomous presence/absence that assess anxious and depressive issues and the Fatalism Scale, with 30 items Likert five-point spread over five factors. Results show that one third of participants mentioned to get easily frightened, feeling nervous, tense or worried as well as unhappy, difficulty on making decisions, and troubles in thinking clearly. About 20% mentioned to have headaches, to sleep badly, to cry more than usual and to feel tired all the time. Regarding Fatalism, results show there is a greater internal allocation and lower external attribution in young participants, but they have some symptoms regarding poor mental health. Discussion is in terms of possible explanations about the results and emphasizes the importance of holistic approaches for a better understanding of the psychosocial impacts of poverty on young people and strengthening the resilience to increase positive mental health in emarginated contexts, where Community Psychology could have an important duty in community health promotion.

Keywords: fatalism, mental health, poverty, youth

Procedia PDF Downloads 325

Authors: Khader A. Almhdawi, Saddam F. Kanaan

Abstract:

Background: Allied health (AH) students, including rehabilitation sciences students, are subjected to significant levels of physical and mental stressors, which could affect their education. This study aimed to study physical and mental of Health-related Quality of Life (HR-QoL) levels along with their predictors among students of nine AH majors. Methods: Students filled validated anonymous surveys covering demographics and life style, Nordic Musculoskeletal Questionnaire, 12-item Short-Form Health Survey (SF-12), and Depression Anxiety Stress Scale (DASS- 42). SF-12 Mental (MCS) and Physical (PCS) summary scores were compared between academic majors and gender. Multiple linear regression models were conducted to examine potential predictors of PCS and MCS scores. Results: 838 students (77.4% females) participated in this study. Participants’ PCS mean score was 45.64±7.93 and found statistically different between the nine academic majors (P < 0.001). Additionally, participants’’ MCS mean score was 39.45±10.86 and significantly greater in males (P < 0.001). Significant PCS scores predictors included hip and upper back musculoskeletal pain, anxiety score, diet self-evaluation, and GPA. Finally, MCS scores were statistically associated with neck musculoskeletal pain, stress score, depression score, number of weekly clinical training hours, gender, university year, GPA, sleep quality self-evaluation, and diet self-evaluation. Conclusion: Clinical educators of AH need to account for students’ low levels of HR-QoL and their academic-related, health-related, and lifestyle-related associated factors. More studies are recommended to investigate the progression of HR-QoL throughout university years and to create effective interventions to improve HR-QoL among healthcare students.

Keywords: medical education, quality of life, stress, anxiety, depression

Procedia PDF Downloads 111

Authors: Jessica C. Bannon, Cleso M. Jordao Jr., Mohammad Melebari, Carlos Leon-Velarde, Roger Johnson, Keith Warriner

Abstract:

There has been an increased incidence of non-O157 Shiga Toxin Escherichia coli (STEC) with six serotypes (Top 6) being implicated in causing haemolytic uremic syndrome (HUS). Beef has been suggested to be a significant vehicle for non-O157 STEC although conclusive evidence has yet to be obtained. The following aimed to determine the prevalence of the Top 6 non-O157 STEC in beef processing using three different diagnostic platforms then characterize the recovered isolates. Hide, carcass and environmental swab samples (n = 60) were collected from a beef processing facility over a 12 month period. Enriched samples were screened using Biocontrol GDS, BAX or PALLgene molecular diagnostic tests. Presumptive non-O157 STEC positive samples were confirmed using conventional PCR and serology. STEC was detected by GDS (55% positive), BAX (85% positive), and PALLgene (93%). However, during confirmation testing only 8 of the 60 samples (13%) were found to harbour STEC. Interestingly, the presence of virulence factors in the recovered isolates was unstable and readily lost during subsequent sub-culturing. There is a low prevalence of Top 6 non-O157 STEC associated with beef although other serotypes are encountered. Yet, the instability of the virulence factors in recovered strains would question their clinical relevance.

Keywords: beef, food microbiology, shiga toxin, STEC

Procedia PDF Downloads 445

Authors: Monika Yadav

Abstract:

The incorporation of a healthy lifestyle significantly contributes to the advancement of economic development. Urbanization, industrialization, and economic growth have enhanced living conditions, promoting sedentary behaviours among individuals with elevated socio-economic statuses. The prevalence of overweight and obesity has increased globally, along with the rise in living standards, posing a growing health risk. Overweight and obesity are known to be precursors to a range of modifiable and metabolic risk factors, contributing to the increase in lifestyle diseases. Unhealthy dietary choices and lifestyle practices primarily drive these diseases. Lifestyle diseases refer to chronic and non-communicable illnesses, encompassing conditions such as hypertension, heart disease, kidney disorders, infertility, polycystic ovary syndrome (PCOD), diabetes, respiratory diseases, and certain forms of cancer. This study examines the prevalence of lifestyle diseases among urban Indian women, explicitly differentiating between individuals with normal weight and those classified as obese. The main aim of this study is to investigate whether there is a correlation between a higher body mass index (BMI) in women and an increased vulnerability to lifestyle diseases when compared to women with a normal BMI. This research provides insights into the intricate relationship between lifestyle, health, and economic development within urban areas.

Keywords: urbanization, economic development, BMI, NCDs, urban, women, lifestyle practices

Procedia PDF Downloads 53

Authors: Ali Ashraf, Ghazaleh Aghaee, Sedigheh Samimian, Mohaya Farzin

Abstract:

Objectives: Previous studies have indicated the positive effect of physical activity and sports on different aspects of health, such as muscle endurance and sleep cycle. However, in university students, particularly medical students, who have limited time and a stressful lifestyle, there have been limited studies exploring this matter with proven statistical results. In this regard, this study aims to find out how regular physical activity can influence the academic performance of medical students during their internship period. Methods: This was a descriptive-analytical study. Overall, 160 medical students (including 80 women and 88 men) voluntarily participated in the study. The Baecke Physical Activity Questionnaire was applied to determine the student’s physical activity levels. The student's academic performance was determined based on their total average academic scores. The data were analyzed in SPSS version 16 software using the independent t-test, Pearson correlation, and linear regression. Results: The average age of the students was 26.0±1.5 years. Eighty-eight students (52.4%) were male, and 142 (84.5%) were single. The student's mean total average academic score was 16.2±1.2, and their average physical activity score was 8.3±1.1. The student's average academic score was not associated with their gender (P=0.427), marital status (P=0.645), and age (P=0.320). However, married students had a significantly lower physical activity level compared to single students (P=0.020). The results indicated a significant positive correlation between student's physical activity levels and average academic scores (r=+0.410 and P<0.001). This correlation was independent of the student’s age, gender, and marital status based on the regression analysis. Conclusion: The results of the current study suggested that the physical activity level in medical students was low to moderate in most cases, and there was a significant direct relationship between student’s physical activity level and academic performance, independent of age, gender, and marital status.

Keywords: exercise, education, physical activity, academic performance

Procedia PDF Downloads 21

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

Abstract:

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

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

Procedia PDF Downloads 111

Authors: Mark Osborn

Abstract:

Clustered, regularly interspaced short palindromic repeat (CRISPR/Cas) proteins can be designed to bind specified DNA and RNA sequences and hold great promise for the accurate detection of nucleic acids for diagnostics. Commercially available reagents were integrated into a CRISPR/Cas9-based lateral flow assay that can detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequences with single-base specificity. This approach requires minimal equipment and represents a simplified platform for field-based deployment. A rapid, multiplex fluorescence CRISPR/Cas9 nuclease cleavage assay capable of detecting and differentiating SARS-CoV-2, influenza A and B, and respiratory syncytial virus in a single reaction was also developed. These findings provide proof of principle for CRISPR/Cas9 point-of-care diagnosis that can detect specific SARS-CoV-2 strain(s). Further, Cas9 cleavage allows for a scalable fluorescent platform for identifying respiratory viral pathogens with overlapping symptomology. Collectively, this approach is a facile platform for diagnostics with broad application to user-defined sequence interrogation and detection.

Keywords: CRISPR/Cas9, lateral flow assay, SARS-Co-V2, single-nucleotide resolution

Procedia PDF Downloads 167

Authors: Jhonas Geraldo Peixoto Flauzino, Pedro Pompeo Boechat Araujo, Alexia Allis Rocha Lima, Giovanna Biângulo Lacerda Chaves, Victor Ryan Ferrão Chaves

Abstract:

Schizophrenia is characterized as a set of psychiatric signs and symptoms (syndrome) that commonly erupt in the stages of adolescence or early adulthood, being recognized as one of the most serious diseases, as it causes important problems during the life of the patient. carrier - both in mental health and in physical health and in social life. Objectives: This is an integrative literature review that aimed to verify what has been produced of scientific knowledge in the field of child and adolescent psychiatry regarding schizophrenia in these stages of life, correlated to the most discussed themes and methodologies of choice for the preparation of studies. Methods: Articles were selected from the following databases: Virtual Health Library and CAPES Journal Portal, published in the last five years; and on Google Scholar, published in 2021, totaling 62 works, searched in September 2021. Results: The studies focus mainly on diagnosis through the DSM-V (25.8%), on drug treatment (25.8%) and in psychotherapy (24.2%), most of them in the literature review format: integrative (27.4%) and systematic (24.2%). Conclusion: The themes and study methods are redundant, and do not cover in depth the immense aspects that encompass Schizophrenia in Childhood and Adolescence, giving attention to the disease in a general way or focusing on the adult patient.

Keywords: schizophrenia, mental health, childhood, adolescence

Procedia PDF Downloads 148

Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

Abstract:

Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

Procedia PDF Downloads 247

Authors: Kassahun Tadesse, Megersa O. Dinka

Abstract:

Drinking water suitability study was conducted for a milky-white stream in remote areas of Ethiopia in order to understand its effect on human health. Water samples were taken from the water source and physicochemical properties were analyzed based on standard methods. The mean values of pH, total dissolved solids, sodium, magnesium, potassium, manganese, chloride, boron, and fluoride were within maximum permissible limits set for health. Whereas turbidity, calcium, irons, hardness, alkalinity, nitrate, and sulfate contents were above the limits. The water is very hard water due to high calcium content. High sulfate content can cause noticeable taste and a laxative (gastrointestinal) effect. The nitrate content was very high and can cause methemoglobinemia (blue baby syndrome) which is a temporary blood disorder in the bottle fed infants. Hence, parents should be advised not to give this water to infants. In conclusion, all physicochemical parameters except for nitrate are safe for health but may affect the appearance and taste, and wear water infrastructures. A high value of turbidity due to suspended minerals is the cause for milky-white colour. However, a mineralogical analysis of suspended sediments is required to identify the exact cause for white colour, and a study on sediment source was recommended.

Keywords: hard water, laxative effect, methemoglobinemia, nitrate, physicochemical, water quality

Procedia PDF Downloads 178

Authors: A. K. Tsafe

Abstract:

The study investigates the efficacy of Special Mathematics Teaching Strategy (SMTS) as against Conventional Mathematics Teaching Strategy (CMTS) in teaching students identified with Mathematics Learning Disabilities (MLDs) – dyslexia, Down syndrome, dyscalculia, etc., in some junior secondary schools around Sokoto metropolis. Errors and misconceptions in learning Mathematics displayed by these categories of students were observed. Theory of variation was used to provide a prism for viewing the MLDs from theoretical perspective. Experimental research design was used, involving pretest-posttest non-randomized approach. Pretest was administered to the intact class taught using CMTS before the class was split into experimental and control groups. Experimental group of the students – those identified with MLDs was taught with SMTS and later mean performance of students taught using the two strategies was sought to find if there was any significant difference between the performances of the students. A null hypothesis was tested at α = 0.05 level of significance. T-test was used to establish the difference between the mean performances of the two tests. The null hypothesis was rejected. Hence, the performance of students, identified with MLDs taught using SMTS was found to be better than their earlier performance taught using CMTS. The study, therefore, recommends amongst other things that teachers should be encouraged to use SMTS in teaching mathematics especially when students are found to be suffering from MLDs and exhibiting errors and misconceptions in the process of learning mathematics.

Keywords: disabilities, errors, learning, misconceptions

Procedia PDF Downloads 78

Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

Abstract:

Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

Procedia PDF Downloads 76

Authors: Wen Hsin Hsu, Pin Lin

Abstract:

Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

Procedia PDF Downloads 47

Authors: Kathleen Canul

Abstract:

Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

Procedia PDF Downloads 267

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

Abstract:

This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

Procedia PDF Downloads 84

Authors: Antoine Vikkey Hinson, Ranty Jolianelle Dassi, Menonli Adjobimey, Rose Mikponhoue, Paul Ayelo

Abstract:

Introduction: The psychological hardship of the teaching profession maintains a chronic stress that inevitably evolves into burnout (BO) in the absence of adequate preventive measures. The objective of this study is to study the prevalence and factors associated with burnout among secondary school teachers in the city of Cotonou in 2022. Methods: This was a descriptive cross-sectional study with an analytical aim and prospective data collection that took place over a period of 2 months, from July 19 to August 19 and from October 1 to October 31, 2022. Sampling was done using a three-stage probability sampling technique. Data analysis was performed using R 4.1.1 software. Bivariate logistic regression was used to identify associated factors. The significance level chosen was 5% (p < 0.05). Results: A total of 270 teachers were included in the study, of whom 208 (77.00%) were men. The mean age of the workers was 38.03 ± 8.30 years. According to the Maslach Burnout Inventory, 58.51% of the teachers had burnout, with 41.10% of teachers in emotional exhaustion, 27.40% in depersonalization and 21.90% in loss of personal accomplishment. The severity of the syndrome was low to moderate in almost all teachers. The occurrence of BO was associated with), not practicing sports (ORa= 2,38 [1,32; 4,28]), jobs training (ORa= 1,86 [1,04; 3,34]) and an imbalance of effort/reward (ORa= 5,98 [2,24;15,98]). Conclusion: The prevalence of BO is high among secondary school teachers in the city of Cotonou. A larger scale study, including research on its consequences on the teacher and the learner, is necessary in order to act quickly to implement a prevention program.

Keywords: burnout, teachers, Maslach burnout inventory, associated factors, Benin

Procedia PDF Downloads 54

Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi

Abstract:

Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.

Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment

Procedia PDF Downloads 486

Authors: Kartik Thakore, Anna-Roza Tamas, Adam Cole

Abstract:

The world health organization (WHO) reports that by 2030 more than 23.7 million deaths annually will be caused by Cardiovascular Diseases (CVDs); with a 2008 economic impact of $3.76 T. Metabolic syndrome is a disorder of multiple metabolic risk factors strongly indicated in the development of cardiovascular diseases. Guided lifestyle intervention driven by live coaching has been shown to have a positive impact on metabolic risk factors. Individuals’ path to improved (decreased) metabolic risk factors are driven by personal motivation and personalized messages delivered by coaches and augmented by technology. Using interactions captured between 400 individuals and 3 coaches over a program period of 500 days, a preliminary model was designed. A novel real time event tracking system was created to track and classify clients based on their genetic profile, baseline questionnaires and usage of a mobile application with live coaching sessions. Classification of clients and coaches was done using a support vector machines application build on Apache Spark, Stanford Natural Language Processing Library (SNLPL) and decision-modeling.

Keywords: guided lifestyle intervention, metabolic risk factors, personal coaching, support vector machines application, Apache Spark, natural language processing

Procedia PDF Downloads 414

Authors: Vladimir Siska, Lukas Kober

Abstract:

Introduction: The research deals with the work satisfaction of nurses working in healthcare institutions in the Slovak Republic, and factors influencing it. Employers should create working conditions that are consonant with the requirements of their employees and make the most of motivation strategies to help them answer to the employess' needs in concordance with various needs and motivation process theories. Methodology: In our research, we aimed to investigate the level of work satisfaction in nurses by carrying out a quantitative analysis using the standardized McCloskey/Mueller Satisfaction scale questionnaire. We used the descriptive positioning characteristics (average, median and variability, standard deviation, minimum and maximum) to process the collected data and, to verify our hypotheses; we employed the double-selection Student T-test, Mann-Whitney U test, and a one-way analysis of variance (One-way ANOVA). Results: Nurses´satisfaction with external rewards is influenced by their age, years of experience, and level of completed education, with all of the abovementioned factors also impacting on the nurses' satisfaction with their work schedule. The type of founding authority of the healthcare institution also constitutes an influence on the nurses' satisfaction concerning relationships in the workplace. Conclusion: The feelling of work dissatisfaction can influence employees in many ways, e.g., it can take the form of burn-out syndrome, absenteeism, or increased fluctuation. Therefore, it is important to pay increased attention to all employees of an organisation, regardless of their position.

Keywords: motivation, nurse, work satisfaction, McCloskey/Mueller satisfaction scale

Procedia PDF Downloads 118

Authors: Mile Vuković, Lana Jerkić Rajić

Abstract:

Introduction: Broca's aphasia is a non-fluent type of aphasic syndrome, which is primarily manifested by impairment of language production. In connected speech, patients with this type of aphasia produce short sentences in which they often omit function words and morphemes or choose inadequate forms. Aim: This research was conducted to examine the morphosyntactic abilities of people with Broca's aphasia, comparing them with neurologically healthy subjects without a language disorder. Method: The sample included 15 patients with Broca's post-stroke aphasia, who had the relatively intact ability of auditory comprehension. The diagnosis of aphasia was based on the Boston Diagnostic Aphasia Examination. The control group comprised 16 neurologically healthy subjects without data on the presence of disorders in speech and language development. The patients' mother tongue was Serbian. The new Serbian Morphosyntactic Abilities Test (SMAT) was used. Descriptive (frequency, percentage, mean, SD, min, max) and inferential (Mann-Whitney U-test) statistics were used in data processing. Results: We noticed statistically significant differences between people with Broca's aphasia and neurotypical subjects on the SMAT (U = 1.500, z = -4.982, p = 0.000). The results showed that people with Broca's aphasia had achieved low scores on the SMAT, regardless of age (ρ = -0.045, p = 0.873) and time post onset (ρ = 0.330, p = 0.229). Conclusion: Preliminary results show that the SMAT has the potential to detect morphosyntactic deficits in Serbian speakers with Broca's aphasia.

Keywords: Broca’s aphasia, morphosyntactic abilities, agrammatism, Serbian language

Procedia PDF Downloads 49

Authors: Saroj Bala Grover, Al Munther Alhasawi, Prem N. Sharma, P. S. N. Menon

Abstract:

Background: Prisoners are considered one of the high-risk populations for the transmission of human immunodeficiency virus (HIV) infection. Targeting this group is one of the strategies to reduce the incidence of acquired immune deficiency syndrome (AIDS) in the community. Subjects and Methods: A cross-sectional study was conducted among male inmates in Kuwait’s prison by administering three sets of questionnaires to assess the level of their knowledge and awareness about the mode of transmission of HIV/AIDS, their risky personal behavior that may lead to HIV infection, and the presence of any negative attitudes and stigmatization towards HIV infected individuals. Results: The study included 123 male inmates, with a mean ± SD age of 30.9 ± 8.4 years. Most participants had good general knowledge (90%) about the mode of transmission of HIV/AIDS, including sharing contaminated syringes, risky personal behaviors such as having unprotected sex and increased number of extramarital relationships (66%), and the avoidance of the regular use of condoms. The younger age group (< 35 years) had more extramarital relationships than those > 35 years (71.4% Vs. 46.4%; p=0.016). There was a perceived attitude of stigmatization among inmates towards HIV-infected persons. Conclusions: This vulnerable group of prisoners, especially young adults, need educational programs to improve knowledge about the transmission of HIV and to correct and change their risky personal behaviors to protect themselves and the community against HIV transmission.

Keywords: HIV/AIDS, Kuwait, prisoners, knowledge, awareness, personal behavior, extramarital relationships, safe sex, discrimination, stigmatization

Procedia PDF Downloads 58

Authors: Amal Abo El-Maaty, Amira Mohamed, Nashwa Abu-Aita, Hisham Morgan

Abstract:

For estimating markers of overweight or obesity of brood mares used for riding and training, 17 mares of different body conditions were subjected to blood sampling and ultrasound examination to measure rump fat thickness and monitor ovulation for six consecutive weeks. Also length (L), heart girth (G) and withers height (H) were measured to estimate body weight (BW), body fat %, body fat mass (BFM) and body mass index (BMI). Mares were classified into three groups according to both body condition score (BCS) and rump back fat (BF). Overweight mares (O) were having BCS > 7 and BF thickness >7mm, moderate body condition (M) mares were having BCS >3and ≤7and BF <3and <7mm, and emaciated mares (E) were having BCS ≤3 and BF ≤3mm. glucose, triglycerides, nitric oxide, ovarian, thyroid, insulin, insulin like growth factor-I (IGF-1), and leptin hormones were measured. Results revealed that BCS, G, L, L*G*H, BW, BF, fat %, BFM were significantly (P<0.0001) decreasing linearly from O to E. T4 concentrations of E were significantly high (P=0.04) compared to M and O but T3 concentrations tended to decrease in E (P>0.05). Insulin and IGF-1 concentrations tended to be high in O (P>0.05) and decrease with the decrease of body condition. M had (P=0.007) the highest leptin, but E mares had the lowest P4 concentrations (P=0.01). Concentrations of glucose and NO decreased with the decrease of BCS and BF but triglycerides of O were insignificantly high. In conclusion, exercise could prevent the development of metabolic syndrome in horses and back fat and morphometric measurements were the easiest and simple assessment of overweight and deviation to obesity.

Keywords: body condition score, insulin, leptin, mares, rump fat

Procedia PDF Downloads 309

Authors: Rueyhung Weng, Chia-En Huang, Jung-Chi-Liao

Abstract:

The transition zone (TZ) serves as a diffusion barrier to regulate the ins and outs of the proteins recruited to the primary cilia. TCTN2 is one of the TZ proteins and its mutation causes Joubert syndrome, a serious multi-organ disease. Despite its important medical relevance, the functions of TCTN2 remain elusive. Here we created a TCTN2 gene deleted retinal pigment epithelial cells (RPE1) using CRISPR/Cas9-based genome editing technique and used this knockout line to reveal roles of TCTN2. TCTN2 knockout RPE1 cells displayed a significantly reduced ciliogenesis or a shortened primary cilium length in the cilium-remaining population. Intraflagellar transport protein IFT88 aberrantly accumulated at the tip of TCTN2 deficient cells. Guanine nucleotide exchange factor Arl13B was mostly absent from the ciliary compartment, with a small population localizing at the ciliary tip. The deficient TZ was corroborated with the mislocalization of two other TZ proteins TMEM67 and MKS1. In addition, TCTN2 deficiency induced TZ impairment led to the suppression of Sonic hedgehog signaling in response to Smoothened (Smo) agonist. Together, depletion of TCTN2 destabilizes other TZ proteins and considerably alters the localization of key transport and signaling-associated proteins, including IFT88, Arl13B, and Smo.

Keywords: CRISPR/Cas9, primary cilia, Sonic hedgehog signaling, transition zone

Procedia PDF Downloads 329