Search results for: respiratory distress syndrome

Authors: Ibrahim Özbek, Erdoğan Mehmet Özkan

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In this study, we generalize (k,n) threshold secret sharing scheme on the study Ozbek and Siap to the codes over the ring Fq+ αFq. In this way, it is mentioned that the method obtained in that article can also be used on codes over rings, and new advantages to be obtained. The method of securely sharing the key in cryptography, which Shamir first systematized and Massey carried over to codes, became usable for all error-correcting codes. The firewall of this scheme is based on the hardness of the syndrome decoding problem. Also, an open study area is left for those working for other rings and code classes. All codes that correct errors with this method have been the working area of this method.

Keywords: secret sharing scheme, linear codes, algebra, finite rings

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Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

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Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure, and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity is the most severe clinical form of obesity, and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate morbid obese children with (MOMetS+) and without (MOMetS-) MetS. Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. A recently introduced anthropometric obesity index, waist circumference + hip circumference/2 ((WC+HC)/2), was confirmed to differ OB children from those with N-BMI, however it has not been tested whether it will find clinical usage for the differential diagnosis of MOMetS+ and MOMetS-. This study was designed to find out the availability of (WC+HC)/2 for the purpose and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. Forty-five MOMetS+ and forty-five MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. Body mass index (BMI), waist-to-hip circumference (W/H), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data was analyzed statistically, and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for W/H, TLFR, TAFR, D2I, and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r=0.961; p<0.001) and MOMetS+ (r=0.936; p<0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r=0.726; p<0.001 in MOMetS- group and r=0.932; p<0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as W/H, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: children, hip circumference, metabolic syndrome, morbid obesity, waist circumference

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Authors: Husham Bayazed

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Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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Authors: Michela Terlizzi, Chiara Colarusso, Aldo Pinto, Rosalinda Sorrentino

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Sphingosine-1-phosphate (S1P) is a membrane-derived bioactive phospholipid exerting a multitude of effects on respiratory cell physiology and pathology through five S1P receptors (S1PR1-5). Higher levels of S1P have been registered in a broad range of respiratory diseases, including inflammatory disorders and cancer, although its exact role is still elusive. Based on our previous study in which we found that S1P/S1PR3 is involved in an inflammatory pattern via the activation of Toll-like Receptor 9 (TLR9), highly expressed on lung cancer cells, the main goal of the current study was to better understand the involvement of S1P/S1PR3 pathway/signaling during lung carcinogenesis, taking advantage of a mouse model of first-hand smoke exposure and of carcinogen-induced lung cancer. We used human samples of Non-Small Cell Lung Cancer (NSCLC), a mouse model of first-hand smoking, and of Benzo(a)pyrene (BaP)-induced tumor-bearing mice and A549 lung adenocarcinoma cells. We found that the intranuclear, but not the membrane, localization of S1PR3 was associated to the proliferation of lung adenocarcinoma cells, the mechanism that was correlated to human and mouse samples of smoke-exposure and carcinogen-induced lung cancer, which were characterized by higher utilization of S1P. Indeed, the inhibition of the membrane S1PR3 did not alter tumor cell proliferation after TLR9 activation. Instead, according to the nuclear localization of sphingosine kinase (SPHK) II, the enzyme responsible for the catalysis of the S1P last step synthesis, the inhibition of the kinase completely blocked the endogenous S1P-induced tumor cell proliferation. These results prove that the endogenous TLR9-induced S1P can on one side favor pro-inflammatory mechanisms in the tumor microenvironment via the activation of cell surface receptors, but on the other tumor progression via the nuclear S1PR3/SPHK II axis, highlighting a novel molecular mechanism that identifies S1P as one of the crucial mediators for lung carcinogenesis-associated inflammatory processes and that could provide differential therapeutic approaches especially in non-responsive lung cancer patients.

Keywords: sphingosine-1-phosphate (S1P), S1P Receptor 3 (S1PR3), smoking-mice, lung inflammation, lung cancer

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Authors: Mustafa Metin Donma

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Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems, was used. One hundred and twenty four children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. Forty-three children with normal body mass index, forty-one and forty morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip C (HC), head C (HdC), neck C (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanin transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. The formula for the index was [(TRG/HDL-C) * (INS/FBG)] * [(WC+HC)/Height] * [(HdC+NC)/Height]. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p<0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: aspartate transaminase, cardiac, children, index, obesity

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Authors: Sait Ozsoy, Asude Gokmen, Mehtap Yondem, Hanife A. Alkan, Gulnaz T. Javan

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Deep neck infection often develops due to upper respiratory tract and odontogenic infections. Gastrointestinal System perforation can occur for many reasons and is in need of the early diagnosis and prompt surgical treatment. In both cases late or incorrect diagnosis may lead to increase morbidity and high mortality. A patient with a diagnosis of deep neck abscess died while under treatment due to sepsis and multiple organ failure. Autopsy finding showed duodenal ulcer and this is reported in the literature.

Keywords: peptic ulcer perforation, peritonitis, retropharyngeal abscess, sepsis

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Authors: Winnie Kung, Xinhua Liu, Debbie Huang, Patricia Kim, Keon Kim, Xiaoran Wang, Lawrence Yang

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Considerable Asian Americans were exposed to the World Trade Center attack due to the proximity of the site to Chinatown and a sizeable number of South Asians working in the collapsed and damaged buildings nearby. Few studies focused on Asians in examining the disaster’s mental health impact, and even less longitudinal studies were reported beyond the first couple of years after the event. Based on the World Trade Center Health Registry, this study examined the trajectory of PTSD of individuals directly exposed to the attack from 2-3 to 5-6 years after the attack, comparing Asians against the non-Hispanic White group. Participants included 2,431 Asians and 31,455 Whites. Trajectories were delineated into the resilient, chronic, delayed-onset and remitted groups using PTSD checklist cut-off score at 44 at the 2 waves. Logistic regression analyses were conducted to compare the poorer trajectories against the resilient as a reference group, using predictors of baseline sociodemographic, exposure to the disaster, lower respiratory symptoms and previous depression/anxiety disorder diagnosis, and recruitment source as the control variable. Asians had significant lower socioeconomic status in terms of income, education and employment status compared to Whites. Over 3/4 of participants from both races were resilient, though slightly less for Asians than Whites (76.5% vs 79.8%). Asians had a higher proportion with chronic PTSD (8.6% vs 7.4%) and remission (5.9% vs 3.4%) than Whites. A considerable proportion of participants had delayed-onset in both races (9.1% Asians vs 9.4% Whites). The distribution of trajectories differed significantly by race (p<0.0001) with Asians faring poorer. For Asians, in the chronic vs resilient group, significant protective factors included age >65, annual household income >$50,000, and never married vs married/cohabiting; risk factors were direct disaster exposure, job loss due to 9/11, lost someone, and tangible loss; lower respiratory symptoms and previous mental disorder diagnoses. Similar protective and risk factors were noted for the delayed-onset group, except education being protective; and being an immigrant a risk. Between the 2 comparisons, the chronic group was more vulnerable than the delayed-onset as expected. It should also be noted that in both comparisons, Asians’ current employment status had no significant impact on their PTSD trajectory. Comparing between Asians against Whites, the direction of the relationships between the predictors and the PTSD trajectories were mostly the same, although more factors were significant for Whites than for Asians. A few factors showed significant racial difference: Higher risk for lower respiratory symptoms for Whites than Asians, higher risk for pre-9/11 mental disorder diagnosis for Asians than Whites, and immigrant a risk factor for the remitted vs resilient groups for Whites but not for Asians. Over 17% Asians still suffered from PTSD 5-6 years after the WTC attack signified its persistent impact which incurred substantial human, social and economic costs. The more disadvantaged socioeconomic status of Asians rendered them more vulnerable in their mental health trajectories relative to Whites. Together with their well-documented low tendency to seek mental health help, outreach effort to this population is needed to ensure follow-up treatment and prevention.

Keywords: PTSD, Asian Americans, World Trade Center Attack, racial differences

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Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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Authors: Aykut Bedük, Kemalettin Eryeşil, Osman Eşmen

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The aim of this study is to examine the relationship between organizational commitment which is defined as a strong belief in and acceptance of the organization’s goals and values, and burnout syndrome and organizational cynicism. Accordingly, a field research based on survey method was conducted on the employees of a health institution operating in the province of Konya. The findings of the research show that there is a positive statistically significant relationship between organizational cynicism and burnout while there is a negative statistically significant relationship between organizational commitment and burnout. Furthermore, it has been also realized that there is a negative and statistically significant relationship between organizational commitment and organizational cynicism.

Keywords: burnout, organizational commitment, organizational cynicism, healthcare management

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Authors: Adinarayana Badveeti, Mohammad Shafi Mir

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In Srinagar city, in India, road safety is an important aspect that creates ecological balance and social well being. A road accident creates a situation that leaves behind distress, sorrow, and sufferings. Therefore identification of causes of road accidents becomes highly essential for adopting necessary preventive measures against a critical event. The damage created by road accidents to large extent is unrepairable and therefore needs attention to eradicate this continuously increasing trend of awful 'epidemic'. Road accident in India is among the highest in the world, with at least approximately 142.000 people killed each year on the road. Kashmir region is an ecologically sensitive place but lacks necessary facilities and infrastructure regarding road transportation, ultimately resulting in the critical event-road accidents creating a major problem for common people in the region. The objective of this project is to study the safety aspect of Srinagar City and also model the accidents with different aspect that causes accidents and also to suggest the possible remedies for lessening/eliminating the road accidents.

Keywords: road safety, road accident, road infrastructure, accident modeling

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Authors: Prateek Rastogi, Jenash Acharya

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Histopathology examination has been a boon to forensic experts all around the world since its implication in autopsy cases. Whenever a case of sudden death is encountered, forensic experts clandestinely focus on cardiovascular, respiratory, gastrointestinal or cranio-cerebral causes. After ruling out poisoning or trauma, they are left with the only option available, histopathology examination. Besides preserving thoracic and abdominal organs, brain tissues are very less frequently subjected for the analysis. Based on provisional diagnosis documented on hospital treatment record files, one hemisphere of grossly unremarkable cerebrum was confirmatively diagnosed by histopathology examination to be a case of cerebral toxoplasmosis.

Keywords: cerebral toxoplasmosis, sudden death, health information, histopathology

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Authors: Momoka Sunohara, Ashley J. Lemieux, Esther Yakobov, Andrew G. Ryder, Tomas Jurcik

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Immigration brings changes in many aspects of an individual's life, from social support dynamics, to housing and language, as well as difficulties with regards to discrimination, trauma, and loss. Past research has mostly emphasized individual differences in mental health and has neglected the impact of social-ecological context, such as acculturation and ethnic density. Purpose: The present study aimed to assess the relationship between variables associated with social integration such as perceived ethnic density and ways of coping, as well as psychological adjustment in a rapidly growing non-visible minority group of immigrants in Canada. Data: A small subset of an archival data from our previously published study was reanalyzed with additional variables. Data included information from 269 Russian-Speaking immigrants in Montreal, Canada. Method: Canonical correlation analysis (CCA) investigated the relationship between two sets of variables. SAS PROC CANCORR was used to conduct CCA on a set of social integration variables, including ethnic density, discrimination, social support, family functioning, and acculturation, and a set of psychological well-being variables, including distress, depression, self-esteem, and life satisfaction. In addition, canonical redundancy analysis was performed to calculate the proportion of variances of original variables explained by their own canonical variates. Results: Significance tests using Rao’s F statistics indicated that the first two canonical correlations (i.e., r1 = 0.64, r2 = 0.40) were statistically significant (p-value < 0.0001). Additionally, canonical redundancy analysis showed that the first two well-being canonical variates explained separately 62.9% and 12.8% variances of the standardized well-being variables, whereas the first two social integration canonical variates explained separately 14.7% and 16.7% variances of the standardized social integration variables. These results support the selection of the first two canonical correlations. Then, we interpreted the derived canonical variates based on their canonical structure (i.e., correlations with original variables). Two observations can be concluded. First, individuals who have adequate social support, and who, as a family, cope by acquiring social support, mobilizing others and reframing are more likely to have better self-esteem, greater life satisfaction and experience less feelings of depression or distress. Second, individuals who feel discriminated yet rate higher on a mainstream acculturation scale, and who, as a family, cope by acquiring social support, mobilizing others and using spirituality, while using less passive strategies are more likely to have better life satisfaction but also higher degree of depression. Implications: This model may serve to explain the complex interactions that exist between social and emotional adjustment and aid in facilitating the integration of individuals immigrating into new communities. The same group may experience greater depression but paradoxically improved life satisfaction associated with their coping process. Such findings need to be placed in the context of Russian cultural values. For instance, some Russian-speakers may value the expression of negative emotions with significant others during the integration process; this in turn may make negative emotions more salient, but also facilitate a greater sense of family and community connection, as well as life satisfaction.

Keywords: acculturation, ethnic density, mental health, Russian-speaking

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Authors: Mukondi Esther Nethavhakone

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In 2020 World Health Organization announced the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as Coronavirus disease 2019 (COVID-19) pandemic. To curb or contain the spread of the novel coronavirus (COVID 19), global governments implemented social distancing and lockdown regulations. Subsequently, it was no longer business as per usual, life as we knew it had changed, and so many aspects of people's lives were negatively affected, including financial and employment stability. Mainly, because companies/businesses had to put their operations on hold, some had to shut down completely, resulting in the loss of income for many people globally. Finances and employment insecurities are some of the issues that exacerbated many social issues that the world was already faced with, such as school drop-outs, teenage pregnancies, sexual assaults, gender-based violence, crime, child abuse, elderly abuse, to name a few. Expectedly the majority of the population's mental health state was threatened. This resulted in an increased number of people seeking mental healthcare services. The increasing need for mental healthcare services in Low and Middle-income countries proves to be a challenge because it is a well-known fact due to financial constraints and not well-established healthcare systems, mental healthcare provision is not as prioritised as the primary healthcare in these countries. It is against this backdrop that the researcher seeks to find viable, cost-effective, and accessible mental health solutions for low and middle-income countries amid the pressures of any pandemic. The researcher will undertake a systematic review of the technology-based mental health solutions that have been implemented/adopted by developed countries during COVID 19 lockdown and social distancing periods. This systematic review study aims to determine if low and middle-income countries can adopt the cost-effective version of digital mental health solutions for the healthcare system to adequately provide mental healthcare services during critical times such as pandemics (when there's an overwhelming diminish in mental health globally). The researcher will undertake a systematic review study through mixed methods. It will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The mixed-methods uses findings from both qualitative and quantitative studies in one review study. It will be beneficial to conduct this kind of study using mixed methods because it is a public health topic that involves social interventions and it is not purely based on medical interventions. Therefore, the meta-ethnographic (qualitative data) analysis will be crucial in understanding why and which digital methods work and for whom does it work, rather than only the meta-analysis (quantitative data) providing what digital mental health methods works. The data collection process will be extensive, involving the development of a database, table of summary of evidence/findings, and quality assessment process lastly, The researcher will ensure that ethical procedures are followed and adhered to, ensuring that sensitive data is protected and the study doesn't pose any harm to the participants.

Keywords: digital, mental health, covid, low and middle-income countries

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Authors: Samaneh Sadat Fattahi Massoom, Hossein Salimi Bajestani

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The study examines loneliness and depression in students who regularly care for themselves after school (latchkey students) in Mashhad and compares them with parent supervised students using a causal-comparative research method. The 270 participants, aged 7 -13, were selected using convenience and cluster random-assignment sampling. Independent t-test results showed significant differences between loneliness (-4.32, p ≤ 0.05) and depression (-3.02, p ≤0.05) among latchkey and non-latchkey students. Using the Pearson correlation test, significant correlation between depression and loneliness among latchkey students was also discovered (r=0.59, p ≤ 0.05). However, regarding non latchkey students, no significant difference between loneliness and depression was observed (r= 0.02. p ≥ 0.05). Multiple regression results also showed that depression variance can be determined by gender (22%) and loneliness (34%). The findings of this study, specifically the significant difference between latchkey and non-latchkey children regarding feelings of loneliness and depression, carries clear implications for parents. It can be concluded that mothers who spend most of their time working out of the house and devoid their children of their presence in the home may cause some form of mental distress like loneliness and depression. Moreover, gender differences affect the degree of these psychological disorders.

Keywords: loneliness, depression, self-care students, latchkey and non-latchkey students, gender

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Authors: A. P. Pashkov

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The number of environmental factors that adversely affect children's health is growing every year; their combination in each territory is different. The contribution of socio-economic factors to the health status of the younger generation is increasing. It is the child’s body that is most sensitive to changes in environmental conditions, responding to this with a deterioration in health. Over the past years, scientists have determined the influence of environmental factors and the incidence of children. Currently, there is a tendency to study regional characteristics of the interaction of a combination of environmental factors with the child's body. The aim of the work was to identify trends in the primary non-infectious morbidity of the children of the Altai Territory as a unique region that combines territories with different levels of environmental quality indicators, as well as to assess the effect of atmospheric air, drinking water and socio-economic indicators on the incidence of children in the region. An unfavorable tendency has been revealed in the region for incidence of such nosological groups as neoplasms, including malignant ones, diseases of the endocrine system, including obesity and thyroid disease, diseases of the circulatory system, digestive diseases, diseases of the genitourinary system, congenital anomalies, and respiratory diseases. Between some groups of diseases revealed a pattern of geographical distribution during mapping and a significant correlation. Some nosologies have a relationship with socio-economic indicators for an integrated assessment: circulatory system diseases, respiratory diseases (direct connection), endocrine system diseases, eating disorders, and metabolic disorders (feedback). The analysis of associations of the incidence of children with average annual concentrations of substances that pollute the air and drinking water showed the existence of reliable correlation in areas of critical and intense degree of environmental quality. This fact confirms that the population living in contaminated areas is subject to the negative influence of environmental factors, which immediately affects the health status of children. The results obtained indicate the need for a detailed assessment of the influence of environmental factors on the incidence of children in the regional aspect, the formation of a database, and the development of automated programs that can predict the incidence in each specific territory. This will increase the effectiveness, including economic of preventive measures.

Keywords: incidence of children, regional features, socio-economic factors, environmental factors

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Authors: Duncan Oteki, Andebut Yeneneh, Daba Gedafa, Nabil Suleiman

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Most agencies lack the equipment required to measure the dynamic modulus (|E*|) of asphalt mixtures, necessitating the need to use predictive models. This study compared measured |E*| values for nine North Dakota asphalt mixes using the original Witczak, modified Witczak, and Hirsch models. The influence of temperature on the |E*| models was investigated, and Pavement ME simulations were conducted using measured |E*| and predictions from the most accurate |E*| model. The results revealed that the original Witczak model yielded the lowest Se/Sy and highest R² values, indicating the lowest bias and highest accuracy, while the poorest overall performance was exhibited by the Hirsch model. Using predicted |E*| as inputs in the Pavement ME generated conservative distress predictions compared to using measured |E*|. The original Witczak model was recommended for predicting |E*| for low-reliability pavements in North Dakota.

Keywords: asphalt mixture, binder, dynamic modulus, MEPDG, pavement ME, performance, prediction

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Authors: I. S. Gandhi, D. N. Patel, M. Johnson, A. R. Hirsch

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Although distortion of taste perception following a cerebrovascular event may seem to be a frivolous consequence of a classic stroke presentation, altered taste perception places patients at an increased risk for malnutrition, weight loss, and depression, all of which negatively impact the quality of life. Impaired taste perception can result from a wide variety of cerebrovascular lesions to various locations, including pons, insular cortices, and ventral posteromedial nucleus of the thalamus. Wallenberg syndrome, also known as a lateral medullary syndrome, has been described to impact taste; however, specific sweet to bitter taste dysgeusia from a territory infarction is an infrequent event; as such, a case is presented. One year prior to presentation, this 64-year-old right-handed woman, suffered a right posterior inferior cerebellar artery aneurysm rupture with resultant infarction, culminating in a ventriculoperitoneal shunt placement. One and half months after this event, she noticed the gradual onset of lack of ability to taste sweet, to eventually all sweet food tasting bitter. Since the onset of her chemosensory problems, the patient has lost 60-pounds. Upon gustatory testing, the patient's taste threshold showed ageusia to sucrose and hydrochloric acid, while normogeusia to sodium chloride, urea, and phenylthiocarbamide. The gustatory cortex is made in part by the right insular cortex as well as the right anterior operculum, which are primarily involved in the sensory taste modalities. In this model, sweet is localized in the posterior-most along with the rostral aspect of the right insular cortex, notably adjacent to the region responsible for bitter taste. The sweet to bitter dysgeusia in our patient suggests the presence of a lesion in this localization. Although the primary lesion in this patient was located in the right medulla of the brainstem, neurodegeneration in the rostal and posterior-most aspect, of the right insular cortex may have occurred due to diaschisis. Diaschisis has been described as neurophysiological changes that occur in remote regions to a focal brain lesion. Although hydrocephalus and vasospasm due to aneurysmal rupture may explain the distal foci of impairment, the gradual onset of dysgeusia is more indicative of diaschisis. The perception of sweet, now tasting bitter, suggests that in the absence of sweet taste reception, the intrinsic bitter taste of food is now being stimulated rather than sweet. In the evaluation and treatment of taste parageusia secondary to cerebrovascular injury, prophylactic neuroprotective measures may be worthwhile. Further investigation is warranted.

Keywords: diaschisis, dysgeusia, stroke, taste

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: Haiu-Lan Chin, Yu-Fen Hsiao, Hua-Ying Chuang, Wei Lee

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An adult with intellectual disability generally has insufficient physical activity which is an important factor leading to premature weakness. Studies in recent years on frailty syndrome have accumulated substantial data about indicators of human aging, including unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Of these indicators, hand-grip strength can be seen as a predictor of mortality, disability, complications, and increased length of hospital stay. Hand-grip strength in fact provides a comprehensive overview of one’s vitality. The research is about the investigation on hand-grip strength of adults with intellectual disabilities in facilities, institutions and workshops. The participants are 197 male adults (M=39.09±12.85 years old), and 114 female ones (M=35.80±8.2 years old) so far. The aim of the study is to figure out the performance of their hand-grip strength, and initiate the setting of training on hand-grip strength in their daily life which will decrease the weakening on their physical condition. Test items include weight, bone density, basal metabolic rate (BMR), static body balance except hand-grip strength. Hand-grip strength was measured by a hand dynamometer and classified as normal group ( ≧ 30 kg for male and ≧ 20 kg for female) and weak group ( < 30 kg for male, < 20 kg for female)The analysis includes descriptive statistics, and the indicators of grip strength fo the adults with intellectual disability. Though the research is still ongoing and the participants are increasing, the data indicates: (1) The correlation between hand-grip strength and degree of the intellectual disability (p ≦. 001), basal metabolic rate (p ≦ .001), and static body balance (p ≦ .01) as well. Nevertheless, there is no significant correlation between grip strength and basal metabolic rate which had been having significant correlation with hand-grip strength. (2) The difference between male and female subjects in hand-grip strength is significant, the hand-grip strength of male subjects (25.70±12.81 Kg) is much higher than female ones (16.30±8.89 Kg). Compared to the female counterparts, male participants indicate greater individual differences. And the proportion of weakness between male and female subjects is also different. (3) The regression indicates the main factors related to grip strength performance include degree of the intellectual disability, height, static body balance, training and weight sequentially. (4) There is significant difference on both hand-grip and static body balance between participants in facilities and workshops. The study supports the truth about the sex and gender differences in health. Nevertheless, the average hand-grip strength of left hand is higher than right hand in both male and female subjects. Moreover, 71.3% of male subjects and 64.2% of female subjects have better performance in their left hand-grip which is distinctive features especially in low degree of the intellectual disability.

Keywords: adult with intellectual disability, frailty syndrome, grip strength, physical condition

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Authors: Mohammed Qutishat, Khaldoun Aldiabat, Khaled Bader, Mohammad Al Qadire

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Cyberchondria refers to the irrational increase of distress about the condition of one's health as a consequence of the World Wide Web quest for medical details. The aim of this study was to examine the relationship between emotional intelligence and cyberchondria among Omani university students. A descriptive correlational design was used to collect data from eligible 370 participants using the Emotional Intelligence Questionnaire, and the short-form version of the Cyberchondria Severity Scale (CSS-12) between January and May 2020 at XX University-Oman. The participants’ age ranged between 18 and 37 years (M = 20.28). The majority of the participants were female, 59.7% (n = 221), single 99.5% (368), in their second academic year, 29.2% (n =108). The mean score of cyberchondria experiences was 32.51, and the mean score of emotional intelligence was 34.91. Linear regression indicated a strong association between cyberchondria and emotional intelligence [F (34.639) = 5.885, P=.000], with a .086 R². In conclusion, the exchange of expertise and peer networking for health-related details utilizing the Internet can benefit students with and without having health problems. Further research and methods should be developed to help students track the online medical tools effectively for the right purposes.

Keywords: emotional intelligence, cyberchondria, smartphone addiction, social media

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Authors: Benghezel Hichem

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Thyroid dysfunction in hemodialysis subjects is represented mainly by hypothyroidism. The objective of our work is to determine the thyroid profile of our hemodialysis patients and to highlight the prevalence of different thyroid disorders. Methods: This is a retrospective study performed on a mono centric 2 months (February and March 2013) on 42 hemodialysis patients (11 male and 31 female). We made the dosage of thyroid hormones Thyrotropin (TSH) ((free thyroxin ) FT4 and free Triodothyronin ) FT3) by chemiluminescence immunoassay method on cobas 6000 Roche Diagnostics. The results: The prevalence of biological hypothyroidism was 18% (7% with a high TSH isolated and a mean +/- SD 9.44 +/- 6.29, 5% with high TSH, and with low FT4 a mean +/- SD is 8.18 +/- 0.53 for TSH and 9.69 +/- 0.22 for FT4, One patient with a high TSH, and low FT4, FT3. 4% of patients with a low T3 syndrome with a mean +/- SD of 3.93 +/- 0,3 for FT3), we notice that 5% of patients with hyperthyroidism TSH collapsed and mean +/- SD of TSH is 0.017 +/- 0,001. Conclusion: The biological Hypothyroidism is a common endocrine disorder in chronic hemodialysis.

Keywords: hypothyroidism, hemodialysis, thyréostimulin, free thyroxin, triodothyronin

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Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

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Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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Authors: Oluwadele Joshua Femi, Akinlabi Ebenezer Yemi, Onaopemipo Adeitan, Kazeem Bello, Anthony Ekeocha, Miraim Tawose

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This study was carried out to determine the physiological and stress index of scavenging chickens in LAFARGE (Ewekoro) and Dangote (Ibese) Cement Factories Area of Ogun State. One hundred adult scavenging chickens comprising of 25 chickens from LAFARGE, Dangote and respective adjourning communities (Imasayi and Wasimi) were used. Experimental birds were caught at night on their perch and kept in cages till the next morning. Data were collected on rectal temperature, pulse rate, and respiratory rate of the birds. Also, 5ml blood was collected through the wing vein of the chickens in each location using a sterilized needle and syringe and transported to laboratory for analysis. Significant (P<0.05) highest pulse rate (215.64 beat/minute) and respiratory rate (19.90 breaths/minute) were recorded among scavenging chickens at LAFARGE (Ewekoro) Area and the least (198.61 beat/minute and 16.93 breaths/minute, respectively) at Imasayi. There was no significant (P>0.05) difference in the rectal temperature of the birds in the study area. Significant (P<0.05) differences were also recorded in the Packed Cell Volume (PCV), Hemoglobin (Hb), White Blood Cell (WBC), Monocyte, and Glucose level of the chickens in study area with the highest (P<0.05) Packed Cell Volume (28.06%) and Haemoglobin (4.01g/dl) recorded in Ibese and the least Packed Cell Volume (22.00%) and Haemoglobin (288g/dl) in Imasayi. Highest (P<0.05) Monocyte (4.28%) and glucose (256.53g/dl) were recorded among scavenging chickens at Dangote (Ibese) while the least Monocyte (0.00%) and Glucose (194.53g/dl) was recorded among chickens at Wasimi. Highest (P<0.05) White Blood Cell (6488.89×103µl) was recorded among chickens at Ewekoro and the lowest value in Ibese (4388.44×103µl). There was no significant (P>0.05) difference in the Heterophyl, Lymphocyte, Basophyl and Heterophyl/Lymphocyte ratio of the chickens in the study Area. The study concluded that chickens reared at LAFARGE (Ewekoro) were stressed and had comprised welfare and health status compared to Dangote (Ibese) cement area and other agrarian communities. Effective environmental mitigation programme should be put in place to enhance the welfare of the scavenging chickens in LAFARGE Cement Factory Area.

Keywords: blood, chicken, poisonous substances, pack cell volume, communities

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Authors: Folorunsho J. O., Umar M. A.

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Access to potable water supply in both the rural and urban regions of the world has been neglected, and this has severely affected man and the aesthetics of the natural environment of man. This has further worsened the issue of diseases prevalence. This study considered the effects of inadequate domestic water supply on human health in selected neighbourhoods of Lokoja. The study used descriptive statistics such as relative frequencies, percentages and inferential statistics to analyse the data obtained through the use of structured questionnaire. The results revealed that the females and male constituted 56% and 44% of the respondents respectively; 62% of the respondents married and 32% are unmarried; respondents between ages 31 and 40 years constitute majority of the study population, while respondents with tertiary education constituted 35%, and those with secondary education were 32% of the total respondents. Furthermore, civil servants constituted 40% and unemployed 16% of the total respondents. In terms of monthly income, 40% of the respondents was found to earn between ₦31,000 - 40,000 monthly. On the perception of households on the availability and adequacy of domestic water supply, the study revealed that 64.7% of the respondents have pipe-borne water as their main source of water supply, with only 28.5% out of the 64.7% have pipe-borne water supply daily. On the relationship between water supply characteristics and health status among households, the result shows that 76% of the respondents perceived a strong relationship between water supply and health status. Cumulatively, 67% of the respondents confirm that both the quality and quantity of water supplied play a critical role in determining health status of residents of the study area. The respondents also reported skin diseases (96%), diarrhoea (96%), malaria (91%), cholera (67%), dysentery (67%), and respiratory diseases (67%) as the most perceived and experienced in the area, the disease rate in the prevalence order of malaria (81%), diarrhoea (61%), skin diseases (58%), cholera (34%), dysentery (31%) and respiratory disease (14%) respectively. Finally, the results further showed how households cope with inadequate water supply with 52% of the respondents confirm that they regularly treat their water before it was deployed for domestic uses, while 35%, 26%, 25%, 10% and 4% of the 52% respectively, adopted boiling, addition of alums, filtering with fabrics, chlorination and bleaching as the preferred treatment methods. The study thus recommended policy options that will aggressively launch adequate potable water supply infrastructure in the study area.Keywords: Potable Water, Supply, Human Health, Perception, Chlorination

Keywords: potable water, human health, perception, chlorination

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Authors: Salma Mefteh-Wali, Marie-Josephe Rigobert

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We investigate the impact of foreign currency debt on firm performance for a sample of non-financial French firms studied over the period 2002 to 2012. As foreign currency debt is both a financing and hedging instrument against foreign exchange risk, we mobilize optimal hedging theory and capital structure theory. When we study the impact on firm value, our main results show that before and after the financial crisis of 2008, foreign debt had the same behavior as domestic debt. We find that during the crisis period, foreign debt positively affects firm value. Investors perceive foreign debt as a natural hedging instrument that is likely to reduce the costs of underinvestment, alleviate cash flow volatility, limit the costs of financial distress, and generate tax shield benefits. Also, our results show that foreign leverage negatively affects the firm performance proxied by ROA and ROE, during and after the financial crisis. However, this impact is positive in the pre-crisis period.

Keywords: foreign currency derivatives, foreign currency debt, foreign currency hedging, firm performance

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Authors: Seema Singh Parmar, Shweta Chauhan

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Aims & Objectives: To evaluate the presence of various psychiatric disorders in patients reporting with a headache as the only symptom. Methodology: 200 patients with the chief complain of a headache who visited the psychiatric OPD of a tertiary care were investigated. Out of them 50 who had pure psychiatric illness without any other neurological disease were investigated, and their diagnosis was made. Independent sample t-tests were applied to generate results. Results: The most common psychiatric diagnosis seen in the sample was Depression (64%) out of which 47% showed features of Depression with anxious distress. Other psychiatric disorders seen were Generalized Anxiety Disorder, Panic Attacks, Somatic Symptom Disorder and Obsessive Compulsive Disorder. For pure psychiatry, headache related illnesses female to male ratio was 1.64. Conclusion: The increasing frequency of psychiatric disorders among patients who only visit the doctor seeking treat a headache shows the need for better identification of psychiatric disorders because proper diagnosis and target of psychiatric treatment shall give complete relief to the patient’s symptomatology.

Keywords: anxiety disorders, depression, headache, panic attacks

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Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

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Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

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Authors: Orkide Donma, Mustafa M. Donma

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Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices

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Authors: Jilu David

Abstract:

Background: Schizophrenia is one of the most misunderstood mental illnesses across the globe. Lack of understanding about mental illnesses often delay treatment, severely affects the functionality of the person, and causes distress to the family. The study, Video-based Psychoeducation for Caregivers of Persons with Schizophrenia, consisted of developing a psychoeducational video about Schizophrenia, its symptoms, causes, treatment, and the importance of family support. Methodology: A quasi-experimental pre-post design was used to understand the feasibility of the study. Qualitative analysis strengthened the feasibility outcomes. Knowledge About Schizophrenia Interview was used to assess the level of knowledge of 10 participants, before and after the screening of the video. Results: Themes of usefulness, length, content, educational component, format of the intervention, and language emerged in the qualitative analysis. There was a statistically significant difference in the knowledge level of participants before and after the video screening. Conclusion: The statistical and qualitative analysis revealed that the video-based psychoeducation program was feasible and that it facilitated a general improvement in knowledge of the participants.

Keywords: Schizophrenia, mental illness, psychoeducation, video-based psychoeducation, family support

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