Search results for: hypertension exercise

Authors: Awais Ahmad

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People of Khyber Pakhtunkhwa (KP) and Federally Administered Tribal Areas (FATA) remains underrepresented in Pakistan’s mainstream media and their miseries and concerns are unheard and unnoticed. Rising the incidents of human rights violation in KP province of Pakistan, and its absence in the mainstream media has raised many questions on the clause of press freedom known as 19/A in the constitution of Pakistan, that has claimed freedom of speech to all Pakistani citizens. Using a ‘think a loud’ research technique, senior most journalists of KP have been interviewed to get to know reasons of why and how Pashtun’s voices have been silenced in a democratic country where individual’s opinion is considered more powerful, and they can exercise freedom to protest and speak-up for their rights. The information collected from the journalists has been used to evaluate press freedom in KP and FATA by applying the institutional theory. The paper evaluates different recent cases where Pashtun journalists, media outlets and social activists were being punished for criticizing authorities and military establishment. This study also explores that the perception of local journalists regarding press freedom and what are the factors they consider it restrictions while they perform their duties.

Keywords: press freedom, federally administered tribal areas (fata), khyber pakhtunkhwa (kp), military establishment

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Authors: Chengliang Xie, Jinhyun Ryu, Hyun Joon Kim, Gyeong Jae Cho, Wan Sung Choi, Sang Soo Kang, Kye Man Cho, Dong Hoon Lee

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Obesity has become a global health problem and a source of major metabolic diseases like type-2 diabetes, hypertension, heart disease, nonalcoholic fatty liver and cancer. Synthetic anti-obesity drugs are effective but very costly and with undesirable side effects, so natural products such as soybean are needed as an alternative for obesity treatment. Lactobacillus Plantarum P1201is a probiotic bacterial strain reported to produce conjugated linoleic acid (CLA) and increase the ratio of aglycone-isoflavone of soybean, both of which have anti-obesity effect. In this study, the anti-obesity effect of the fermented soybean extract with P1201 (FSE) will be evaluated compared with that of the soybean extract (SE) by 3T3-L1 cells as an in vitro model of adipogenesis. 3T3-L1 cells were treated with SE and FSE during the nine days of the differentiation, lipid accumulation was evaluated by oil-red staining and triglyceride content and the mRNA expression level of adipogenic or lipogenic genes were analyzed by RT-PCR and qPCR. The results showed that formation of lipid droplets in differentiated 3T3-L1 cells was inhibited and triglyceride content was reduced by 23.1% after treated with 1000 μg/mL of FSE compared with control. For SE-treated groups, no delipidating effect was observed. The effect of FSE on adipogenesis inhibition can be attributed to the down-regulation of mRNA expressionof CCAAT/enhancer binding protein (C/EBP-α), lipoprotein lipase (LPL), adiponectin, adipocyte fatty acid-binding protein (aP2), fatty acid synthesis (FAS) and CoA carboxylase (ACC). Our results demonstrated that the anti-obesity effect of soybean can be improved by fermentation with P1201, and P1201can be used as a potential probiotic bacterial strain to produce natural anti-obesity food.

Keywords: fermentation, Lactobacillus plantarum P1201, obesity, soybean

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Authors: Juan C. Reyes, Linnette Rodríguez, Héctor Villanueva, Jorge Vázquez, Ivonne Rivera

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On July 2020, a private non-profit community health center (HealthProMed) that serves people without a medical insurance plan or with limited resources in one of the most populated areas in San Juan, Puerto Rico, implemented a COVID-19 case investigation and contact-tracing surveillance system. Nursing personnel at the health center completed a computerized case investigation form that was translated, adapted, and modified from CDC’s Patient Under Investigation (PUI) Form. Between July 13, 2020, and March 17, 2022, a total of 9,233 SARS-CoV-2 tests were conducted at the health center, 16.9% of which were classified as confirmed cases (positive molecular test) and 27.7% as probable cases (positive serologic test). Most of the confirmed cases were females (60.0%), under 20 years old (29.1%), and living in their homes (59.1%). In the 14 days before the onset of symptoms, 26.3% of confirmed cases reported going to the supermarket, 22.4% had contact with a known COVID-19 case, and 20.7% went to work. The symptoms most commonly reported were sore throat (33.4%), runny nose (33.3%), cough (24.9%), and headache (23.2%). The most common preexisting medical conditions among confirmed cases were hypertension (19.3%), chronic lung disease including asthma, emphysema, COPD (13.3%), and diabetes mellitus (12.8). Multiple logistic regression analysis revealed that patients who used alcohol frequently during the last two weeks (OR=1.43; 95%CI: 1.15-1.77), those who were in contact with a positive case (OR=1.58; 95%CI: 1.33-1.88) and those who were obese (OR=1.82; 95%CI: 1.24-2.69) were significantly more likely to be a confirmed case after controlling for sociodemographic variables. Implementing a case investigation and contact-tracing component at community health centers can be of great value in the prevention and control of COVID-19 at the community level and could be used in future outbreaks.

Keywords: community health center, Puerto Rico, risk factors, SARS-CoV-2

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Authors: Salah Alrabeei, Mohammad Yousuf

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The goal of option pricing theory is to help the investors to manage their money, enhance returns and control their financial future by theoretically valuing their options. However, most of the option pricing models have no analytical solution. Furthermore, not all the numerical methods are efficient to solve these models because they have nonsmoothing payoffs or discontinuous derivatives at the exercise price. In this paper, we solve the American option under jump diffusion models by using efficient time-dependent numerical methods. several techniques are integrated to reduced the overcome the computational complexity. Fast Fourier Transform (FFT) algorithm is used as a matrix-vector multiplication solver, which reduces the complexity from O(M2) into O(M logM). Partial fraction decomposition technique is applied to rational approximation schemes to overcome the complexity of inverting polynomial of matrices. The proposed method is easy to implement on serial or parallel versions. Numerical results are presented to prove the accuracy and efficiency of the proposed method.

Keywords: integral differential equations, jump–diffusion model, American options, rational approximation

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Authors: In-Hwan Baek

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Valsartan is a potent and highly selective antagonist of the angiotensin II type 1 receptor, and is widely used for the treatment of hypertension. The aim of this study was to investigate the pharmacokinetic properties of the valsartan in dogs following oral administration of a single dose using quantitative modeling approaches. Forty beagle dogs were randomly divided into two group. Group A (n=20) was administered a single oral dose of valsartan 80 mg (Diovan® 80 mg), and group B (n=20) was administered a single oral dose of valsartan 160 mg (Diovan® 160 mg) in the morning after an overnight fast. Blood samples were collected into heparinized tubes before and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24 h following oral administration. The plasma concentrations of the valsartan were determined using LC-MS/MS. Non-compartmental pharmacokinetic analyses were performed using WinNonlin Standard Edition software, and modeling approaches were performed using maximum-likelihood estimation via the expectation maximization (MLEM) algorithm with sampling using ADAPT 5 software. After a single dose of valsartan 80 mg, the mean value of maximum concentration (Cmax) was 2.68 ± 1.17 μg/mL at 1.83 ± 1.27 h. The area under the plasma concentration-versus-time curve from time zero to the last measurable concentration (AUC24h) value was 13.21 ± 6.88 μg·h/mL. After dosing with valsartan 160 mg, the mean Cmax was 4.13 ± 1.49 μg/mL at 1.80 ± 1.53 h, the AUC24h was 26.02 ± 12.07 μg·h/mL. The Cmax and AUC values increased in proportion to the increment in valsartan dose, while the pharmacokinetic parameters of elimination rate constant, half-life, apparent of total clearance, and apparent of volume of distribution were not significantly different between the doses. Valsartan pharmacokinetic analysis fits a one-compartment model with first-order absorption and elimination following a single dose of valsartan 80 mg and 160 mg. In addition, high inter-individual variability was identified in the absorption rate constant. In conclusion, valsartan displays the dose-dependent pharmacokinetics in dogs, and Subsequent quantitative modeling approaches provided detailed pharmacokinetic information of valsartan. The current findings provide useful information in dogs that will aid future development of improved formulations or fixed-dose combinations.

Keywords: dose-dependent, modeling, pharmacokinetics, valsartan

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: Ting Hsiang Chang, Cheng Zuo Tsai

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In recent years, sports culture dominated in Taiwan, which spurred the rapid development of the sports industry. More innovative and high-tech sporting goods were developed to provide choices for consumers. Nowadays, Taiwan has gradually entered the aging society where people pay more attention to health promotion, delay of aging and other related issues among senior. However, it is an undeniable fact that moderate exercise is a great help to delay aging. Therefore, how senior select the appropriate sporting goods, including sports shoes, sportswear, sports equipment, and even the sports brands when engaged in various kinds of sports, are explored in this research. Therefore, this study sets the reference indicators by exploring the brands of sporting goods, that senior aged 50-70 choose in a fog peak district, the Taichung City, as the subjects of study by answering a questionnaire. Also, this study offers recommendations in terms of the design, marketing or selling of sporting goods for the senior, and how owners of sports brands or related sports industries should target them.

Keywords: senior, aging, sporting goods, sports brand

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Authors: Pius Agbebi Alaba

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The study emphasized on the effects of contemporary and prospect trends on the development of Hospitality and Tourism in Nigeria. Specifically, the study examined globalization, safety and security, diversity, service, technology, demographic changes and price–value as contemporary trends while prospect trends such as green and Eco-lodgings, Development of mega hotels, Boutique hotels, Intelligent hotels with advanced technology using the guest’s virtual fingerprint in order to perform all the operations, increasing employee salaries in order retain the existing Staff, More emphasis on the internet and technology, Guests’ virtual and physical social network were equally examined. The methodology for the study involved review of existing related study, books, journal and internet. The findings emanated from the exercise showed clearly that the impact of both trends on the development of Hospitality and Tourism in Nigeria would bring about rapid positive transformation of her socio-economic, political and cultural environment. The implication of the study is that it will prepare both private and corporate individuals in hospitality and tourism business for the challenges inherent in both trends.

Keywords: hospitality and tourism, Nigeria's centenary, trends, implications

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Authors: Sílvia Pereira Mello, Eliane Rodrigues, Maria de Lourdes Andrade, Marcelo Pereira, Giselle Dias, Jose Seixas Filho

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Frog meat is a highly digestible food and its use is recommended in diets aimed at fighting cholesterol, obesity, and arterial hypertension, as well as for treating gastrointestinal disorders. In this study, the soups were developed with frog meat in addition to other ingredients which did not present allergenic potential. The carcasses of the thawed frogs went through bleaching and deboning, and other ingredients (vegetables and condiments) were then added to the separated meat. After the process of cooking, the soups were cooled and later on frozen at -40° C for 3 hours and then taken to the LS 3000 B lyophilizer for 24 hours. The soups were submitted to microbiological analysis: enumeration of total coliforms and Bacillus cereus; identification of coagulase positive Staphylococcus; isolation and identification of Salmonella spp.; and physical-chemical analysis; application of micro-Kjeldahl method for protein, Soxhlet method for lipids, use of a heating chamber at 105ºC for moisture, incineration method (500-550°C) for ash, and Decagon's Pawkit equipment for determining water activity. Acceptance test was performed with 50 elderly people, all between 60 and 85 years of age. The degree of acceptance was demonstrated using a seven points structured hedonic scale in which the taster expressed their impression towards the product. Results of the microbiological analysis showed that all samples met the standards established by the National Health Surveillance Agency of Brazil (ANVISA). Results of the acceptance test indicated that all the soups were accepted considering overall impression and intended consumption. In addition to its excellent nutritional quality, the dehydrated soups made with frog meat are presented as a solution for consumers due to convenience in preparation, consumption and storage.

Keywords: bacteriological quality, lithobates catesbeianus, instant soup, proximate composition, sensory analysis

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Authors: M. A. Munteanu, A. M. Lungu, A. I. Chivescu, V. Teodorescu, E. Tufanoiu, C. Nicolae, T. I. Nanea

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Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i), which were first developed as antidiabetic medications, have demonstrated numerous positive benefits on the cardiovascular system, especially in the prevention of heart failure (HF). HF is a challenging, multifaceted disease that needs all-encompassing therapy. It should not be viewed as a limited form of heart illness but rather as a systemic disease that leads to multiple organ failure and death. SGLT2i is an extremely effective tool for treating HF by using its pleiotropic effects. In addition to its use in patients with diabetes mellitus who are at high cardiovascular risk or who have already experienced a cardiovascular event, SGLT2i administration has been shown to have positive effects on a variety of HF manifestations and stages, regardless of the patient's presence of diabetes mellitus. Material and Methods: According to the guide, 110 patients (83 males and 27 females) with heart failure with mildly reduced ejection fraction (HFmrEF), with T2D and neoplasia, were enrolled in the prospective study. The structural and functional state of the left ventricle myocardium and ejection fraction was assessed through echocardiography. Patients were randomized to receive once-daily dapagliflozin 10 mg. Results: Patients with HFmrEF were divided into 3 subgroups according to age. 7% (8) patients aged < 45 years, 35% (28) patients aged between 46-59 years, and 58% (74) patients aged> 60 years. The most prevalent comorbidities were hypertension (43.1%), coronary heart disease (40%), and obesity (33.2%). Study drug discontinuation and serious adverse events were not frequent in the subgroups, in either men or women, until now. Conclusions: SGLT-2 inhibitors are a novel class of antidiabetic agents that have demonstrated positive efficacy and safety outcomes in the setting of HFmrEF. Until now, in our study, dapagliflozin was safe and well-tolerated irrespective of sex.

Keywords: diabetes mellitus type 2, Sodium-glucose co-transporters-2 inhibitors, heart failure, neoplasia

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Authors: Ç. Erdoğan, T. Turan

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Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.

Keywords: cancer treatment, children, nursing, yoga

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Authors: Yoke-Mui Lim, Yahaya Ahmad

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Conservation works in Malaysia that is procured by public organisation usually follow the traditional approach where the works are tendered based on Bills of Quantities (BQ). One of the purposes of tendering is to enable the selection of a competent contractor that offers a competitive price. While competency of the contractors are assessed by their technical knowledge, experience and track records, the assessment of pricing will be dependent on the tender amount. However, the issue currently faced by the conservation works sector is the difficulty in assessing the competitiveness and reasonableness of the tender amount due to the high variance between the tenders amount. Thus, this paper discusses the factors that cause difficulty to the tenderers in pricing competitively in a bidding exercise for conservation tenders. Data on tendering is collected from interviews with conservation works contractors to gain in-depth understanding of the barriers faced in pricing tenders of conservation works. Findings from the study lent support to the contention that the variance of tender amount is very high amongst tenderers. The factors identified in the survey are the format of BQ, hidden works, experience and labour and material costs.

Keywords: building conservation, Malaysia, bill of quantities, tender

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Keyvan Molanorouzi, Selina Khoo, Tony Morris

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In recent years, there has been a decline in physical activity among adults. Motivation has been shown to be a crucial factor in maintaining physical activity. The purpose of this study was to whether PA motives measured by the Physical Activity and Leisure Motivation Scale PALMS predicted actual amount of PA at a later time to provide evidence for the construct validity of the PALMS. A quantitative, cross-sectional descriptive research design was employed. The Demographic Form, PALMS, and International Physical Activity Questionnaire Short form (IPAQ-S) questionnaires were used to assess motives and amount for physical activity in adults on two occasions. A sample of 640 (489 male, 151 female) undergraduate students aged 18 to 25 years (mean ±SD; 22.30±8.13 years) took part in the study. Male participants were divided into three types of activities, namely exercise, racquet sport, and team sports and female participants only took part in one type of activity, namely team sports. After 14 weeks, all 640 undergraduate students who had filled in the initial questionnaire (Occasion 1) received the questionnaire via email (Occasion 2). Of the 640 students, 493 (77%; 378 males, 115 females) emailed back the completed questionnaire. The results showed that not only were pertinent sub-scales of PALMS positively related to amount of physical activity, but separate regression analyses showed the positive predictive effect of PALMS motives for amount of physical activity for each type of physical activity among participants. This study supported the construct validity of the PALMS by showing that the motives measured by PALMS did predict amount of PA. This information can be obtained to match people with specific sport or activity which in turn could potentially promote longer adherence to the specific activity.Methods: A quantitative, cross-sectional descriptive research design was employed. The Demographic Form, PALMS, and International Physical Activity Questionnaire Short form (IPAQ-S) questionnaires were used to assess motives and amount for physical activity in adults on two occasions. A sample of 640 (489 male, 151 female) undergraduate students aged 18 to 25 years (mean ±SD; 22.30±8.13 years) took part in the study. Male participants were divided into three types of activities, namely exercise, racquet sport, and team sports and female participants only took part in one type of activity, namely team sports. After 14 weeks, all 640 undergraduate students who had filled in the initial questionnaire (Occasion 1) received the questionnaire via email (Occasion 2). Of the 640 students, 493 (77%; 378 males, 115 females) emailed back the completed questionnaire. Results: The results showed that not only were pertinent sub-scales of PALMS positively related to amount of physical activity, but separate regression analyses showed the positive predictive effect of PALMS motives for amount of physical activity for each type of physical activity among participants. This study supported the construct validity of the PALMS by showing that the motives measured by PALMS did predict amount of PA. Conclusion: This information can be obtained to match people with specific sport or activity which in turn could potentially promote longer adherence to the specific activity.

Keywords: physical activity, motivation, level of physical activity, type of physical activity

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Authors: Ika Wulansari, Yati Afiyanti, Indang Trihandini

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Sleeping disorder experienced by patients with breast cancer can affect the physical, mental, health, and well-being. This study examines the effect of progressive muscle relaxation training and sleep hygiene education to change sleep quality scores of the patient with breast cancer. The study design using quasi-experiment with pre-post test within the control group, involving 62 breast cancer patients using consecutive sampling method in Jakarta. Statistical test results with independent t-test showed a significant difference in score of sleep quality between in intervention group and the control group (6,66±3,815; 9,30±3,334, p-value = 0,005). Progressive muscle relaxation exercise and sleep hygiene education proven to be affective to change the patients sleeping quality, so that it can be an alternative therapeutic option to overcome sleeping disorders.

Keywords: sleeping disorders, breast cancer, progressive muscle relaxation, sleep hygiene education

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Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

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Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

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Authors: Omowunmi Amao

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Sansevieria liberica belongs to the family Agavaceae (Ruscaceae or Dracaenaceae). They are widely distributed throughout the tropics. Literature review suggests that in Nigeria, the leaves and roots of Sansevieria liberica are used in traditional medicine for the treatment of asthma, abdominal pains, colic, diarrhea, eczema, gonorrhea, hemorrhoids, hypertension, monorrhagia, piles, sexual weakness, snake bites, and wounds of the foot. In this context, the standardized Methanolic extract of roots of Sansevieria liberica is hypothesized for the evaluation of the hypoglycemic activity. Material and Methods: Inbreed adult male sprague-Dawley albino rats were used in the experiment. The suspension of standardized Methanol extract (ME) of Sansevieria liberica was treated for hypoglycemic activity in oral glucose tolerance test (OGTT) method. The suspension of standardized Methanolic extract (ME) of Sansevieria liberica was also treated for hypoglycemic activity in streptozotocin-induced diabetic rats. Results: The Methanolic extract (ME) of Sanseviera liberica root (100 mg/kg, 200mg/kg, and 400 mg/kg) showed potential hypoglycemic activity in diabetic rats, and further in OGTT method. Furthermore, Methanolic extract of Sanseviera liberica root showed significant (P<0.05) increase in final body weight, total hemoglobin, insulin, albumin and high-density lipoprotein levels, however, decrease in fluid intake, glycosylated hemoglobin, urea, creatinine, total cholesterol, triglyceride and low-density lipoprotein levels. Additionally, it improved oxidative stress in terms of reducing lipid peroxidase and superoxide dismutase, and elevating catalase activity. Conclusions: These findings suggest that the Methanolic extract of Sanseviera liberica root was found to be potential hypoglycemic, and would be a promising candidate for the treatment of diabetes.

Keywords: diabetes, Sanseviera liberica, hypoglycemic activity, diabetes and metabolism

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: Malay K. Das, Bhanu P. Sahu

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Furosemide is a weakly acidic diuretic indicated for treatment of edema and hypertension. It has very poor solubility but high permeability through stomach and upper gastrointestinal tract (GIT). Due to its limited solubility it has poor and variable oral bioavailability of 10-90%. The aim of this study was to enhance the oral bioavailability of furosemide by preparation of nanosuspensions. The nanosuspensions were prepared by nanoprecipitation with sonication using DMSO (dimethyl sulfoxide) as a solvent and water as an antisolvent (NA). The prepared nanosuspensions were sterically stabilized with polyvinyl acetate (PVA).These were characterized for particle size, ζ potential, polydispersity index, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), X-ray diffraction (XRD) pattern and release behavior. The effect of nanoprecipitation on oral bioavailability of furosemide nanosuspension was studied by in vitro dissolution and in vivo absorption study in rats and compared to pure drug. The stable nanosuspension was obtained with average size range of the precipitated nanoparticles between 150-300 nm and was found to be homogenous showing a narrow polydispersity index of 0.3±0.1. DSC and XRD studies indicated that the crystalline furosemide drug was converted to amorphous form upon precipitation into nanoparticles. The release profiles of nanosuspension formulation showed up to 81.2% release in 4 h. The in vivo studies on rats revealed a significant increase in the oral absorption of furosemide in the nanosuspension compared to pure drug. The AUC0→24 and Cmax values of nanosuspension were approximately 1.38 and 1.68-fold greater than that of pure drug, respectively. Furosemide nanosuspension showed 20.06±0.02 % decrease in systolic blood pressure compared to 13.37±0.02 % in plain furosemide suspension, respectively. The improved oral bioavailability and pharmacodynamics effect of furosemide may be due to the improved dissolution of furosemide in simulated gastric fluid which results in enhanced oral systemic absorption of furosemide from stomach region where it has better permeability.

Keywords: furosemide, nanosuspension, bioavailability enhancement, nanoprecipitation, oral drug delivery

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Authors: Tobias Stephan Kaeding, Rebecca Schwarz, Momme Kück, Lothar Stein

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Introduction: The goal of this randomized and controlled study is to examine whether whole-body vibration (WBV) training is able to reduce self-reported physical disability in office employees with chronic low-back pain. Materials and methods: 41 subjects (68.3% female/mean age 45.5 ± 9.1 years/mean BMI 26.6 ± 5.2) were randomly allocated to an intervention group (INT (n= 21)) or a control group (CON (n=20). The INT participated in WBV training 2.5 times per week for 3 months. The primary outcome was the change in the Roland and Morris disability questionnaire (RMQ) score over the study period. In addition, secondary outcomes included changes in the Oswestry Disability Index (ODI). Results: The compliance with the intervention in the INT reached a mean of 81.1% ± 31.2% with no long-lasting unwanted side effects. We found significant positive effects of 3 months of WBV training in the INT compared to the CON regarding the RMQ (p=0.027) and the ODI (p=0.002). Conclusions: WBV training seems to be an effective, safe and suitable intervention for the reduction of the self-reported physical disability in seated working employees with chronic low-back pain.

Keywords: back pain, exercise, occupational health management, vibration training

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Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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Authors: Meltem Işık, Fatma Gür, İbrahim Kılıç

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This study aims to explore the effects of hemsball shooting techniques on the fine motor skill level of children with hearing disabilities. A total number of 26 children with hearing disabilities, ages ranging between 7 and 11 and which were equally divided into experimental group and control group participated in the study. In this context, an exercise training program dedicated to hemsball shooting techniques was introduced to the experimental group 3 days a week in one hour sessions for a period of 10 weeks. BOT-2 fine motor skills test which includes three dimensions (fine motor accuracy, fine motor task completion, and dexterity) was selected as the data collection method. Descriptive statistics along with two-factor ANOVA which was focused on repetitive measurements of the differences between pretest and posttest scores of both groups were used in the analysis of the data collected. The results of this study showed that hemsball shooting techniques have a statistically significant effect on the fine motor skill level.

Keywords: hemsball shooting techniques, BOT-2 test, fine motor skills, hearing disabilities

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Authors: Wincharles Coker

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This study troubles the role the state as the chief sponsor of higher education plays in shaping communication training in Ghana. Using a public university as a case study, it explores how the government of Ghana, through its regimes of control, exercises its authority over the means of production in the academy. Based on Wenger’s community of practice theory and critical theory, the research analyzes the political economy within which higher education in the country operates, focusing on the mandates of two of its bodies: the National Council for Tertiary Education (NCTE) and the National Accreditation Board (NAB). Results show that communication training in Ghana is shaped by three basic strategies of control: developmentalism, bureaucratization, and corporatization. This governmentality, the research reveals nonetheless, largely constrains the agency and practices of the community of communication faculty and administrators, and thus presents a major challenge to the exercise of intellectual freedom, and the self-critical nature of the academy. The study bears implications for further research in the political economy of communication studies, the administration of higher education, and critical/cultural studies in education.

Keywords: communication, developmentalism, educattion, governmentality

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Authors: Sibo Lu, Zhongkai Qian, Haotian Zhang

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This article examines the phenomenon of micro-sovereignty in the context of property management and its implications for biopolitics and urban governance in mainland China. It explores the transformation of urban spaces into privatized communities managed by property companies, leading to the reterritorialization of urban areas and the segmentation of urban populations. Drawing on legal frameworks, we analyze how commercial real estate development and property management have reshaped the urban landscape, placing nearly all urban residents within service areas of property management firms, thus establishing micro-sovereign entities that exercise control over residential spaces. Through a critique of property management's sovereign effects on social organization and the exploration of autonomous, democratic alternatives in community governance, this article contributes to the broader discourse on sovereignty, governance, and resistance within the urban milieu of contemporary China. It underscores the urgent need for more democratic forms of community management that can transcend the capitalist logic of property management companies and foster genuine participatory governance at the grassroots level.

Keywords: biopolitic, critical theory, political sociology, political philosophy

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Authors: Hafsa Raheel

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Objectives: Secondary school girls, ages 15–19 years old were surveyed to find out the coping strategies they used when stressed. Adolescents, who are affected with stress and depression early in life, suffer from depression throughout their lives, especially if they are utilizing improper ways to cope with it. Methods: A cross-sectional school-based survey among 1028 adolescent girls was conducted among the secondary schools in Riyadh city, Kingdom of Saudi Arabia. Results: About 25% stated that they cry, 19% listen to music, 15% start eating a lot, 12% sit alone/isolate themselves, 11% pray/read the Quran, 10% get into a verbal argument or a fight. Only a few, 3% exercise, and 2% stated that they find someone to discuss and talk to. Conclusion: The majority of the adolescent girls in our survey rely on emotion-related coping mechanisms rather than problem-solving mechanisms. This can cause long-term implications in these adolescents as there is an increased probability to develop depression later on in life. Policy makers need to implement strategies for early identification of stress and depression. Talking to friends and family can serve as an effective way to cope with stress.

Keywords: adolescents, stress, Saudi Arabia, mental health

Procedia PDF Downloads 263

Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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Authors: Santina Sahibon, Sivasooriar Sivaneson, Martin Giddy, Nelson Nheu, Siti Sazeelah, Choo Kok Ming, Thuhairah Abdul Rahman, Fatmawati Binti Kamal

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Introduction: Establishing population-based reference intervals (RI) are essential when evaluating laboratory test results and for method verification. Our laboratory initiated an exercise to establish RI for routine coagulation profile as part of the method verification procedure and to determine any differences in RI between three analyzers planned to be used in the laboratory. Methodology: 145 blood samples were collected and analysed for activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), and fibrinogen] using three coagulation analysers which were CA104, CA660, and CS-2500 (Sysmex, USA). RI was established at 2.5th and 97.5th percentiles. Results: The RI for aPTT between C104, C660 and CS-2500 are (RI: 20.5-30.2 sec), (RI: 21.5-29.2 sec) and (RI: 22.7-30.3 sec) respectively. The RI for PT were (RI: 7.5-10.3 sec), (RI: 9.2- 11.1 sec) and (RI: 9.8-11.9 sec) for C104, CA660 and CS-2500 respectively. INR had an RI of (RI: 0.87- 1.16), (RI: 0.89-1.10) and (0.90-1.11) respectively on CA104, C660 and CS-2500. Fibrinogen RI was (RI: 2.04-4.62 g/L) and (2.05-4.76 g/L) on the CA660 and CS-2500, respectively. Conclusion: The RI was similar across the analytical platforms for aPTT, INR, and fibrinogen. However, CA104 showed lower RI compared to the other two analysers for PT. This highlights the potential variability in results between instruments that need to be addressed when verifying RI.

Keywords: coagulation, reference interval, APTT, PT, INR, fibrinogen

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Authors: Taisuke Sakaki, Toshihiko Shimokawa, Nobuhiro Ushimi, Koji Murakami, Yong-Kwun Lee, Kazuhiro Tsuruta, Kanta Aoki, Kaoru Fujiie, Ryuji Katamoto, Atsushi Sugyo

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Recently attention has been focused on incomplete spinal cord injuries (SCI) to the central spine caused by pressure on parts of the white matter conduction pathway, such as the pyramidal tract. In this paper, we focus on a training robot designed to assist with primary walking-pattern training. The target patient for this training robot is relearning the basic functions of the usual walking pattern; it is meant especially for those with incomplete-type SCI to the central spine, who are capable of standing by themselves but not of performing walking motions. From the perspective of human engineering, we monitored the operator’s actions to the robot and investigated the movement of joints of the lower extremities, the circumference of the lower extremities, and exercise intensity with the machine. The concept of the device was to provide mild training without any sudden changes in heart rate or blood pressure, which will be particularly useful for the elderly and disabled. The mechanism of the robot is modified to be simple and lightweight with the expectation that it will be used at home.

Keywords: training, rehabilitation, SCI patient, welfare, robot

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Authors: Paul Licina, Emma M. Johnston, David Lisle, Mark Young, Chris Brady

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Background: Lumbar pars pathology is a common cause of pain in the growing spine. It can be seen in young athletes participating in at-risk sports and can affect sporting performance and long-term health due to its resistance to traditional management. There is a current lack of consensus of classification and treatment for pars injuries. Previous systems used CT to stage pars defects but could not assess early stress reactions. A modified classification is proposed that considers findings on MRI, significantly improving early treatment guidance. The treatment protocol is designed for patients aged 5 to 19 years. Method: Clinical screening identifies patients with a low, medium, or high index of suspicion for lumbar pars injury using patient age, sport participation and pain characteristics. MRI of the at-risk cohort enables augmentation of existing CT-based classification while avoiding ionising radiation. Patients are classified into five categories based on MRI findings. A type 0 lesion (stress reaction) is present when CT is normal and MRI shows high signal change (HSC) in the pars/pedicle on T2 images. A type 1 lesion represents the ‘early defect’ CT classification. The group previously referred to as a 'progressive stage' defect on CT can be split into 2A and 2B categories. 2As have HSC on MRI, whereas 2Bs do not. This distinction is important with regard to healing potential. Type 3 lesions are terminal stage defects on CT, characterised by pseudarthrosis. MRI shows no HSC. Results: Stress reactions (type 0) and acute fractures (1 and 2a) can heal and are treated in a custom-made hard brace for 12 weeks. It is initially worn 23 hours per day. At three weeks, patients commence basic core rehabilitation. At six weeks, in the absence of pain, the brace is removed for sleeping. Exercises are progressed to positions of daily living. Patients with continued pain remain braced 23 hours per day without exercise progression until becoming symptom-free. At nine weeks, patients commence supervised exercises out of the brace for 30 minutes each day. This allows them to re-learn muscular control without rigid support of the brace. At 12 weeks, bracing ceases and MRI is repeated. For patients with near or complete resolution of bony oedema and healing of any cortical defect, rehabilitation is focused on strength and conditioning and sport-specific exercise for the full return to activity. The length of this final stage is approximately nine weeks but depends on factors such as development and level of sports participation. If significant HSC remains on MRI, CT scan is considered to definitively assess cortical defect healing. For these patients, return to high-risk sports is delayed for up to three months. Chronic defects (2b and 3) cannot heal and are not braced, and rehabilitation follows traditional protocols. Conclusion: Appropriate clinical screening and imaging with MRI can identify pars pathology early. In those with potential for healing, we propose hard bracing and appropriate rehabilitation as part of a multidisciplinary management protocol. The validity of this protocol will be tested in future studies.

Keywords: adolescents, MRI classification, pars interticularis, treatment protocol

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Authors: Dipak Sonawane, Sudarshan Daga, Somesh Gupta

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Quantitative risk assessment (QRA) is a very precise and consistent approach to defining the likelihood, consequence and severity of a major incident/accident. A variety of hazardous cargoes in bulk, such as hydrocarbons and flammable/toxic chemicals, are handled at various ports. It is well known that most of the operations are hazardous, having the potential of damaging property, causing injury/loss of life and, in some cases, the threat of environmental damage. In order to ensure adequate safety towards life, environment and property, the application of scientific methods such as QRA is inevitable. By means of these methods, comprehensive hazard identification, risk assessment and appropriate implementation of Risk Control measures can be carried out. In this paper, the authors, based on their extensive experience in Risk Analysis for ports and harbors, have exhibited how QRA can be used in practice to minimize and contain risk to tolerable levels. A specific case involving the operation for unloading of hydrocarbon at a port is presented. The exercise provides confidence that the method of QRA, as proposed by the authors, can be used appropriately for the identification of hazards and risk assessment of Ports and Terminals.

Keywords: quantitative risk assessment, hazard assessment, consequence analysis, individual risk, societal risk

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