Search results for: pain score

Authors: Akbar Nawaz Khan, Abdul Ghaffar, Abdur Rehman, Muhammad Naeem Riaz, Sayed Muhammad Hassan Andrabi

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The present study was conducted to compare sheep rearing in nomadic with transhumance system in term of production parameters. The following parameters which studied for comparison were household size, landholding area, flock size, body condition score, fecal egg count and live weight change in sheep under nomadic and transhumance systems of management in Malakand since October 2010 to March 2011. Further the effects of Body Condition Score (BCS) and Fecal Egg Count (FEC) on production were also examined. Two systems were checked for the purpose to check the efficiency of production. A total of eight flocks, four each from nomadic and transhumance system were selected for the study; each flock was divided into treatment and controlled groups to check the effect of treatment or de-wormers. A total of 160 animals were selected randomly (80 treated, 80 controlled). The adult ram average weight transhumance system was 55.58 kg while in nomadic that was 54.16 kg, weight change was positive, and the highest change was recorded in transhumance treated which was 13%. Fecal egg count was record low (75 EPG) in transhumance treated group while high (330 EPG) in nomadic controlled. Body condition score was recorded 3.6 for transhumance treated and 3.32 for nomadic treated. It is concluded from the present study that transhumance system performed significantly (p < 0.05) better in respect of live weight, BCS, FEC, family size, Landholding area, number of animals in a flock, offspring record, culling, and mortality. Mean values are 7.367 ± 0221, 0.900 ± 0.071, 63.167 ± 1.559, 55.600 ± 1.480, 8.300 ± 0.321 and 2.500 ± 0.158 respectively. De-wormer effect on FEC showed a significant reduction in egg load in mature sheep on both systems.

Keywords: small ruminant, sheep, nomadic, transhumance, Malakand, production efficiency

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Authors: Yan Ping Chen, Hau Yin Chung

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The Ideal Profile Method (IPM) is a newly developed descriptive sensory analysis conducted by consumers without previous training. To perform this test, both the perceived and the ideal intensities from the judgements of consumers on products’ attributes, as well as their hedonic ratings were collected for formulating an ideal product (the most liked one). In addition, Ideal Profile Analysis (IPA) was conducted to check the consistency of the ideal data at both the panel and consumer levels. In this test, 12 commercial plain sufus bought from Hong Kong local market were tested by 113 consumers according to the IPM, and rated on 22 attributes. Principal component analysis was used to profile the perceived and the ideal spaces of tested products. The consistency of ideal data was then checked by IPA. The result showed that most consumers shared a common ideal. It was observed that the sensory product space and the ideal product space were structurally similar. Their first dimensions all opposed products with intense fermented related aroma to products with less fermented related aroma. And the predicted ideal profile (the estimated liking score around 7.0 in a 9.0-point scale) got higher hedonic score than the tested products (the average liking score around 6.0 in a 9.0-point scale). For the majority of consumers (95.2%), the stated ideal product considered as a potential ideal through checking the R2 coefficient value. Among all the tested products, sample-6 was the most popular one with consumer liking percentage around 30%. This product with less fermented and moldy flavour but easier to melt in mouth texture possessed close sensory profile according to the ideal product. This experiment validated that data from untrained consumers could be guided as useful information. Appreciated sensory characteristics could be served as reference in the optimization of the commercial plain sufu.

Keywords: ideal profile method, product development, sensory evaluation, sufu (fermented soybean curd)

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Authors: Jineetkumar Gawad, Chandrakant Bonde

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Tuberculosis (TB) is a major worldwide concern whose control has been exacerbated by HIV, the rise of multidrug-resistance (MDR-TB) and extensively drug resistance (XDR-TB) strains of Mycobacterium tuberculosis. The interest for newer and faster acting antitubercular drugs are more remarkable than any time. To search potent compounds is need and challenge for researchers. Here, we tried to design lead for inhibition of Decaprenyl phosphoryl-β-D-ribose 2′-epimerase (DprE1) enzyme. Arabinose is an essential constituent of mycobacterial cell wall. DprE1 is a flavoenzyme that converts decaprenylphosphoryl-D-ribose into decaprenylphosphoryl-2-keto-ribose, which is intermediate in biosynthetic pathway of arabinose. Latter, DprE2 converts keto-ribose into decaprenylphosphoryl-D-arabinose. We had a selection of 23 compounds from azaindole series for computational study, and they were drawn using marvisketch. Ligands were prepared using Maestro molecular modeling interface, Schrodinger, v10.5. Common pharmacophore hypotheses were developed by applying dataset thresholds to yield active and inactive set of compounds. There were 326 hypotheses were developed. On the basis of survival score, ADRRR (Survival Score: 5.453) was selected. Selected pharmacophore hypotheses were subjected to virtual screening results into 1000 hits. Hits were prepared and docked with protein 4KW5 (oxydoreductase inhibitor) was downloaded in .pdb format from RCSB Protein Data Bank. Protein was prepared using protein preparation wizard. Protein was preprocessed, the workspace was analyzed using force field OPLS 2005. Glide grid was generated by picking single atom in molecule. Prepared ligands were docked with prepared protein 4KW5 using Glide docking. After docking, on the basis of glide score top-five compounds were selected, (5223, 5812, 0661, 0662, and 2945) and the glide docking score (-8.928, -8.534, -8.412, -8.411, -8.351) respectively. There were interactions of ligand and protein, specifically HIS 132, LYS 418, TRY 230, ASN 385. Pi-pi stacking was observed in few compounds with basic Imidazo [4,5-b] pyridine ring. We had basic azaindole ring in parent compounds, but after glide docking, we received compounds with Imidazo [4,5-b] pyridine as a basic ring. That might be the new lead in the process of drug discovery.

Keywords: DprE1 inhibitors, in silico drug designing, imidazo [4, 5-b] pyridine, lead, tuberculosis

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Authors: Rohin Rameswarapu, Sameer Valsangkar

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Background: Globally, musculoskeletal disorders are the largest single cause of work-related illnesses accounting for over 33% of all newly reported occupational illnesses. Risk factors for MSD need to be delineated to suggest means for amelioration. Material and methods: In this current cross-sectional study, the prevalence of MSDs among workers in an electrical company assembly line, the socio-demographic and job characteristics associated with MSD were obtained through a semi-structured questionnaire. A quantitative assessment of the physical risk factors through the Rapid Upper Limb Assessment (RULA) tool, and measurement of psychosocial risk factors through a Likert scale was obtained. Statistical analysis was conducted using Epi-info software and descriptive and inferential statistics including chi-square and unpaired t test were obtained. Results: A total of 263 workers consented and participated in the study. Among these workers, 200 (76%) suffered from MSD. Most of the workers were aged between 18–27 years and majority of the workers were women with 198 (75.2%) of the 263 workers being women. A chi square test was significant for association between male gender and MSD with a P value of 0.007. Among the MSD positive group, 4 (2%) had a grand score of 5, 10 (5%) had a grand score of 6 and 186 (93%) had a grand score of 7 on RULA. There were significant differences between the non-MSD and MSD group on five out of the seven psychosocial domains, namely job demand, job monotony, co-worker support, decision control and family and environment domains. Discussion: The current cross-sectional study demonstrates a high prevalence of MSD among assembly line works with inherent physical and psychosocial risk factors and recommends that not only physical risk factors, addressing psychosocial risk factors through proper ergonomic means is also essential to the well-being of the employee.

Keywords: musculoskeletal disorders, India, occupational health, Rapid Upper Limb Assessment (RULA)

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Babak Mirzashahi, Arvin Najafi, Pejman Mansouri, Mahmoud Farzan

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Background: The most effective treatment of posterior cruciate ligament (PCL) tears and the consequence of untreated PCL injuries remain controversial. Objectives: The aim of this study is to assess outcomes of fixation of tibial posterior cruciate ligament (PCL) avulsion fractures via a modified technique. Patients and Methods: From January, 2009 to March, 2012, there were 45 cases of PCL tibial avulsion fractures that were referred to our hospital and were managed through a modified open posterior approach. Fixation of Tibial PCL avulsion fractures were fixed by means of a lag screw and washer placed through our modified open posterior approach. Range of motion was begun on the first postoperative day. Clinical stability, range of motion, gastrocnemius muscle strength, radiographic investigation, and patient’s overall quality of life was analyzed at final follow up visit. Results: The average of overall musculoskeletal functional evaluation scores was 15 (range 3–35). All patients achieved union of their fracture and had clinically stable knees at the latest follow-up. The mean preoperative Lysholm score for 15 knees was 62 ± 8 (range, 50-75); the mean postoperative Lysholm score was 92± 7 (range, 75-101). A significant difference in Lysholm scores between preoperative and final follow-up evaluations was found (P < .05). At first-year follow-up, 42 (93%) patients revealed a difference of less than 10 mm in thigh circumference between their injured and healthy knees. Conclusions: The management of displaced large PCL avulsion fractures with placement of a cancellous lag screw with washer by means of the modified open posterior approach leads to satisfactory clinical, radiographic, and functional results and reduces the operation time and less blood loss. Level of evidence: IV.

Keywords: posterior cruciate ligament, tibial fracture, lysholm knee score, patient outcome assessment

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Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

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Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m²), B – 442 females with obesity (BMI >29.9 kg/m²)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

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Authors: Robi Lou Logarta, Meliz Ann Marilag, Kristyl Lee Nisnisan, Felipe Lula Jr.

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Nowadays, alcohol is consumed widely around the globe for plenty of reasons. College years are the time that the students really decide if whether they will or will not engage into alcohol, although alcohol drinking begins before students arrive at college. The reasons on why college students consume alcohol vary in many categories. The norms on alcohol drinking are addiction, emotional pain reliever, popularity purposes, socialization, and a medium of euphoria for most students; college students in particular are most likely to feel this need. After tons of requirements to be complied and courses to be reviewed, they felt a need for celebration and relaxation which ends up in drinking with college mates and a few old friends. A lot of reasons consist the consumption of alcohol and this research determined the reasons behind the students’ onset for alcohol consumption; the main reason for such action and the experiences they encountered after in-take, furthermore, the correlation of alcohol drinking to the average allowance of the involved participants; Mindanao State University-Iligan Institute of Technology Students whether it affects their spending towards alcohol or not. This study assumes that alcohol drinking for MSU-IIT students’ is done to relieve emotional pain caused by flunking in particular subjects as well as dealing with romance, as part of the student body, these acts are noticeable enough which made this hypothesis be formulated. Selected MSU-IIT students were asked about their opinions regarding reasons of alcohol consumption. There were 100 respondents consisting of first year to fifth-year students aging 17-23 years old. Choices were given to the students to mark their most favorable reason for drinking that is adult influence, curiosity, family/personal problems, peer pressure, stress. Using the bar and pie chart illustrations, the collected data was then analyzed and among the given choices, the result has invalidated the hypothesis. The outcome shows that curiosity is the topmost reason why students start to drink and not due to emotional pain. With this, another hypothesis is formulated stating that millennial is a curious generation; this generation has changed the norm of drinking. One of the characteristics of the Y generation is being adventurous which correlates to how they get curious about things and the same goes for alcohol consumption, compared to the latter, this generation can be considered early drinkers in this manner. Therefore, it is concluded that MSU-IIT students which are part of the generation Y are adventurous enough to try unfamiliar beverages to satisfy their curious minds.

Keywords: adult influence, curiosity, family/personal problems, peer pressure, stress

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Authors: Sawsan Kamal Kalil El Galad, Heba Shafik Ibrahim Mohamed, Rania Ismail Moussa

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New developments in the technological world have made the internet an innovative way for individuals and families to communicate. Social media sites help in fulfilling communication needs and wants of their users. The use of social media may have an effect on the family relation either in a positive or negative manner. This study aimed to investigate the family relationships among users and non users of social media. The study followed a cross- sectional descriptive comparative research design. It was conducted on 360 employees, at Damanhour University in Elbeheira, Egypt. Brief Family Relationship Scale (BFRS) was used to collect the data of this study. The results revealed that the mean score of the social media users is slightly increased in relation to the non users of social media mean score with no significant difference between both groups. It was concluded that using social media for short time has no effect on the family relationship, sitting with family in daily base satisfy the social and emotional needs of its member and enhance family relations. Recommendations encompassed that the time spent on social media should be assessed regularly to prevent being isolated from the family members. Educational programs to increase the parent’s awareness how to deal with their children regarding social media and its risks.

Keywords: social media, family relationships, communication needs, culture

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Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

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BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

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Authors: Sam J. Cooley, Mary L. Quinton, Benjamin J. Parry, Mark J. G. Holland, Richard J. Whiting, Jennifer Cumming

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Practitioners draw attention to people’s character strengths to promote empowerment and well-being. This paper explores the possibility that existing approaches for assessing character strengths (e.g., the Values in Action survey; VIA-IS) could be even more autonomy supportive and empowering when combined with strengths profiling, an ideographic tool informed by personal construct theory (PCT). A PCT approach ensures that: (1) knowledge is co-created (i.e., the practitioner is not seen as the ‘expert’ who leads the process); (2) individuals are not required to ‘fit’ within a prescribed list of characteristics; and (3) individuals are free to use their own terminology and interpretations. A combined Strengths Profiling and VIA approach was used in a sample of homeless youth (aged 16-25) who are commonly perceived as ‘hard-to-engage’ through traditional forms of assessment. Strengths Profiling was completed face-to-face in small groups. Participants (N = 116) began by listing a variety of personally meaningful characteristics. Participants gave each characteristic a score out of ten for how important it was to them (1 = not so important; 10 = very important), their ideal competency, and their current competency (1 = poor; 10 = excellent). A discrepancy score was calculated for each characteristic (discrepancy score = ideal score - current score x importance), whereby a lower discrepancy score indicated greater satisfaction. Strengths Profiling was used at the beginning and end of a 10-week positive youth development programme. Experiences were captured through video diary room entries made by participants and through reflective notes taken by the facilitators. Participants were also asked to complete a pre-and post-programme questionnaire, measuring perceptions of well-being, self-worth, and resilience. All of the young people who attended the strengths profiling session agreed to complete a profile, and the majority became highly engaged in the process. Strengths profiling was found to be an autonomy supportive and empowering experience, with each participant identifying an average of 10 character strengths (M = 10.27, SD = 3.23). In total, 215 different character strengths were identified, each with varying terms and definitions used, which differed greatly between participants and demonstrated the value in soliciting personal constructs. Using the participants’ definitions, 98% of characteristics were categorized deductively into the VIA framework. Bravery, perseverance, and hope were the character strengths that featured most, whilst temperance and courage received the highest discrepancy scores. Discrepancy scores were negatively correlated with well-being, self-worth, and resilience, and meaningful improvements were recorded following the intervention. These findings support the use of strengths profiling as a theoretically-driven and novel way to engage disadvantaged youth in identifying and monitoring character strengths. When young people are given the freedom to express their own characteristics, the resulting terminologies extend beyond the language used in existing frameworks. This added freedom and control over the process of strengths identification encouraged youth to take ownership over their profiles and apply their strengths. In addition, the ability to transform characteristics post hoc into the VIA framework means that strengths profiling can be used to explore aggregated/nomothetic hypotheses, whilst still benefiting from its ideographic roots.

Keywords: ideographic, nomothetic, positive youth development, VIA-IS, assessment, homeless youth

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Authors: Almira Sharafeeva

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In the Soviet Union of the 1930s, motherhood was seen as a natural need of women. The masculine Bolshevik state did not see the emancipated woman as free from her maternal burden. In order to support the idea of "joyful motherhood," a medical discourse on the anesthesia of childbirth emerges. In March 1935 at the IX Congress of obstetricians and gynecologists the People's Commissar of Public Health of the RSFSR G.N. Kaminsky raised the issue of anesthesia of childbirth. It was also from that year that medical, literary and artistic editions with enviable frequency began to publish articles, studies devoted to the issue, the goal - to anesthetize all childbirths in the USSR - was proclaimed. These publications were often filled with anti-German and anti-capitalist propaganda, through which the advantages of socialism over Capitalism and Nazism were demonstrated. At congresses, in journals, and at institute meetings, doctors' discussions around obstetric anesthesia were accompanied by discussions of shortening the duration of the childbirth process, the prevention and prevention of disease, the admission of nurses to the procedure, and the proper behavior of women during the childbirth process. With the help of articles from medical periodicals of the 1930s., brochures, as well as documents from the funds of the Institute of Obstetrics and Gynecology of the Academy of Medical Sciences of the USSR (TsGANTD SPb) and the Department of Obstetrics and Gynecology of the NKZ USSR (GARF) in this paper we will show, how the advantages of the Soviet system and the socialist way of life were constructed through the problem of childbirth pain relief, and we will also show how childbirth pain relief in the USSR was related to the foreign policy situation and how projects of labor pain relief were related to the anti-abortion policy of the state. This study also attempts to answer the question of why anesthesia of childbirth in the USSR did not become widespread and how, through this medical procedure, the Soviet authorities tried to take control of a female function (childbirth) that was not available to men. Considering this subject from the perspective of gender studies and the social history of medicine, it is productive to use the term "biopolitics. Michel Foucault and Antonio Negri, wrote that biopolitics takes under its wing the control and management of hygiene, nutrition, fertility, sexuality, contraception. The central issue of biopolitics is population reproduction. It includes strategies for intervening in collective existence in the name of life and health, ways of subjectivation by which individuals are forced to work on themselves. The Soviet state, through intervention in the reproductive lives of its citizens, sought to realize its goals of population growth, which was necessary to demonstrate the benefits of living in the Soviet Union and to train a pool of builders of socialism. The woman's body was seen as the object over which the socialist experiment of reproductive policy was being conducted.

Keywords: labor anesthesia, biopolitics of stalinism, childbirth pain relief, reproductive policy

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Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

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Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

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Authors: Muhammad Rehan Usman, Muhammad Arslan Usman, Soo Young Shin

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The new era of digital communication has brought up many challenges that network operators need to overcome. The high demand of mobile data rates require improved networks, which is a challenge for the operators in terms of maintaining the quality of experience (QoE) for their consumers. In live video transmission, there is a sheer need for live surveillance of the videos in order to maintain the quality of the network. For this purpose objective algorithms are employed to monitor the quality of the videos that are transmitted over a network. In order to test these objective algorithms, subjective quality assessment of the streamed videos is required, as the human eye is the best source of perceptual assessment. In this paper we have conducted subjective evaluation of videos with varying spatial and temporal impairments. These videos were impaired with frame freezing distortions so that the impact of frame freezing on the quality of experience could be studied. We present subjective Mean Opinion Score (MOS) for these videos that can be used for fine tuning the objective algorithms for video quality assessment.

Keywords: frame freezing, mean opinion score, objective assessment, subjective evaluation

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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Authors: Tahamina Begum, Wan Nor Azlen Wan Mohamad, Faruque Reza, Wan Rosilawati Wan Rosli

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To assess auditory perception and cognitive function during pregnancy is necessary as the pregnant women need extra effort for attention mainly for their executive function to maintain their quality of life. This study aimed to investigate neural correlates of cognitive and behavioral processing during mid trimester pregnancy. Event-Related Potentials (ERPs) were studied by using 128-sensor net and PAS or COWA (controlled Oral Word Association), WCST (Wisconsin Card Sorting Test), RAVLTIM (Rey Auditory Verbal and Learning Test: immediate or interference recall, delayed recall (RAVLT DR) and total score (RAVLT TS) were tested for neuropsychology assessment. In total 18 subjects were recruited (n= 9 in each group; control and pregnant group). All participants of the pregnant group were within 16-27 (mid trimester) weeks gestation. Age and education matched control healthy subjects were recruited in the control group. Participants were given a standardized test of auditory cognitive function as auditory oddball paradigm during ERP study. In this paradigm, two different auditory stimuli (standard and target stimuli) were used where subjects counted silently only target stimuli with giving attention by ignoring standard stimuli. Mean differences between target and standard stimuli were compared across groups. N100 (auditory sensory ERP component) and P300 (auditory cognitive ERP component) were recorded at T3, T4, T5, T6, Cz and Pz electrode sites. An equal number of electrodes showed non-significantly shorter amplitude of N100 component (except significantly shorter at T3, P= 0.05) and non-significant longer latencies (except significantly longer latency at T5, P= 0.008) of N100 component in pregnant group comparing control. In case of P300 component, maximum electrode sites showed non-significantly higher amplitudes and equal number of sites showed non-significant shorter latencies in pregnant group comparing control. Neuropsychology results revealed the non-significant higher score of PAS, lower score of WCST, lower score of RAVLTIM and RAVLTDR in pregnant group comparing control. The results of N100 component and RAVLT scores concluded that auditory perception is mildly impaired and P300 component proved very mild cognitive dysfunction with good executive functions in second trimester of pregnancy.

Keywords: auditory perception, pregnancy, stimuli, trimester

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Authors: Kittitara Chunlakittiphan, Patompong Satapornpong

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Introduction: The variation of genetics affects how our body responds to pharmaceuticals elucidates the correlation between long-term use of medical cannabis and adverse drug reactions (ADRs). Medical cannabis is regarded as the treatment for chronic pain, cancer pain, acute pain, psychological disorders, multiple sclerosis and migraine management. However, previous studies have shown that delta-9-Tetrahydrocannabinol (THC), an ingredient found in cannabis, was the cause of ADRs in CB1 receptors found in humans. Previous research suggests that distributions of the cannabinoid type 1 (CB1) receptor gene and pharmacogenetic markers, which vary amongst different populations, might affect incidences of ADRs. Although there is an evident need to investigate the level of the CB1 receptor gene (rs806365), studies on the distribution of CB1-pharmacogenetics markers in Thai patients are limited. Objective: Therefore, the aim of this study is to investigate the distribution of the rs806365 polymorphism in Thai patients who have been treated with medical cannabis. Materials and Methods: We enrolled 31 Thai patients with THC-induced ADRs and 34 THC-tolerant controls to take part in this study. All patients with THC-induced ADRs were accessed through a review of medical records by physicians. EDTA blood of 3ml was collected to obtain the CNR1 gene (rs806365) and genotyping of this gene was conducted using the real-time PCR ViiA7 (ABI, Foster City, CA, USA) following the manufacturer’s instruction. Results: The sample consisted of 65 patients (40/61.54%) were females and (25/38.46%) were males, with an age range of 19-87 years, who have been treated with medical cannabis. In this study, the most common THC-induced ADRs were dry mouth and/or dry throat, tachycardia, nausea, and arrhythmia. Across the whole sample, we found that 52.31% of Thai patients carried a heterozygous variant (rs806365, CT allele). Moreover, the number of rs806365 (CC, homozygous variant) carriers totaled seventeen people (26.15%) amongst the subjects of Thai patients treated with medical cannabis. Furthermore, 17 out of 22 patients (77.27%) who experienced severe ADRs: Tachycardia and/or arrhythmia, carried an abnormal rs806365 gene (CT and CC alleles). Conclusions: The results propose that the rs806365 gene is widely distributed amongst the Thai population and there is a link between this gene and vulnerability to developing THC-induced ADRs after being treated with medical cannabis. Therefore, it is necessary to screen for the rs806365 gene before using medical cannabis to treat a patient.

Keywords: rs806365, THC-induced adverse drug reactions, CB1 receptor, Thai population

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Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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Authors: Jaweriya Aftab, Madho Mal, Hamida Memon

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The first case of coronavirus disease 2019 (COVID-19) in Pakistan was recorded on February 26th, 2020. While the country went through various phases of lockdowns, the importance of proper sensitization campaigns was highlighted by healthcare workers to combat misinformation. Past studies via Google trends analysis have shown a rise in public interest in multiple COVID-19-related symptoms as well as cardiovascular symptoms. As there is a paucity of data related to the trends in Pakistan, we conducted a retrospective analysis to bridge further information. Methods: As per the recommendations from past studies, a Google trend analysis was conducted for various symptoms, including ‘Fever’, ‘Chest Pain’, ‘Shortness of Breath’, and ‘Cough’ between 1st January 2019 to 31st December 2021. The trends in various search results were analyzed and modeled. Results: Our analysis found various rises in public interest in the various symptoms (fever, chest pain, shortness of breath, and cough) that correspond closely to the wave of the virus's spread in the country. Conclusion: Our study confirms similar trends in Pakistan as previously reported in studies from India, USA, and UK, whereby the public interest in various COVID-19 symptoms rose with the number of cases. This further highlights the need for a strong approach to combat misinformation during such a critical period.

Keywords: covid, trend, Pakistan, public

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Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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Authors: Pankaj Dhiman, Simranjeet Kaur

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This research paper presents a comprehensive sentiment analysis of social media responses to videos on Facebook, YouTube, Twitter, and Instagram during the 2024 Indian general elections. The study focuses on the sentiment patterns of voters towards the National Democratic Alliance (NDA) and The Indian National Developmental Inclusive Alliance (INDIA) on these platforms. The analysis aims to understand the impact of social media on voter sentiment and its correlation with the election outcome. The study employed a mixed-methods approach, combining both quantitative and qualitative methods. With a total of 200 posts analysed during general election-2024 final phase, the sentiment analysis was conducted using natural language processing (NLP) techniques, including sentiment dictionaries and machine learning algorithms. The results show that NDA received significantly more positive sentiment responses across all platforms, with a positive sentiment score of 47% compared to INDIA's score of 38.98 %. The analysis also revealed that Twitter and YouTube were the most influential platforms in shaping voter sentiment, with 60% of the total sentiment score coming from these two platforms. The study's findings suggest that social media sentiment analysis can be a valuable tool for understanding voter sentiment and predicting election outcomes. The results also highlight the importance of social media in shaping public opinion and the need for political parties to engage effectively with voters on these platforms. The study's implications are significant, as they indicate that social media can be a key factor in determining the outcome of elections. The findings also underscore the need for political parties to develop effective social media strategies to engage with voters and shape public opinion.

Keywords: Indian Elections-2024, NDA, INDIA, sentiment analysis, social media, democracy

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Authors: Amnah M. A. Alsuhaibani, Amal N. Al-Kuraieef

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Introduction: In the recent decades, production of low-calorie jams is needed for diabetics that comprise low calorie fruits and low calorie sweeteners. Object: the research aimed to prepare low calorie formulated pumpkin jams (fructose, stevia and aspartame) incorporated with soy bean and evaluate the jams through chemical analysis and sensory evaluation after storage for six month. Moreover, the possible effect of consumption of low calorie jams on diabetic rats was investigated. Methods: Five formulas of pumpkin jam with different sucrose, fructose, stevia and aspartame sweeteners and soy bean were prepared and stored at 10 oC for six month compared to ordinary pumpkin jam. Chemical composition and sensory evaluation of formulated jams were evaluated at zero time, 3 month and 6 month of storage. The best three acceptable pumpkin jams were taken for biological study on diabetic rats. Rats divided into group (1) served as negative control and streptozotocin induce diabetes four rat groups that were positive diabetic control (group2), rats fed on standard diet with 10% sucrose soybean jam, fructose soybean jam and stevia soybean jam (group 3, 4&5), respectively. Results: The content of protein, fat, ash and fiber were increased but carbohydrate was decreased in low calorie formulated pumpkin jams compared to ordinary jam. Production of aspartame soybean pumpkin jam had lower score of all sensory attributes compared to other jam then followed by stevia soybean Pumpkin jam. Using non nutritive sweeteners (stevia & aspartame) with soybean in processing jam could lower the score of the sensory attributes after storage for 3 and 6 months. The highest score was recorded for sucrose and fructose soybean jams followed by stevia soybean jam while aspartame soybean jam recorded the lowest score significantly. The biological evaluation showed a significant improvement in body weight and FER of rats after six weeks of consumption of standard diet with jams (Group 3,4&5) compared to Group1. Rats consumed 10% low calorie jam with nutrient sweetener (fructose) and non nutrient sweetener (stevia) soybean jam (group 4& 5) showed significant decrease in glucose level, liver function enzymes activity, and liver cholesterol & total lipids in addition of significant increase of insulin and glycogen compared to the levels of group 2. Conclusion: low calorie pumpkin jams can be prepared by low calorie sweeteners and soybean and also storage for 3 months at 10oC without change sensory attributes. Consumption of stevia pumpkin jam fortified with soybean had positive health effects on streptozoticin induced diabetes in rats.

Keywords: pumpkin jam, HFCS, aspartame, stevia, storage

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Authors: Terada Pinyo

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This study is a survey research designed to evaluate the quality of graduate students and factors influencing their quality. The sample group consists of 240 students. The data are collected from stratified sampling and are analyzed and calculated by instant computer program. Statistics used are percentage, mean, standard deviation, Pearson correlation coefficient, Cramer’s V and logistic regression analysis. It is found that the graduate students’ opinions regarding their characteristics according to the Thai Qualifications Framework for Higher Education (TQF) are at high score range both overall and specific category. The top categories that received the top score are interpersonal skills and responsibility, ethics and morals, knowledge, cognitive skills, numerical analysis with communication and information technology skills, respectively. On the other hand, factors affecting the quality of graduate students are cognitive skills, numerical analysis with communication and information technology, knowledge, interpersonal skills and responsibility, ethics and morals, and career regarding sales/business, respectively.

Keywords: student quality evaluation, Thai qualifications framework for higher education, graduate school, cognitive skills

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Authors: Christopher Leung, Guillermo Becerril-Martinez

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Amyloidosis is a rare systemic disease where abnormal proteins invade various organs and impede their function. Occasionally, they can manifest in a solidary organ such as the heart, lung, and nervous systems; rarely do they manifest in the gallbladder. Diagnosis often requires biopsy of the affected area and histopathology shows deposition of abnormally folded globular proteins called amyloid proteins. This case presents a 69-year-old male with a 3-month history of RUQ pain, diarrhea and non-specific symptoms of tiredness, etc. On imaging, both his US and CT abdomen showed gallbladder wall thickening and pericholecystic fluid, which may represent acute cholecystitis with hypodense lesions around the gallbladder, possibly representing liver abscesses. Given his symptoms of abdominal pain and imaging findings, this gentleman eventually had a laparoscopic cholecystectomy showing a gangrenous gallbladder with a mass on the liver bed. On histopathology, it showed amorphous hyaline eosinophilic material, which Congo-stained confirmed amyloidosis. Amyloidosis explained his non-specific symptoms, he avoided further biopsy, and he was commenced immediately on Lenalidomide. Involvement of the gallbladder is extremely rare, with less than 30 cases around the world. Half of the cases are reported as primary amyloidosis. This case adds to the current literature regarding primary gallbladder amyloidosis. Importantly, this case highlights how laparoscopic cholecystectomy can help with the diagnosis of gallbladder amyloidosis.

Keywords: amyloidosis, cholecystitis, gangrenous cholecystitis, gallbladder, systemic amyloidosis

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Authors: Esmaeil Sarikhani

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Objectives: Considering the importance of introducing new methods of improving self-compassion and compassion to the others in nursing students, this study intends to evaluate the effect of self-compassion training on nursing students. Methods: This is a field trial study in which 52 nursing interns from Isfahan University of Medical Sciences were selected using convenience sampling method and divided in two experimental and control groups. The sampling was done during two phases: before and after the intervention. The intervention consisted of eight sessions over eight weeks of self-compassion training. The data were collected using the self-compassion standard questionnaire with 26 questions before and after the intervention. Data were then analyzed by the SPSS18 software and independent and paired T-tests, and also Chi-square and Mann-Whitney tests. Results: The results obtained from the independent t-test showed that the mean score of self-compassion and its components in the experimental group was significantly increased compared to the control group (p < 0.001). Comparing the groups, the mean overall score difference of self-compassion and its components had also a statistically significant change after the intervention (p < 0.001). Conclusion: Self-compassion training program, leads to improving nursing students' self-compassion. As it seems, this method can be used as an important training course in order to improve compassion of nursing students to themselves and the others.

Keywords: self-compassion, student, nursing students, field trial

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Authors: M. Zeitoun, K. Abdallah, M. Rashwan

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Introduction: A growing body of evidence indicates that apelin, a relatively recent member of the adipokines family, has a potential anti-atherogenic effect. An association between low serum apelin state and coronary artery disease (CAD) was previously reported; however, the relationship between apelin and the atherosclerotic burden was unclear. Objectives: Our aim was to explore the correlation of serum apelin level with coronary calcium score (CCS) as a quantitative marker of coronary atherosclerosis. Methods: This observational cross-sectional study enrolled 100 consecutive subjects referred for cardiac multi-detector computed tomography (MDCT) for assessment of CAD (mean age 54 ± 9.7 years, 51 male and 49 females). Clinical parameters, glycemic and lipid profile, high sensitivity CRP (hsCRP), homeostasis model assessment of insulin resistance (HOMA-IR), serum creatinine and complete blood count were assessed. Serum apelin levels were determined using a commercially available Enzyme Immunoassay (EIA) Kit. High-resolution non-contrast CT images were acquired by a 64-raw MDCT and CCS was calculated using the Agatston scoring method. Results: Forty-three percent of the studied subjects had positive coronary artery calcification (CAC). The mean CCS was 79 ± 196.5 Agatston units. Subjects with detectable CAC had significantly higher fasting plasma glucose, HbA1c, and WBCs count than subjects without detectable CAC (p < 0.05). Most importantly, subjects with detectable CAC had significantly lower serum apelin level than subjects without CAC (1.3 ± 0.4 ng/ml vs. 2.8 ± 0.6 ng/ml, p < 0.001). In addition, there was a statistically significant inverse correlation between serum apelin levels and CCS (r = 0.591, p < 0.001); on multivariate analysis this correlation was found to be independent of traditional cardiovascular risk factors and hs-CRP. Conclusion:To the best of our knowledge, this is the first report of an independent association between apelin and CCS in patients with suspected CAD. Apelin emerges as a possible novel biomarker for CAD, but this result remains to be proved prospectively.

Keywords: HbA1c, apelin, adipokines, coronary calcium score (CCS), coronary artery disease (CAD)

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Authors: Dalila Chaid, Bennameur Fedilli, Mohammed Amine Bellelou

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The study focuses on the experience of lower-limb amputees, who face both physical and psychological challenges due to their disability. Chronic neuropathic pain and various types of limb pain are common in these patients. They often require orthopaedic interventions for issues such as dressings, infection, ulceration, and bone-related problems. Research Aim: The aim of this study is to determine the most suitable anaesthetic technique for lower-limb amputees, which can provide them with the greatest comfort and prolonged analgesia. The study also aims to demonstrate the effectiveness and cost-effectiveness of ultrasound-guided local regional anaesthesia (LRA) in this patient population. Methodology: The study is an observational analytical study conducted over a period of eight years, from 2010 to 2018. It includes a total of 955 cases of revisions performed on lower limb stumps. The parameters analyzed in this study include the effectiveness of the block and the use of sedation, the duration of the block, the post-operative visual analog scale (VAS) scores, and patient comfort. Findings: The study findings highlight the benefits of ultrasound-guided LRA in providing comfort by optimizing post-operative analgesia, which can contribute to psychological and bodily repair in lower-limb amputees. Additionally, the study emphasizes the use of alpha2 agonist adjuvants with sedative and analgesic properties, long-acting local anaesthetics, and larger volumes for better outcomes. Theoretical Importance: This study contributes to the existing knowledge by emphasizing the importance of choosing an appropriate anaesthetic technique for lower-limb amputees. It highlights the potential of ultrasound-guided LRA and the use of specific adjuvants and local anaesthetics in improving post-operative analgesia and overall patient outcomes. Data Collection and Analysis Procedures: Data for this study were collected through the analysis of medical records and relevant documentation related to the 955 cases included in the study. The effectiveness of the anaesthetic technique, duration of the block, post-operative pain scores, and patient comfort were analyzed using statistical methods. Question Addressed: The study addresses the question of which anaesthetic technique would be most suitable for lower-limb amputees to provide them with optimal comfort and prolonged analgesia. Conclusion: The study concludes that ultrasound-guided LRA, along with the use of alpha2 agonist adjuvants, long-acting local anaesthetics, and larger volumes, can be an effective approach in providing comfort and improving post-operative analgesia for lower-limb amputees. This technique can potentially contribute to the psychological and bodily repair of these patients. The findings of this study have implications for clinical practice in the management of lower-limb amputees, highlighting the importance of personalized anaesthetic approaches for better outcomes.

Keywords: neuropathic pain, ultrasound-guided peripheral nerve block, DN4 quiz, EMG

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Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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Authors: Amna Ali Nasser Al-Saadi, Riken Homma, Kazuhisa Iki

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Need to generate objective communication between researchers, Practitioners and policy makers are top concern of sustainability. Despite the fact that many places have successes in achieving some aspects of sustainable urban development, there are no scientific facts to convince policy makers in the rest of the world to apply their guides and manuals. This is because each of them was developed to fulfill the need of specific city. The question is, how to learn the lesson from each case study? And how distinguish between the potential criteria and negative one? And how quantify their effects in the future development? Walkability has been found as a solution to achieve healthy life style as well as social, environmental and economic sustainability. Moreover, it is complicated as every aspect of sustainable development. This research is stand on quantitative- comparative methodology in order to assess pedestrian oriented development. Three Analyzed Areas (AAs) were selected. One site is located in Oman in which hypotheses as motorized oriented development, while two sites are in Japan where the development is pedestrian friendly. The study used Multi-Criteria Evaluation Method (MCEM). Initially, MCEM stands on Analytic Hierarchy Process (AHP). The later was structured into main goal (walkability), objectives (functions and layout) and attributes (the urban form criteria). Secondly, the GIS were used to evaluate the attributes in multi-criteria maps. Since each criterion has different scale of measurement, all results were standardized by z-score and used to measure the co-relations among cr iteria. Different scenario was generated from each AA. After that, MCEM (AHP- OWA) based on GIS measured the walkability score and determined the priority of criteria development in the non-walker friendly environment. As results, the comparison criteria for z-score presented a measurable distinguished orientation of development. This result has been used to prove that Oman is motorized environment while Japan is walkable. Also, it defined the powerful criteria and week criteria regardless to the AA. This result has been used to generalize the priority for walkable development.

Keywords: walkability, sustainable development, multi- criteria evaluation method, gis

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Authors: Ulas Cinar, Omer Faruk Ugurlu, Selcuk Cebi

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Occupational safety risk management is the most important element of a safe working environment. Effective risk management can only be possible with accurate analysis and evaluations. Scoring-based risk assessment methods offer considerable ease of application as they convert linguistic expressions into numerical results. It can also be easily adapted to any field. Contrary to all these advantages, important problems in scoring-based methods are frequently discussed. Effective measurability is one of the most critical problems. Existing methods allow experts to choose a score equivalent to each parameter. Therefore, experts prefer the score of the most likely outcome for risk. However, all other possible consequences are neglected. Assessments of the existing methods express the most probable level of risk, not the real risk of the enterprises. In this study, it is aimed to develop a method that will present a more comprehensive evaluation compared to the existing methods by evaluating the probability and severity scores, all sub-parameters, and potential results, and a new scoring-based method is proposed in the literature.

Keywords: occupational health and safety, risk assessment, scoring based risk assessment method, underground mining, weighted risk scores

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