Search results for: chronic pain

Authors: Yen-Fen Shen, Meng-Fan Li

Abstract:

The study aims to investigate the effect of full-body vertical rhythmic training on fatigue, physical activity, and quality of life among middle-aged and elderly hemodialysis patients. The study adopted a quasi-experimental research method and recruited 43 long-term hemodialysis patients from a medical center in northern Taiwan, with 23 and 20 participants in the experimental and control groups, respectively. The experimental group received full-body vertical rhythmic training as an intervention, while the control group received standard hemodialysis care without any intervention. Both groups completed the measurements by using "Fatigue Scale", "Physical Activity Scale" and "Chinese version of the Kidney Disease Quality of Life Questionnaire" before and after the study. The experimental group underwent a 10-minute full-body vertical rhythmic training three times per week, which lasted for eight weeks before receiving regular hemodialysis treatment. The data were analyzed by SPSS 25 software, including descriptive statistics such as frequency distribution, percentages, means, and standard deviations, as well as inferential statistics, including chi-square, independent samples t-test, and paired samples t-test. The study results are summarized as follows: 1. There were no significant differences in demographic variables, fatigue, physical activity, and quality of life between the experimental and control groups in the pre-test. 2. After the intervention of the “full-body vertical rhythmic training,” the experimental group showed significantly better results in the category of "feeling tired and fatigued in the lower back", "physical functioning role limitation", "bodily pain", "social functioning", "mental health", and "impact of kidney disease on life quality." 3. The paired samples t-test results revealed that the control group experienced significant differences between the pre-test and post-test in the categories of feeling tired and fatigued in the lower back, bodily pain, social functioning mental health, and impact of kidney disease on life quality, with scores indicating a decline in life quality. Conversely, the experimental group only showed a significant worsening in bodily pain" and the impact of kidney disease on life quality, with lower change values compared to the control group. Additionally, there was an improvement in the condition of "feeling tired and fatigued in the lower back" for the experimental group. Conclusion: The intervention of the “full-body vertical rhythmic training” had a certain positive effect on the quality of life of the experimental group. While it may not entirely enhance patients' quality of life, it can mitigate the negative impact of kidney disease on certain aspects of the body. The study provides clinical practice, nursing education, and research recommendations based on the results and discusses the limitations of the research.

Keywords: hemodialysis, full-body vertical rhythmic training, fatigue, physical activity, quality of life

Procedia PDF Downloads 14

Authors: Barun K. De

Abstract:

Acquired immunodeficiency syndrome (AIDS) is caused by two types of human immunodeficiency viruses, collectively designated HIV. HIV infection is spreading globally particularly in developing countries. Before an individual is diagnosed with HIV, the disease goes through different phases. First there is an acute early phase that is followed by an established or chronic phase. Subsequently, there is a latency period after which the individual becomes immunodeficient. It is in the acute phase that an individual is highly infectious due to a high viral load. Presently, HIV diagnosis involves use of tests that do not detect the acute phase infection during which both the viral RNA and p24 antigen are expressed. Instead, these less sensitive tests detect antibodies to viral antigens which are typically sero-converted later in the disease process following acute infection. These antibodies are detected in both asymptomatic HIV-infected individuals as well as AIDS patients. Studies indicate that early diagnosis and treatment of HIV infection can reduce medical costs, improve survival, and reduce spreading of infection to new uninfected partners. Newer 4th generation combination antigen/antibody tests are highly sensitive and specific for detection of acute and established HIV infection (HIV1 and HIV2) enabling immediate linkage to care. The CDC (Center of Disease Control, USA) recently recommended an algorithm involving three different tests to screen and diagnose acute and established infections of HIV-1 and HIV-2 in a general population. Initially a 4th generation combo test detects a viral antigen p24 and specific antibodies against HIV -1 and HIV-2 envelope proteins. If the test is positive it is followed by a second test known as a differentiation assay which detects antibodies against specific HIV-1 and HIV-2 envelope proteins confirming established infection of HIV-1 or HIV-2. However if it is negative then another test is performed that measures viral load confirming an acute HIV-1 infection. Screening results of a Phoenix area population detected 0.3% new HIV infections among which 32.4% were acute cases. Studies in the U.S. indicate that this algorithm effectively reduces HIV infection through immediate treatment and education following diagnosis.

Keywords: new algorithm, HIV, diagnosis, infection

Procedia PDF Downloads 394

Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

Abstract:

Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

Procedia PDF Downloads 173

Authors: Maryam Tabrizi, Shahrzad Aarup

Abstract:

Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

Procedia PDF Downloads 163

Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

Abstract:

Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.

Keywords: economic burden, low back pain, musculoskeletal disorders, real-world

Procedia PDF Downloads 209

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

Abstract:

Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

Procedia PDF Downloads 253

Authors: Mohamed M. Mashaly, Ahmed M. F. El Shiwi

Abstract:

Background: Shoulder impingement syndrome is an encroachment of subacromial tissues, rotator cuff, subacromial bursa, and the long head of the biceps tendon, as a result of narrowing of the subacromial space. Activities requiring repetitive or sustained use of the arms over head often predispose the rotator cuff tendon to injury. Purpose: To compare between Combined effect therapeutic exercises and Shockwave therapy versus therapeutic exercises and phonophoresis in the treatment of shoulder impingement syndrome. Methods: Thirty patients diagnosed as shoulder impingement syndrome stage II Neer classification due to mechanical causes. Patients were randomly distributed into two equal groups. The first group consisted of 15 patients with a mean age of (45.46+8.64) received therapeutic exercises (stretching exercise of posterior shoulder capsule and strengthening exercises of shoulder muscles) and shockwave therapy (6000 shocks, 2000/session, 3 sessions, 2 weeks apart, 0.22mJ/mm^2) years. The second group consisted of 15 patients with a mean age of 46.26 (+ 8.05) received same therapeutic exercises and phonophoresis (3 times per week, each other day, for 4 consecutive weeks). Patients were evaluated pretreatment and post treatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions. Results: Patients of both groups showed significant improvement in all the measured variables. In between groups difference the shock wave group showed a significant improvement in all measured variables than phonophoresis group. Interpretation/Conclusion: Combined effect of therapeutic exercises and shock wave were more effective than therapeutic exercises and phonophoresis on decreasing shoulder pain severity, shoulder functional disability, increasing in shoulder flexion, abduction, internal rotation in patients with shoulder impingement syndrome.

Keywords: shoulder impingement syndrome, therapeutic exercises, shockwave, phonophoresis

Procedia PDF Downloads 463

Authors: Mary Abigail T. Ty, Mary Jocelyn Yu-Laygo, Jocelyn Z. Mariano

Abstract:

This is a case of L.S.T., a 61 year old, G6P4 (3124) who presented with a one month history of intermittent, brownish, watery, non foul smelling vaginal discharge. There were no other accompanying symptoms. On rectovaginal examination, a palpable adnexal mass on the left was appreciated, with the lower border measuring 3 cm. The mass was non-tender, had irregular borders and solid areas. On transvaginal sonography, it revealed a left pelvic mass measuring 3 x 4 x 2 cm, with a Sassone score of 9. It had vascularization. The primary consideration was Ovarian Newgrowth, probably malignant in nature. CA-125 results were slightly elevated at 43.2 u/ml (NV: 0-35 u/ml). After intraoperative evaluation, the left fallopian tube was converted into a 9 x 4.5 x 3 cm bulbous cystic mass with solid areas. On cut section, the ampullary portion of the fallopian tube contained necrotic and friable looking tissues. Specimen was sent for frozen section and results revealed adenocarcinoma of the left fallopian tube. Patient subsequently underwent complete surgical staging with unremarkable post-operative course. The Surg Ico pathologic diagnosis was G6P4 (3124) Fallopian tube serous cystadenocarcinoma stage 1. The mean incidence of PFTC is 3.6 per million women yearly. This is associated with a generally low survival rate. The primary diagnosis is very difficult to establish because only 0–10% of patients suffering from PFTC are diagnosed pre-operatively. Symptoms play a very important role in the discovery of this disease, because there will be no presentation to the hospital without symptoms. The most common of which may be vaginal bleeding, abdominal pain, a palpable mass and ascites. A conglomerate of manifestations may be encountered, but not at all times. This is termed hydrops tubae profluens where there is presence of colicky pain with relief from intermittent passage of serosanguinous vaginal discharge. The significance of this report is to emphasize the rarity of the case and how the dilemma in the diagnosis is almost always present despite ancillary procedures.

Keywords: fallopian tube carcinoma, prognosis, rare, risk factors

Procedia PDF Downloads 312

Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

Abstract:

Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

Procedia PDF Downloads 238

Authors: Roberto Cassino, Valeria Dissette, Carlo Alberto Bignozzi, Daniele Pazzi

Abstract:

Background and Aims: The aim of this work was to investigate, both ‘in vitro’ and ‘in vivo’, if the new SCX technology (SiO2-Ag+Chlorex) can easily defeat infections and it is really more effective than SSD (SilverSulfaDiazine). ‘In vitro’ methods: we tested ‘in vitro’ the effectiveness of both silver materials using a pool of 5 strains: Pseudomonas Aeruginosa, Staphylococcus aureus, Escherichia Coli, Enterococcus hirae and Candida Albicans. 100 µl of this pool have been seeded on Petri dishes and kept for 24 hours in incubation at 37 C°. ‘In vivo’ methods: we enrolled patients with multiple infectious chronic wounds (according with cutting & harding criteria for infection); after a qualitative evaluation of the wounds bacterial population, taking a sample by plug, we included in the study 6 patients for a total of 10 wounds, infected by one or more of the microorganisms used for the ‘in vitro’ test. The protocol consisted of a treatment with a spray powder of SSD every 48 hours for 14 days; in case of worsening we should have to start a new treatment with a spray powder containing silicon dioxide, ionic silver and chlorexidine (SiO2-Ag+Chlorex) every 48 hours for 14 days. We evaluated the number of clinical signs of infection and the disappearance or not of the wound edge erithema. ‘In vitro’ results: SSD demonstrated a wide zone of inhibition within 24 hours, but after 5 days there was no more signs of inhibition; on the contrary SCX had a good inhibition ring that lasted more than 5 days. ‘In vivo’ results: all wounds treated with SSD got worse; the signs of infection increased and the wound edge erithema did not disappear. According with the protocol, we treated then all wounds with SCX and they all improved within the period of observation with complete disappearance of clinical signs of infection and no more wound edge erithema. Conclusions: the study demonstrated the effectiveness of SiO2-Ag+Chlorex, especially in terms of long lasting antimicrobial action. We had the same results ‘in vitro’, so that there has been a perfect correspondence between the laboratory outcomes and the clinical ones.

Keywords: chronic wounds, infections, ionic silver, SSD

Procedia PDF Downloads 317

Authors: Olufunke O. Obanla, Oluseye O. Onabanjo, Silifat A. Sanni, Mojisola O. Adegunwa, Wasiu A. O. Afolabi, Omolola O. Oyawoye, Atinuke Titilola Lano-Maduagu

Abstract:

Background: Dietary fat is implicated in the increasing development of chronic diseases in developing countries while dietary fibre plays a major role in the management of these diseases. Accurate nutrient composition data for composite dishes unique to a population is essential for the development of a nutrient database and the calculation of dietary intake. Methods: Representative samples of standardized Nigerian soups and dishes were analyzed for fatty acids using gas chromatography-mass spectrophotometry (GC-MS) and dietary fibre using an enzymatic-gravimetric standard method of AOAC. Results: The total Saturated Fatty acids (SFAs) ranged from 0.74+0.3g/100g to 73.82+0.07g/100g. The total monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) ranged from 2.16+1.13g/100g for Yam pottage to 22.25+0.58g/100g for Okazi soup and eba, and from 0.42+0.10g/100g for Yam pottage to 10.22+0.1g/100g for Pounded yam with egusi ball soup, respectively. Trans fat was observed in Alapafubu and Tuwo shinkafa (2.80+0.2g/100g), Yam pottage (0.20+0.15g/100g), Steamed bean pudding (1.28+0.53g/100g) and Ikokore (5.33+0.41g/100g). The Total Dietary Fibre (TDF) contents of the dishes ranged from 12.95+2.99g/100g in Jollof rice to 62.00+0.94g/100g in Melon seed and vegetable soup, the Soluble Dietary Fibre (SDF) ranged from 2.05+0.32g/100g in Steamed bean pudding to 7.81+0.74g/100g in Ikokore while the Insoluble Dietary Fibre (IDF) ranged from 8.20+0.43g/100g in Jollof rice to 57.91+4.69g/100g in melon seed and vegetable soup. Conclusions: The study has indicated that some Nigerian dishes are characterized by high SFAs, TFAs and dietary fibre, moderate MUFAs and very low levels of PUFAs. High levels of SFAs in some soups and dishes are a major public health concern.

Keywords: healthy diet, dietary fibre, fatty acid profile, chronic diseases, Nigerian dishes

Procedia PDF Downloads 356

Authors: Nicholas C. Rose, Christopher D. Spicer

Abstract:

The regeneration of damaged or diseased tissues would provide an invaluable therapeutic tool in biological research and medicine. Cells must be provided with a number of different biochemical signals in order to form mature tissue through complex signaling networks that are difficult to recreate in synthetic materials. The ability to attach and detach bioactive proteins from material in an iterative and dynamic manner would therefore present a powerful way to mimic natural biochemical signaling cascades for tissue growth. We propose to reversibly attach these bioactive proteins using ortho-boronoimine (oBI) linkages and related derivatives formed by the reaction of an ortho-boronobenzaldehyde with a nucleophilic amine derivative. To enable the use of oBIs for biomaterial modification, we have studied binding and cleavage processes with precise detail in the context of small molecule models. A panel of oBI complexes has been synthesized and screened using a novel Förster resonance energy transfer (FRET) assay, using a cyanine dye FRET pair (Cy3 and Cy5), to identify the most reactive boron-aldehyde/amine nucleophile pairs. Upon conjugation of the dyes, FRET occurs under Cy3 excitation and the resultant ratio of Cy3:Cy5 emission directly correlates to conversion. Reaction kinetics and equilibria can be accurately quantified for reactive pairs, with dissociation constants of oBI derivatives in water (KD) found to span 9-orders of magnitude (10⁻²-10⁻¹¹ M). These studies have provided us with a better understanding of oBI linkages that we hope to exploit to reversibly attach bioconjugates to materials. The long-term aim of the project is to develop a modular biomaterial platform that can be used to help combat chronic diseases such as osteoarthritis, heart disease, and chronic wounds by providing cells with potent biological stimuli for tissue engineering.

Keywords: dynamic, bioconjugation, bornoimine, rapid, physiological

Procedia PDF Downloads 85

Authors: Yara Saleh, Sebastien Antherieu, Romain Dusautoir, Jules Sotty, Laurent Alleman, Ludivine Canivet, Esperanza Perdrix, Pierre Dubot, Anne Platel, Fabrice Nesslany, Guillaume Garcon, Jean-Marc Lo-Guidice

Abstract:

Air pollution is one of the leading causes of premature death worldwide. Among air pollutants, particulate matter (PM) is a major health risk factor, through the induction of cardiopulmonary diseases and lung cancers. They are composed of coarse, fine and ultrafine particles (PM10, PM2.5, and PM0.1 respectively). Ultrafine particles are emerging unregulated pollutants that might have greater toxicity than larger particles, since they are more abundant and consequently have higher surface area per unit of mass. Our project aims to develop a relevant in vivo model of sub-chronic exposure to atmospheric particles in order to elucidate the specific respiratory impact of ultrafine particles compared to fine particulate matter. Quasi-ultrafine (PM0.18) and fine (PM2.5) particles have been collected in the urban industrial zone of Dunkirk in north France during a 7-month campaign, and submitted to physico-chemical characterization. BALB/c mice were then exposed intranasally to 10µg of PM0.18 or PM2.5 3 times a week. After 1 or 3-month exposure, broncho alveolar lavages (BAL) were performed and lung tissues were harvested for histological and transcriptomic analyses. The physico-chemical study of the collected particles shows that there is no major difference in elemental and surface chemical composition between PM0.18 and PM2.5. Furthermore, the results of the cytological analyses carried out show that both types of particulate fractions can be internalized in lung cells. However, the cell count in BAL and preliminary transcriptomic data suggest that PM0.18 could be more reactive and induce a stronger lung inflammation in exposed mice than PM2.5. Complementary studies are in progress to confirm these first data and to identify the metabolic pathways more specifically associated with the toxicity of ultrafine particles.

Keywords: environmental pollution, lung affect, mice, ultrafine particles

Procedia PDF Downloads 228

Authors: Karlygash Tulendieva

Abstract:

Presently vaccination is the most effective method of prevention of flu and its complications. The purpose of this study was to analyze the impact of the increase of coverage of the population of South Kazakhstan region with flu vaccination and decrease of the ARVI morbidity. The analysis was performed on the data of flu vaccination of risk groups, including children under one year and pregnant women. Data on ARVI morbidity during 2010-2015 and data on vaccination were taken from the reports of the Epidemiological Surveillance Unit of Department of Consumers’ Rights Protection of South Kazakhstan region. Coverage with flu vaccination of the risk groups was annually increasing and in 2015 it reached 16% (450,000/2,800,682) from the total population. The ARVI morbidity rate in the entire population in 2010 was 2,010.4 per 100,000 of the population and decreased 3.2 times to 609.9 per 100,000 of the population in 2015. Annual growth was observed from 2010 to 2015 of specific weight of the vaccinated main risk groups: healthcare workers by 51% (from 17,331 in 2010 to 33,538 in 2015), children with chronic pulmonary and cardio-vascular diseases, immune deficiency, weak and sickly children above six months by 39% (from 63,122 in 2010 to 158,023 in 2015), adults with chronic co-morbidities by 27% (from 44,271 in 2010 to 162,595 in 2015), persons above 65 by 17% (from 10,276 in 2010 to 57,875 in 2015), and annual coverage of pregnant women on second or third trimester from 34,443 in 2010 to 37,969 in 2015. Starting from 2013 and until 2015 vaccination was performed in the region with coverage of at least 90% of children from 6 months to one year. The ARVI morbidity in this age group decreased 3.3 times from 8,687.8 per 100,000 of the population in 2010 to 2,585.8 per 100,000 of the population in 2015. Vaccination of pregnant women on 2-3 trimester was started in the region in 2012. Annual increase of vaccination coverage of pregnant women from 86.1% (34,443/40,000) in 2012 to 95% (37,969/40,000) in 2015 decreased the morbidity 1.5 times from 4,828.8 per 100,000 of population in 2012 to 3,022.7 per 100,000 of population in 2015. Following the increase of vaccination coverage of the population in South Kazakhstan region, the trend was observed of decrease of ARVI morbidity rates among the population and main risk groups, among pregnant women and children under one year.

Keywords: acute respiratory viral infections, flu, risk groups, vaccination

Procedia PDF Downloads 231

Authors: Atefeh Abedini, Pegah Soltani, Arda Kiani

Abstract:

Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association.

Keywords: mycobacterium tuberculosis, sarcoidosis, genome, DNA, trans-bronchial needle aspiration

Procedia PDF Downloads 17

Authors: Itsuo Yokoyama, Rikako Kikuti, Naoko Watabe, Tosinori Asai, Sarai Tsuyoshi

Abstract:

Introduction: Chronic kidney disease presents significant changes in mineral and bone metabolism, referred to as CKD-MBD. These changes lead to decreased bone mass, heightened bone fragility, fractures, and increased vascular and valvular calcification, ultimately impacting cardiovascular outcomes. Key contributors to these complications in dialysis patients include calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and the vitamin D hormonal system. Methods: In our outpatient dialysis clinic, we monitor the long-term effects of vascular calcifications by calculating the volume of calcified areas in the abdominal aorta based on CT scan data. The results revealed a progressive nature of vascular calcification. To extend our study, we measured the volume of calcification in bones (vertebrae and femur) corresponding to Hounsfield units of 200 and 300. The study aims to investigate changes in osteoporosis during a 5-year follow-up period and its relationship with extraosseous calcification. Results and Considerations: While extraosseous calcification demonstrated a generally progressive nature, often resistant to medical treatment, the degree of osteoporotic change varied among patients. The majority exhibited continuous osteoporotic changes, while some showed improvement or minimal changes in bone calcification. Variations in the distribution and magnitude of osteoporotic changes were observed between groups based on the timing of hemodialysis initiation during the study. The former group tended to display more osteoporotic changes, possibly attributed to differences in medication between the groups. Other contributing factors may include the patient's age, duration of dialysis, or causes of renal disease. In conclusion, we emphasize the importance of carefully monitoring calcium and phosphate levels and maintaining adequate dialysis therapy to prevent osteoporosis in dialysis patients.

Keywords: CKD-MBD, dialysis, calcification, kidney

Procedia PDF Downloads 35

Authors: Nurjannatul Naim Kamaruddin, Tengku Sifziuzl Tengku Muhammad, Aina Farahiyah Abdul Manan, Habsah Mohamad

Abstract:

Atherosclerosis which leads to cardiovascular diseases such as myocardial infarction, unstable angina (ischemic heart pain), sudden cardiac death and stroke is the principal cause of death worldwide. It has been a very critical issue as current common drug treatment, statin therapy has left bad side effects like rhabdomyolysis, atrial fibrillation, liver disease, abdominal and chest pain. Interestingly, the discoveries of proprotein convertase subtilisin-kexin type 9 have paved a new way in the treatment of atherosclerosis. This serine protease is believed to involve in the regulation of LDL- uptake by LDL-receptor. Therefore, this study was conducted to evaluate the potential of Acanthaster plancii fractions to reduce the transcriptional activity of the PCSK9 promoter. In this study, the marine organism which is Acanthaster plancii has been used as the source for marine compounds in inhibiting PCSK9. The cytotoxicity activity of ten fractions from the methanol extracts of Acanthaster plancii was investigated on HepG2 cell lines using MTS assay and dual glo luciferase assay was carried out later to analyses the effects of the samples in reducing the transcriptional activity of the PCSK9 promoter. Both assays used fractions with five different concentrations, 3.13µg/mL, 6.25µg/mL, 12.5µg/mL, 25µg/mL, and 50µg/mL. MTS assay indicated that the fractions are non-cytotoxic towards HepG2 cell lines as their IC50 value is greater than 30µg/mL. Whilst, for the dual glo luciferase assay, among all the fractions, Enhance Fraction 2 (EF2) showed the best potential in reducing the transcriptional activity of the PCSK9 promoter. The results indicated that this EF2 gave the lowest PCSK9 promoter expression at low concentration which is 0.2 fold change at 6.25µg/mL. This finding suggested that further analysis should be done to validate the potential of Acanthaster plancii as the source of anti-atherosclerotic agent.

Keywords: Acanthaster plancii, atherosclerosis, luciferase assay, PCSK9

Procedia PDF Downloads 133

Authors: Moustafa Ali Elwan, Ibrahim Salem Abdelrafa, Ashraf Moharm

Abstract:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed oral and topical drugs worldwide. Moreover, NSAIDs are responsible for most of all adverse drug reactions. For several decades, there are numerous attempts to use the cutaneous layers as a gate into the body for the local delivery of the therapeutic agent. Transdermal drug delivery is a validated technology contributing significantly to global pharmaceutical care. Transdermal Drug Delivery systems can be improved by using therapeutic agents. Moreover, Transdermal Drug Delivery systems can be improved by using chemical enhancers like ultrasound or iontophoresis. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. Objective: to compare the drug administration by ‘iontophoresis’ versus the oral rule. Methods: This study was conducted at the Faculty of Physical Therapy, Modern University for technology and information, Cairo, Egypt, on 20 participants (8 female & 12 male) who complained of tennis elbow. Their mean age was (25.45 ± 3.98) years, and all participants were assessed in many aspects: Pain threshold was assessed by algometer. Range of motion was assessed by electro goniometer, and isometric strength was assessed by a portable hand-held dynamometer. Then Participants were randomly assigned into two groups: group A was treated with oral NSAID (diclofenac) while group B was treated via administration of NSAIDs (diclofenac) via an iontophoresis device. All the participants were subjected to blood samples analysis in both pre-administration of the drug and post-administration of the drug for 24 hours (sample/every 6 hours). Results: The results demonstrated that there was a significant improvement in group b, “iontophoresis NSAIDs group,” more than in group B,” oral NSAIDs group,” in all measurements ‘ pain threshold, strength, and range of motion. Also, the iontophoresis method shows higher maximum plasma concentrations (Cmax) and concentration-time curves than the oral method.

Keywords: diclofenac, iontophoresis, NSAIDs, oral, tennis elbow

Procedia PDF Downloads 101

Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

Abstract:

Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

Procedia PDF Downloads 261

Authors: Marek Kuźniewski, Magdalena B. Kaziuk , Danuta Fedak, Paulina Dumnicka, Ewa Stępień, Beata Kuśnierz-Cabala, Władysław Sułowicz

Abstract:

Background: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKD patients. Methods: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKD patients and 35 healthy volunteers. In CKD patients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CaSc) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration. Cardiovascular and overall mortality data were collected during a 7-years follow-up. Results: OPG plasma concentrations were higher in CKD patients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKD patients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKD patients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. Conclusions: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.

Keywords: osteoprotegerin, tumor necrosis factor-related apoptosis-inducing ligand, receptor activator of nuclear factor kappa-B ligand, hemodialysis, chronic kidney disease, cardiovascular disease

Procedia PDF Downloads 326

Authors: Promise Ufomadu, Edgar Rodriguez, Grace Lee

Abstract:

Cutaneous Leishmaniasis (CL) is an infection caused by a variety of Leishmania species which are protozoan organisms that are typically carried by sandflies found in tropical regions. The parasite causes skin lesions that may resolve spontaneously but commonly become chronic and therefore necessitate thorough clinical attention. We present a 15-year-old female patient with CL of her bilateral dorsal hands, which resolved after a 28-day course of miltefosine. This case details the significance of compiling a thorough patient history and considering CL as a possible differential in patients from endemic regions.

Keywords: leishmaniasis, infection, immigrant, parasites, pediatrics

Procedia PDF Downloads 72

Authors: Deepa Shokeen, Bani Tamber Aeri

Abstract:

Food environments are believed to play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. The relationship between the food environment and obesity is complex. While there is little research linking food access with obesity as an outcome measure in any age group, with the help of this article we will try to understand the relationship between what we eat and the environmental context in which these food choices are made. Methods: A literature search of studies published between January 2000 and December 2013 was undertaken on computerized medical, social science, health, nutrition and education databases including Google, PubMed etc. Reports of organisations such as World Health Organisation (WHO), Centre for Chronic Disease Control (CCDC) were studied to project the data. Results: Studies show that food environments play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. Evidence indicates that the food environment may help explain the obesity and cardio-metabolic risk factors among young adults. Conclusion: Cardiovascular disease is the ever growing chronic disease, the incidence of which will increase markedly in the coming decades. Therefore, it is the need of the hour to assess the prevalence of various risk factors that contribute to the incidence of cardiovascular diseases especially in the work environment. Research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. We need to ascertain the impact of selected food and nutrition environments (Information, organization, community, consumer) on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behaviour of the adults.

Keywords: food environment, prevalence, cardiovascular disease, India, worksite, risk factors

Procedia PDF Downloads 392

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

Abstract:

Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

Procedia PDF Downloads 86

Authors: Allioua Meryem

Abstract:

Similar to much of the developing world, Algeria is currently undergoing an epidemiological transition. While mal- and under-nutrition and infectious diseases used to be the main causes of poor health, today there is a higher proportion of chronic, non-communicable diseases (NCDs), including cardiovascular disease, diabetes mellitus, cancer, etc. According to estimates for Algeria from the World Health Organization (WHO), NCDs accounted for 63% of all deaths in 2010. The objective of this study was the assessment of eating habits and anthropometric characteristics in a group of youth aged 15 to 19 years in Tlemcen. This study was conducted on a total effective of 806 youth enrolled in a descriptive cross-sectional study; the classification of nutritional status has been established by international standards IOTF, youth were defined as obese if they had a BMI ≥ 95th percentile, and youth with 85th ≤ BMI ≤ 95th percentile were defined as overweight. Wc is classified by the criteria HD, Wc with moderate risk ≥ 90th percentile and Wc with high risk ≥ 95th percentile. The dietary assessment was based on a 24-hour dietary recall assisted by food records. USDA’S nutrient database for Nutrinux® program was used to analyze dietary intake. Nutrients adequacy ratio was calculated by dividing daily individual intake to dietary recommended intake DRI for each nutrient. 9% of the population was overweight, 3% was obese, 7.5% had abdominal obesity, foods eaten in moderation are chips, cookies, chocolate 1-3 times/day and increased consumption of fried foods in the week, almost half of youth consume sugary drinks more than 3 times per week, we observe a decreased intake of energy, protein (P < 0.001, P = 0.003), SFA (P = 0.018), the NAR of phosphorus, iron, magnesium, vitamin B6, vitamin E, folate, niacin, and thiamin reflecting less consumption of fruit, vegetables, milk, and milk products. Youth surveyed have eating habits at risk of developing obesity and chronic disease.

Keywords: food intake, health, anthropometric characteristics, Algeria

Procedia PDF Downloads 536

Authors: Nanteza Rachel

Abstract:

Background: Worldwide, there were 36.7 million people living with Human Immunodeficiency Virus (HIV) in 2015, up from 35 million at the end of 2013. Wakiso district is one of the hotspots for the Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) infection in Uganda, with the prevalence of 8.1 %. Herbal medicine has gained popularity among Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) patients as adjuvant therapy to reduce the adverse effects of ART. Regardless of the subsidized and physical availability of the Anti-Retroviral Therapy (ART), majority of Africans living with Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) resort to adding to their ART traditional medicine. Result found out from a pilot observation made by the PI that indicate 13 out of 30 People Living with AIDS(PLWA) who are attending Human Immunodeficiency Virus (HIV) clinics in Wakiso district reported to be using herbal preparations despite the fact that they were taking Anti Retro Viral (ARVs) this prompted this study to be done. Purpose of the study: To determine the prevalence and factors associated with concurrent use of herbal medicine and anti-retroviral therapy among HIV/AIDS patients attending selected HIV clinics in Wakiso district. Methodology: This was a cross sectional study with both quantitative data collection (use of a questionnaire) and qualitative data collection (key informants’ interviews). A mixed method of sampling was used, that is, purposive and random sampling. Purposive sampling was based on the location in the district and used to select 7 health facilities basing on the 7 health sub districts from Wakiso. Simple random sampling was used to select one HIV clinic from each of the 7 health sub districts. Furthermore, the study units were enrolled in to the study as they entered into the HIV clinics, and 105 respondents were interviewed. Both manual and computer packages (SPSS) were used to analyze the data Results: The prevalence of concurrent use of herbal medicine and ART was 38 (36.2%). Commonly HIV symptom treated with herbs was fever 27(71.1%), diarrhea 3(7.9%) and cough 2(5.3%). Commonly used herbs for fever (Omululuza (Vernonica amydalina), Ekigagi (Aloe sp), Nalongo (Justicia betonica Linn) while for diarrhea was Ntwatwa. The side effects also included; too much pain, itchy pain of HIV, aneamia,felt sick, loss/gain appetite, joint pain and bad dreams. Herbs used to sooth the side effects were; for aneamia was avocado leaves Parea Americana mill The significant factors associated with concurrent use of herbal medicine were being familiar with herbs and conventional medicine for management HIV symptoms being expensive. The other significant factor was exhibiting hostility to patients by health personnel providing HIV care. Conclusion: Herbal medicine is widely used by clients in HIV/AIDS care. Patients being familiar with herbs and conventional medicine being expensive were associated with concurrent use of herbal medicine and ART. The exhibition of hostility to the HIV/AIDS patients by the health care providers was also associated with concurrent use of herbal medicine and ART among HIV/AIDS patients.

Keywords: HIV patients, herbal medicine, antiretroviral therapy, factors associated

Procedia PDF Downloads 80

Authors: David Tennison

Abstract:

Epistemic injustice, an injustice done to a person specifically in their capacity as a “knower”, is a subtle form of discrimination, yet its effects can be as dehumanizing and damaging as more overt forms of discrimination. The lens of epistemic injustice has, in recent years, been fruitfully applied to the field of healthcare, examining questions of agency, power, credibility and belief in doctor-patient interactions. Contested illness patients (e.g., those with illnesses lacking scientific consensuses such as fibromyalgia (FM), Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) and Long Covid) face higher levels of scrutiny than other patient groups and are often disbelieved or dismissed when their ailments cannot be easily imaged or tested for- often encapsulated by the expression “it’s all in your head”. Using the case study of FM, the trials of contested illness patients in healthcare can be conceptualized in terms of epistemic injustice, and what is going wrong in these doctor-patient relationships can be effectively diagnosed. This case study also helps reveal epistemic dysfunction (structural epistemic issues embedded in the healthcare system), how this relates to stigma identity-based prejudice, and how the healthcare system upholds existing societal hierarchies and disenfranchises the most vulnerable. In the modern landscape, where cases of these chronic illnesses are not only on the rise but future pandemics threaten to add to their number, this conversation is crucial for the well-being of patients and providers. This presentation will cover what epistemic injustice is and how it can be applied to the politics of the doctor-patient interaction on a micro level and the politics of the healthcare system more broadly. Contested illnesses will be explored in terms of how the “contested” label causes the patient to experience disease stigma and lowers their credibility in healthcare and across other aspects of life. This will be explored in tandem with a discussion of existing identity-based prejudice in the healthcare system and how social identities (such as those of gender, race, and socioeconomic status) intersect with the contested illness label. The effects of epistemic injustice, which include worsening patients’ symptoms of mental health and potentially disenfranchising them from the healthcare system altogether, will be presented alongside the potential ethical quandaries this poses for providers. Finally, issues with the way healthcare appointments and the modern NHS function will be explored in terms of epistemic injustice and solutions to improve doctor-patient communication and patient care will be discussed. The relationship between contested illness patients and healthcare providers is notoriously poor, and while this can mean frustration or feelings of unfulfillment in providers, the negative effects for patients are much more severe. The purpose of this research, then, is to highlight these issues and suggest ways in which to improve the healthcare experience for these patients, along with improving doctor-patient communication and mending the doctor-patient relationship in a tangible and realistic way. This research also aims to provoke important conversations about belief and hierarchy in medical settings and how these aspects intersect with identity prejudices.

Keywords: epistemic injustice, fibromyalgia, contested illnesses, chronic illnesses, doctor-patient relationships, philosophy of medicine

Procedia PDF Downloads 51

Authors: Medet K. Khamitov, Marat M. Ospanov, Vasiliy M. Lozovoy, Zhenis N. Sakuov, Dastan Z. Rustemov

Abstract:

With a high rectosigmoid transitional zone in children with Hirschsprung’s disease, the upper rectal, sigmoid, left colon arteries are ligated during the pull-through of the descending part of the colon. As a result, the inferior mesenteric artery ceases to participate in the blood supply to the descending part of the colon. As a result, the reduced colon is supplied with blood only by the middle colon artery, which originates from the superior mesenteric artery. Insufficiency of blood supply to the reduced colon is the cause of the development of chronic hypoxia of the intestinal wall or necrosis of the reduced descending colon. Some surgeons prefer to preserve the left colon artery. However, it is possible to stretch the mesentery, which can lead to bowel retraction to anastomotic leaks and stenosis. Chronic hypoxia of the reduced colon, in turn, is the cause of acquired (secondary) aganglionosis. The highest frequency of anastomotic leaks is observed in children older than five years. The purpose is to reduce the risk of complications in the pull-through procedure of the descending part of the colon in patients with Hirschsprung’s disease by ensuring its sufficient mobility and maintaining blood supply to the lower mesenteric artery. Methodology and events. Two children aged 5 and 7 years with Hirschsprung’s disease were operated under the conditions of the hospital in Nur-Sultan. The diagnosis was made using x-ray contrast enema and histological examination. Operational technique. After revision of the left part of the colon and assessment of the architectonics of its blood vessels, parietal mobilization of the affected sigmoid and rectum was performed on laparotomy access, while maintaining the arterial and venous terminal arcades of the sigmoid vessels. Then, the descending branch of the left colon artery was crossed (if there is an insufficient length of the reduced intestine, the left colonic artery itself may also be crossed). This manipulation provides additional mobility of the pull-through descending part of the colon. The resulting "windows" in the mesentery of the reduced intestine were sutured to prevent the development of an internal hernia. Formed a full-blooded, sufficiently long transplant from the transverse loops of the splenic angle and the descending parts of the colon with blood supply from the upper and lower mesenteric artery, freely, without tension, is reduced to the rectal zone with the coloanal anastomosis 1.5 cm above the dentate line. Results. The postoperative period was uneventful. Patients were discharged on the 7th day. The observation was carried out for six months. In no case, there was a bowel retraction, anastomotic leak, anastomotic stenosis, or other complications. Conclusion. The presented technique of mobilization of the colon for the pull-through procedure in a high transitional rectosigmoid zone of Hirschsprung’s disease allows to maintain normal blood supply to the distal part of the colon and to avoid the tension of the colon. The technique allows reducing the risk of anastomotic leak, bowel necrosis, chronic ischemia, to exclude colon retraction and anastomotic stenosis.

Keywords: blood supply, children, colon mobilization, Hirschsprung's disease, pull-through

Procedia PDF Downloads 136

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

Abstract:

Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

Procedia PDF Downloads 116

Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

Abstract:

Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

Procedia PDF Downloads 293

Authors: Ibrahim M. S. Shnawa, Naeem R. R. Algebory

Abstract:

The procedure for the assessment of the urinary mucosal cryoglobulin (UMCG) is being reviewed, testified and evaluated. The major features of UMCG are rather similar to that of serum cryoglobulin. Such evident similarities are forming the reality for the existence of the UMCG. There were seven characterizing criteria useable for the identification for UMCG. Upon matching them to the Irish criteria for serum cryoglobulin, some modifications are being proposed to the 16th standards that has been formulated and built as an Irish criterion. The existence of UMCG is being reported for the first time in human chronic infectious bacterial disease.

Keywords: urinary, mucosal, cryoglubulin, standard immunofixation

Procedia PDF Downloads 452