Search results for: concurrent chemotherapy and radiation therapy
2804 Influence of Rational Emotive Therapy on Substance Abuse Among Secondary School Students in Benue State
Authors: Justina I. Reamen
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The study examined the influence of rational emotive therapy on the treatment of substance abuse among Senior Secondary School Students in Makurdi metropolis Benue State Nigeria. This research adopted youth self report scale which was distributed to 1,690 SSS Students drawn from Government day Secondary School Makurdi and Government Model College Makurdi. Afterwards, 200 who were identified to indulge in substance abuse were selected for the study, 100 each from the two schools. 100 were taken as the control group and 100 as the experimental group, (50 of each group from each school). The Rational Emotive Behavior Therapy (REBT) intervention program was presented to the experimental group for seven (7) weeks. The students were taught how to apply REBT’s cognitive, Emotive and Behavioral techniques on their problems. After which post test was conducted to find out the impact of REBT on the treatment of adolescent students with substance abuse problem. GLM repeated measures of ANOVA were used to analyze the data from the study. The study reveals that REBT has positive impact on the treatment of adolescent students that abuse substances in the study area. Between pretest to post-test scores, a significant difference was observed (F=26.939; P=000) in substance abuse where a decrease of 1.12 (pre-10.91, post-9.79) scores was noticed irrespective of the groups. However, when the decrease in substance abuse were analyzed group wise, (experimental control) again significant F value (F=38.782; P=000) was obtained. From the mean scores it is evident that experimental group decreased it means by 2.56 (Pre-10.04 - Post-8.83) scores compared to control group, which changed its scores by only 0.32 scores (pre 11.04 - Post 11.36). Recommendations were made based on the findings of the research.Keywords: abuse, influence, substance, therapy, treatment
Procedia PDF Downloads 2382803 Effectiveness of Myofascial Release Technique in Treatment of Sacroiliac Joint Hypo-Mobility in Postnatal Women
Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk
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Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal
Procedia PDF Downloads 1062802 Radiation Dosimetry Using Sintered Pellets of Yellow Beryl (Heliodor) Crystals
Authors: Lucas Sátiro Do Carmo, Betzabel Noemi Silva Carrera, Shigueo Watanabe, J. F. D. Chubaci
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Beryl is a silicate with chemical formula Be₃Al₂(SiO₃)₆ commonly found in Brazil. It has a few colored variations used as jewelry, like Aquamarine (blueish), Emerald (green) and Heliodor (yellow). The color of each variation depends on the dopant that is naturally present in the crystal lattice. In this work, Heliodor pellets of 5 mm diameter and 1 mm thickness have been produced and investigated using thermoluminescence (TL) to evaluate its potential for use as gamma ray’s dosimeter. The results show that the pellets exhibited a prominent TL peak at 205 °C that grows linearly with dose when irradiated from 1 Gy to 1000 Gy. A comparison has been made between powdered and sintered dosimeters. The results show that sintered pellets have higher sensitivity than powder dosimeter. The TL response of this mineral is satisfactory for radiation dosimetry applications in the studied dose range.Keywords: dosimetry, beryl, gamma rays, sintered pellets, new material
Procedia PDF Downloads 1012801 Synergistic Effect of Doxorubicin-Loaded Silver Nanoparticles – Polymeric Conjugates on Breast Cancer Cells
Authors: Nancy M. El-Baz, Laila Ziko, Rania Siam, Wael Mamdouh
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Cancer is one of the most devastating diseases, and has over than 10 million new cases annually worldwide. Despite the effectiveness of chemotherapeutic agents, their systemic toxicity and non-selective anticancer actions represent the main obstacles facing cancer curability. Due to the effective enhanced permeability and retention (EPR) effect of nanomaterials, nanoparticles (NPs) have been used as drug nanocarriers providing targeted cancer drug delivery systems. In addition, several inorganic nanoparticles such as silver (AgNPs) nanoparticles demonstrated a potent anticancer activity against different cancers. The present study aimed at formulating core-shell inorganic NPs-based combinatorial therapy based on combining the anticancer activity of AgNPs along with doxorubicin (DOX) and evaluating their cytotoxicity on MCF-7 breast cancer cells. These inorganic NPs-based combinatorial therapies were designed to (i) Target and kill cancer cells with high selectivity, (ii) Have an improved efficacy/toxicity balance, and (iii) Have an enhanced therapeutic index when compared to the original non-modified DOX with much lower dosage The in-vitro cytotoxicity studies demonstrated that the NPs-based combinatorial therapy achieved the same efficacy of non-modified DOX on breast cancer cell line, but with 96% reduced dose. Such reduction in DOX dose revealed that the combination between DOX and NPs possess a synergic anticancer activity against breast cancer. We believe that this is the first report on a synergic anticancer effect at very low dose of DOX against MCF-7 cells. Future studies on NPs-based combinatorial therapy may aid in formulating novel and significantly more effective cancer therapeutics.Keywords: nanoparticles-based combinatorial therapy, silver nanoparticles, doxorubicin, breast cancer
Procedia PDF Downloads 4432800 Photovoltaic Water Pumping System Application
Authors: Sarah Abdourraziq
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Photovoltaic (PV) water pumping system is one of the most used and important applications in the field of solar energy. However, the cost and the efficiency are still a concern, especially with continued change of solar radiation and temperature. Then, the improvement of the efficiency of the system components is a good solution to reducing the cost. The use of maximum power point tracking (MPPT) algorithms to track the output maximum power point (MPP) of the PV panel is very important to improve the efficiency of the whole system. In this paper, we will present a definition of the functioning of MPPT technique, and a detailed model of each component of PV pumping system with Matlab-Simulink, the results shows the influence of the changing of solar radiation and temperature in the output characteristics of PV panel, which influence in the efficiency of the system. Our system consists of a PV generator, a boost converter, a motor-pump set, and storage tank.Keywords: PV panel, boost converter, MPPT, MPP, PV pumping system
Procedia PDF Downloads 4002799 Sintered Phosphate Cement for HLW Encapsulation
Authors: S. M. M. Nelwamondo, W. C. M. H. Meyer, H. Krieg
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The presence of volatile radionuclides in high level waste (HLW) in the nuclear industry limits the use of high temperature encapsulation technologies (glass and ceramic). Chemically bonded phosphate cement (CBPC) matrixes can be used for encapsulation of low level waste. This waste form is however not suitable for high level waste due to the radiolysis of water in these matrixes. In this research, the sintering behavior of the magnesium potassium phosphate cement waste forms was investigated. The addition of sintering aids resulted in the sintering of these phosphate cement matrixes into dense monoliths containing no water. Experimental evidence will be presented that this waste form can now be considered as a waste form for volatile radionuclides and high level waste as radiation studies indicated no chemical phase transition or physical degradation of this waste form.Keywords: chemically bonded phosphate cements, HLW encapsulation, thermal stability, radiation stability
Procedia PDF Downloads 6412798 Cosmic Background Reduction in the Radiocarbon Measurements by Liquid Scintillation Spectrometry
Authors: Natasa Todorovic, Jovana Nikolov
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Guard detector efficiency, cosmic background, and its variation were determinate using ultra low-level liquid scintillation spectrometer Quantulus 1220, equipped with an anti-Compton guard detector, in the surface laboratory at the University of Novi Sad, Serbia, Atmospheric pressure variation has an observable effect on the anti-Compton guard detector count rate. and the cosmic muon flux is lower during a high-pressure period. Also, the guard detector Compton continuum provides a good view of the level of gamma radiation in the laboratory environment. The efficiency of the guard detector in the channel interval from 750 to 1024 was assessed to 93.45%; efficiency in the entire window (channels 1 to 1024) was 75.23%, which is in good agreement with literature data.Keywords: cosmic radiation, background reduction, liquid scintillation counting, guard detector efficiency
Procedia PDF Downloads 1612797 Endoscopic Treatment of Esophageal Injuries Using Vacuum Therapy
Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev
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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy
Procedia PDF Downloads 1102796 Concurrent Validity of Synchronous Tele-Audiology Hearing Screening
Authors: Thidilweli Denga, Bessie Malila, Lucretia Petersen
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The Coronavirus Disease of 2019 (COVID-19) pandemic should be taken as a wake-up call on the importance of hearing health care considering amongst other things the electronic methods of communication used. The World Health Organization (WHO) estimated that by 2050, there will be more than 2.5 billion people living with hearing loss. These numbers show that more people will need rehabilitation services. Studies have shown that most people living with hearing loss reside in Low-Middle Income Countries (LIMC). Innovative technological solutions such as digital health interventions that can be used to deliver hearing health services to remote areas now exist. Tele-audiology implementation can potentially enable the delivery of hearing loss services to rural and remote areas. This study aimed to establish the concurrent validity of the tele-audiology practice in school-based hearing screening. The study employed a cross-sectional design with a within-group comparison. The portable KUDUwave Audiometer was used to conduct hearing screening from 50 participants (n=50). In phase I of the study, the audiologist conducted on-site hearing screening, while the synchronous remote hearing screening (tele-audiology) using a 5G network was done in phase II. On-site hearing screening results were obtained for the first 25 participants (aged between 5-6 years). The second half started with the synchronous tele-audiology model to avoid order-effect. Repeated sample t-tests compared threshold results obtained in the left and right ears for onsite and remote screening. There was a good correspondence between the two methods with a threshold average within ±5 dB (decibels). The synchronous tele-audiology model has the potential to reduce the audiologists' case overload, while at the same time reaching populations that lack access due to distance, and shortage of hearing professionals in their areas of reach. With reliable and broadband connectivity, tele-audiology delivers the same service quality as the conventional method while reducing the travel costs of audiologists.Keywords: hearing screening, low-resource communities, portable audiometer, tele-audiology
Procedia PDF Downloads 1252795 Predictors of Non-Adherence to Pharmacological Therapy in Patients with Type 2 Diabetes
Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto
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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan
Procedia PDF Downloads 4422794 Influence of Gamma-Radiation Dosimetric Characteristics on the Stability of the Persistent Organic Pollutants
Authors: Tatiana V. Melnikova, Lyudmila P. Polyakova, Alla A. Oudalova
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As a result of environmental pollution, the production of agriculture and foodstuffs inevitably contain residual amounts of Persistent Organic Pollutants (POP). The special attention must be given to organic pollutants, including various organochlorinated pesticides (OCP). Among priorities, OCP is DDT (and its metabolite DDE), alfa-HCH, gamma-HCH (lindane). The control of these substances spends proceeding from requirements of sanitary norms and rules. During too time often is lost sight of that the primary product can pass technological processing (in particular irradiation treatment) as a result of which transformation of physicochemical forms of initial polluting substances is possible. The goal of the present work was to study the OCP radiation degradation at a various gamma-radiation dosimetric characteristics. The problems posed for goal achievement: to evaluate the content of the priority of OCPs in food; study the character the degradation of OCP in model solutions (with micro concentrations commensurate with the real content of their agricultural and food products) depending upon dosimetric characteristics of gamma-radiation. Qualitative and quantitative analysis of OCP in food and model solutions by gas chromatograph Varian 3400 (Varian, Inc. (USA)); chromatography-mass spectrometer Varian Saturn 4D (Varian, Inc. (USA)) was carried out. The solutions of DDT, DDE, alpha- and gamma- isomer HCH (0.01, 0.1, 1 ppm) were irradiated on "Issledovatel" (60Co) and "Luch - 1" (60Co) installations at a dose 10 kGy with a variation of dose rate from 0.0083 up to 2.33 kGy/sec. It was established experimentally that OCP residual concentration in individual samples of food products (fish, milk, cereal crops, meat, butter) are evaluated as 10-1-10-4 mg/kg, the value of which depends on the factor-sensations territory and natural migration processes. The results were used in the preparation of model solutions OCP. The dependence of a degradation extent of OCP from a dose rate gamma-irradiation has complex nature. According to our data at a dose 10 kGy, the degradation extent of OCP at first increase passes through a maximum (over the range 0.23 – 0.43 Gy/sec), and then decrease with the magnification of a dose rate. The character of the dependence of a degradation extent of OCP from a dose rate is kept for various OCP, in polar and nonpolar solvents and does not vary at the change of concentration of the initial substance. Also in work conditions of the maximal radiochemical yield of OCP which were observed at having been certain: influence of gamma radiation with a dose 10 kGy, in a range of doses rate 0.23 – 0.43 Gy/sec; concentration initial OCP 1 ppm; use of solvent - 2-propanol after preliminary removal of oxygen. Based on, that at studying model solutions of OCP has been established that the degradation extent of pesticides and qualitative structure of OCP radiolysis products depend on a dose rate, has been decided to continue researches radiochemical transformations OCP into foodstuffs at various of doses rate.Keywords: degradation extent, dosimetric characteristics, gamma-radiation, organochlorinated pesticides, persistent organic pollutants
Procedia PDF Downloads 2532793 Perspectives and Challenges a Functional Bread With Yeast Extract to Improve Human Diet
Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires
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Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia
Procedia PDF Downloads 592792 The Anesthesia Considerations in Robotic Mastectomies
Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev
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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.Keywords: anesthesia, mastectomies, robotic, hypercarbia
Procedia PDF Downloads 1162791 Gamma Irradiation Effects on the Crystal Structural and Transport Properties of Bi₂Te₃ Thin Films Grown by Thermal Evaporation
Authors: Shoroog Alraddadi
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In this study, the effect of gamma irradiation on the structural and transport properties of Bismuth Telluride (Bi₂Te₃) thin films was investigated. Bi₂Te₃ thin films with thicknesses varying from 100 nm to 500 nm were grown using thermal evaporation in vacuum 10⁻⁵ Torr. The films were irradiated by Gamma radiation with different doses (50, 200, and 500 kGy). The crystal structure of Bi₂Te₃ thin films was studied by XRD diffraction. It was showed that the degree of crystallinity of films increases as the doses increase. Furthermore, it was found that the electrical conductivity of Bi₂Te₃ increase as the doses increase. From these results, it can be concluding that the effect of radiation on the structural and transport properties was positive at the levels of irradiation used.Keywords: bismuth telluride, gamma irradiation, thin film, transport properties
Procedia PDF Downloads 1612790 Phage Therapy as a Potential Solution in the Fight against Antimicrobial Resistance
Authors: Sanjay Shukla
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Excessive use of antibiotics is a main problem in the treatment of wounds and other chronic infections and antibiotic treatment is frequently non-curative, thus alternative treatment is necessary. Phage therapy is considered one of the most effective approaches to treat multi-drug resistant bacterial pathogens. Infections caused by Staphylococcus aureus are very efficiently controlled with phage cocktails, containing a different individual phages lysate infecting a majority of known pathogenic S. aureus strains. The aim of current study was to investigate the efficiency of a purified phage cocktail for prophylactic as well as therapeutic application in mouse model and in large animals with chronic septic infection of wounds. A total of 150 sewage samples were collected from various livestock farms. These samples were subjected for the isolation of bacteriophage by double agar layer method. A total of 27 sewage samples showed plaque formation by producing lytic activity against S. aureus in double agar overlay method out of 150 sewage samples. In TEM recovered isolates of bacteriophages showed hexagonal structure with tail fiber. In the bacteriophage (ØVS) had an icosahedral symmetry with the head size 52.20 nm in diameter and long tail of 109 nm. Head and tail were held together by connector and can be classified as a member of the Myoviridae family under the order of Caudovirale. Recovered bacteriophage had shown the antibacterial activity against the S. aureus in vitro. Cocktail (ØVS1, ØVS5, ØVS9 and ØVS 27) of phage lysate were tested to know in vivo antibacterial activity as well as the safety profile. Result of mice experiment indicated that the bacteriophage lysate was very safe, did not show any appearance of abscess formation which indicates its safety in living system. The mice were also prophylactically protected against S. aureus when administered with cocktail of bacteriophage lysate just before the administration of S. aureus which indicates that they are good prophylactic agent. The S. aureus inoculated mice were completely recovered by bacteriophage administration with 100% recovery which was very good as compere to conventional therapy. In present study ten chronic cases of wound were treated with phage lysate and follow up of these cases was done regularly up to ten days (at 0, 5 and 10 d). Result indicated that the six cases out of ten showed complete recovery of wounds within 10 d. The efficacy of bacteriophage therapy was found to be 60% which was very good as compared to the conventional antibiotic therapy in chronic septic wounds infections. Thus, the application of lytic phage in single dose proved to be innovative and effective therapy for treatment of septic chronic wounds.Keywords: phage therapy, phage lysate, antimicrobial resistance, S. aureus
Procedia PDF Downloads 1222789 Parametric Analysis of Water Lily Shaped Split Ring Resonator Loaded Fractal Monopole Antenna for Multiband Applications
Authors: C. Elavarasi, T. Shanmuganantham
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A coplanar waveguide (CPW) feed is presented, and comprising a split ring resonator (SRR) loaded fractal with water lily shape is used for multi band applications. The impedance matching of the antenna is determined by the number of Koch curve fractal unit cells. The antenna is designed on a FR4 substrate with a permittivity of εr = 4.4 and size of 14 x 16 x 1.6 mm3 to generate multi resonant mode at 3.8 GHz covering S band, 8.68 GHz at X band, 13.96 GHz at Ku band, and 19.74 GHz at K band with reflection coefficient better than -10 dB. Simulation results show that the antenna exhibits the desired voltage standing wave ratio (VSWR) level and radiation patterns across the wide frequency range. The fundamental parameters of the antenna such as return loss, VSWR, good radiation pattern with reasonable gain across the operating bands are obtained.Keywords: fractal, metamaterial, split ring resonator, waterlily shape
Procedia PDF Downloads 2792788 Craving Intensity Measurements in Opiate Addicts to Objectify the Opioid Substitution Therapy Dose and Reduce the Relapse Risk
Authors: Igna Brajevic-Gizdic, Magda Pletikosa Pavić
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Introduction: Research in opiate addiction is increasingly indicating the importance of substitution therapy in opiate addicts. Opiate addiction is a chronic relapsing disease that includes craving as a criterion. Craving has been considered a predictor of a relapse, which is defined as a strong desire with an excessive need to take a substance. The study aimed to measure the intensity of craving using the VAS (visual analog scale) in opioid addicts taking Opioid Substitution Therapy (OST). Method: The total sample compromised of 30 participants in outpatient treatment. Two groups of opiate addicts were considered: Methadone-maintenance and buprenorphine-maintenance addicts. The participants completed the survey questionnaire during the outpatient treatment. Results: The results indicated high levels of cravings in patients during the treatment of OST, which is considered an important destabilization factor in abstinence. Thus, the use of methadone/buprenorphine dose should be considered. Conclusion: These findings provided an objective measurement of methadone /buprenorphine dosage and therapy options. The underdoes of OST can put patients at high risk of relapse, resulting in high levels of craving. Thus, when determining the therapeutic dose of OST, it is crucial to consider patients' cravings. This would achieve stabilization more quickly and avoid relapse in abstinence. Subjective physician assessment and patients' statement are the main criteria to determine OST dosage. Future studies should use larger sample sizes and focus on the importance of intensity craving measurement on OST to objectify methadone /buprenorphine dosage.Keywords: buprenorphine, craving, heroin addicts, methadone, OST
Procedia PDF Downloads 912787 Perception and Knowledge of the Jordanian Society of Occupational Therapy
Authors: Wesam Darawsheh
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Background: there are scarcity of studies done to investigate the level of knowledge and the level of awareness and perception of Jordanians about occupational therapy (OT). Aim: to investigate the level of awareness of lay people, clients receiving services and healthcare professionals of OT, identify the common misconceptions about OT, and to explore ways whereby the knowledge and awareness about OT can be increased. Methodology: a cross sectional design was employed in this study where a survey was distributed in the Northern, Southern, Western, Eastern provinces and the Middle (capital city: Amman) province of Jordan. The survey consisted of eight section and 61 questions that aims to investigate the demographics of participants, self evaluation concerning knowledge and awareness about OT, sources of knowledge about OT, the perception of the aims, fields of practice, OT settings, misconceptions about OT, and suggestion to improve knowledge and awareness about OT. Results: A total of 829 participants were enrolled in this study: 459 lay people, 155 clients who are currently receiving OT services, 215 healthcare professionals. About 57% of the participants did not hear about OT, and 48% of those who reported to hear about OT did not have sufficient knowledge about it. There are several misconceptions associated with OT. The statistical analysis was executed using IBM SPSS software, Version 22.0 (SPSS, Chicago, USA). Conclusion: it is the responsibility of OTRs to increase the knowledge and awareness about OT in Jordan. This is required for the profession to proliferate and to be given its status.Keywords: knowledge, occupational therapy misconceptions, healthcare professionals, lay people, Jordan
Procedia PDF Downloads 3692786 Heating System for Water Pool by Solar Energy
Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale
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A swimming pool heating system is presented, composed of two alternative collectors with serial PVC absorber tubes that work in regimen of forced stream that is gotten through a bomb. A 500 liters reservoir was used, simulating the swimming pool, being raised some data that show the viability of the considered system. The chosen outflow was corresponding to 100 l/h. In function of the low outflow it was necessary the use of a not popular bomb, choosing the use of a low outflow alternative pumping system, using an air conditioner engine with three different rotations for the desired end. The thermal data related to each collector and their developed system will be presented. The UV and thermal degradations of the PVC exposed to solar radiation will be also boarded, demonstrating the viability of using tubes of this material as absorber elements of radiation in water heating solar collectors.Keywords: solar energy, solar swimming pool, water heating, PVC tubes, alternative system
Procedia PDF Downloads 4672785 Evaluation of Uniformity for Gafchromic Sheets for Film Dosimetry
Authors: Fayzan Ahmed, Saad Bin Saeed, Abdul Qadir Jangda
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Gafchromic™ sheet are extensively used for the QA of intensity modulated radiation therapy and other in-vivo dosimetry. Intra-sheet Non-uniformity of scanner as well as film causes undesirable fluctuations which are reflected in dosimetry The aim of this study is to define a systematic and robust method to investigate the intra-sheet uniformity of the unexposed Gafchromic Sheets and the region of interest (ROI) of the scanner. Sheets of lot No#: A05151201 were scanned before and after the expiry period with the EPSON™ XL10000 scanner in the transmission mode, landscape orientation and 72 dpi resolution. ROI of (8’x 10’ inches) equal to the sheet dimension in the center of the scanner is used to acquire images with full transmission, block transmission and with sheets in place. 500 virtual grids, created in MATALB® are imported as a macros in ImageJ (1.49m Wayne Rasband) to analyze the images. In order to remove the edge effects, the outer 86 grids are excluded from the analysis. The standard deviation of the block transmission and full transmission are 0.38% and 0.66% confirming a higher uniformity of the scanner. Expired and non-expired sheets have standard deviations of 2.18% and 1.29%, show that uniformity decreases after expiry. The results are promising and indicates a good potential of this method to be used as a uniformity check for scanner and unexposed Gafchromic sheets.Keywords: IMRT, film dosimetry, virtual grids, uniformity
Procedia PDF Downloads 4972784 Effects of Kinesio Taping on Pain and Functions of Chronic Nonspecific Low Back Pain Patients
Authors: Ahmed Assem Abd El Rahim
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BACKGROUND: Low back pain (LBP) is enormously common health problem& most of subjects experience it at some point of their life. Kinesio-taping is one of therapy methods introduced for studied cases with nonspecific low back pain. OBJECTIVES: to look at how Kinesio-taping affects studied cases with non-specific low back pain in terms of discomfort, range of motion, & back muscular strength. SUBJECTS: 40 mechanical LBP patients aged 20-40 years had been assigned haphazardly into two groups, They had been selected from outpatient clinic, KasrAl-AiniHospital, Cairo university. Methods: GroupA: 20 patients received the I-shape KT longitudinally & conventional physiotherapy program. Group B:20 studied cases received application of the KT Horizontally & conventional physiotherapy program. pain had been measured by visual analog scale, Range of motion had been measured by Roland Morris Disability Questionnaire (RMDQ), & strength had been measured by an isokinetic dynamometer before & after therapy. Therapy sessions had been three times weekly for four weeks. RESULTS: Groups (A & B) discovered decrease in pain& disability and rise in their flexion, extension ROM & peak torque of trunk extensor after end of 4 weeks of program. mean values of pain scale after therapy had been 3.7 and 5.04 in groups A & B. mean values of Disability scale after treatment had been 7.87.and 9.35 in groups A & B. mean values of ROM of flexion had been 28.06, and 24.53 in groups A & B. mean values of ROM of extension had been 13.43 & 10.73 in groups A & B. mean values of Peak torque of lumbar extensors were 65.43 and 63.22 in groups A & B. Though, participants who received the I-shape KT longitudinally as well as conventional physiotherapy program (group A), discovered more reduction in pain& disability and more improvement in ROM of flexion, extension, and Peak torque of lumbar extensors value (P<0.001) after therapy program CONCLUSION: Therapeutic longitudinal Kinesio-taping application with conventional physiotherapy will be more valuable than Therapeutic horizontal Kinesio-taping application with conventional physiotherapy when treating nonspecific low back pain studied cases.Keywords: Kinesio taping, function, low back pain, muscle power
Procedia PDF Downloads 672783 One Year Follow up of Head and Neck Paragangliomas: A Single Center Experience
Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa
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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.Keywords: clinical outcomes, head and neck, management, paragangliomas
Procedia PDF Downloads 1462782 pH and Thermo-Sensitive Nanogels for Anti-Cancer Therapy
Authors: V. Naga Sravan Kumar Varma, H. G. Shivakumar
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The aim of the study was to develop dual sensitive poly (N-isopropylacrylamide-co-acrylic acid) (PNA) nanogels(NGs) and studying its applications for Anti-Cancer therapy. NGs were fabricated by free radical polymerization using different amount of N-isopropylacrylamide and acrylic acid. A study for polymer composition over the effect on LCST in different pH was evaluated by measuring the absorbance at 500nm using UV spectrophotometer. Further selected NG’s were evaluated for change in hydrodynamic diameters in response to pH and temperature. NGs which could sharply respond to low pH value of cancer cells at body temperature were loaded with Fluorouracil (5-FU) using equilibrium swelling method and studied for drug release behaviour in different pH. A significant influence of NGs polymer composition over pH dependent LCST was observed. NGs which were spherical with an average particle size of 268nm at room temperature, shrinked forming an irregular shape when heated above to their respective LCST. 5FU loaded NGs did not intervene any difference in pH depended LCST behaviour of NGs. The in vitro drug release of NGs exhibited a pH and thermo-dependent control release. The cytoxicity study of blank carrier to MCF7 cell line showed no cytotoxicity. The results indicated that PNA NGs could be used as a potential drug carrier for anti-cancer therapy.Keywords: pH and thermo-sensitive, nanogels, P(NIPAM-co-AAc), anti-cancer, 5-FU
Procedia PDF Downloads 3542781 Kinematic Analysis of the Calf Raise Test Using a Mobile iOS Application: Validation of the Calf Raise Application
Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier
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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.Keywords: calf raise test, mobile application, validity, reliability
Procedia PDF Downloads 1692780 Evaluation and Association of Thyroid Function Tests with Liver Function Parameters LDL and LDH Level Before and after I131 Therapy
Authors: Sabika Rafiq, Rubaida Mehmood, Sajid Hussain, Atia Iqbal
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Background and objectives: The pathogenesis of liver function abnormalities and cardiac dysfunction in hyperthyroid patients after I131 treatment is still unclear. This study aimed to determine the effects of radioiodine I131 on liver function parameters, lactate dehydrogenase (LDH) and low-density lipoproteins (LDL) before and after I131 therapy hyperthyroidism patients. Material & Methods: A total of 52 patients of hyperthyroidism recommended for I131were involved in this study with ages ranging from 12–65 years (mean age=38.6±14.8 & BMI=11.5±3.7). The significance of the differences between the results of 1st, 2nd and 3rd-time serum analysis was assessed by unpaired student’s t-test. Associations between the parameters were assessed by Spearman correlation analysis. Results: Significant variations were observed for thyroid profile free FT3 (p=0.04), FT4 (p=0.01), TSH (p=0.005) during the follow-up treatment. Before taking I131 (serum analyzed at 1st time), negative correlation of FT3 with AST (r=-0.458, p=0.032) and LDL (r=-0.454, p=0.039) were observed. During 2nd time (after stopping carbimazole), no correlation was assessed. Two months after the administration of I131 drops, a significant negative association of FT3 (r=-0.62, p=0.04) and FT4(r=-0.61, p=0.02) with ALB were observed. FT3(r=-0.82, p=0.00) & FT4 (r=-0.71, p=0.00) also showed negative correlation with LDL after I131 therapy. Whereas TSH showed significant positive association with ALB (r=0.61, p=0.01) and LDL (r=0.70, p=0.00) respectively. Conclusion: Current findings suggested that the association of TFTs with biochemical parameters in patients with goiter recommended for iodine therapy is an important diagnostic and therapeutic tool. The significant changes increased in transaminases and low-density lipoprotein levels after taking I131drops are alarming signs for heart and liver function abnormalities and warrant physicians' attention on an urgent basis.Keywords: hyperthyroidism, carbimazole, radioiodine I131, liver functions, low-density lipoprotein
Procedia PDF Downloads 1592779 Design and Characterization of Aromatase Inhibitor Loaded Nanoparticles for the Treatment of Breast Cancer
Authors: Harish K. Chandrawanshi, Mithun S. Rajput, Neelima Choure, Purnima Dey Sarkar, Shailesh Jain
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The present research study aimed to fabricate and evaluate biodegradable nanoparticles of aromatase inhibitor letrozole, intended for breast cancer therapy. Letrozole loaded poly(D,L-lactide-co-glycolide acid) nanoparticles were prepared by solvent evaporation method using dichlorometane as solvent (oil phase) and polyvinyl alcohol (PVA) as aqueous phase. Prepared nanoparticles were characterized by particle size, infrared spectra, drug loading efficiency, drug entrapment efficiency and in vitro release and also evaluated for in vivo anticancer activity. The high speed homogenizer was used to produce stable nanoparticles of mean size range 198.35 ± 0.04 nm with high entrapment efficiency (69.86 ± 2.78%). Percentage of drug and homogenization speed significantly influenced the particle size, entrapment efficiency and release (p<0.05). The nanoparticles show significant in vivo anticancer activity against Ehrlich ascites carcinoma in mice. The significant system sustained the release of letrozole drug effectively and further investigation could exhibit its potential usefulness in breast cancer therapy.Keywords: breast cancer/therapy, letrozole, nanoparticles, PLGA
Procedia PDF Downloads 5812778 Effect of External Radiative Heat Flux on Combustion Characteristics of Rigid Polyurethane Foam under Piloted-Ignition and Radiative Auto-Ignition Modes
Authors: Jia-Jia He, Lin Jiang, Jin-Hua Sun
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Rigid polyurethane foam (RPU) has been extensively applied in building insulation system, yet with high flammability for being easily ignited by high temperature spark or radiative heat flux from other flaming materials or surrounding building facade. Using a cone calorimeter by Fire Testing Technology and thermal couple tree, this study systematically investigated the effect of radiative heat flux on the ignition time and characteristic temperature distribution during RPU combustion under different heat fluxes gradient (12, 15, 20, 25, 30, 35, 40, 45, and 50 kW/m²) with spark ignition/ignition by radiation. The ignition time decreases proportionally with increase of external heat flux, meanwhile increasing the external heat flux raises the peak heat release rate and impresses on the vertical temperature distribution greatly. The critical ignition heat flux is found to be 15 and 25 kW/m² for spark ignition and radiative ignition, respectively. Based on previous experienced ignition formula, a methodology to predict ignition times in both modes has been developed theoretically. By analyzing the heat transfer mechanism around the sample surroundings, both radiation from cone calorimeter and convection flow are considered and calculated theoretically. The experimental ignition times agree well with the theoretical ones in both radiative and convective conditions; however, the observed critical ignition heat flux is higher than the calculated one under piloted-ignition mode because the heat loss process, especially in lower heat flux radiation, is not considered in this developed methodology.Keywords: rigid polyurethane foam, cone calorimeter, ignition time, external heat flux
Procedia PDF Downloads 2192777 Evaluation of the Ability of COVID-19 Infected Sera to Induce Netosis Using an Ex-Vivo NETosis Monitoring Tool
Authors: Constant Gillot, Pauline Michaux, Julien Favresse, Jean-Michel Dogné, Jonathan Douxfils
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Introduction: NETosis has emerged as a crucial yet paradoxical factor in severe COVID-19 cases. While neutrophil extracellular traps (NETs) help contain and eliminate viral particles, excessive NET formation can lead to hyperinflammation, exacerbating tissue damage and acute respiratory distress syndrome (ARDS). Aims: This study evaluates the relationship between COVID-19-infected sera and NETosis using an ex-vivo model. Methods: Sera from 8 post-admission COVID-19 patients, after receiving corticoid therapy, were used to induce NETosis in neutrophils from a healthy donor. NET formation was tracked using fluorescent markers for DNA and neutrophil elastase (NE) every 2 minutes for 8 hours. The results were expressed as a percentage of DNA/NE released over time. Key metrics, including T50 (time to 50% release) and AUC (area under the curve), representing total NETosis potential), were calculated. A 27-cytokine screening kit was used to assess the cytokine composition of the sera. Results: COVID-19 sera induced NETosis based on their cytokine profile. The AUC of NE and DNA release decreased with time following corticoid therapy, showing a significant reduction in 6 of the 8 patients (p<0.05). T50 also decreased in parallel with AUC for both markers. Cytokines concentration decrease with time after therapy administration. There is correlation between 14 cytokines concentration and NE release. Conclusion: This ex-vivo model successfully demonstrated the induction of NETosis by COVID-19 sera using two markers. A clear decrease in NETosis potential was observed over time with glucocorticoid therapy. This model can be a valuable tool for monitoring NETosis and investigating potential NETosis inducers and inhibitors.Keywords: NETosis, COVID-19, cytokine storm, biomarkers
Procedia PDF Downloads 282776 An Observational Study of Vitamin B12 Levels and Peripheral Neuropathy Profile in Patients of Diabetes Mellitus on Metformin Therapy
Authors: Kamesh Gupta, Nitin Jain, Anurag Rohatgi
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Objective: To study Vitamin B12 levels and presence of peripheral neuropathy among diabetes mellitus patients on metformin therapy. Method: The observational study was conducted from November 2014 to March 2015. Patients were selected from the Lady Hardinge Medical College, Delhi, India. Exhaustive history regarding dietary habits and metformin usage was taken. Lab tests including HbA1c levels and Vit B12 assays were done, on the basis of which patients were classified into subgroups. Peripheral neuropathy was detected by both clinical scoring and electrophysiological studies. Appropriate Statistical analysis for observational studies was done to evaluate the data. Results: The average duration of metformin usage was higher in patients with definite B12 deficiency (9.4y) than patients with normal B12 levels (5.6 y). Patients in the definite B12 deficiency group had much higher incidence of neuropathy (89%) than patients with no deficiency (27%). The incidence of neuropathy was higher in cases with longer metformin usage (100% with 18-22y of use and 83% with 14-17y of use) than shorter periods (29% with 2-5y of use and 75% with 6-9y of use). Conclusion: Thus patients on long-term metformin therapy are at a high risk for Vitamin B12 deficiency. Definite and possible Vitamin B12 deficiency on metformin had an earlier onset of neuropathy than the subgroup with normal Vitamin B12 levels.Keywords: diabetic neuroptahy, cobalamine deficiency, metformin, nerve conduction studies
Procedia PDF Downloads 3702775 Lower Risk of Ischemic Stroke in Hormone Therapy Users with Use of Chinese Herbal Medicine
Authors: Shu-Hui Wen, Wei-Chuan Chang, Hsien-Chang Wu
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Background: Little is known about the benefits and risks of use of Chinese herbal medicine (CHM) in conditions related to hormone therapy (HT) use on the risk of ischemic stroke (IS). The aim of this study is to explore the risk of IS in menopausal women treated with HT and CHM. Materials and methods: A total of 32,441 menopausal women without surgical menopause aged 40- 65 years were selected from 2003 to 2010 using the 2-million random samples of the National Health Insurance Research Database in Taiwan. According to the medication usage of HT and CHM, we divided the current and recent users into two groups: an HT use-only group (n = 4,989) and an HT/CHM group (n = 9,265). Propensity-score matching samples (4,079 pairs) were further created to deal with confounding by indication. The adjusted hazard ratios (HR) of IS during HT or CHM treatment were estimated by the robust Cox proportional hazards model. Results: The incidence rate of IS in the HT/CHM group was significantly lower than in the HT group (4.5 vs. 12.8 per 1000 person-year, p < 0.001). Multivariate analysis results indicated that additional CHM use was significant with a lower risk of IS (HR = 0.3; 95% confidence interval, 0.21-0.43). Further subgroup analyses and sensitivity analyses had similar findings. Conclusion: We found that combined use of HT and CHM was associated with a lower risk for IS than HT use only. Further study is needed to examine possible mechanism underlying this association.Keywords: Chinese herbal medicine, hormone therapy, ischemic stroke, menopause
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