Search results for: symptomatic visceral leishmaniasis

Authors: Sheema Shuja Khattak, Gule Saman, Imran Khan, Abdus Salam

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Image segmentation plays an important role in medical imaging applications. Therefore, accurate methods are needed for the successful segmentation of medical images for diagnosis and detection of various diseases. In this paper, we have used maximum entropy to achieve image segmentation. Maximum entropy has been calculated using Shannon, Renyi, and Tsallis entropies. This work has novelty based on the detection of skin lesion caused by the bite of a parasite called Sand Fly causing the disease is called Cutaneous Leishmaniasis.

Keywords: shannon, maximum entropy, Renyi, Tsallis entropy

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Authors: Daphne Fietz

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This paper builds on a reflection on an autobiographical experience of uncanniness during fieldwork in the white Afrikaner settlement Orania in South Africa. Drawing on Kristeva’s theory of abjection to establish a theory of Whiteness which is based on boundary threats, it is argued that the uncanny experience as the emergence of the abject points to a moment of crisis of the author’s Whiteness. The emanating abject directs the author to her closeness or convergence with Orania's inhabitants, that is a reciprocity based on mutual Whiteness. The experienced confluence appeals to the author’s White complicity to racism. With recourse to Butler’s theory of subjectivation, the abject, White complicity, inhabits both the outside of a discourse on racism, and of the 'self', as 'I' establish myself in relation to discourse. In this view, the qualities of the experienced abject are linked to the abject of discourse on racism, or, in other words, its frames of intelligibility. It then becomes clear, that discourse on (overt) racism functions as a necessary counter-image through which White morality is established instead of questioned, because here, by White reasoning, the abject of complicity to racism is successfully repressed, curbed, as completely impossible in the binary construction. Hence, such discourse endangers a preservation of racism in its pre-discursive and structural forms as long as its critique does not encompass its own location and performance in discourse. Discourse on overt racism is indispensable to White ignorance as it covers underlying racism and pre-empts further critique. This understanding directs us towards a form of critique which does necessitate self-reflection, uncertainty, and vigilance, which will be referred to as a discourse of relationality. Such a discourse diverges from the presumption of a detached author as a point of reference, and instead departs from attachment, dependence, mutuality and embraces the visceral as a resource of knowledge of relationality. A discourse of relationality points to another possibility of White engagement with Whiteness and racism and further promotes a conception of responsibility, which allows for and highlights dispossession and relationality in contrast to single agency and guilt.

Keywords: abjection, discourse, relationality, the visceral, whiteness

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Authors: G. Berhane, F. Kebede

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A feeding trial was conducted to enhance the utilization of locally produced full-fat soybean by the broiler industry. The study had three phases such as starter (1-14d), grower (15–28d), and finisher (29–49d) phases. A completely randomized design (CRD) was used in the starter phase with three treatments (commercial soybean meal (SBM) was replaced by raw full-fat soybean (RFSB) at 0, 10, or 20%), and each was replicated eight times. A total of 408 unsexed one-day-old Cobb-500 broiler chicks were randomly allocated to replicates. A 2 x 3 factorial arrangement was used in both second (grower) and third (finisher) phase trials, which had six experimental diets. These six treatments were formed by dividing the original three diets (containing 0, 10, or 20% of RFSB into two and then by pelleting anyone from each respective group and leaving the other as mash. Every treatment had four replications and 17 birds in each. Chemical compositions of feed ingredients were analyzed, and data on the initial body weight of chicks, feed offered, feed leftover, body weight (BW) of chickens, and mortality were collected. At the end of the experiment, two birds (one male and one female) per replicate were randomly selected and humanly slaughtered. Weights of dressed, eviscerated, cut parts of the carcass and visceral organs were weighed and recorded. Results indicated that feed intake (FI), body weight gain (BWG), BW, and feed conversion ratio (FCR) of broilers were not significantly affected (P=0.05) by supplementation of a leveled RFSB on diets at starter, grower, and finisher phases. The FI at the finisher stage was also significantly (P=0.05) influenced by the feed forms. However, weights of dressed, eviscerated, cut parts of the carcass and visceral organs were not significantly (P=0.05) affected by both RFSB supplementation, up to 20%, and feed forms. It is concluded that commercial SBM can be replaced by locally produced RFSB up to 20% without pelleting the diets.

Keywords: broilers, carcass characteristics, raw full-fat soybean, weight gain

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Authors: B. Körner

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This paper compares deviant behaviour in two different readings: 1) as symptomatic for so-called ‘mental illness’ and 2) as part of artistic creation. It analyses works of performance art in the respective frames of psychiatric evaluation and performance studies. This speculative comparison offers an alternative interpretation of mad behaviour beyond pathologisation. It questions the distinction of psychiatric diagnosis, which can contribute to reducing the stigmatisation of mad people. The stigma associated with madness entails exclusion, prejudice, and systemic oppression. Symptoms of psychiatric diagnoses can be considered as behaviour exceptional to the psychological norm. This deviant behaviour constitutes an outsider role which is also defining for the societal role of ‘the artist’, whose transgressions of the norm are expected and celebrated. The research proposes the term ‘artistic exceptionalism’ for this phenomenon. In this study, a set of performance artworks are analysed within the frame of an art-theoretical interpretation and as if they were the basis of a psychiatric assessment. This critical comparison combines the perspective on ‘mental illness’ of mad studies with methods of interpretation used in performance studies. The research employs auto theory and artistic research; interweaving lived experience with scientific theory building through the double role of the author as both performance artist and survivor researcher. It is a distinctly personal and mad thought experiment. The research proposes three major categories of artistic strategies approaching madness: (a) confronting madness (processing and publicly addressing one's own experiences with mental distress through artistic creation), (b) creating critical conditions (conscious or unconscious, voluntary or involuntary creation of crisis situations in order to create an intense experience for a work of art), and (c) symptomatic strategies. This paper focuses on the last of the three categories: symptomatic strategies. These can be described as artistic methods with parallels to forms of coping with and/or symptoms of ‘mental disorders.’ These include, for example feverish activity, a bleak worldview, additional perceptions, an urge for order, and the intensification of emotional experience. The proposed categories are to be understood as a spectrum of approaches that are not mutually exclusive. This research does not aim to diagnose or pathologise artists or their strategies; disease value is neither sought nor assumed. Neither does it intend to belittle psychological suffering, implying that it cannot be so bad if it is productive for artists. It excludes certain approaches that romanticise and/or exoticise mental distress, for example, artistic portrayal of people in mental crisis (e.g., documentary-observational or exoticising depictions) or the deliberate and exaggerated imitation of their forms of expression and behaviour as ‘authentic’ (e.g., Art Brut). These are based on the othering of the Mad and thus perpetuate the social stigma to which they are subjected. By noting that the same deviant behaviour can be interpreted as the opposite in different contexts, this research offers an alternative approach to madness beyond the confines of psychiatry. It challenges the distinction of psychiatric diagnosis and exposes its social constructedness. Hereby, it aims to empower survivors and reduce the stigmatisation of madness.

Keywords: artistic research, mad studies, mental health, performance art, psychiatric stigma

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Vinti Davar

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Background: Worldwide, at least 2.8 million people die each year as a result of being overweight or obese, and 35.8 million (2.3%) of global DALYs are caused by overweight or obesity. Obesity is acknowledged as one of the burning public health problems reducing life expectancy and quality of life. The body composition analysis of the university population is essential in assessing the nutritional status, as well as the risk of developing diseases associated with abnormal body fat content so as to make nutritional recommendations. Objectives: The main aim was to determine the prevalence of obesity and overweight in University students using Anthropometric analysis and BIA methods Material and Methods: In this cross-sectional study, 283 university students participated. The body composition analysis was undertaken by using mainly: i) Anthropometric Measurement: Height, Weight, BMI, waist circumference, hip circumference and skin fold thickness, ii) Bio-electrical impedance was used for analysis of body fat mass, fat percent and visceral fat which was measured by Tanita SC-330P Professional Body Composition Analyzer. The data so collected were compiled in MS Excel and analyzed for males and females using SPSS 16.Results and Discussion: The mean age of the male (n= 153) studied subjects was 25.37 ±2.39 year and females (n=130) was 22.53 ±2.31. The data of BIA revealed very high mean fat per cent of the female subjects i.e. 30.3±6.5 per cent whereas mean fat per cent of the male subjects was 15.60±6.02 per cent indicating a normal body fat range. The findings showed high visceral fat of both males (12.92±3.02) and females (16.86±4.98). BMI, BF% and WHR were higher among females, and BMI was higher among males. The most evident correlation was verified between BF% and WHR for female students (r=0.902; p<0.001). The correlation of BFM and BF% with thickness of triceps, sub scapular and abdominal skin folds and BMI was significant (P<0.001). Conclusion: The studied data made it obvious that there is a need to initiate lifestyle changing strategies especially for adult females and encourage them to improve their dietary intake to prevent incidence of non communicable diseases due to obesity and high fat percentage.

Keywords: anthropometry, bioelectrical impedance, body fat percentage, obesity

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Authors: I. P. Ezeugwunne, C. C. Onyenekwe, J. E. Ahaneku, G. I. Ahaneku

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Introduction: It has been reported that acute myocardial infarction (AMI) might occur at 1.5 ng/ml troponin level. HIV infection has been documented to influence antiviral drugs, stimulate the production of proteins that enhance fatty acids synthesis. Information on cardiac status in HIV-infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein profile of HIV subjects in pre-and-post 12 months of antiretroviral therapy (ART) using 1.5 ng/ml troponin diagnostic cut-off for myocardial infarction (MI) in Nnewi, South Eastern, Nigeria. Methodology: A total of 30 symptomatic HIV subjects without malaria co-infection with a mean age of 40.70 ±10.56 years were randomly recruited for this prospective case-controlled study. Serum apolipoproteins (Apo A1, A2, B, C2,C3 and Apo E), troponin and CD4 counts were measured using standard laboratory methods. Parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for MI. Analysis of variance and student paired t-tests were used for data analyses. Results: paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels of ApoA1, ApoB and ApoC3 in symptomatic HIV subjects before antiretroviral therapy (ART) when compared with after therapy at p<0.05 respectively. The troponin value was significantly higher amongst the group studied at p<0.05, respectively. Conclusion: The increased values of troponin observed among the groups were higher than the diagnostic cut-off for AMI. This may imply that AMI may occur at any group of studies. But the significant reduction in the serum levels of Apo A2, Apo B, Apo C3, Apo E and a significant increase in serum levels of Apo A1, Apo C2 and blood CD4 counts as the length of therapy lengthened may indicate possible cardio-protective effects of the ART on the heart, which may connote recovery.

Keywords: ART, apolipoprotein, HIV, myocardial infarction

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Authors: Orkide Donma, Mustafa M. Donma

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Chronologic age (CA) of individuals is closely related to obesity and generally affects the magnitude of obesity parameters. On the other hand, close association between basal metabolic rate (BMR) and metabolic age (MA) is also a matter of concern. It is suggested that MA higher than CA is the indicator of the need to improve the metabolic rate. In this study, the aim was to assess some commonly used obesity parameters, such as obesity degree, visceral adiposity, BMR, BMR-to-weight ratio, in several groups with varying differences between MA and CA values. The study comprises adults, whose ages vary between 18 and 79 years. Four groups were constituted. Group 1, 2, 3 and 4 were composed of 55, 33, 76 and 47 adults, respectively. The individuals exhibiting -1, 0 and +1 for their MA-CA values were involved in Group 1, which was considered as the control group. Those, whose MA-CA values varying between -5 and -10 participated in Group 2. Those, whose MAs above their real ages were divided into two groups [Group 3 (MA-CA; from +5 to + 10) and Group 4 (MA-CA; from +11 to + 12)]. Body mass index (BMI) values were calculated. TANITA body composition monitor using bioelectrical impedance analysis technology was used to obtain values for obesity degree, visceral adiposity, BMR and BMR-to-weight ratio. The compiled data were evaluated statistically using a statistical package program; SPSS. Mean ± SD values were determined. Correlation analyses were performed. The statistical significance degree was accepted as p < 0.05. The increase in BMR was positively correlated with obesity degree. MAs and CAs of the groups were 39.9 ± 16.8 vs 39.9 ± 16.7 years for Group 1, 45.0 ± 15.3 vs 51.4 ± 15.7 years for Group 2, 47.2 ± 12.7 vs 40.0 ± 12.7 years for Group 3, and 53.6 ± 14.8 vs 42 ± 14.8 years for Group 4. BMI values of the groups were 24.3 ± 3.6 kg/m², 23.2 ± 1.7 kg/m², 30.3 ± 3.8 kg/m², and 40.1 ± 5.1 kg/m² for Group 1, 2, 3 and 4, respectively. Values obtained for BMR were 1599 ± 328 kcal in Group 1, 1463 ± 198 kcal in Group 2, 1652 ± 350 kcal in Group 3, and 1890 ± 360 kcal in Group 4. A correlation was observed between BMR and MA-CA values in Group 1. No correlation was detected in other groups. On the other hand, statistically significant correlations between MA-CA values and obesity degree, BMI as well as BMR/weight were found in Group 3 and in Group 4. It was concluded that upon consideration of these findings in terms of MA-CA values, BMR-to-weight ratio was found to be much more useful indicator of the severe increase in obesity development than BMR. Also, the lack of associations between MA and BMR as well as BMR-to-weight ratio emphasize the importance of consideration of MA-CA values rather than MA.

Keywords: basal metabolic rate, basal metabolic rate-to-weight-ratio, chronologic age, metabolic age, obesity degree

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Authors: Lucia Pappalardo, Sara Abdul Majid Azzam

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Camel milk is widely consumed by people living in arid areas of the world, where it is also known for its potential therapeutic and medical properties. Indeed it has been used as a treatment for several diseases such as tuberculosis, dropsy, asthma, jaundice and leishmaniasis in India, Sudan and some parts of Russia. A wealth of references is available in literature for the composition of milk from different diary animals such as cows, goats and sheep. Camel milk instead has not been extensively studied, despite its nutritional value. In this study commercial cow and camel milk samples, bought from the local market, were analyzed by 1D 1H-NMR and multivariate statistics in order to identify the different composition of the low-molecular-weight compounds in the milk mixtures. The samples were analyzed in their native conditions without any pre-treatment. Our preliminary study shows that the two different types of milk samples differ in the content of metabolites such as orotate, fats and more.

Keywords: camel, cow, milk, Nuclear Magnetic Resonance (NMR)

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Authors: Madhuri S. Ghate, Rahul P. Chavhan, Shriya S. Nahar

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Learning objective: •To describe Magnetic Resonance Imaging (MRI) imaging appearances of typical and atypical uterine fibroids with emphasis on differentiating it from other similar conditions. •To classify uterine fibroids according to International Federation of Gynecology and Obstetrics (FIGO) Sub-classifications system and emphasis on its clinical significance. •To show cases with atypical imaging appearances atypical fibroids Material and methods: MRI of Pelvis had been performed in symptomatic women of child bearing age group on 1.5T and 3T MRI using T1, T2, STIR, FAT SAT, DWI sequences. Contrast was administered when degeneration was suspected. Imaging appearances of Atypical fibroids and various degenerations in fibroids were studied. Fibroids were classified using FIGO Sub-classification system. Its impact on surgical decision making and clinical outcome were also studied qualitatively. Results: Intramural fibroids were most common (14 patients), subserosal 7 patients, submucosal 5 patients . 6 patients were having multiple fibroids. 7 were having atypical fibroids. (1 hyaline degeneration, 1 cystic degeneration, 1 fatty, 1 necrosis and hemorrhage, 1 red degeneration, 1 calcification, 1 unusual large bilobed growth). Fibroids were classified using FIGO system. In uterus conservative surgeries, the lesser was the degree of myometrial invasion of fibroid, better was the fertility outcome. Conclusion: Relationship of fibroid with mucosal and serosal layers is important in the management of symptomatic fibroid cases. Risk to fertility involved in uterus conservative surgeries in women of child bearing age group depends on the extent of myometrial invasion of fibroids. FIGO system provides better insight into the degree of myometrial invasion. Knowledge about the atypical appearances of fibroids is important to avoid diagnostic confusion and untoward treatment.

Keywords: degeneration, FIGO sub-classification, MRI pelvis, uterine fibroids

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Authors: Yang Yang, Luciana Magalhães Rebelo Alencar, Martha Sahylí Ortega Pijeira, Beatriz da Silva Batista, Alefe Roger Silva França, Erick Rafael Dias Rates, Ruana Cardoso Lima, Sara Gemini-Piperni, Ralph Santos-Oliveira

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Radium-²²³ dichloride ([²²³Rₐ]RₐCl₂) is an alpha particle-emitting radiopharmaceutical currently approved for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. [²²³Rₐ]RₐCl₂ is bone-seeking calcium mimetic that bonds into the newly formed bone stroma, especially osteoblastic or sclerotic metastases, killing the tumor cells by inducing DNA breaks in a potent and localized manner. Nonetheless, the successful therapy of osteosarcoma as primary bone tumors is still a challenge. Nanomicelles are colloidal nanosystems widely used in drug development to improve blood circulation time, bioavailability, and specificity of therapeutic agents, among other applications. In addition, the enhanced permeability and retention effect of the nanosystems, and the renal excretion of the nanomicelles reported in most cases so far, are very attractive to achieve selective and increased accumulation in tumor site as well as to increase the safety of [²²³Rₐ]RₐCl₂ in the clinical routine. In the present work, [²²³Rₐ]RₐCl₂ nanomicelles were produced, characterized, in vitro evaluated, and compared with pure [²²³Rₐ]RₐCl2 solution using SAOS2 osteosarcoma cells. The [²²³Rₐ]RₐCl₂ nanomicelles were prepared using the amphiphilic copolymer Pluronic F127. The dynamic light scattering analysis of freshly produced [²²³Rₐ]RₐCl₂ nanomicelles demonstrated a mean size of 129.4 nm with a polydispersity index (PDI) of 0.303. After one week stored in the refrigerator, the mean size of the [²²³Rₐ]RₐCl₂ nanomicelles increased to 169.4 with a PDI of 0.381. Atomic force microscopy analysis of [223Rₐ]RₐCl₂ nanomicelles exhibited spherical structures whose heights reach 1 µm, suggesting the filling of 127-Pluronic nanomicelles with [²²³Rₐ]RₐCl₂. The viability assay with [²²³Rₐ]RₐCl₂ nanomicelles displayed a dose-dependent response as it was observed using pure [²²³Rₐ]RₐCl2. However, at the same dose, [²²³Rₐ]RₐCl₂ nanomicelles were 20% higher efficient in killing SAOS2 cells when compared with pure [²²³Rₐ]RₐCl₂. These findings demonstrated the effectiveness of the nanosystem validating the application of nanotechnology in targeted alpha therapy with [²²³Ra]RₐCl₂. In addition, the [²²³Rₐ]RaCl₂nanomicelles may be decorated and incorporated with a great variety of agents and compounds (e.g., monoclonal antibodies, aptamers, peptides) to overcome the limited use of [²²³Ra]RₐCl₂.

Keywords: nanomicelles, osteosarcoma, radium dichloride, targeted alpha therapy

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Authors: Cho Achidi

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Tomato is a crucial food crop significantly contributes to global food and nutrition security. However, postharvest losses severely limit its role. Therefore, it is necessary to develop sustainable strategies to minimize these losses and improve the shelf-life of tomato fruits. One of the major concerns is bacterial infections, particularly by faecal coliform bacteria, which can cause food poisoning and illnesses like diarrhoea and dysentery. This study seeks to identify the presence of coliform bacteria on tomato fruits in fields and markets in Muea, Buea Municipality. The study also evaluated different management strategies to reduce the bacterial incidence and load on tomato fruits. A total of 200 fruits were sampled for both the coliform survey and shelf-life analysis. Ten farmers and traders provided samples, including asymptomatic and symptomatic tomato fruits. The samples designated for shelf-life analysis were treated with Aquatab, warm water, lemon, and onion. The results indicated that out of the 80 symptomatic samples collected, 12.5% contained faecal and total coliform species. Among the ten farms sampled, 14% were infected with coliform bacteria, with the highest infestation rate of 60% recorded in field 4. Furthermore, 15% of the asymptomatic tomato fruits were found to be infected by coliform bacteria. Regarding the management strategies, Aquatabs exhibited the highest efficacy in reducing the incidence of coliform bacteria on tomato fruits, followed by onion and lemon extracts. Although hot water treatment effectively removed bacteria from the fruits, damaging the cell wall negatively affected their shelf-life. Overall, this study emphasizes the severity of coliform bacterial pathogens in the Muea area, particularly their occurrence on asymptomatic tomatoes, which poses a significant concern for plant quarantine services. It also demonstrates potential options for mitigating this bacterial challenge.

Keywords: tomato, shelf-life analysis, food and nutrition security, coliform bbacteria

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Authors: A. H. Dikko, D. N Tsado, M. S. T. Rita, D. S. Umar

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This study was conducted on eighteen (18) New Zealand and chinchilla breeds of rabbits were used. The rabbits were allotted to 3 treatments with each treatment having six (6) animals with two (2) replicates. T1 were castrated, which both testes was removed (Bilateral); T2 were castrated, which only one testes was removed (unilateral) and T3 were not castrated (control). In nutrient digestibility, T1 and T2 (p>0.05) has a higher rate than T3. There was no significant (p<0.05) difference in live weight and dressing weight among the treatment groups. There is a significant (p > 0.05) difference in visceral organs in the treatment groups.

Keywords: New Zealand, chinchilla, castration, bilateral, unilateral

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Authors: Thomas Wetere

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Background: The coronavirus disease 2019 (COVID-19) pandemic (COVID-19) virus infection is a severe infectious disease with the highly transmissible variant, which become the global public health treat now. It has taken the life of more than 4 million people so far. What makes the disease the worst of all is no specific effective treatment available, its dynamics is not much researched and understood. Methodology: To end the global COVID-19 pandemic, implementation of multiple population-wide strategies, including vaccination, environmental factors, Government action, testing, and contact tracing, is required. In this article, a new mathematical model incorporating both temperature and government action to study the dynamics of the COVID-19 pandemic has been developed and comprehensively analysed. The model considers eight stages of infection: susceptible (S), infected Asymptomatic and Undetected(IAU ), infected Asymptomatic and detected(IAD), infected symptomatic and Undetected(ISU ), infected Symptomatic and detected(ISD), Hospitalized or threatened(H), Recovered(R) and Died(D). Results: The existence as well as non-negativity of the solution to the model is also verified, and the basic reproduction number is calculated. Besides, stability conditions are also checked, and finally, simulation results are compared with real data. The results demonstrates that effective government action will need to be combined with vaccination to end the ongoing COVID-19 pandemic. Conclusion: Vaccination and Government action are highly the crucial measures to control the COVID-19 pandemic. Besides, as the cost of vaccination might be high, we recommend an optimal control to reduce the cost and number of infected individuals. Moreover, in order to prevent COVID-19 pandemic, through the analysis of the model, the government must strictly manage the policy on COVID-19 and carry it out. This, in turn, helps for health campaigning and raising health literacy which plays a role to control the quick spread of the disease. We finally strongly believe that our study will play its own role in the current effort of controlling the pandemic.

Keywords: modeling, COVID-19, MCMC, stability

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Authors: Victor Pena Ribeiro, Caroline Arruda, Jennyfer Andrea Aldana Mejia, Jairo Kenupp Bastos

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Leishmaniasis is a serious health problem around the world. The treatment of infected individuals with pentavalent antimonial drugs is the main therapeutic strategy. However, they present high toxicity and persistence side effects. Therefore, the discovery of new and safe natural-derived therapeutic agents against leishmaniasis is important. Propolis is a resin of viscous consistency produced by Apis mellifera bees from parts of plants. The main types of Brazilian propolis are green, red, yellow and brown. Thus, the aim of this work was to investigate the chemical composition and leishmanicidal properties of a brown propolis (BP). For this purpose, the hydroalcoholic crude extract of BP was obtained and was fractionated by liquid-liquid chromatography. The chemical profile of the extract and its fractions were obtained by HPLC-UV-DAD. The fractions were submitted to preparative HPLC chromatography for isolation of the major compounds of each fraction. They were analyzed by NMR for structural determination. The volatile compounds were obtained by hydrodistillation and identified by GC/MS. Promastigote forms of Leishmania amazonensis were cultivated in M199 medium and then 2×106 parasites.mL-1 were incubated in 96-well microtiter plates with the samples. The BP was dissolved in dimethyl sulfoxide (DMSO) and diluted into the medium, to give final concentrations of 1.56, 3.12, 6.25, 12.5, 25 and 50 µg.mL⁻¹. The plates were incubated at 25ºC for 24 h, and the lysis percentage was determined by using a Neubauer chamber. The bioassays were performed in triplicate, using a medium with 0.5% DMSO as a negative control and amphotericin B as a positive control. The leishimnicidal effect against promastigote forms was also evaluated at the same concentrations. Cytotoxicity experiments also were performed in 96-well plates against normal (CHO-k1) and tumor cell lines (AGP01 and HeLa) using XTT colorimetric method. Phenolic compounds, flavonoids, and terpenoids were identified in brown propolis. The major compounds were identified as follows: p-coumaric acid (24.6%) for a methanolic fraction, Artepelin-C (29.2%) for ethyl acetate fraction and the compounds of hexane fraction are in the process of structural elucidation. The major volatile compounds identified were β-caryophyllene (10.9%), germacrene D (9.7%), nerolidol (10.8%) and spathulenol (8.5%). The propolis did not show cytotoxicity against normal cell lines (CHO) with IC₅₀ > 100 μg.mL⁻¹, whereas the IC₅₀ < 10 μg.mL⁻¹ showed a potential against the AGP01 cell line, propolis did not demonstrate cytotoxicity against HeLa cell lines IC₅₀ > 100 μg.mL⁻¹. In the determination of the leishmanicidal activity, the highest (50 μg.mL⁻¹) and lowest (1.56 μg.mL⁻¹) concentrations of the crude extract caused the lysis of 76% and 45% of promastigote forms of L. amazonensis, respectively. To the amastigote form, the highest (50 μg.mL⁻¹) and lowest (1.56 μg.mL⁻¹) concentrations caused the mortality of 89% and 75% of L. amazonensis, respectively. The IC₅₀ was 2.8 μg.mL⁻¹ to amastigote form and 3.9 μg.mL⁻¹ to promastigote form, showing a promising activity against Leishmania amazonensis.

Keywords: amastigote, brown propolis, cytotoxicity, promastigote

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Authors: Gema Gómez-Casado, Alba Rodríguez-Muñoz, Virginia Mela-Rivas, Pallavi Kompella, Francisco José Tinahones-Madueña, Isabel Moreno-Indias, Almudena Ortega-Gómez

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Obesity is a high-priority health problem worldwide due to its high prevalence. The proportion of obese and overweight subjects in industrialized countries exceeds half of the population in most cases. Beyond the metabolic problem, obesity boosts inflammation levels in the organism. The gut microbiota, considered an organ by itself, controls a high variety of processes at a systemic level. In fact, the microbiota interacts closely with the immune system, being crucial in determining the maturation state of neutrophils, key effectors of the innate immune response. It is known that changes in the diet exert strong effects on the variety and activity of the gut microbiota. The effect that those changes have on the axis microbiota-immune response is an unexplored field. In this study, 10 patients with obesity (weight 114,3 ± 14,5Kg, BMI 40,47±3,66) followed a Mediterranean-hypocaloric diet for 3 months, reducing their initial weight by 12,71 ± 3%. A transplant of microbiota from these patients before and after the diet was performed into wild type “germ-free” mice (n=10/group), treated with antibiotics. Six weeks after the transplant, mice were euthanized, and the presence of cells from the innate immune system were analysed in different organs (bone marrow, blood, spleen, visceral adipose tissue, and intestine) by flow cytometry. No differences were observed in the number of myeloid cells in bone marrow, blood, spleen, or visceral adipose tissue of mice transplanted with patient’s microbiota before and after following the Mediterranean diet. However, the intestine of mice that received post-diet microbiota presented a marked decrease in the number of neutrophils (whose presence is associated with tissue inflammation), as well as macrophages. In line with these findings, intestine monocytes from mice with post-diet microbiota showed a less inflammatory profile (lower Ly6Gˡᵒʷ proportion of cells). These results point toward a decrease in the inflammatory state of the intestinal tissue, derived from changes in the gut microbiota, which occurred after a 3-month Mediterranean diet.

Keywords: obesity, nutrition, Mediterranean diet, gut microbiota, immune system

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Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman

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Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.

Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection

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Authors: Karen V. Lee

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The background and significance of this study involve communication in education by a faculty advisor exploring story and music that informs others about a disabled teacher. Social issues draw deep reflection about the emotional turmoil. As a musician becoming a teacher is a passionate yet complex endeavor, the faculty advisor shares a poetic but painful story about a disabled teacher being inducted into the teaching profession. The qualitative research method as theoretical framework draws on autoethnography of music and story where the faculty advisor approaches a professor for advice. His musicianship shifts her forward, backward, and sideways through feelings that evoke and provoke curriculum to remove communication barriers in education. They discover they do not transfer knowledge from educational method classes. Instead, the autoethnography embeds musical language as a metaphorical conduit for removing communication barriers in teacher education. Sub-themes involve communication barriers and educational technologies to ensure teachers receive social, emotional, physical, spiritual, and intervention disability resources that evoke visceral, emotional responses from the audience. Major findings of the study discover how autoethnography of music and story bring the authors to understand wider political issues of the practicum internship for teachers with disabilities. An epiphany reveals the irony of living in a culture of both uniformity and diversity. They explore the constructs of secrecy, ideology, abnormality, and marginalization by evoking visceral and emotional responses from the audience. As the voices harmonize plot, climax, characterization, and denouement, they dramatize meaning that is episodic yet incomplete to highlight the circumstances surrounding the disabled protagonist’s life. In conclusion, the qualitative research method argues for embracing storied experiences that depict communication in education. Scholarly significance embraces personal thoughts and feelings as a way of understanding social phenomena while highlighting the importance of removing communication barriers in education. The circumstance about a teacher with a disability is not uncommon in society. Thus, the authors resolve to removing barriers in education by using stories to transform the personal and cultural influences that provoke new ways of thinking about the curriculum for a disabled teacher.

Keywords: communication in education, communication barriers, autoethnography, teaching

Procedia PDF Downloads 241

Authors: Orkide Donma, Mustafa M. Donma

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Basal metabolic rate is questioned as a risk factor for weight gain. The relations between basal metabolic rate and body composition have not been cleared yet. The impact of fat mass on basal metabolic rate is also uncertain. Within this context, indices based upon total body mass as well as total body fat mass are available. In this study, the aim is to investigate the potential clinical utility of these indices in the adult population. 287 individuals, aged from 18 to 79 years, were included into the scope of the study. Based upon body mass index values, 10 underweight, 88 normal, 88 overweight, 81 obese, and 20 morbid obese individuals participated. Anthropometric measurements including height (m), and weight (kg) were performed. Body mass index, diagnostic obesity notation model assessment index I, diagnostic obesity notation model assessment index II, basal metabolic rate-to-weight ratio were calculated. Total body fat mass (kg), fat percent (%), basal metabolic rate, metabolic age, visceral adiposity, fat mass of upper as well as lower extremities and trunk, obesity degree were measured by TANITA body composition monitor using bioelectrical impedance analysis technology. Statistical evaluations were performed by statistical package (SPSS) for Windows Version 16.0. Scatterplots of individual measurements for the parameters concerning correlations were drawn. Linear regression lines were displayed. The statistical significance degree was accepted as p < 0.05. The strong correlations between body mass index and diagnostic obesity notation model assessment index I as well as diagnostic obesity notation model assessment index II were obtained (p < 0.001). A much stronger correlation was detected between basal metabolic rate and diagnostic obesity notation model assessment index I in comparison with that calculated for basal metabolic rate and body mass index (p < 0.001). Upon consideration of the associations between basal metabolic rate-to-weight ratio and these three indices, the best association was observed between basal metabolic rate-to-weight and diagnostic obesity notation model assessment index II. In a similar manner, this index was highly correlated with fat percent (p < 0.001). Being independent of the indices, a strong correlation was found between fat percent and basal metabolic rate-to-weight ratio (p < 0.001). Visceral adiposity was much strongly correlated with metabolic age when compared to that with chronological age (p < 0.001). In conclusion, all three indices were associated with metabolic age, but not with chronological age. Diagnostic obesity notation model assessment index II values were highly correlated with body mass index values throughout all ranges starting with underweight going towards morbid obesity. This index is the best in terms of its association with basal metabolic rate-to-weight ratio, which can be interpreted as basal metabolic rate unit.

Keywords: basal metabolic rate, body mass index, children, diagnostic obesity notation model assessment index, obesity

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Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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Authors: Jean Pierre Kabue, Emma Meader, Afsatou Ndama Traore, Paul R. Hunter, Natasha Potgieter

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Norovirus is now considered the most common cause of outbreaks of nonbacterial gastroenteritis. Limited data are available for Norovirus strains in Africa, especially in rural and peri-urban areas. Despite the excessive burden of diarrhea disease in developing countries, Norovirus infections have been to date mostly reported in developed countries. There is a need to investigate intensively the role of viral agents associated with diarrhea in different settings in Africa continent. To determine the prevalence and genetic diversity of Norovirus strains circulating in the rural communities in the Limpopo Province, South Africa and investigate the genetic relationship between Norovirus strains, a cross-sectional study was performed on human stools collected from rural communities. Between July 2014 and April 2015, outpatient children under 5 years of age from rural communities of Vhembe District, South Africa, were recorded for the study. A total of 303 stool specimens were collected from those with diarrhea (n=253) and without (n=50) diarrhea. NoVs were identified using real-time one-step RT-PCR. Partial Sequence analyses were performed to genotype the strains. Phylogenetic analyses were performed to compare identified NoVs genotypes to the worldwide circulating strains. Norovirus detection rate was 41.1% (104/253) in children with diarrhea. There was no significant difference (OR=1.24; 95% CI 0.66-2.33) in Norovirus detection between symptomatic and asymptomatic children. Comparison of the median CT values for NoV in children with diarrhea and without diarrhea revealed significant statistical difference of estimated GII viral load from both groups, with a much higher viral burden in children with diarrhea. To our knowledge, this is the first study reporting on the differences in estimated viral load of GII and GI NoV positive cases and controls. GII.Pe (n=9) were the predominant genotypes followed by GII.Pe/GII.4 Sydney 2012 (n=8) suspected recombinant and GII.4 Sydney 2012 variants(n=7). Two unassigned GII.4 variants and an unusual RdRp genotype GII.P15 were found. With note, the rare GIIP15 identified in this study has a common ancestor with GIIP15 strain from Japan previously reported as GII/untypeable recombinant strain implicated in a gastroenteritis outbreak. To our knowledge, this is the first report of this unusual genotype in the African continent. Though not confirmed predictive of diarrhea disease in this study, the high detection rate of NoV is an indication of subsequent exposure of children from rural communities to enteric pathogens due to poor sanitation and hygiene practices. The results reveal that the difference between asymptomatic and symptomatic children with NoV may possibly be related to the NoV genogroups involved. The findings emphasize NoV genetic diversity and predominance of GII.Pe/GII.4 Sydney 2012, indicative of increased NoV activity. An uncommon GII.P15 and two unassigned GII.4 variants were also identified from rural settings of the Vhembe District/South Africa. NoV surveillance is required to help to inform investigations into NoV evolution, and to support vaccine development programmes in Africa.

Keywords: asymptomatic, common, outpatients, norovirus genetic diversity, sporadic gastroenteritis, South African rural communities, symptomatic

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Authors: Nassibeh Hosseini-Vasoukolaei, Amir Ahmad Akhavan, Mahmood Jeddi-Tehrani, Ali Khamesipour, Mohammad Reza Yaghoobi Ershadi, Kamhawi Shaden, Valenzuela Jesus, Hossein Mirhendi, Mohammad Hossein Arandian

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Zoonotic cutaneous leishmaniasis (ZCL) is an endemic disease in many rural areas of Iran. Sand flies were collected from rural areas of Esfahan province and were identified using valid identification keys. DNA was extracted from sand flies and Nested PCRs were done using specific primers. In this study, 44 out of 152 (28.9 %) sand flies were infected with L. majoralone. Eight sand flies showed mixed infection: four sand flies (2.6 %) were infected with L. major, L. turanicaand L. gerbili, one sand fly (0.7 %) was infected with L. major and L. turanica and three sand flies (2 %) were infected with L. turanicaand L. gerbili. Our results demonstrate the natural infection of P. papatasi sand fly with three species of L. major, L. turanica and L. gerbili which are circulating among R. opimusreservoir host and P. papatasi sand fly vector in central Iran.

Keywords: Phlebotomus papatasi, Leishmania major, Leishmania turanica, Leishmania gerbili, mixed infection, Iran

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Authors: Sunita Gakkhar, Arti Mishra

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In this paper, a nonlinear host vector model has been proposed and analyzed for the two strain dengue dynamics incorporating ADE effect. The model considers that the asymptomatic infected people are more responsible for secondary infection than that of symptomatic ones and differentiates between them. The existence conditions are obtained for various equilibrium points. Basic reproduction number has been computed and analyzed to explore the effect of secondary infection enhancement parameter on dengue infection. Stability analyses of various equilibrium states have been performed. Numerical simulation has been done for the stability of endemic state.

Keywords: dengue, ade, stability, threshold, asymptomatic, infection

Procedia PDF Downloads 431

Authors: Evgeny Pokushalov, Andrey Ponomarenko, John Smith, Michael Johnson, Claire Garcia, Inessa Pak, Evgenya Shrainer, Dmitry Kudlay, Sevda Bayramova, Richard Miller

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Background: Obesity is a complex, multifactorial chronic disease that poses significant health risks. Recent advancements in artificial intelligence (AI) offer the potential for more personalized and effective dietary supplement (DS) regimens to promote weight loss. This study aimed to evaluate the efficacy of AI-guided DS prescriptions compared to standard physician-guided DS prescriptions in obese patients. Methods: This randomized, parallel-group pilot study enrolled 60 individuals aged 40 to 60 years with a body mass index (BMI) of 25 or greater. Participants were randomized to receive either AI-guided DS prescriptions (n = 30) or physician-guided DS prescriptions (n = 30) for 180 days. The primary endpoints were the percentage change in body weight and the proportion of participants achieving a ≥5% weight reduction. Secondary endpoints included changes in BMI, fat mass, visceral fat rating, systolic and diastolic blood pressure, lipid profiles, fasting plasma glucose, hsCRP levels, and postprandial appetite ratings. Adverse events were monitored throughout the study. Results: Both groups were well balanced in terms of baseline characteristics. Significant weight loss was observed in the AI-guided group, with a mean reduction of -12.3% (95% CI: -13.1 to -11.5%) compared to -7.2% (95% CI: -8.1 to -6.3%) in the physician-guided group, resulting in a treatment difference of -5.1% (95% CI: -6.4 to -3.8%; p < 0.01). At day 180, 84.7% of the AI-guided group achieved a weight reduction of ≥5%, compared to 54.5% in the physician-guided group (Odds Ratio: 4.3; 95% CI: 3.1 to 5.9; p < 0.01). Significant improvements were also observed in BMI, fat mass, and visceral fat rating in the AI-guided group (p < 0.01 for all). Postprandial appetite suppression was greater in the AI-guided group, with significant reductions in hunger and prospective food consumption, and increases in fullness and satiety (p < 0.01 for all). Adverse events were generally mild-to-moderate, with higher incidences of gastrointestinal symptoms in the AI-guided group, but these were manageable and did not impact adherence. Conclusion: The AI-guided dietary supplement regimen was more effective in promoting weight loss, improving body composition, and suppressing appetite compared to the physician-guided regimen. These findings suggest that AI-guided, personalized supplement prescriptions could offer a more effective approach to managing obesity. Further research with larger sample sizes is warranted to confirm these results and optimize AI-based interventions for weight loss.

Keywords: obesity, AI-guided, dietary supplements, weight loss, personalized medicine, metabolic health, appetite suppression

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Authors: A. Aceranti, L. Moretti, S. Vernocchi, M. Colorato, P. Caristia

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Irritable bowel syndrome (IBS) is the association between abdominal pain, abdominal distension and intestinal dysfunction for recurring periods. About 10% of the world's population has IBS at any given time in their life, and about 200 people per 100,000 receive an initial diagnosis of IBS each year. Persistent pain is recognized as one of the most pervasive and challenging problems facing the medical community today. Persistent pain is considered more as a complex pathophysiological, diagnostic and therapeutic situation rather than as a persistent symptom. The low efficiency of conventional drug treatments has led many doctors to become interested in the non-drug alternative treatment of IBS, especially for more severe cases. Patients and providers are often dissatisfied with the available drug remedies and often seek complementary and alternative medicine (CAM), a unique and holistic approach to treatment that is not a typical component of conventional medicine. Osteopathic treatment may be of specific interest in patients with IBS. Osteopathy is a complementary health approach that emphasizes the role of the musculoskeletal system in health and promotes optimal function of the body's tissues using a variety of manual techniques to improve body function. Osteopathy has been defined as a patient-centered health discipline based on the principles of interrelation between body structure and function, the body's innate capacity for self-healing and the adoption of a whole person health approach. mainly by practicing manual processing. Studies reported that osteopathic manual treatment (OMT) reduced IBS symptoms, such as abdominal pain, constipation, diarrhea, and improved general well-being. The focus in the treatment of IBS with osteopathy has gone beyond simple spinal alignment, to directly address the abnormal physiology of the body using a series of direct and indirect techniques. The topic of this study was chosen for different reasons: due to the large number of people involved who suffer from this disorder and for the dysfunction itself, since nowadays there is still little clarity about the best type of treatment and, above all, to its origin. The visceral component in the osteopathic field is still a world to be discovered, although it is related to a large part of patient series, it has contents that affect numerous disciplines and this makes it an enigma yet to be solved. The study originated in the didactic practice where the curiosity of a topic is marked that, even today, no one is able to explain and, above all, cure definitively. The main purpose of this study is to try to create a good basis on the osteopathic discipline for subsequent studies that can be exhaustive in the best possible way, resolving some doubts about which treatment modality can be used with more relevance. The path was decided to structure it in such a way that 3 types of osteopathic treatment are used on 3 groups of people who will be selected after completing a questionnaire, which will deem them suitable for the study. They will, in fact, be divided into three groups where: - the first group was given a visceral osteopathic treatment. - The second group was given a manual osteopathic treatment of neurological stimulation. - The third group received a placebo treatment. At the end of the treatment, questionnaires will be re-proposed respectively one week after the session and one month after the treatment from which any data will be collected that will demonstrate the effectiveness or otherwise of the treatment received. The sample of 50 patients examined underwent an oral interview to evaluate the inclusion and exclusion criteria to participate in the study. Of the 50 patients questioned, 17 people who underwent different osteopathic techniques were eligible for the study. Comparing the data related to the first assessment of tenderness and frequency of symptoms with the data related to the first follow-up shows a significant improvement in the score assigned to the different questions, especially in the neurogenic and visceral groups. We are aware of the fact that it is a study performed on a small sample of patients, and this is a penalizing factor. We remain, however, convinced that having obtained good results in terms of subjective improvement in the quality of life of the subjects, it would be very interesting to re-propose the study on a larger sample and fill the gaps.

Keywords: IBS, osteopathy, colon, intestinal inflammation

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Authors: Saeed S. Al-Sokari, Nasser A. Awadh Ali, Lianet Monzote

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Leishmaniasis (CL) is endemic in at least 82 countries and considered to be a major public-health problem (1). The annual incidence of CL is 1–1.5 million cases of which 90% occur in only seven countries: Afghanistan, Algeria, Brazil, Iran, Peru, Saudi Arabia and Syria (2). In Saudi Arabia, the disease was first described in 1973 by Moursy and Shoura (3). Currently, CL is common in the human population in different localities, including the Eastern Province of Saudi Arabia and in particular the Al-Hassa Oasis that is a known endemic area for CL (4). Five methanolic extracts obtained from Achillea biebersteinii (flower leaf), Euphorbia antiquorm, Solanum incanum (leaf and fruit extracts), collected from Albaha region and selected from ethno-botanical data, were screened for their anti-leishmanial activity against Leishmania amazonensis (6). The cytotoxic activity against normal peritoneal macrophages from normal BALB/c mice was also determined (6). The five extracts had IC50 values ranging from < 12.5 to 37.8 µg/ml against promastigotes. Achillea biebersteinii flower, Euphorbia antiquorm, Solanum incanum leaf extracts showed anti-leishmanial activities with IC50 between < 12.5 - 26.9µg/mL and acceptable selectivity indices of 8 - 5.

Keywords: plant extracts, Albaha, Leishmania amazonensis, Medicinal

Procedia PDF Downloads 347

Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

Procedia PDF Downloads 48

Authors: Georgina Cherry, Taranpreet Rai, Luke Boyden, Sitira Williams, Andrea Wright, Richard Brown, Viva Chu, Alasdair Cook, Kevin Wells

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Estimating population-level burden, abilities of pet-parents to identify disease and demand for veterinary services worldwide is challenging. The purpose of this study is to compare a feline pruritus survey with social media listening (SML) data discussing this condition. Surveys are expensive and labour intensive to analyse, but SML data is freeform and requires careful filtering for relevancy. This study considers data from a survey of owner-observed symptoms of 156 pruritic cats conducted using Pet Parade® and SML posts collected through web-scraping to gain insights into the characterisation and management of feline pruritus. SML posts meeting a feline body area, behaviour and symptom were captured and reviewed for relevance representing 1299 public posts collected from 2021 to 2023. The survey involved 1067 pet-parents who reported on pruritic symptoms in their cats. Among the observed cats, approximately 18.37% (n=196) exhibited at least one symptom. The most frequently reported symptoms were hair loss (9.2%), bald spots (7.3%) and infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin (8.2%). Notably, bald spots were the primary symptom reported for short-haired cats, while other symptoms were more prevalent in medium and long-haired cats. Affected body areas, according to pet-parents, were primarily the head, face, chin, neck (27%), and the top of the body, along the spine (22%). 35% of all cats displayed excessive behaviours consistent with pruritic skin disease. Interestingly, 27% of these cats were perceived as non-symptomatic by their owners, suggesting an under-identification of itch-related signs. Furthermore, a significant proportion of symptomatic cats did not receive any skin disease medication, whether prescribed or over the counter (n=41). These findings indicate a higher incidence of pruritic skin disease in cats than recognized by pet owners, potentially leading to a lack of medical intervention for clinically symptomatic cases. The comparison between the survey and social media listening data revealed bald spots were reported in similar proportions in both datasets (25% in the survey and 28% in SML). Infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin accounted for 31% of symptoms in the survey, whereas it represented 53% of relevant SML posts (excluding bumpy skin). Abnormal licking or chewing behaviours were mentioned by pet-parents in 40% of SML posts compared to 38% in the survey. The consistency in the findings of these two disparate data sources, including a complete overlap in affected body areas for the top 80% of social media listening posts, indicates minimal biases in each method, as significant biases would likely yield divergent results. Therefore, the strong agreement across pruritic symptoms, affected body areas, and reported behaviours enhances our confidence in the reliability of the findings. Moreover, the small differences identified between the datasets underscore the valuable insights that arise from utilising multiple data sources. These variations provide additional depth in characterising and managing feline pruritus, allowing for more comprehensive understanding of the condition. By combining survey data and social media listening, researchers can obtain a nuanced perspective and capture a wider range of experiences and perspectives, supporting informed decision-making in veterinary practice.

Keywords: social media listening, feline pruritus, surveys, felines, cats, pet owners

Procedia PDF Downloads 134

Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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Authors: Zerihun Tesfaye Nigusse

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Objective: This study evaluates the antileishmanial activity of the methanolic extract of Aloe otallensis (A. otallensis) on the promastigote stage of Leishmaniadonovani (L. donovani) as compared to standard drugs and to screen its phytochemical constituents. Methods: Phytochemical screening was done by using the method mentioned by Evans and Trease on methanolic extract of the exudates of Aloe otallensis leaves. The extract was also evaluated for in vitro antileishmanial activity against L. donavani, which is found in the Parasitology Unit of Black Lion Hospital. The result was compared to standard drugs of sodium stibogluconate, milfostin and paramomycin. Results: The extract has good antileishmanial activity with an IC50 of 0.123 0 μg/mL on L. donovani (AM 563). The experimental data showed that relatively, it had better activity than paramomycin and milfostin but less activity than sodium stibogluconate. The data analyses were done by GraphPad Prism version 5 software after it was read by an ELISA reader at the wavelength of 650 nm. The phytochemical screening of the exudates of A. otallensis showed the presence of phenol, alkaloid and saponin. Conclusions: The methanol extract of the exudates of A.otallensishas a good anti- leishmaniasis activity and this may be attributed to phenol, alkaloid and saponin present in the plant. But it needs further analysis for the conformation of which constituent presents in high concentration to know which one has the strongest effect.

Keywords: anti leshimaniasis, aloe otallensis, leshimania ethiopica, IC50

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