Search results for: clinical area

Authors: Leonard Simoni, Ilir Alimehmeti, Ervina Shirka, Endri Hasimi, Ndricim Kallashi, Verona Beka, Suerta Kabili, Artan Goda

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Background: Diabetes Mellitus type 2, small vessel calibre, stented length of vessel, complex lesion morphology, and prior bypass surgery have resulted risk factors for In-Stent Restenosis (ISR). However, there are some contradictory results about body mass index (BMI) as a risk factor for ISR. Purpose: We want to identify clinical, lesional and procedural factors that can predict clinical ISR in our patients. Methods: Were enrolled 759 patients who underwent first-time elective PCI with Bare Metal Stents (BMS) from September 2011 to December 2013 in our Department of Cardiology and followed them for at least 1.5 years with a median of 862 days (2 years and 4 months). Only the patients re-admitted with ischemic heart disease underwent control coronary angiography but no routine angiographic control was performed. Patients were categorized in ISR and non-ISR groups and compared between them. Multivariate analysis - Binary Logistic Regression: Forward Conditional Method was used to identify independent predictive risk factors. P was considered statistically significant when <0.05. Results: ISR compared to non-ISR individuals had a significantly lower BMI (25.7±3.3 vs. 26.9±3.7, p=0.004), higher risk anatomy (LM + 3-vessel CAD) (23% vs. 14%, p=0.03), higher number of stents/person used (2.1±1.1 vs. 1.75±0.96, p=0.004), greater length of stents/person used (39.3±21.6 vs. 33.3±18.5, p=0.01), and a lower use of clopidogrel and ASA (together) (95% vs. 99%, p=0.012). They also had a higher, although not statistically significant, prevalence of Diabetes Mellitus (42% vs. 32%, p=0.072) and a greater number of treated vessels (1.36±0.5 vs. 1.26±0.5, p=0.08). In the multivariate analysis, Diabetes Mellitus type 2 and multiple stents used were independent predictors risk factors for In-Stent Restenosis, OR 1.66 [1.03-2.68], p=0.039, and OR 1.44 [1.16-1.78,] p=0.001, respectively. On the other side higher BMI and use of clopidogrel and ASA together resulted protective factors OR 0.88 [0.81-0.95], p=0.001 and OR 0.2 [0.06-0.72] p=0.013, respectively. Conclusion: Diabetes Mellitus and multiple stents are strong predictive risk factors, whereas the use of clopidogrel and ASA together are protective factors for clinical In-Stent Restenosis. Paradoxically High BMI is a protective factor for In-stent Restenosis, probably related to a larger diameter of vessels and consequently a larger diameter of stents implanted in these patients. Further studies are needed to clarify this finding.

Keywords: body mass index, diabetes mellitus, in-stent restenosis, percutaneous coronary intervention

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Authors: Sandeep Pandey, Nimra Habib, Ranjana Singh, Abbas Ali Mahdi

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Leukemia is a malignancy of blood that mainly affects children and young adults; while advancement in the early diagnosis will have the potential to improve the outcome of diseases. A wide range of disease including leukemia shows inflammatory signals in their pathogenesis. In a pilot study conducted in our laboratory, 52 people were screened, of which 26 had leukemia and 26 were free from any kind of malignancy. We performed the estimation of the inflammatory cytokine Interleukin-8 and it was found significantly raised in all the leukemia patients concerning healthy volunteers who participated in the study. Flow cytometry had been performed for the confirmation of leukemia and further genomic, and proteomic, analyses of the sample revealed that IL-8 levels showed a positive correlation in patients with leukemia. The results had shown constitutive secretion of interleukin-8 by leukemia cells. So, our finding demonstrated that IL-8 is considered to have a role in the pathogenesis of leukemia, and quantification of IL-8 levels in leukemia conditions might be more useful and feasible in the clinical setting for the prediction of drug responses where it may represent a putative target for innovative diagnostic toward effective therapeutic approaches. However, further research explorations in this area are needed that include a greater number of patients with all different forms of leukemia, and estimating their IL-8 levels may hold the key for the additional predictive values on the recurrence of leukemia and its prognosis.

Keywords: T-ALL, IL-8, leukemia pathogenesis, cancer therapeutics

Procedia PDF Downloads 63

Authors: Said M. AL-Mashaikhi, El-Said I. El-Shafey, Fakhreldin O. Suliman, Saleh Al-Busafi

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Activated carbon (AC) was prepared from date palm leaflets via NaOH activation. AC was oxidized using nitric acid, producing oxidized activated carbon (OAC). OAC was surface functionalized using different amine surfactants, including methylamine (ONM), ethylamine (ONE), and diethylamine (ONDE) using the amide coupling process. Produced carbons were surface characterized for surface area and porosity, X-ray diffraction, SEM, FTIR, and TGA. AC surface area (580 m²/g) has shown a decrease in oxidation to 260 m²/g for OAC. On amine functionalization, the surface area has further decreased to 218, 108, and 20 m²/g on functionalization with methylamine, ethylamine, and diethylamine, respectively. FTIR and TGA showed that the nature of amine functionalization of AC is chemical. Methylene blue sorption was tested on these carbons in terms of kinetics and equilibrium. Sorption was found faster on amine-functionalized carbons than both AC and OAC, and this is due to hydrophobic interaction with the alkyl groups immobilized with data following pseudo second-order reaction. On the other hand, AC showed the slowest adsorption kinetic process due to the diffusion in the porous structure of AC. Sorption equilibrium data was found to follow the Langmuir sorption isotherm with maximum sorption found on ONE. Regardless of its lower surface area than activated carbon, ethylamine functionalized AC showed better performance than AC in terms of kinetics and equilibrium for dye removal.

Keywords: activated carbon, dye removal, functionalization, hydrophobic interaction, water treatment

Procedia PDF Downloads 154

Authors: Nasreen Thebo, W. Shaikh, A. J. Laghari, P. Nangni

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Prunus dulcis (Almond) shell extract is demonstrated for its biomedical applications. Shell extract prepared by soxhlet method and further characterized by UV-Visible spectrophotometer, atomic absorption spectrophotometer (AAS), FTIR, GC-MS techniques. In this study, the antifungal activity of almond shell extract was observed against clinically isolated pathogenic fungi by strip method. The antioxidant potential of crude shell extract of was evaluated by using DPPH (2-2-diphenyl-1-picryhydrazyl) and radical scavenging system. The possibility of short term therapy was only 20 days. The total antioxidant activity varied from 94.38 to 95.49% and total phenolic content was found as 4.455 mg/gm in almond shell extract. Finally the results provide a great therapeutic potential against Tinea capitis infection of scalp. Included in this study of shell extract that show scientific evidence for clinical efficacy, as well as found to be more useful in the treatment of dermatologic disorders and without any doubt it can be recommended to be Patent.

Keywords: Tinea capitis, DPPH, FTIR, GC-MS therapeutic treatment

Procedia PDF Downloads 369

Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

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Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

Procedia PDF Downloads 327

Authors: Mohamed Abdalla Saleem, Hana Ellafi

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The study area is located in the eastern part of the Sirt Basin, in the Sarir-Hameimat arm of the basin, south of Amal High. The area covers the northern part of the Hamemat Trough and the Rakb High. All of these tectonic elements are part of the major and common tectonics that were created when the old Sirt Arch collapsed, and most of them are trending NW-SE. This study has been conducted to investigate the subsurface structures and the sedimentology characterization of the area and attempt to define its development tectonically and stratigraphically. About 7600 land gravity measurements, 22500 gridded magnetic data, and petrographic core data from some wells were used to investigate the subsurface structural features both vertically and laterally. A third-order separation of the regional trends from the original Bouguer gravity data has been chosen. The residual gravity map reveals a significant number of high anomalies distributed in the area, separated by a group of thick sediment centers. The reduction to the pole magnetic map also shows nearly the same major trends and anomalies in the area. Applying the further interpretation filters reveals that these high anomalies are sourced from different depth levels; some are deep-rooted, and others are intruded igneous bodies within the sediment layers. The petrographic sedimentology study for some wells in the area confirmed the presence of these igneous bodies and defined their composition as most likely to be gabbro hosted by marine shale layers. Depth investigation of these anomalies by the average depth spectrum shows that the average basement depth is about 7.7 km, while the top of the intrusions is about 2.65 km, and some near-surface magnetic sources are about 1.86 km. The depth values of the magnetic anomalies and their location were estimated specifically using the 3D Euler deconvolution technique. The obtained results suggest that the maximum depth of the sources is about 4938m. The total horizontal gradient of the magnetic data shows that the trends are mostly extending NW-SE, others are NE-SW, and a third group has an N-S extension. This variety in trend direction shows that the area experienced different tectonic regimes throughout its geological history.

Keywords: sirt basin, tectonics, gravity, magnetic

Procedia PDF Downloads 52

Authors: Pandurang Balwant, Ashutosh Mishra, Jyothi V., Abhay Soni, Padmakar C., Rafat Quamar, Ramesh J.

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The sea water intrusion in the coastal aquifers has become one of the major environmental concerns. Although, it is a natural phenomenon but, it can be induced with anthropogenic activities like excessive exploitation of groundwater, seacoast mining, etc. The geological and hydrogeological conditions including groundwater heads and groundwater pumping pattern in the coastal areas also influence the magnitude of seawater intrusion. However, this problem can be remediated by taking some preventive measures like rainwater harvesting and artificial recharge. The present study is an attempt to identify suitable sites for rainwater harvesting in salt intrusion affected area near coastal aquifer of Jafrabad town, Amreli district, Gujrat, India. The physico-chemical water quality results show that out of 25 groundwater samples collected from the study area most of samples were found to contain high concentration of Total Dissolved Solids (TDS) with major fractions of Na and Cl ions. The Cl/HCO3 ratio was also found greater than 1 which indicates the salt water contamination in the study area. The geophysical survey was conducted at nine sites within the study area to explore the extent of contamination of sea water. From the inverted resistivity sections, low resistivity zone (<3 Ohm m) associated with seawater contamination were demarcated in North block pit and south block pit of NCJW mines, Mitiyala village Lotpur and Lunsapur village at the depth of 33 m, 12 m, 40 m, 37 m, 24 m respectively. Geospatial techniques in combination of Analytical Hierarchy Process (AHP) considering hydrogeological factors, geographical features, drainage pattern, water quality and geophysical results for the study area were exploited to identify potential zones for the Rainwater Harvesting. Rainwater harvesting suitability model was developed in ArcGIS 10.1 software and Rainwater harvesting suitability map for the study area was generated. AHP in combination of the weighted overlay analysis is an appropriate method to identify rainwater harvesting potential zones. The suitability map can be further utilized as a guidance map for the development of rainwater harvesting infrastructures in the study area for either artificial groundwater recharge facilities or for direct use of harvested rainwater.

Keywords: analytical hierarchy process, groundwater quality, rainwater harvesting, seawater intrusion

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Authors: G. Battistoni, F. Collamati, E. De Lucia, R. Faccini, C. Mancini-Terracciano, M. Marafini, I. Mattei, S. Muraro, V. Patera, A. Sarti, A. Sciubba, E. Solfaroli Camillocci, M. Toppi, G. Traini, S. M. Valle, C. Voena

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Accelerated charged particles, mainly protons and carbon ions, are presently used in Particle Therapy (PT) to treat solid tumors. The precision of PT exploiting the charged particle high localized dose deposition in tissues and biological effectiveness in killing cancer cells demands for an online dose monitoring technique, crucial to improve the quality assurance of treatments: possible patient mis-positionings and biological changes with respect to the CT scan could negatively affect the therapy outcome. In PT the beam range confined in the irradiated target can be monitored thanks to the secondary radiation produced by the interaction of the projectiles with the patient tissue. The Dose Profiler (DP) is a novel device designed to track charged secondary particles and reconstruct their longitudinal emission distribution, correlated to the Bragg peak position. The feasibility of this approach has been demonstrated by dedicated experimental measurements. The DP has been developed in the framework of the INSIDE project, MIUR, INFN and Centro Fermi, Museo Storico della Fisica e Centro Studi e Ricerche 'E. Fermi', Roma, Italy and will be tested at the Proton Therapy center of Trento (Italy) within the end of 2017. The DP combines a tracker, made of six layers of two-view scintillating fibers with square cross section (0.5 x 0.5 mm2) with two layers of two-view scintillating bars (section 12.0 x 0.6 mm2). The electronic readout is performed by silicon photomultipliers. The sensitive area of the tracking planes is 20 x 20 cm2. To optimize the detector layout, a Monte Carlo (MC) simulation based on the FLUKA code has been developed. The complete DP geometry and the track reconstruction code have been fully implemented in the MC. In this contribution, the DP hardware will be described. The expected detector performance computed using a dedicated simulation of a 220 MeV/u carbon ion beam impinging on a PMMA target will be presented, and the result will be discussed in the standard clinical application framework. A possible procedure for real-time beam range monitoring is proposed, following the expectations in actual clinical operation.

Keywords: online range monitoring, particle therapy, quality assurance, tracking detector

Procedia PDF Downloads 234

Authors: Muhammad Waqas Baqai, Noman Shahzad, Rehman Alvi

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Communication among health care givers is the essence of quality patient care and any compromise results in errors and inefficiency leading to cumbersome outcomes. The use of smartphone among health professionals has increased tremendously. Almost every health professional carries it and majority of them uses a third party communication software called whatsApp for work related communications. It gives instant access to the person responsible for any particular query and therefore helps in efficient and timely decision making. It is also an easy way of sharing medical documents, multimedia and provides platform for consensual decision making through group discussions. However clinical communication through whatsApp has some demerits too including reduction in verbal communication, worsening professional relations, unprofessional behavior, risk of confidentiality breach and threats from cyber-attacks. On the other hand the traditional pager device being used in many health care systems is a unidirectional communication that lacks the ability to convey any information other than the number to which the receiver has to respond. Our study focused on these two widely used modalities of communication among doctors of the largest tertiary care center of Pakistan i.e. The Aga Khan University Hospital. Our aim was to note which modality is considered better and has fewer threats to medical data. Approval from ethical review committee of the institute was taken prior to conduction of this study. We submitted an online survey form to all the interns and residents working at our institute and collected their response in a month’s time. 162 submissions were recorded and analyzed using descriptive statistics. Only 20% of them were comfortable with using pagers exclusively, 52% with whatsApp and 28% with both. 65% think that whatsApp is time-saving and quicker than pager. 54% of them considered whatsApp to be causing nuisance from work related notifications in their off-work hours. 60% think that they are more likely to miss information through pager system because of the unidirectional nature. Almost all (96%) of residents and interns found whatsApp to be useful in terms of saving information for future reference. For urgent issues, majority (70%) preferred pager over whatsApp and also pager was considered more valid in terms of hospital policies and legal issues. Among major advantages of whatsApp as listed by them were; easy mass communication, sharing of clinical pictures, universal access and no need of carrying additional device. However the major drawback of using whatsApp for clinical communication that everyone shared was threat to patients’ confidentiality as clinicians usually share pictures of wounds, clinical documents etc. Lastly we asked them if they think there is a need of a separate application for instant communication dedicated to clinical communication only and 90% responded positively. Therefore, we concluded that both modalities have their merits and demerits but the greatest drawback with whatsApp is the risk of breach in patients’ confidentiality and off-work disturbance. Hence, we recommend a more secure, institute-run application for all intra hospital communications where they can share documents, pictures etc. easily under a controlled environment.

Keywords: WhatsApp, pager, clinical communication, confidentiality

Procedia PDF Downloads 135

Authors: Surinder Deswal, Vineet Verma

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Air Quality Index (AQI) is used as a tool to indicate the level of severity and disseminate the information on air pollution to enable the public to understand the health and environmental impacts of air pollutant concentration levels. The annual and seasonal variation of criteria air pollutants concentration based on the National Ambient Air Quality Monitoring Programme has been conducted for a period of nine years (2006-2014) using the AQI system. AQI was calculated using IND-AQI methodology and Maximum Operator Concept is applied. An attempt has been made to quantify the variations in AQI on an annual and seasonal basis over a period of nine years. Further, year-wise frequency of occurrence of AQI in each category for all the five stations is analysed, which presents in depth analysis of trends over the period of study. The best air quality was observed in the Noida residential area, followed by Noida industrial area during the study period; whereas, Bulandshahar industrial area and Faridabad residential area were observed to have the worst air quality. A shift in the worst air quality from winter to summer season has also been observed during the study period. Further, the level of Respirable Suspended Particulate Matter was found to be above permissible limit at all the stations. The present study helps in enhancing public awareness and calls for the need of immediate measures to be taken to counter-effect the cause of the increasing level of air pollution.

Keywords: air quality index, annual trends, criteria pollutants, seasonal variation

Procedia PDF Downloads 262

Authors: Khaled M. Ali, Ayman A. Mostafa, Soliman M. Soliman

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Objectives: To describe the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats, and to determine the short-term outcomes after surgical treatment of these cats. Animals Eighteen client-owned cats of different breeds (52 females and 28 males), ranging in age from 3 months to 6 years, with corneal ulcers. Procedures: Cats were clinically evaluated to initially determine the concurrent corneal abnormalities. Endoscopic examination was performed to determine the anterior and posterior segments abnormalities. Superficial and deep stromal ulcers were treated using conjunctival flap. Corneal sequestrum was treated by partial keratectomy and conjunctival flap. Anterior synechia was treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon was treated by removal of the adhered conjunctival membrane from the cornea. Incurable endophthalmitis was treated surgically by extirpation. Short-term outcomes after surgical managements of selected corneal abnormalities were then assessed clinically and endoscopically. Results: Deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechia with secondary glaucoma and corneal scarring were the most common complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechia, and corneal sequestration. Conclusions: Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Immediate management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats.

Keywords: cats, complicated corneal ulceration, clinical, endoscopic diagnosis, FHV-1

Procedia PDF Downloads 274

Authors: N. P. Patidar, J. Earnest, Laxmikant Nagar, Akshay Sharma

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This paper describes the diligence of a new input signal based fuzzy power system stabilizer in multi-machine power system. Instead of conventional input pairs like speed deviation (∆ω) and derivative of speed deviation i.e. acceleration (∆ω ̇) or speed deviation and accelerating power deviation of each machine, in this paper, deviation of active power through the tie line colligating two areas is used as one of the inputs to the fuzzy logic controller in concurrence with the speed deviation. Fuzzy Logic has the features of simple concept, easy effectuation, and computationally efficient. The advantage of this input is that, the same signal can be fed to each of the fuzzy logic controller connected with each machine. The simulated system comprises of two fully symmetrical areas coupled together by two 230 kV lines. Each area is equipped with two superposable generators rated 20 kV/900MVA and area-1 is exporting 413 MW to area-2. The effectiveness of the proposed control scheme has been assessed by performing small signal stability assessment and transient stability assessment. The proposed control scheme has been compared with a conventional PSS. Digital simulation is used to demonstrate the performance of fuzzy logic controller.

Keywords: Power System Stabilizer (PSS), small signal stability, inter-area oscillation, fuzzy logic controller, membership function, rule base

Procedia PDF Downloads 519

Authors: Mangana B. Rampheri, Timothy Dube, Farai Dondofema, Tatenda Dalu

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Identifying and delineating groundwater-dependent ecosystems (GDEs) is critical to the well understanding of the GDEs spatial distribution as well as groundwater allocation. However, this information is inadequately understood due to limited available data for the most area of concerns. Thus, this study aims to address this gap using remotely sensed, analytical hierarchy process (AHP) and in-situ data to identify and delineate GDEs in Khakea-Bray Transboundary Aquifer. Our study developed GDEs index, which integrates seven explanatory variables, namely, Normalized Difference Vegetation Index (NDVI), Modified Normalized Difference Water Index (MNDWI), Land-use and landcover (LULC), slope, Topographic Wetness Index (TWI), flow accumulation and curvature. The GDEs map was delineated using the weighted overlay tool in ArcGIS environments. The map was spatially classified into two classes, namely, GDEs and Non-GDEs. The results showed that only 1,34 % (721,91 km2) of the area is characterised by GDEs. Finally, groundwater level (GWL) data was used for validation through correlation analysis. Our results indicated that: 1) GDEs are concentrated at the northern, central, and south-western part of our study area, and 2) the validation results showed that GDEs classes do not overlap with GWL located in the 22 boreholes found in the given area. However, the results show a possible delineation of GDEs in the study area using remote sensing and GIS techniques along with AHP. The results of this study further contribute to identifying and delineating priority areas where appropriate water conservation programs, as well as strategies for sustainable groundwater development, can be implemented.

Keywords: analytical hierarchy process (AHP), explanatory variables, groundwater-dependent ecosystems (GDEs), khakea-bray transboundary aquifer, sentinel-2

Procedia PDF Downloads 100

Authors: Yuning Guan

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Under the background of rapid urbanization, mountainous counties need to break through mountain barriers for urban expansion due to undulating topography, resulting in ecological problems such as landscape fragmentation and reduced biodiversity. Green infrastructure networks are constructed to alleviate the contradiction between urban expansion and ecological protection, promoting the healthy and sustainable development of urban ecosystems. This study applies the MSPA model, the MCR model and Linkage Mapper Tools to identify eco-sources and eco-corridors in the Shapingba District of Chongqing and combined with landscape connectivity assessment and circuit theory to delineate the importance levels to extract ecological pinch point areas on the corridors. The results show that: (1) 20 ecological sources are identified, with a total area of 126.47 km², accounting for 31.88% of the study area, and showing a pattern of ‘one core, three corridors, multi-point distribution’. (2) 37 ecological corridors are formed in the area, with a total length of 62.52km, with a ‘more in the west, less in the east’ pattern. (3) 42 ecological pinch points are extracted, accounting for 25.85% of the length of the corridors, which are mainly distributed in the eastern new area. Accordingly, this study proposes optimization strategies for sub-area protection of ecological sources, grade-level construction of ecological corridors, and precise restoration of ecological pinch points.

Keywords: green infrastructure network, morphological spatial pattern, minimal cumulative resistance, mountainous counties, circuit theory, shapingba district

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Authors: Peng Guo

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Objective To investigate the clinical characteristics and changes of video-polysomnography (v-PSG) in Parkinson disease (PD) patients accompanied with cognitive impairment. Methods Three hundred and ninety-four patients with PD were enrolled in Beijing Tiantan Hospital, according to CI level, the patients were divided into PD without cognitive impairment (PD-NCI), PD with mild cognitive impairment (PD-MCI), and PD with dementia (PDD) group. Collect patient's demographic data, including gender, onset age, education level and duration. The cognitive function of PD patients was evaluated by Montreal cognitive assessment (MoCA) scale, and the overall cognitive function and cognitive domains of the three groups were compared.Using v-PSG to assess the sleep status of patients. Correlation analysis of MoCA Scale and v-PSG results in PD-CI group. Results 1. In 394 cases of PD, 94 cases (23.86%) in PD-NCI group , 177 cases(44.92%) in PD-MCI group , 123 cases (31.22%) in PDD group. 2.There was no significant difference in gender, age of onset, education level and duration in PD-NCI group, PD-MCI group and PDD group （P＞0.05）. 3. The total score of MoCA scale in PD-NCI group, PD-MCI group and PDD group decreased one by one. In PD-NCI group, PD-MCI group and PDD group, the scores of each cognitive domain in MoCA scale decreased significantly（P<0.05）. 4.Compared with the PD-MCI group, PDD group had lower total sleep time, lower sleep efficiency （P<0.05）. Compared with PD-NCI group, PDD group had lower total sleep time and lower sleep efficiency （P<0.05）.5. The sleep efficiency of PD-CI patients is positively correlated with the total score of MoCA scale, visual spatial function, executive function, delayed recall and attention score（P<0.05). Conclusions The incidence of CI in PD patients was high; The cognitive function and cognitive domains of PD-CI patients were significantly impaired; In patients with PD-CI, total sleep time decreased, sleep efficiency decreased, and it was related to overall cognitive function and partial cognitive impairment.

Keywords: Parkinson disease, cognitive impairment, clinical characteristics, sleep disorders, video-polysomnography

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Authors: Nalini Kaul, Barrie Drewitt, Elsie Kohoot

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Hyperpigmentation is the third most common pigmentary disorder where dermatologic treatment is sought. It affects all ages resulting in skin darkening because of melanin accumulation. An uneven skin tone because of either exposure to the sun (solar lentigos/age spots/sun spots or skin disruption following acne, or rashes (post-inflammatory hyperpigmentation -PIH) or hormonal changes (melasma) can lead to significant psychosocial impairment. Dyschromia is a result of various alterations in biochemical processes regulating melanogenesis. Treatments include the daily use of sunscreen with lightening, brightening, and exfoliating products. Depigmentation is achieved by various depigmenting agents: common examples are hydroquinone, arbutin, azelaic acid, aloesin, mulberry, licorice extracts, kojic acid, niacinamide, ellagic acid, arbutin, green tea, turmeric, soy, ascorbic acid, and tranexamic acid. These agents affect pigmentation by interfering with mechanisms before, during, and after melanin synthesis. While immediate correction is much sought after, patience and diligence are key. Our objective was to assess the effects of a facial product with pigmentation treatment and UV protection in 35 healthy F (35-65y), meeting the study criteria. Subjects with mild to moderate hyperpigmentation and fine lines with no use of skin-lightening products in the last six months or any dermatological procedures in the last twelve months before the study started were included. Efficacy parameters included expert clinical grading for hyperpigmentation, radiance, skin tone & smoothness, fine lines, and wrinkles bioinstrumentation (Corneometer®, Colorimeter®), digital photography and imaging (Visia-CR®), and self-assessment questionnaires. Safety included grading for erythema, edema, dryness & peeling and self-assessments for itching, stinging, tingling, and burning. Our results showed statistically significant improvement in clinical grading scores, bioinstrumentation, and digital photos for hyperpigmentation-brown spots, fine lines/wrinkles, skin tone, radiance, pores, skin smoothness, and overall appearance compared to baseline. The product was also well-tolerated and liked by subjects. Conclusion: Facial hyperpigmentation is of great concern, and treatment strategies are increasingly sought. Clinical trials with both subjective and objective assessments, imaging analyses, and self-perception are essential to distinguish evidence-based products. The multifunctional cosmetic product tested in this clinical study showed efficacy, tolerability, and subject satisfaction in reducing hyperpigmentation and global photoaging.

Keywords: hyperpigmentation; photoaging, clinical testing, expert visual evaluations, bio-instruments

Procedia PDF Downloads 68

Authors: Subhra Chattopadhyay

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New Towns are usually built up at city-periphery with an eye to accommodate overspill population and functions of the city. ‘New towns are self-sufficient planned towns having a full range of urban economic and social activities, so it can provide employments for all of its inhabitants as well as a balanced self-content social community could be maintained’. In 3rd world countries New towns often emerge from scratch i.e on the area having no urban background and therefore, it needs a massive land conversion from rural to urban. This paper aims to study the implication of such land title transfer into rural sustainability with a case study at Jatragachi, New Town Kolkata. Broad objectives of this study are to understand 1. new changes in this area like i)changes in land use, ii) demographic changes, iii) occupational changes of the local people and 2.their view about new town planning. Major observations are stated below. The studied area was completely rural till recent years and is now at the heart of New Town Kolkata. Though this area is now under the jurisdiction of New Town Kolkata Development Authority (NKDA), it is still administrated by rural self-government.It creates administrative confusion and misuse of public capital. It is observed in this study that cultivation was the mainstay of livelihood for the majority of residents till recent past. There was a dramatic rise in irrigated area in the decade of 90’s pointing out agricultural prosperity.The area achieved the highest productivity of rice in the District. Percentage of marginal workers dropped significantly.In addition to it, ascending women’s literacy rate as found in this rural Mouza obviously indicates a constant social progress .Through land conversion, this flourishing agricultural land has been transformed into urban area with highly sophisticated uses. Such development may satisfy educated urban elite but the dwellers of the area suffer a lot. They bear the cost of new town planning through loss of their assured food and income as well as their place identity. The number of marginal workers increases abruptly. The growth of female literacy drops down. The area loses its functional linkages with its surroundings and fails to prove its actual growth potentiality. The physical linkages( like past roads and irrigation infrastructure) which had developed through time to support the economy become defunct. The ecological services which were provided by the agricultural field are denied. The historicity of this original site is demolished. Losses of the inhabitants of the area who have been evicted are also immense and cannot be materially compensated. Therefore, the ethos of such new town planning in stake of rural sustainability is under question. Need for an integrated approach for rural and urban development planning is felt in this study.

Keywords: new town, sustainable development, growth potentiality, land transfer

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Wu Liching

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Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

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Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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Authors: Muhammad Saad, AzherBaig, Anwar Maqsood, Muhammad Waseem

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The grey wolf has been ranked endangered and Asiatic jackal as near threatened in Pakistan. Scientific data on population and threats to these species are not available in Pakistan, which is required for their proper management and conservation. The present study was conducted to collect data on distribution range, population status and threats to both of these Canis species in Lehri Nature Park. The data were collected using direct observations and indirect signs in the field. The population of grey wolf and Asiatic jackal were scattered into pocket of the study area and its surroundings. The current population of grey wolf was estimated 06 individuals and that of Asiatic jackal 28 individuals in the study area. The present study showed that grey wolf and Asiatic jackal were distributed in the northern and southern part of the study area having dense vegetation cover of tress and shrub between the altitudes of 330 m and 515 m. The research finding revealed that the scrub forest is the most preferred habitat of both the species but due to anthropogenic pressure the scrub forest is under severe threat. The dominant trees species were Acacia modesta, Zizyphus nummularia, and Prosopis juliflora and shrubs species of Dodonea-viscosa, Calotropis procera and Adhatoda vasica. Urial is one of the natural prey species: their population is low due to a number of reasons and therefore the maximum dependence of the wolves was on the livestock of the local and nomadic shepherds. The main prey species in the livestock was goats and sheep. The interviews were conducted with the eye witnesses of wolf attacks including livestock being killed by 5-6 numbers of wolves in different hamlets in the study area. The killing rate of the livestock by the wolves was greater when the nomadic shepherds were present in the area and decreased when they left the area. Presence of nomadic shepherds and killing rate has relation with the shifting of the wolves from the study area. It is further concluded that the population of the grey wolf and Asiatic jackal has decreased over time due to less availability of the natural prey species and habitat destruction.

Keywords: wildlife ecology, population conservation, rehabilitation, conservation

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Authors: Desalegn Feyissa Desu

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Drug therapy problem is a significant challenge to provide high quality health care service for the patients. It is associated with morbidity, mortality, increased hospital stay, and reduced quality of life. Moreover, pediatric patients are quite susceptible to drug therapy problems. Thus this study aimed to assess drug therapy problem and its contributing factors among pediatric patients diagnosed with infectious disease admitted to pediatric ward of Jimma university medical center, from April 1 to June 30, 2018. Prospective observational study was conducted among pediatric patients with infectious disease admitted from April 01 to June 30, 2018. Drug therapy problems were identified by using Cipolle’s and strand’s drug related problem classification method. Patient’s written informed consent was obtained after explaining the purpose of the study. Patient’s specific data were collected using structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to statistical software package version 21.0 for analysis. To identify predictors of drug therapy problems occurrence, multiple stepwise backward logistic regression analysis was done. The 95% CI was used to show the accuracy of data analysis and statistical significance was considered at p-value < 0.05. A total of 304 pediatric patients were included in the study. Of these, 226(74.3%) patients had at least one drug therapy problem during their hospital stay. A total of 356 drug therapy problems were identified among two hundred twenty six patients. Non-compliance (28.65%) and dose too low (27.53%) were the most common type of drug related problems while disease comorbidity [AOR=3.39, 95% CI= (1.89-6.08)], Polypharmacy [AOR=3.16, 95% CI= (1.61-6.20)] and more than six days stay in hospital [AOR=3.37, 95% CI= (1.71-6.64) were independent predictors of drug therapy problem occurrence. Drug therapy problems were common in pediatric patients with infectious disease in the study area. Presence of comorbidity, polypharmacy and prolonged hospital stay were the predictors of drug therapy problem in study area. Therefore, to overcome the significant gaps in pediatric pharmaceutical care, clinical pharmacists, Pediatricians, and other health care professionals have to work in collaboration.

Keywords: drug therapy problem, pediatric, infectious disease, Ethiopia

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Authors: Anil Kumar Pandey

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A compact planar monopole antenna with dual-band operation suitable for wireless local area network (WLAN) application is presented in this paper. The antenna occupies an overall area of 18 ×12 mm². The antenna is fed by a coplanar waveguide (CPW) transmission line and it combines two folded strips, which radiates at 2.4 and 5.2 GHz. In the proposed antenna, by optimally selecting the antenna dimensions, dual-band resonant modes with a much wider impedance matching at the higher band can be produced. Prototypes of the obtained optimized design have been simulated using EM solver. The simulated results explore good dual-band operation with -10 dB impedance bandwidths of 50 MHz and 2400 MHz at bands of 2.4 and 5.2 GHz, respectively, which cover the 2.4/5.2/5.8 GHz WLAN operating bands. Good antenna performances such as radiation patterns and antenna gains over the operating bands have also been observed. The antenna with a compact size of 18×12×1.6 mm³ is designed on an FR4 substrate with a dielectric constant of 4.4.

Keywords: CPW antenna, dual-band, electromagnetic simulation, wireless local area network (WLAN)

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Authors: Walid Mousa, Mohamed Nayel, Ahmed Zaghawa, Akram Salama, Ahmed El-Sify, Hesham Rashad, Dina El-Shafey

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Mycoplasmosis in small ruminants constitutes a serious contagious problem in smallholders causing severe economic losses worldwide. This study was conducted to determine the clinical, Minimum Inhibitory Concentration (MIC) and molecular characterization of Mycoplasma species associated in sheep breeding herds in Menoufiya governorate, Egypt. Out of the examination of 400 sheep, 104 (26%) showed respiratory manifestations, nasal discharges, cough and conjunctivitis with systemic body reaction. Meanwhile, out of these examined sheep, only 56 (14%) were positive for mycoplasma isolation onto PPLO(Pleuropneumonia-like organisms) specific medium. The MIC for evaluating the efficacy of sensitivity of Mycoplasma isolates against different antibiotics groups revealed that both the Linospectin and Tylosin with 2ug, 0.25ug/ml concentration were the most effective antibiotics for Mycoplasma isolates. The application of PCR was the rapid, specific and sensitive molecular approach for detection of M. ovipneumoniae, and M. arginine at 390 and 326 bp, respectively, in all tested isolates. In conclusion, the diagnosis of Mycoplsamosis in sheep is important to achieve effective control measures and minimizing the disease dissemination among sheep herds.

Keywords: MIC, mycoplasmosis, PCR, sheep

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Authors: O. B. Enemuo, A. A. Onubuogu

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This work evaluated the influence of interior of decoration on customer perception of hotels in Uyo Akwa Ibom State. Specifically the study identified the various interior decoration used in hotels in the study area, determined the interior decoration used in hotels that appeal to the customer more, ascertained the influence of interior decoration on the level of patronage in the hotel in the study area and suggested ways of improving the interior decoration of hotels in the study area for sustainability. The study was guided by four research questions and two hypotheses. It adopted survey research design; structured questionnaire was used for data collection. The samples for the study were four hundred (400) staff and managers from the various hotels in the study area. Data generated were analyzed using mean and standard deviation analyses of variance (ANOVA) derived from regression analyses to test the hypotheses. The result of the finding showed that satisfactory interior decoration has a positive influence on the sustainability of the hospitality establishments in Uyo. The hypothesis showed that there was a significant relationship between the gender perception on the influence of interior decoration in the hotel and significant relationship between the gender perceptions on the influence of interior decoration in the hotels. From the finding, it was recommended that the hotels should design interior decorative service delivery system which has an impact on customer satisfaction in the hospitality industry and practiced healthy decorative environment and increased customer satisfaction.

Keywords: influence, interior decoration, customer’s perception, hotels

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Authors: Ayal Siegel, Moshe Inbar, Amatzya Peled

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This study examined the characteristic runoff coefficient in different urban areas. The main area studied is located in the city of Haifa, northern Israel. Haifa spreads out eastward from the Mediterranean seacoast to the top of the Carmel Mountain range with an elevation of 300 m. above sea level. For this research project, four watersheds were chosen, each characterizing a different part of the city; 1) Upper Hadar, a spacious suburb on the upper mountain side; 2) Qiryat Eliezer, a crowded suburb on a level plane of the watershed; 3) Technion, a large technical research university which is located halfway between the top of the mountain range and the coast line. 4) Keret, a remote suburb, on the southwestern outskirts of Haifa. In all of the watersheds found suitable, instruments were installed to continuously measure the water level flowing in the channels. Three rainfall gauges scattered in the study area complete the hydrological requirements for this research project. The runoff coefficient C in peak discharge events was determined by the Rational Formula. The main research finding is the significant relationship between the intensity of rainfall, and the impervious area which is connected to the drainage system of the watershed. For less intense rainfall, the full potential of the connected impervious area will not be exploited. As a result, the runoff coefficient value decreases as do the peak discharge rate and the runoff yield from the storm event. The research results will enable application to other areas by means of hydrological model to be be set up on GIS software that will make it possible to estimate the runoff coefficient of any given city watershed.

Keywords: runoff coefficient, rational method, time of concentration, connected impervious area.

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Authors: Rozi Laskaraki, Argyris Karapetsas, Aikaterini Karapetsa

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This paper is focused on the efficacy of a rehabilitation program based on musical activities, implied to a group of school-aged dyslexic children. Objective: The purpose of this study was to investigate the efficacy of auditory training including musical exercises in children with developmental dyslexia (DD). Participants and Methods: 45 third-, and fourth-grade students with DD and a matched control group (n=45) were involved in this study. In the beginning, students participated in a clinical assessment, including both electrophysiological (i.e., event related potentials (ERPs) esp.P300 waveform) and neuropsychological tests, being conducted in Laboratory of Neuropsychology, at University of Thessaly, in Volos, Greece. Initial assessment’s results confirmed statistically significant lower performance for children with DD, compared to that of the typical readers. After clinical assessment, a subgroup of children with dyslexia was submitted to a music auditory training program, conducted in 45-minute training sessions, once a week, for twenty weeks. The program included structured and digitized musical activities involving pitch, rhythm, melody and tempo perception and discrimination as well as auditory sequencing. After the intervention period, children underwent a new recording of ERPs. Results: The electrophysiological results revealed that children had similar P300 latency values to that of the controls, after the remediation program; thus children overcame their deficits. Conclusion: The outcomes of the current study suggest that ERPs is a valid clinical tool in neuropsychological assessment settings and dyslexia can be ameliorated through music auditory training.

Keywords: dyslexia, event related potentials, learning disabilities, music, rehabilitation

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Authors: Bello Yusuf Idi

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The Gongola arm of the Upper Banue Trough, Northeastern Nigeria is predominantly covered by the outcrops of Limestone-bearing rocks in form of Sandstone with intercalation of carbonate clay, shale, basaltic, felsphatic and migmatide rocks at subpixel dimension. In this work, subpixel classification algorithm was used to classify the data acquired from landsat 7 Enhance Thematic Mapper (ETM+) satellite system with the aim of producing fractional distribution image for three most economically important solid minerals of the area: Limestone, Basalt and Migmatide. Linear Spectral Unmixing (LSU) algorithm was used to produce fractional distribution image of abundance of the three mineral resources within a 100Km2 portion of the area. The results show that the minerals occur at different proportion all over the area. The fractional map could therefore serve as a guide to the ongoing reconnaissance for the economic potentiality of the formation.

Keywords: linear spectral un-mixing, upper benue trough, gongola arm, geological engineering

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Authors: Rezvan Hosseinian

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: disease subsets, hand radiography, joint erosion, sclerosis

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Authors: Nasrin Azarbani

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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