Search results for: severity of illness

Authors: Ya-Chuan Tseng, Hsin-Yi Liu, Meei-Fang Lou, Guey-Shiun Huang

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Purpose: Sensory impairments are common in older adults. Hearing and visual impairments affect their physical and mental health and quality of life (QOL) adversely. However, systematic reviews of the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life are scarce. The purpose of this systematic review was to determine the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life. Methods: Searches of EMBASE, PubMed, CINAHL, MEDLINE, Cochrane Library and Airiti Library were conducted between January 2006 and December 2017 using the keywords ‘quality of life,’ ‘life satisfaction,’ ‘well-being,’ ‘hearing impairment’ and ‘visual impairment’ Two authors independently assessed methodologic quality using a modified Downs and Black tool. Data were extracted by the first author and then cross-checked by the second author. Results: Twenty-three studies consisting mostly of community-dwelling older adults were included in our review. Sensory impairment was found to be in significant association with quality of life, with an increase in hearing impairment or visual impairment severity resulting in a lower quality of life. Quality of life for dual sensory impairment was worse than for hearing impairment or visual impairment individually. Conclusions: A significant association was confirmed between hearing impairment, visual impairment, dual sensory impairment and quality of life. Our review can be used to enhance health care personnel’s understanding of sensory impairment in older adults and enable healthcare personnel to actively assess older adults’ sensory functions so that they can help alleviate the negative impact of sensory impairments on QOL in older adults.

Keywords: nursing, older adults, quality of life, systematic review, hearing impairment, visual impairment

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Authors: Shukla Ila, Azmi Lubna, S. S. Gupta, Ch. V. Rao

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Oxidative stress has been increasingly associated with the induction and progression of liver damage. The current study was conducted to record the effect of combination of Lactobacillus and Lichen rangiferinus extract (LRE + Lac) on the severity of injury in experimental alcoholic liver disease and how it affects plasma levels of prostaglandin E2, endotoxin, thromboxane B2, and leukotriene B4. Male Wistar rats were grouped into five comprising six animals in each group. Group 1 served as negative control. Groups 2-5 were administered 10% ethanol for six weeks. Group 3 was administered with extract (200 mg/kg), group 4 received the diet containing 10% ethanol plus a bolus of lactobacilli GG (1010 CFU), and group 5 animals were given silymarin along with alcohol and it served as positive control. Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein content, γ-glutamyltransferase, glutathione S-transferase, oxidative stress markers, glutathione, malondialdehyde and glutathione reductase were determined using standard diagnostic kits. Histopathological analysis of liver tissue was also made. A positive relation was found between plasma endotoxin levels and degree of liver injury. The pathology records were also related positively with leukotriene B4 and thromboxane B2. But a negative correlation was obtained with PgE2 levels. This study led us to hypothesize that the increased endotoxin levels modulate liver metabolism of eicosanoid, which gradually leads to liver injury. Endotoxemia increases leukotriene and thromboxane levels in plasma.

Keywords: lactobacillus, Lichen rangiferinus, endotoxemia, silymarin

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Authors: Anderson Chidi Amadioha, Promise Chidi Kenkwo, A. A. Markson

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Cassava (Manihot esculenta Crantz) is an important food and cash crop that provide cheap source of carbohydrate for food, feed and raw material for industries hence a commodity for feature economic development of developing countries. Despite the importance, its production potentials is undermined by disease agents that greatly reduce yield and render it unfit for human consumption and industrial use. Pathogenicity tests on fungal isolates from infected cassava revealed Aspergillus flavus, Rhizopus stolonifer, Aspergillus niger, and Trichodderma viride as rot-causing organisms. Water and ethanol extracts of Piper guineense, Ocimum graticimum, Cassia alata, and Tagetes erecta at 50% concentration significantly inhibited the radial growth of the pathogens in vitro and their development and spread in vivo. Low cassava rot incidence and severity was recorded when the extracts were applied before than after spray inoculating with spore suspension (1x105 spores/ml of distilled water) of the pathogenic organisms. The plant materials are readily available, and their extracts are biodegradable and cost effective. The fungitoxic potentials of extracts of these plant materials could be exploited as potent biopesticides in the management of postharvest fungal deterioration of cassava especially in developing countries where synthetic fungicides are not only scarce but also expensive for resource poor farmers who produce over 95% of the food consumed.

Keywords: cassava, biopesticides, in vitro, in vivo, pathogens, plant extracts

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Authors: Khayra Zerrouki, Noureddine Djebli, Esra Eroglu, Afife Mat, Ozhan Gul

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Neurodegenerative diseases of the human brain comprise a variety of disorders that affect an increasing percentage of the population. Alzheimer’s disease (AD) is a complex, multifactorial, heterogeneous mental illness, which is characterized by an age-dependent loss of memory and an impairment of multiple cognitive functions, but this 10 last years it concerns the population most and most young. Hypericum perforatum has traditionally been used as an external anti-inflammatory and healing remedy for the treatment of swellings, wounds and burns, diseases of the alimentary tract and psychological disorders. It is currently of great interest due to new and important therapeutic applications. In this study, the chemical composition of methanolic extract of Hypericum perforatum (HPM) was analysed by using high performance liquid chromatography – diode array detector (HPLC-DAD). The in vitro antioxidant activity of HPM was evaluated by using several antioxidant tests. HSM exhibits inhibitory capacity against posphatidylcholine liposome peroxidation, induced with iron and ascorbic acid, scavenge DPPH and superoxide radicals and act as reductants. The cytotoxic activity of HSM was also determined by using MTT cell viability assay on HeLa and NRK-52E cell lines. The in vivo activity studies in Swiss mice were determined by using behavioral, memory tests and histological study. According to tests results HPM that may be relevant to the treatment of cognitive disorders. The results of chemical analysis showed a hight level of hyperforin and quercitin that had an important antioxidant activity proved in vitro with the DPPH, anti LPO and SOD; this antioxidant activity was confirmed in vivo after the non-toxic results by means of improvement in behavioral and memory than the reducing shrunken in pyramidal cells of mice brains.

Keywords: AlCl3, alzheimer, mice, neuroprotective, neurotoxicity, phytotherapy

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Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Majed Ahmed Al-Mansoub, Muhammad Qamar

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There is a progressive increase in the prevalence of early onset Type 2 diabetes mellitus. Early detection of Type 2 diabetes enhances the length and/or quality of life which might result from a reduction in the severity, frequency or prevent or delay of its long-term complications. The study aims to determine the onset age for the first diagnosis of Type 2 diabetes mellitus. A retrospective study conducted in the endocrine clinic at Hospital Pulau Pinang in Penang, Malaysia, January- December 2016. Records of 519 patients with Type 2 diabetes mellitus were screened to collect demographic data and determine the age of first-time diabetes mellitus diagnosis. Patients classified according to the age of diagnosis, gender, and ethnicity. The study included 519 patients with age (55.6±13.7) years, female 265 (51.1%) and male 254 (48.9%). The ethnicity distribution was Malay 191 (36.8%), Chinese 189 (36.4%) and Indian 139 (26.8%). The age of Type 2 diabetes diagnosis was (42±14.8) years. The female onset of diabetes mellitus was at age (41.5±13.7) years, while male (42.6±13.7) years. Distribution of diabetic onset by ethnicity was Malay at age (40.7±13.7) years, Chinese (43.2±13.7) years and Indian (42.3±13.7) years. Diabetic onset was classified by age as follow; ≤20 years’ cohort was 33 (6.4%) cases. Group >20- ≤40 years was 190 (36.6%) patients, and category >40- ≤60 years was 270 (52%) subjects. On the other hand, the group >60 years was 22 (4.2%) patients. The range of diagnosis was between 10 and 73 years old. Conclusion: Malay and female have an earlier onset of diabetes than Indian, Chinese and male. More than half of the patients had diabetes between 40 and 60 years old. Diabetes mellitus is becoming more common in younger age <40 years. The age at diagnosis of Type 2 diabetes mellitus has decreased with time.

Keywords: age of onset, diabetes diagnosis, diabetes mellitus, Malaysia, outpatients, type 2 diabetes, retrospective study

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Authors: Hilal Ahmad Punoo

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Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of octadecadienoic acid with two conjugated double bonds. Of more than a dozen isomers of CLA found naturally in dairy and meat products from ruminants, c-9, t-11 and t-10, c-12 are the two isomers with known physiological importance, including anticarcinogenic, antidiabetic, antilipogenic, and antiatherosclerotic effects. Conjugated linoleic acids (CLA) may influence the onset and severity of several chronic diseases, including various cancers, atherosclerosis, obesity, bone density loss, and diabetes. These findings are of special interest to the agriculture community, because dietary sources of CLA are almost exclusively beef and dairy products. Thus, a better understanding of the specific isomers and mechanisms responsible for these positive effects of CLA on human health would be both prudent and economically beneficial. To date, research related to the advantages of CLA consumption on human health has been conducted using experimental laboratory animals and cell culture systems. These data consistently show that relatively low levels of CLA can influence risk of cancer. Further, very recent investigations suggest that the predominate CLA isoform (cis-9, trans-11 CLA or rumenic acid) found in beef and milk fat possesses anticarcinogenic effects but does not alter body composition; the trans-10, cis-12 CLA has been shown to inhibit lipogenesis. Clearly, further work, especially using human subjects, will be required to characterize the potential benefits of CLA consumption on human health. Moreover, we suggest that foods naturally containing high amounts of CLA (e.g., beef and dairy products) be considered as meeting the definition of functional foods.

Keywords: conjugated linoleic acid, potential health benefits, fats, animals, humans

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Authors: Olayide Ogunsiji, Glenda McDonald

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Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

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Authors: Surachart Koyadun

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Currently, Plasmodium knowlesi malaria has spread to almost all countries in Southeast Asia. This research aimed to 1) describe the epidemiology of Plasmodium knowlesi malaria, 2) examine the clinical symptoms of P. knowlesi malaria patients 3) analyze the ecology, animal reservoir and entomology of P. knowlesi malaria. 4) summarize the diagnosis, blood parasites, and treatment of P. knowlesi malaria. The study design was a case report combined with retrospective descriptive survey research. A total of 34 study subjects were patients with a confirmed diagnosis of P. knowlesi malaria who received treatment at hospitals and vector-borne disease control units in Songkhla Province during 2021 – 2022. The results of the epidemiological study unveiled the majority of the samples were male, had a history of staying overnight in the forest before becoming sick, the source of the infection was in the forest, and the season during which they were sick was mostly summer. The average length of time from the onset of illness until receiving a blood test was 3.8 days. The average length of hospital stay was 4 days. Patients were treated with Chloroquine Phosphate, Primaquine, Artesunate, Quinine, and Dihydroartemisinin-piperaquine (40 mg DHA-320 mg PPQ). One death was seen in 34 P. knowlesi malaria patients. All remaining patients recovered and responded to treatment. All symptoms improved after drug administration. No treatment failures were found. Analyses of ecological, zoonotic and entomological data revealed an association between infected patients and forested, monkey-hosted and mosquito-transmitted areas. The recommendation from this study was that the Polymerase Chain Reaction (PCR) method should be used in conjunction with the Thick/Thin Film test and blood parasite test (Parasitaemia) for the specificity of the infection, accuracy of diagnosis, leading to treatment of disease in a timely manner and be effective in disease control.

Keywords: human malaria, Plasmodium knowlesi, zoonotic disease, diagnosis and treatment, epidemiology, ecology

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Authors: Rosa Suryantini, Reine S. Wulandari, Slamet Rifanjani

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Acacia (Acacia mangium) is a forest plant species which is produced to pulp and paper. The high demand for pulp and paper increase the acacia plantation forest area. However, the outbreak of Ganoderma (root rot pathogen) infection becomes obstacles for the development of acacia plantations. This is due to the extent of host range and species of Ganoderma. Ganoderma has also the ability to survive the long-term without hosts. The diversity of the host and Ganoderma species affects its virulence. Therefore, this study aimed to determine the virulence of Ganoderma from different hosts (acacia, palm oil (Elaeis guineensis) and rubber (Hevea brasiliensis)). The methods were isolation and morphology identification of Ganoderma, and inoculation of Ganoderma isolates on acacia seedlings. The results showed that the three isolates of Ganoderma from different hosts had a morphological similarity with G. Lucidum (according to Ganoderma isolated from acacia or G1), G. boninense (according to Ganoderma isolated from palm oil or G2) and G. applanatum (according to Ganoderma isolated from rubber or G3). Symptoms of infection in acacia were seen at 3 months of age. The symptoms were begun with chlorosis, necrosis and death of seedlings (such as burning). Necrosis was started from the tip of the leaf. Based on this visible symptoms, G1 was moderate virulence isolate and G2 was low virulence isolate while G3 was avirulen isolate. The symptoms were still growing in accordance with the development of plant so it affected the value of diseases severity index. Ganoderma infection decreased the dry weight of seedlings, ie. 3.82 g (seedlings that were inoculated by G1), 4.01 g (seedlings that were inoculated by G2); and 5.02 g (seedlings that were inoculated by G3) when the dry weight of seedlings control was 10,02 g. These results provide information for early control of Ganoderma diseases on acacia especially those planted near rubber and oil palm crops.

Keywords: Acacia, Ganoderma, infection, virulence

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

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Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

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Authors: Neha Bhadauria, Indu Gaur, Shilpi Shilpi, Susmita Goswami, Prabir K. Paul

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The aerial surface of plants colonized by Human Enteric Pathogens ()has been implicated in outbreaks of enteric diseases in humans. Practice of organic farming primarily using animal dung as manure and sewage water for irrigation are the most significant source of enteric pathogens on the surface of leaves, fruits and vegetables. The present work aims to have an insight into the molecular mechanism of interaction of Human Enteric Pathogens or their metabolites with cell wall receptors in plants. Tomato plants grown under aseptic conditions at 12 hours L/D photoperiod, 25±1°C and 75% RH were inoculated individually with S. fonticola and K. pneumonia. The leaves from treated plants were sampled after 24 and 48 hours of incubation. The cell wall and cytoplasmic proteins were extracted and isocratically separated on 1D SDS-PAGE. The sampled leaves were also subjected to formaldehyde treatment prior to isolation of cytoplasmic proteins to study protein-protein interactions induced by Human Enteric Pathogens. Protein bands extracted from the gel were subjected to MALDI-TOF-TOF MS analysis. The foremost interaction of Human Enteric Pathogens on the plant surface was found to be cell wall bound receptors which possibly set ups a wave a critical protein-protein interaction in cytoplasm. The study revealed the expression and suppression of specific cytoplasmic and cell wall-bound proteins, some of them being important components of signaling pathways. The results also demonstrated HEP induced rearrangement of signaling pathways which possibly are crucial for adaptation of these pathogens to plant surface. At the end of the study, it can be concluded that controlling the over-expression or suppression of these specific proteins rearrange the signaling pathway thus reduces the outbreaks of food-borne illness.

Keywords: cytoplasmic protein, cell wall-bound protein, Human Enteric Pathogen (HEP), protein-protein interaction

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Authors: Muhammad Aasim, Mehmet Karataş, Fatih Erci, Şeyma Bakırcı, Ecenur Korkmaz, Burak Kahveci

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Water hyssop (Bacopa monnieri L. Wettst.) is an important medicinal aquatic/semi aquatic plant native to India where it is used in traditional medicinal system. The plant contains bioactive compounds mainly Bacosides which are the main ingridient of commercial drug available as memory enhancer tonic. The local name of water hyssop is Brahmi and brahmi based drugs are available against for curing chronic diseases and disorders Alzheimer’s disease, anxiety, asthma, cancer, mental illness, respiratory ailments, and stomach ulcers. The plant is not a cultivated plant and collection of plant from nature make palnt threatened to endangered. On the other hand, low seed viability and availability make it difficult to propagate plant through traditional techniques. In recent years, plant tissue culture techniques have been employed to propagate plant for its conservation and production for continuous availability of secondary metabolites. On the other hand, application of nanoparticles has been reported for increasing biomass, in vitro regeneration and secondary metabolites production. In this study, silver nanoparticles (AgNPs) were applied at the rate of 2, 4, 6, 8 and 10 ppm to Murashihe and Skoog (MS) medium supplemented with 1.0 mg/l Benzylaminopurine (BAP), 3.0% sucrose and 0.7% agar. Leaf explants of water hyssop were cultured on AgNPs containing medium. Shoot induction from leaf explants were relatively slow compared to medium without AgNPs. Multiple shoot induction was recorded after 3-4 weeks of culture comapred to control that occured within 10 days. Regenerated shoots were rooted successfully on MS medium supplemented with 1.0 mg/l IBA and acclimatized in the aquariums for further studies.

Keywords: Water hyssop, Silver nanoparticles, In vitro, Regeneration, Secondary metabolites

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Authors: Inkyong Yi

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Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

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Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

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Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: Yahia Massinissa, Yahia Mouloud

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Cystic fibrosis (CF), the most common lethal genetic disease in the Europe population, is caused by mutations in the transmembrane conductance regulator gene (CFTR). It affects most organs including an epithelial tissue, base of hydroelectrolytic transepithelial transport, notably that aerial ways, the pancreas, the biliary ways, the intestine, sweat glands and the genital tractus. The gene whose anomalies are responsible of the cystic fibrosis codes for a protein Cl channel named CFTR (cystic fibrosis transmembrane conductance regulator) that exercises multiple functions in the cell, one of the most important in control of sodium and chlorine through epithelia. The deficient function translates itself notably by an abnormal production of viscous secretion that obstructs the execrator channels of this target organ: one observes then a dilatation, an inflammation and an atrophy of these organs. It also translates itself by an increase of the concentration in sodium and in chloride in sweat, to the basis of the sweat test. In order to do a phenotypical and genotypical diagnosis at a part of the Algerian population, our survey has been carried on 16 patients with evocative symptoms of the cystic fibrosis at that the clinical context has been confirmed by a sweat test. However, anomalies of the CFTR gene have been determined by electrophoresis in gel of polyacrylamide of the PCR products (polymerase chain reaction), after enzymatic digestion, then visualized to the ultraviolet (UV) after action of the ethidium bromide. All mutations detected at the time of our survey have already been identified at patients attained by this pathology in other populations of the world. However, the important number of found mutation with regard to the one of the studied patients testifies that the origin of this big clinical variability that characterizes the illness in the consequences of an enormous diversity of molecular defects of the CFTR gene.

Keywords: cystic fibrosis, CFTR gene, polymorphism, algerian population, sweat test, genotypical diagnosis

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Authors: Daniel Pinheiro Da Silva Junior, Aline Paes, Daniel De Oliveira, Christiano Lacerda Ghuerren, Marcio Duran

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The Courts of Accounts are institutions responsible for overseeing and point out irregularities of Public Administration expenses. They have a high demand for processes to be analyzed, whose decisions must be grounded on severity laws. Despite the existing large amount of processes, there are several cases reporting similar subjects. Thus, previous decisions on already analyzed processes can be a precedent for current processes that refer to similar topics. Identifying similar topics is an open, yet essential task for identifying similarities between several processes. Since the actual amount of topics is considerably large, it is tedious and error-prone to identify topics using a pure manual approach. This paper presents a tool based on Machine Learning and Natural Language Processing to assists in building a labeled dataset. The tool relies on Topic Modelling with Latent Dirichlet Allocation to find the topics underlying a document followed by Jensen Shannon distance metric to generate a probability of similarity between documents pairs. Furthermore, in a case study with a corpus of decisions of the Rio de Janeiro State Court of Accounts, it was noted that data pre-processing plays an essential role in modeling relevant topics. Also, the combination of topic modeling and a calculated distance metric over document represented among generated topics has been proved useful in helping to construct a labeled base of similar and non-similar document pairs.

Keywords: courts of accounts, data labelling, document similarity, topic modeling

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Authors: Adar Pelah, Avraham Adelman, Amanda Balash, Jake Mitchell, Mattan J. Pelah, Viswadeep Sarangi, Xin Chen Cai, Zadok Storkey, Gregg B. Fields, Ximena Levy, Ali A. Danesh

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Introduction: Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 infection (PASC), or Long COVID, while primarily a respiratory disorder, can also include dizziness, lasting weeks to months in individuals who had previously tested positive for COVID-19. This study utilized gait analysis to assess the potential vestibular effects of PASC on the presentation of gait anomalies. Materials and Methods: The study included 11 participants who tested positive for COVID-19, a mean of 2.8 months prior to gait testing (PP=11), and 8 control participants who did not test positive for COVID-19 (NP=8). Participants walked 7.5m at three self-selected speeds: ‘slow,’ ‘normal,’ and ‘fast.’ Mean walking speeds were determined for each speed and overall range from four laps on an instrumented walkway using video capture. Results: A Z-test at 0.05 significance was used for speed range, ‘normal’ and ‘fast’ at the lower tail, and for ‘slow’ at the higher tail. Average speeds (m/s) were: ‘slow’ (PP=0.709, NP=0.678), ‘normal’ (PP=1.141, NP=1.170), ‘fast’ (PP=1.529, NP=1.821), average range (PP=0.846, NP=1.143). Significant speed decreases between PP and NP were observed in ‘fast’ (-17.43%) and average range (-29.86%), while changes in ‘slow’ (+2.44%) and ‘normal’ (-4.39%) speeds were not significant. Conclusions: Long COVID is a recognized disability (Americans with Disabilities Act), and although it presents variably, dizziness, vertigo, and tinnitus are not uncommon in COVID-19 infection. These results suggest that potential inner-ear damage may persist and manifest in gait changes even after recovery from acute illness. Further research with a larger sample size may indicate the need for providers to consider PASC when diagnosing patients with vestibular dysfunction.

Keywords: gait analysis, long-COVID, vestibular dysfunction, walking speed

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Maria Do Carmo Baracho De Alencar, Marciene Campos Fialho, Maria Do Carmo Vitório Ramos

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The subjects affected by Repetitive Strain Injury/Work Related Musculoskeletal Disorder (RSI/WRMSD) face an everyday life marked by pain, feelings of worthlessness and incapacity caused by the disease, and aggravated often because of discrimination society. Aim: To investigate the experiences and feelings of workers affected by RSI/WRMSD in removal from work situations and to understand the repercussions on mental health. Methods: Clinical records of workers were consulted, opened from July 1, 2014, to July 1, 2015, at the Reference Center for Worker's Health, in Santos city-SP. Selection of workers affected by RSI /WRMSD and who had experienced the removal from work situation due to the disease, and invitation to participate in the study. Semi-structured and individual interviews were carried out based on a pre-elaborated script, and for thematic content analysis. Results: Of a total of 502 medical records, 157 were selected, and of these, 18 workers participated in the interviews, both gender, most of them with low education level, aged between 35 and 56 years, and from different professions. Diseases affected several physical body regions and some workers had more than one body region affected by chronic pain. In the testimonies emerged the psychic suffering by the process of illness at work, fear of dismissal, invisibility of pain, in medical expertise attendance, by the incapacity to perform tasks that were easily achievable, with feelings of uselessness, revolt, and injustice, among others. Conclusion: The workers need to be readapted to new life situations, and the study promotes reflections on the need for more interdisciplinary actions and of the Psychology to the workers affected by RSI/ WRMSD.

Keywords: repetitive strain injury, cumulative trauma disorder, absence from work, mental health, occupational health

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Authors: Bhavna Rajagopal, Mrinmoyi Kulkarni

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Today women experience more menstrual cycles than their ancestors did a hundred years ago, owing to early puberty, fewer pregnancies and dietary changes. Much of the research in menstruation is located in the medical domain with a focus on physical symptoms. The research in psychology is largely concerned with premenstrual syndrome (PMS), whereas the focus in sociology is on social and cultural practices relating to menstruation. Research that simultaneously studies the physical, psychological, social and cultural aspects is lacking. Therefore, in this study, an attempt has been made to identify socio-cultural, psychological and physical factors that interact to influence a woman’s experience of menstruation in the urban setting. The study included seven unmarried women in the age group of 24-30 and data was obtained through a focus group discussion. The transcript of the focus group discussion was thematically analysed. Two major themes relating to the self and social experience of menstruation emerged. Themes relating to the self included menarcheal experiences, self-perception, mood and management of menstrual hygiene and symptoms while themes relating to social experience included the construction of menstruation by family and peers, and cultural factors. Attitudes towards the menstrual cycle appeared to be primarily influenced by severity of symptoms and the resulting disruption to daily life. Outcomes of this study have indicated that future research needs to study menstruation and its impact on women’s wellbeing by adopting a socio-ecological approach and by collecting data using the whole cycle approach across a woman’s reproductive years.

Keywords: India, menstrual cycle, psychosocial approach, wellbeing

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Authors: Arunima Datta, Prathama Guha Chaudhuri, Ashis Mukhopadhyay

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Background: Acceptance and commitment therapy (ACT) is one of the newer forms (third wave) therapy. This therapy helps a cancer patient to increase acceptance level about their disease as well as their present situation. Breast cancer patients are known to suffer from depression and mild cognitive impairment; both affect their quality of life. Objectives:The present study had assessed effect of structured ACT intervention on cognitive function and acceptance level among breast cancer patients who were undergoing chemotherapy. Method: Data was collected from 123 breast cancer patients those who were undergoing chemotherapy were willing to undergo psychological treatment, with no history of past psychiatric illness. Their baseline of cognitive function and acceptance levels were assessed using validated tools. The effect of sociodemographic factors and clinical factors on cognitive function was determined at baseline.The participants were randomly divided into two groups: experimental (ACT, 4 sessions over 2 months) and control group. Cognitive function and acceptance level were measured during post intervention on 2months follow-up. Appropriate statistical analyses were performed to determine the effect on cognitive function and acceptance level in two groups. Result: At baseline, the factors that significantly influenced slower speed of task performance were ER PR HER2 status; number of chemo cycle, treatment type (Adjuvant and neo-adjuvant) was related with that. Sociodemographic characteristics did not show any significant difference between slow and fast performance. Per and post intervention analysis showed that ACT intervention resulted in significant difference both in terms of speed of cognitive performance and acceptance level. Conclusion: ACT is an effective therapeutic option for treating mild cognitive impairment and improve acceptance level among breast cancer patients undergoing chemotherapy.

Keywords: acceptance and commitment therapy, breast cancer, quality of life, cognitive function

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Authors: Abdulkadir I.

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Scientists have come to terms with the fact that climate change has been and is expected to cause a significant increase in the severity and frequency of drought events. The northeast region of Nigeria is one of the most, if not the most, affected regions by drought in the country. Therefore, it is on this note that the present study applied ArcGIS and XLSTAT Software and explored drought and its trend in the northeast region of the country using the vegetation health index (VHI), Mann-Kendal, and Sen’s slope between 2001 and 2020. The study also explored the areas that remained under drought and no-drought conditions at intervals of five years for the period under review. The result of Mann-Kendal (-0.07) and Sen’s slope (-0.19) revealed that there was a decreasing trend in VHI over the period under review. The result further showed that the period between 2010 and 2015 had a minimum area of no-drought conditions of about 24%, with Gombe State accounting for the lowest percentage among the six States, about 0.9% of the total area of no-drought conditions. The result further showed the areas that were under drought conditions between 2010 and 2015 represented about 9.1%, with Borno State accounting for the highest percentage among the six States, about 2.5% of the total area under drought conditions. The masked-out areas stood at 66.8%, with Borno State accounting for the highest percentage among the six States, about 20.2% of the total area under drought conditions. Therefore, collective efforts are needed to put in place sustainable land management in the affected areas so as to mitigate the sprawl of desertification in the region.

Keywords: climate change, drought, Mann Kendal, sustainable land management, vegetation health index

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Authors: P. G. S. Madushani, L. D. Illeperuma

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Abstract Noise is one of the most common physical hazards in industrial settings. The prevalence of Noise Induced Hearing Loss (NIHL) is on the rise with increasedduration of exposure and the increase in the severity of hearing loss. The purpose of the study was to determine auditory effects among textile workers and to establish associations between the degree of hearing loss and exposure duration, degree of hearing loss and noise level and the proportion of hearing related complaints. A cross sectional descriptive study using purposive sampling was carried out. An interviewer administered questionnaire and Distortion Product Oto Acoustic Emission (DPOAE) hearing screening on 127 (72 female and 55 male) textile workers of the selected textile plant in Seeduwa, Sri Lanka was done (Age: M= 31.16, SD=7.75). Noise measurements were done in six sections of the factory and average noise levels were obtained. Diagnostic hearing evaluations were done for 60 (57.75%) subjects, referred from the DPOAE hearing screening test. The degree of hearing loss and the exposure duration had a significant association in the high frequency region of 4 kHz to 8 kHz (p < 0.05). Noise levels fluctuated between 90.3±0.8 dBA and 50.6. ±0.52 dBA. 30.83% of workers reported having NIHL. Most of the workers (33.9%) complained difficulty in conversing in noisy backgrounds. Other complaints as tinnitus, dizziness, ear fullness and headache were reported in less than 30%. workers who were exposed to noise for more than 15 years were affected with NIHL in the high frequency region. Administrative controls and engineering controls need to be implemented to manage hazardous noise levels in industrial settings. Hearing Conservation Programs should be initiated and implemented for textile workers.

Keywords: textile industry, NIHL, degree of hearing loss, noise levels, auditory effects

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Authors: Clara Oliver, Oibar Martinez

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This paper is intended to reveal the severity of electrostatic discharge (ESD) effects in electronic and optoelectronic devices by performing sensitivity tests based on Human Body Model (HBM) standard. We explain here the HBM standard in detail together with the typical failure modes associated with electrostatic discharges. In addition, a prototype of electrostatic charge generator has been designed, fabricated, and verified to stress electronic devices, which features a compact high voltage source. This prototype is inexpensive and enables one to do a battery of pre-compliance tests aimed at detecting unexpected weaknesses to static discharges at the component level. Some tests with different devices were performed to illustrate the behavior of the proposed generator. A set of discharges was applied according to the HBM standard to commercially available bipolar transistors, complementary metal-oxide-semiconductor transistors and light emitting diodes. It is observed that high current and voltage ratings in electronic devices not necessarily provide a guarantee that the device will withstand high levels of electrostatic discharges. We have also compared the result obtained by performing the sensitivity tests based on HBM with a real discharge generated by a human. For this purpose, the charge accumulated in the person is monitored, and a direct discharge against the devices is generated by touching them. Every test has been performed under controlled relative humidity conditions. It is believed that this paper can be of interest for research teams involved in the development of electronic and optoelectronic devices which need to verify the reliability of their devices in terms of robustness to electrostatic discharges.

Keywords: human body model, electrostatic discharge, sensitivity tests, static charge monitoring

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Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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Authors: Bartelsen-Raemy Annabelle, Gerber Andrea

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Objectives: The adoption of the UN Convention on the Rights of Persons with Disabilities has the effect that higher education institutions in Switzerland are called upon to promote inclusive university education. In this context, our School of Social Work aims to provide fair participation and the removal of barriers in our study programmes at bachelor’s and master’s levels. In 2015 we developed a concept of reasonable adjustments for students with disabilities and chronic illness as an instrument to provide equal opportunities for those students. We reviewed the implementation of this concept as part of our quality management process. Using a qualitative research design, we explored how affected students and lecturers experience the processes and measures taken and which barriers they still perceive. Methods: We captured subjective perspectives and experience of measures by conducting 15 problem-centred interviews with affected students and three experimental focus groups with lecturers. The data was processed using structured qualitative content analysis and summarised as key categories. Results: All respondents evaluated the concept of reasonable adjustment very positively and emphasised its importance for equal opportunities. Our analysis revealed differences in the usage and perception of both groups and showed that the students interviewed were a heterogeneous group with different needs. Overall, the students described the adjustments, in particular in relation to examinations and other assignments, as a great relief. The lecturers expressed high standards for their own teaching and supervision of students and, at the same time, wished for more support from the university. However, despite the positive evaluation by the lecturers, the limits of reasonable adjustment became evident. It is necessary to consider the limits of reasonable adjustments in terms of professional skills. Conclusion: Reasonable adjustments should, therefore, be seen as an element of an inclusive university culture that must be complemented by further measures. Taking this into account, we have planned further research as a basis for the development of a diversity and inclusion policy.

Keywords: opportunities and limits, reasonable adjustment, social work education, students with disabilities

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Authors: John Olav Bjornestad, Bjorn Tore Johansen

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The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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Authors: Shivani Tiwari, Prathibha Karanth, B. Rajashekhar

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Impairments of syntactic morphology are often considered central in children with Specific Language Impairment (SLI). In English and related languages, deficits of tense-related grammatical morphology could serve as a clinical marker of SLI. Yet, cross-linguistic studies on SLI in the recent past suggest that the nature and severity of morphosyntactic deficits in children with SLI varies with the language being investigated. Therefore, in the present study we investigated the morphosyntactic deficits in a group of children with SLI who speak Kannada, a morphologically complex Dravidian language spoken in Indian subcontinent. A group of 15 children with SLI participated in this study. Two more groups of typical developing children (15 each) matched for language and age to children with SLI, were included as control participants. All participants were assessed for morphosyntactic comprehension and expression using standardized language test and a spontaneous speech task. Results of the study showed that children with SLI differed significantly from age-matched but not language-matched control group, on tasks of both comprehension and expression of morphosyntax. This finding is, however, in contrast with the reports of English-speaking children with SLI who are reported to be poorer than younger MLU-matched children on tasks of morphosyntax. The observed difference in impairments of morphosyntax in Kannada-speaking children with SLI from English-speaking children with SLI is explained based on the morphological richness theory. The theory predicts that children with SLI perform relatively better in morphologically rich language due to occurrence of their frequent and consistent features that mark the morphological markers. The authors, therefore, conclude that language-specific features do influence manifestation of the disorder in children with SLI.

Keywords: specific language impairment, morphosyntax, Kannada, manifestation

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