Search results for: values-based medicine

Authors: Yohanes Buang, Suwari

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Increasing interest of society in use and creation of herbal medicines has encouraged scientists/researchers to establish an ideal method to produce the best quality and quantity of pharmaceutical extracts. To have highest the antioxidative extracts, the method used must be at optimum conditions. Hence, the best method is not only able to provide highest quantity and quality of the isolated pharmaceutical extracts but also it has to be easy to do, simple, fast, and cheap. The characterization of solvents in maceration technique, in present study, involved various variables influencing quantity and quality of the pharmaceutical extracts, such as solvent’s optimum acidity-alkalinity (pH), temperature, concentration, and contact time. The shifting polarity of the solvent by combinations of water with ethanol (70:30) and (50:50) were also performed to completely record the best solvent system in application of maceration technology. Among those three solvents threated within Myrmecodia pendens, as a model of natural product, the results showed that water solvent system with conditions of alkalinity pH, optimum temperature, concentration, and contact time, is the best system to perform the maceration in order to have the highest isolated antioxidative activated extracts. The optimum conditions of the water solvent are at the alkalinity pH 9 up, 30 mg/mL of concentration, 40 min of contact time, 100 °C of temperature, and no ethanol used to replace parts of the water solvent. The present study strongly recommended the best conditions of solvent system to isolate the pharmaceutical extracts of natural products in application of the maceration technology.

Keywords: extracts, herbal medicine, natural product, maceration technique

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Authors: Francisco Dos Santos, Diogo Fonseca-Pereira, Sílvia Arroz-Madeira, Henrique Veiga-Fernandes

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Haematopoiesis is a developmental process that generates all blood cell lineages in health and disease. This relies on quiescent haematopoietic stem cells (HSCs) that are able to differentiate, self renew and expand upon physiological demand. HSCs have great interest in regenerative medicine, including haematological malignancies, immunodeficiencies and metabolic disorders. However, the limited yield from existing HSC sources drives the global need for reliable techniques to expand harvested HSCs at high quality and sufficient quantities. With the extensive use of cord blood progenitors for clinical applications, there is a demand for a safe and efficient expansion protocol that is able to overcome the limitations of the cord blood as a source of HSC. StemCell2MAXTM developed a technology that enhances the survival, proliferation and transplantation efficiency of HSC, leading the way to a more widespread use of HSC for research and clinical purposes. StemCell2MAXTM MIX is a solution that improves HSC expansion up to 20x, while preserving stemness, when compared to state-of-the-art. In a recent study by a leading cord blood bank, StemCell2MAX MIX was shown to support a selective 100-fold expansion of CD34+ Hematopoietic Stem and Progenitor Cells (when compared to a 10-fold expansion of Total Nucleated Cells), while maintaining their multipotent differentiative potential as assessed by CFU assays. The technology developed by StemCell2MAXTM opens new horizons for the usage of expanded hematopoietic progenitors for both research purposes (including quality and functional assays in Cord Blood Banks) and clinical applications.

Keywords: cord blood, expansion, hematopoietic stem cell, transplantation

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Authors: Bilge Kaan Tekelioglu, Mehmet Celik, Mahmut Ali Gokce, Ladine Celik, Yusuf Uzun

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A male mature barn owl (Tyto alba) was brought to Cukurova University Ceyhan Veterinary Medicine Faculty at the beginning of January 2017. The bird was found at a local state elementary school’s garden where had been terribly damaged by metal wires. On the clinical examination, the animal was in shock and atonic position at arrival and seems to have feather problems and severe injuries. The ears, eyes, claws and wounded areas were checked and no signs of viral, microbial or ecto-parasitic infection were observed. The bird has been declared by U.S. wild life Office as endangered species. At first, the owl was kept in silent, warm and darkened cabinet against shock and warmed fluid replacement was started by % 5 dextrose solution per orally. On the second day, we started per oral forced feeding with chicken flesh meat dipped into the dextrose solution. On the third day, the bird was continued to be fed with fresh meat. At the fourth day, the owl was started to be fed with chicks during the next 3 days died by natural means which has been supplied by a local breeder. At the first 3 days 1 chick per day and the following days 2 chicks per day has been given per orally. The tenth day we started flying exercises in a small and non-windowed room safely. The saved owl was kept in this room for 10 more days. Finally, the owl was released at the habitation where it had been found injured. This study has one more time proved that, if you save one, you can save more. Wild life is in danger all over the world. Every living creature has right and deserves a chance to live.

Keywords: wild life, barn owl, Tyto alba, rescue, life support, feeding

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Authors: Thidarat Duangyod, Chanida Palanuvej, Nijsiri Ruangrungsi

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Pentace burmanica Kurz., belonging to the Malvaceae family, is commonly used for anti-diarrhea in Thai traditional medicine. A method for quantification of (+)-catechin and (-)-epicatechin in P. burmanica stem bark from 12 different Thailand markets by reverse-phase high performance liquid chromatography (HPLC) was investigated and validated. The analysis was performed by a Shimadzu DGU-20A3 HPLC equipped with a Shimadzu SPD-M20A photo diode array detector. The separation was accomplished with an Inersil ODS-3 column (5 µm x 4.6 x 250 mm) using 0.1% formic acid in water (A) and 0.1% formic acid in acetonitrile (B) as mobile phase at the flow rate of 1 ml/min. The isocratic was set at 20% B for 15 min and the column temperature was maintained at 40 ºC. The detection was at the wavelength of 280 nm. Both (+)-catechin and (-)-epicatechin existed in the ethanolic extract of P. burmanica stem bark. The content of (-)-epicatechin was found as 59.74 ± 1.69 µg/mg of crude extract. In contrast, the quantitation of (+)-catechin content was omitted because of its small amount. The method was linear over a range of 5-200 µg/ml with good coefficients (r2 > 0.99) for (+)-catechin and (-)-epicatechin. Limit of detection values were found to be 4.80 µg/ml for (+)-catechin and 5.14 µg/ml for (-)-epicatechin. Limit of quantitation of (+)-catechin and (-)-epicatechin were of 14.54 µg/ml and 15.57 µg/ml respectively. Good repeatability and intermediate precision (%RSD < 3) were found in this study. The average recoveries of both (+)-catechin and (-)-epicatechin were obtained with good recovery in the range of 91.11 – 97.02% and 88.53 – 93.78%, respectively, with the %RSD less than 2. The peak purity indices of catechins were more than 0.99. The results suggested that HPLC method proved to be precise and accurate and the method can be conveniently used for (+)-catechin and (-)-epicatechin determination in ethanolic extract of P. burmanica stem bark. Moreover, the stem bark of P. burmanica was found to be a rich source of (-)-epicatechin.

Keywords: pentace burmanica, (+)-catechin, (-)-epicatechin, high performance liquid chromatography

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Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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Authors: Yasin I. Tayem, Jamil Ahmed, Mahmood Bahzad, Abdullah Alnama, Fahad Al Asfoor, Mahmood A. Jalil, Mohammed Radhi, Ahmed Alenezi, Khalid A. J. Al-Khaja

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Drug-drug interactions (DDIs) represent a significant cause of patient’s morbidity and mortality. The rate of DDIs is rapidly increasing worldwide with the increasing proportion of ageing population and frequent requirement of polypharmacy-prescription of multiple drugs to treat comorbidities. Prescribing physicians are responsible for checking their prescriptions for the presence and severity of DDIs. However, since a large number of new drugs are approved and marketed every year, new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely only upon their previous knowledge of medicine to avoid potential DDIs. The aim of this study was to explore the perceptions of physicians working at primary healthcare centers in Bahrain towards DDIs and how they manage them during their practice. Methodology: In this cross-sectional study, physicians working at all governmental primary healthcare centers in Bahrain were invited to voluntarily, privately and anonymously respond to a self-administered questionnaire. The questionnaire aims to assess their self-reported knowledge of DDIs and how they check for them in their practice. The participants were requested to provide socio demographic data and information related to their attitudes towards DDIs including strategies they employ for detecting and managing them, and their awareness of drugs which commonly cause DDIs. At the end of the questionnaire, an open-ended item was added to allow participants to further add any comment. Findings and Conclusions: The study is going on currently, and the results and conclusions will be presented at the conference.

Keywords: awareness, drug interactions, health centres, physicians

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Authors: Nitesh Kumar, Adel Elrasheed, Antonio Gagliardilugo

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Introduction and aims: PRP has been increasing in popularity over the past decade. It is used in many facets of medicine and dentistry such as osteoarthritis, hair loss, skin rejunavation, healing of tendons after injury. Due to the increasing popularity of PRP in third molar surgery in dentistry, this study aims to identify the role of platelet rich plasma and its function in third molar surgery. Methodology: Three databases were chosen to source the articles for review: pubmed, science direct, and Cochrane. The keywords “platelet rich plasma”, “third molar extraction” and “wisdom tooth extraction” and literature review were used to search for relevant articles. Articles that were not in English were omitted and only systematic reviews relevant to the study were collected. All systematic reviews abstracts pertinent to the study were read by two reviewers to avoid bias. Results/statistics: 20 review articles were obtained of which 13 fulfilled the criteria. The Amstar tool validified the strength of these review articles. There is strong evidence in the literature that PRP in third molar surgery decreases post op pain, swelling and recovery time. 20 review articles were obtained of which 13 fulfilled the criteria. The Amstar tool validified the strength of these review articles. There is strong evidence in the literature that PRP in third molar surgery decreases post op pain, swelling and recovery time. Conclusions/clinical relevance: Platelet rich plasma plays a crucial role in patient recovery following the extraction of third molars and should be considered and offered as a routine part of third molar therapy.

Keywords: PRP, third molar, extractions, wisdom teeth

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Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

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Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

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Authors: Turan Yaman, Zabit Yener, Ismail Celik

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The aim of this study was to investigate the antioxidant properties and protective role of honey, considered a part of traditional medicine, against carcinogen chemical aflatoxin (AF) exposure in rats, which were evaluated by histopathological changes in liver and kidney, measuring level of serum marker enzymes [aspartate aminotransferase (AST), alanin aminotransferase (ALT), gamma glutamil transpeptidase (GGT)], antioxidant defense systems [Reduced glutathione (GSH), glutathione reductase (GR), superoxide dismutase (SOD), glutathione-S-transferase (GST) and catalase (CAT)], and lipid peroxidation content in liver, erythrocyte, brain, kidney, heart and lungs. For this purpose, a total of eighteen healthy Sprague-Dawley rats were randomly allocated into three experimental groups: A (Control), B (AF-treated) and C (AF+honey-treated). While rats in group A were fed with a diet without AF, B, and C groups received 25 µg of AF/rat/day, where C group additionally received 1 mL/kg of honey by gavage for 90 days. At the end of the 90-day experimental period, we found that the honey supplementation decreased the lipid peroxidation and the levels of enzyme associated with liver damage, increased enzymatic and non-enzymatic antioxidants in the AF+honey-treated rats. Hepatoprotective and nephroprotective effects of honey is further substantiated by showing almost normal histological architecture in AF+honey-treated group, compared to degenerative changes in the liver and kidney of AF-treated rats. Additionally, honey supplementation ameliorated antioxidant defense systems and lipid peroxidation content in other tissues of AF+honey-treated rats. In conclusion, the present study indicates that honey has a hepatoprotective and nephroprotective effect in rats with experimental aflatoxicosis due to its antioxidant activity.

Keywords: aflatoxicosis, honey, histopathology, malondialdehyde, antioxidant, rat

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Authors: Sangeeta Pilkhwal Sah, C. S. Mathela, Kanwaljit Chopra

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Valeriana wallichii DC, an ayurvedic traditional medicine, popularly named as Indian valerian exist as three chemotypes. GC-MS analysis of V. wallichii essential oil in present study showed maaliol as the major constituent followed by the presence of β-gurjunene, acoradiene, guaiol and α-santalene. The results thus confirmed it to be a maaliol chemotype. Further, the antidepressant-like effect of root essential oil (10, 20 and 40 mg/kg p.o.) was investigated in both acute and chronic treatment study using forced swim test in mice. Single administration of different doses produced an inverted U shaped curve and significantly inhibited the immobility period (39.7% and 58%) at doses 10 and 40 mg/kg respectively. Standard drug imipramine significantly decreased immobility period (59.8%). None of the doses altered locomotor activity except a significant decrease of 44.9% was observed with 40 mg/kg (p < 0.05). Similarly, daily administration of essential oil for 14 days produced a dose dependent effect with significantly reduced immobility period (70.9%) at 40 mg/kg dose only whereas imipramine produced 86% decrease (p < 0.05). The neurotransmitter levels in mouse brain were estimated on day 14 after the behavioral study. Significant increase in the level of norepinephrine (10%) and dopamine (23%) (p < 0.05) was found at 40 mg/kg dose, while no change was observed at 10 and 20 mg/kg doses. The antidepressant-like effect of essential oil (40 mg/kg) was prevented by pretreatment of mice with L-arginine (750 mg/kg i.p.) and sildenafil (5 mg/kg i.p). On the contrary, pretreatment of mice with L-NAME (10 mg/kg i.p.) or methylene blue (10 mg/kg i.p.) potentiated the antidepressant action of essential oil (20 mg/kg). The findings thus demonstrated that nitric oxide pathway is involved in mediating antidepressant like effect of essential oil from this chemotype.

Keywords: Valeriana wallichii DC chemotype, essential oil, forced swim test, nitric oxide modulators, neurotransmitters

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Authors: Vanessa G. P. Severino, JOÃO Gabriel M. Junqueira, Michelle N. G. do Nascimento, Francisco W. B. Aquino, João B. Fernandes, Ana P. Terezan

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The scientific interest in analyzing VOCs represents a significant modern research field as a result of importance in most branches of the present life and industry. Therefore it is extremely important to investigate, identify and isolate volatile substances, since they can be used in different areas, such as food, medicine, cosmetics, perfumery, aromatherapy, pesticides, repellents and other household products through methods for extracting volatile constituents, such as solid phase microextraction (SPME), hydrodistillation (HD), solvent extraction (SE), Soxhlet extraction, supercritical fluid extraction (SFE), stream distillation (SD) and vacuum distillation (VD). The Chemometrics is an area of chemistry that uses statistical and mathematical tools for the planning and optimization of the experimental conditions, and to extract relevant chemical information multivariate chemical data. In this context, the focus of this work was the study of the chemical VOCs by SPME of the specie X. aromatica, in search of constituents that can be used in the industrial sector as well as in food, cosmetics and perfumery, since these areas industrial has a considerable role. In addition, by chemometric analysis, we sought to maximize the answers of this research, in order to search for the largest number of compounds. The investigation of flowers from X. aromatica in vitro and in alive mode proved consistent, but certain factors supposed influence the composition of metabolites, and the chemometric analysis strengthened the analysis. Thus, the study of the chemical composition of X. aromatica contributed to the VOCs knowledge of the species and a possible application.

Keywords: chemometrics, flowers, HS-SPME, Xylopia aromatica

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Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

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The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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Authors: V. Nigam, V. Nambiar

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Aegle Marmelos leaf has been used as a remedy for various gastrointestinal infections and lowering blood sugar level in traditional system of medicine in India due to the presence of various constituents such as flavonoids, tannins and alkaloids (eg. Aegelin, Marmelosin, Luvangetin).The objective of the present study was to evaluate the total antioxidant activity, total and individual phenol content of the wild and cultivated variety of Aegle marmelos leaves to assess the role of this plant in ethanomedicine in India. The methanolic extracts of the leaves were screened for total antioxidant capacity through Ferric Reducing Antioxidant Potential (FRAP) and 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay; Total Phenol content (TPC) through spectrophotometric technique based on Folin Ciocalteau assay and for qualitative estimation of phenols, High performance Liquid Chromatography was used. The TPC of wild and cultivated variety was 7.6% and 6.5% respectively whereas HPLC analysis for quantification of individual polyphenol revealed the presence of gallic acid, chlorogenic acid and Ferullic acid in wild variety whereas gallic acid, Ferullic acid and pyrocatechol in cultivated variety. FRAP values and IC 50 value (DPPH) for wild and cultivated variety was 14.65 μmol/l and 11.80μmol/l; 437 μg/ml and 620μg/ml respectively and thus it can be used as potential inhibitor of free radicals. The wild variety was having more antioxidant capacity than the cultivated one it can be exploited further for its therapeutic application. As Aegle marmelos is rich in antioxidant, it can be used as food additives to delay the oxidative deterioration of foods and as nutraceutical in medicinal formulation against degenerative diseases like diabetes.

Keywords: antioxidant activity, aegle marmelos, antidiabetic, nutraceutical

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Authors: Bárbara Durão, Pedro Almeida, David Ramilo, André Meneses, Rute Canejo-Teixeira

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The importance of quality of life (QoL) assessment in veterinary medicine is an integral part of patient care. This is especially true in cases of chronic diseases, such as chronic kidney disease (CKD), where the ever more advanced treatment options prolong the patient’s life. Whether this prolongment of life comes with an acceptable quality of life remains has been called into question. The aim of this study was to evaluate the relationship between CKD disease biomarkers and QoL in cats. Thirty-seven cats diagnosed with CKD and with no known concurrent illness were enrolled in an observational study. Through the course of several evaluations, renal biomarkers were assessed in blood and urine samples, and owners retrospectively described their cat’s quality of life using a validated instrument for this disease. Correlations between QoL scores (AWIS) and the biomarkers were assessed using Spearman’s rank test. Statistical significance was set at p-value < 0.05, and every serial sample was considered independent. Thirty-seven cats met the inclusion criteria, and all owners completed the questionnaire every time their pet was evaluated, giving a total of eighty-four questionnaires, and the average-weighted-impact-score was –0.5. Results showed there was a statistically significant correlation between the quality of life and most of 17 the studied biomarkers and confirmed that CKD has a negative impact on QoL in cats especially due to the management of the disease and secondary appetite disorders. To our knowledge, this is the attempt to assess the correlation between renal biomarkers and QoL in cats. Our results reveal a strong potential of this type of approach in clinical management, mainly in situations where it is not possible to measure biomarkers. Whilst health-related QoL is a reliable predictor of mortality and morbidity in humans; our findings can help improve the clinical practice in cats with CKD.

Keywords: chronic kidney disease, biomarkers, quality of life, feline

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Authors: Lee Ping Ang, Salvatore Tomasello, Jun Wen, Marc S. Appelhans

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With about 225 species, Zanthoxylum L. is the second most species rich genus in Rutaceae. It is the only genus with a pantropical distribution. Economically, it is used in several Asian countries as traditional medicine and spice. In the past Zanthoxylum was divided into two genera, the temperate Zanthoxylum sensu strictu (s.s.) and the (sub)tropical Fagara, due to the large differences in flower morphology: heterochlamydeous in Fagara and homochlamydeous in Zanthoxylum s.s.. This genus is much under studied and previous phylogenetic studies using Sanger sequencing did not resolve the relationships sufficiently. In this study, we use Hybrid Capture with a specially designed bait set for Zanthoxylum to sequence 347 putatively single-copy genes. The taxon sampling has been largely improved as compared to previous studies and the preliminary results will be based on 371 specimens representing 133 species from all continents and major island groups. Our preliminary results reveal similar tree topology as the previous studies while providing more details to the backbone of the phylogeny. The phylogenetic tree consists of four main clades: A) African/Malagasy clade, B) Z. asiaticum clade - a clade consisting widespread species occurring in (sub)tropical Asia and Africa as well as Madagascar, C) Asian/Pacific clade and D) American clade, which also includes the temperate Asian species. The merging of Fagara and Zanthoxylum is supported by our results and the homochlamydeous flowers of Zanthoxylum s.s. are likely derived from heterochlamydeous flowers. Several of the morphologically defined sections within Zanthoxylum are not monophyletic. The study dissemination will (1) introduce the framework of this project; (2) present preliminary results and (3) the ongoing progress of the study.

Keywords: Zanthoxylum, phylogenomic, hybrid capture, pantropical

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Authors: Keiko Shimazu, Yasuhiro Maida, Tetsuya Sugata, Daisuke Tamakoshi, Kenji Makabe, Haruki Suzuki

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In this paper, we report how to acquire serious victims’ locations in the Acute Stage of Large-scale Disasters, in an Emergency Information Network System designed by us. The background of our concept is based on the Great East Japan Earthquake occurred on March 11^th, 2011. Through many experiences of national crises caused by earthquakes and tsunamis, we have established advanced communication systems and advanced disaster medical response systems. However, Japan was devastated by huge tsunamis swept a vast area of Tohoku causing a complete breakdown of all the infrastructures including telecommunications. Therefore, we noticed that we need interdisciplinary collaboration between science of disaster medicine, regional administrative sociology, satellite communication technology and systems engineering experts. Communication of emergency information was limited causing a serious delay in the initial rescue and medical operation. For the emergency rescue and medical operations, the most important thing is to identify the number of casualties, their locations and status and to dispatch doctors and rescue workers from multiple organizations. In the case of the Tohoku earthquake, the dispatching mechanism and/or decision support system did not exist to allocate the appropriate number of doctors and locate disaster victims. Even though the doctors and rescue workers from multiple government organizations have their own dedicated communication system, the systems are not interoperable.

Keywords: crisis management, disaster mitigation, messing, MGRS, military grid reference system, satellite communication system

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Authors: Mohammed Bnebaghdad, Feriel Betouche, Malika Semmani

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Image processing become more sophisticated over time due to technological advances, especially artificial intelligence (AI) technology. Currently, AI image processing is used in many areas, including surveillance, industry, science, and medicine. AI in medical image processing can help doctors diagnose diseases faster, with minimal mistakes, and with less effort. Among these diseases is malaria, which remains a major public health challenge in many parts of the world. It affects millions of people every year, particularly in tropical and subtropical regions. Early detection of malaria is essential to prevent serious complications and reduce the burden of the disease. In this paper, we propose and implement a scheme based on AI image processing to enhance malaria disease diagnosis through automated analysis of blood smear images. The scheme is based on the convolutional neural network (CNN) method. So, we have developed a model that classifies infected and uninfected single red cells using images available on Kaggle, as well as real blood smear images obtained from the Central Laboratory of Medical Biology EHS Laadi Flici (formerly El Kettar) in Algeria. The real images were segmented into individual cells using the watershed algorithm in order to match the images from the Kaagle dataset. The model was trained and tested, achieving an accuracy of 99% and 97% accuracy for new real images. This validates that the model performs well with new real images, although with slightly lower accuracy. Additionally, the model has been embedded in a Raspberry Pi4, and a graphical user interface (GUI) was developed to visualize the malaria diagnostic results and facilitate user interaction.

Keywords: medical image processing, malaria parasite, classification, CNN, artificial intelligence

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Authors: Pravaree Phuneerub, Chanida Palanuvej, Nijsiri Ruangrungsi

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Cymbopogon nardus Rendel (Family Gramineae) is commonly known as citronella grass. The dried root of C. nardus is used for antipyretic, anti-inflammation, anti-analgesic and anticancer in traditional Thai medicine. Transverse sectional and pulverized C. nardus root were illustrated. The volatile oil was extracted from oil gland by hydrodistillation and analysed by GC/MS. Cymbopogon nardus root was exhaustively extracted by continuously maceration in ethanol and water respectively. The mutagenic and antimutagenic properties of the ethanol extract and fractionated water extract of C. nardus root were evaluated by Ames assay using the S. typhimurium strains TA98 and TA100 as the models. The result indicated that the anatomical character of root transverse section displayed epidermis, parenchyma, oil gland, phloem, xylem vessel, endodermis and pith. Histological characters of root powder showed parenchyma containing oleoresin, parenchyma in longitudinal view, reticulate vessel, annular vessel, starch granules and fragment of fiber. The root volatile oil was rich in sesquiterpenes dominated by elemol (22.87%) and alpha-eudesmol (16.09%). For mutagenic activity, the both extracts of C. nardus were no mutagenic toward S. typhimurium strains TA98 and TA100. Furthermore, the ethanol extract and fractionated water extract of C. nardus root demonstrated strong antimutagenic effect against of nitrite treated 1-aminopyrene to S. typhimurium strains TA98 and TA100. This present investigation suggested that the dried root extract of C. nardus can be further developed as promising antimutagenic agent.

Keywords: Cymbopogon nardus, volatile oil analysis, mutagenic, antimutagenic effect, Ames Salmonella assay

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Authors: Denise Levy

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Nuclear technology is part of our everyday life and its beneficial applications help to improve the quality of our lives. Nevertheless, in Brazil, most often the media and social networks tend to associate radiation to nuclear weapons and major accidents, and there is still great misunderstanding about the peaceful applications of nuclear science. The Educational Portal Radioatividades (Radioactivities) is a corporate social responsibility initiative that takes advantage of the growing impact of Internet to offer high quality scientific information for teachers and students throughout Brazil. This web-based initiative focusses on the positive applications of nuclear technology, presenting the several contributions of ionizing radiation in different contexts, such as nuclear medicine, agriculture techniques, food safety and electric power generation, proving nuclear technology as part of modern life and a must to improve the quality of our lifestyle. This educational project aims to contribute for democratization of scientific education and social inclusion, approaching society to scientific knowledge, promoting critical thinking and inspiring further reflections. The website offers a wide variety of ludic activities such as curiosities, interactive exercises and short courses. Moreover, teachers are offered free web-based material with full instructions to be developed in class. Since year 2013, the project has been developed and improved according to a comprehensive study about the realistic scenario of ICTs infrastructure in Brazilian schools and in full compliance with the best e-learning national and international recommendations.

Keywords: information and communication technologies, nuclear technology, science communication, society and education

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Authors: Ervin Meqikukiqi

Abstract:

It is difficult to assess how athletes can best modify their movements to prevent non contact ACL injuries. Speaking with an athletic trainer, physical therapist, or sports medicine specialist is a good place to start. Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physical therapist or athletic trainer to improve performance-or rehabilitation efforts after an injury has occurred. Current studies also demonstrate that specific types of training, such as jump routines and learning to pivot properly, help athletes prevent ACL injuries. These types of exercises and training programs are more beneficial if athletes start when they are young. It may be optimal to integrate prevention programs during early adolescence, prior to when young athletes develop certain habits that increase the risk of an ACL injury. This is a 20 minute program designed to reduce the risk of tears of the Anterior Cruciate Ligament. It should be started at least four and preferably six weeks prior to start of competition.Ideally it is done five times per week preseason and three times per week in season.The coach or trainer must constantly observe athletes during these exercises to correct and maintain proper technique. Once the athletes understand the principles, they can monitor and coach each other. Four phases: Warm-up, Strengthening, Plyometrics, Agility and Balance.

Keywords: athletes, acl, prevention, injuries, plyoemtric, proprioception, agillity

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Authors: Geetanjali Sharma

Abstract:

Guillain Barre’ syndrome (GBS) is an auto-immune mediated demyelination poly-radiculo-neuropathy. Clinical features include progressive symmetrical ascending muscle weakness of more than two limbs, areflexia with or without sensory, autonomic and brainstem abnormalities, the purpose of this study was to determine subclinical neurological changes of CNS with GBS and to establish the presence of central demyelination in GBS. The study was prospective and conducted in the Department of Physiology, Pt. B. D. Sharma Post-graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India to find out early central demyelination in clinically diagnosed patients of GBS. These patients were referred from the department of Medicine of our Institute to our department for electro-diagnostic evaluation. The study group comprised of 40 subjects (20 clinically diagnosed GBS patients and 20 healthy individuals as controls) aged between 6-65 years. Brain Stem evoked Potential (BAEP) were done in both groups using RMS EMG EP mark II machine. BAEP parameters included the latencies of waves I to IV, inter peak latencies I-III, III-IV & I-V. Statistically significant increase in absolute peak and inter peak latencies in the GBS group as compared with control group was noted. Results of evoked potential reflect impairment of auditory pathways probably due to focal demyelination in Schwann cell derived myelin sheaths that cover the extramedullary portion of auditory nerves. Early detection of the sub-clinical abnormalities is important as timely intervention reduces morbidity.

Keywords: brainstem, demyelination, evoked potential, Guillain Barre’

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

Abstract:

Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

Procedia PDF Downloads 96

Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

Abstract:

Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

Procedia PDF Downloads 319

Authors: González A. Julio, Ramírez L. Leonardo, Puerta A. Gabriel

Abstract:

Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.

Keywords: cloud storage, decision trees, diagnostic image, search, telemedicine

Procedia PDF Downloads 204

Authors: Molly Pui Man Wong

Abstract:

In this study, a blended and interactive e-learning Courseware that our team developed will be introduced, and our team’s experiences on how the e-learning Courseware and the flipped classroom benefit student learning in bioethics in the medical program will be shared. This study is a continuation of the previously established study, which provides a summary of the well-developed e-learning Courseware in a blended learning approach and an update on its efficiency and efficacy. First, a collection of animated videos capturing selected topics of bioethics and related ethical issues and dilemma will be introduced. Next, a selection of problem-based learning videos (“simulated doctor-patient role play”) with pop-up questions and discussions will be further discussed. Our recent findings demonstrated that these activities launched by the Courseware strongly engaged students in bioethics education and enhanced students’ critical thinking and creativity, which were consistent with the previous data in the preliminary studies. Moreover, the educational benefits of the online art exhibition, art jamming, and competition will be discussed, through which students could express bioethics through arts and enrich their learning in medical research in an interactive, fun, and entertaining way, strengthening their interests in bioethics. Furthermore, online survey questionnaires and focus group interviews were conducted. Consistent with the preliminary studies, our results indicated that implementing the e-learning Courseware with a flipped classroom in bioethics education enhanced both active learning and student engagement. In conclusion, our Courseware not only reinforces education in art, bioethics, and medicine but also benefits students in understanding and critical thinking in socio-ethical issues and serves as a valuable learning tool in bioethics teaching and learning.

Keywords: bioethics, courseware, e-learning, flipped classroom

Procedia PDF Downloads 127

Authors: Tomas Drevinskas, Ruta Mickiene, Audrius Maruska, Nicola Tiso, Algirdas Salomskas, Raimundas Lelesius, Agneta Karpovaite, Ona Ragazinskiene, Loreta Kubiliene

Abstract:

Antiviral effect of substances accumulated by plants and natural products is known to ethno-pharmacy and modern day medicine. Antiviral properties are usually assigned to volatile compounds and polyphenols. This research work is divided into several parts and the task of this part was to investigate potential plants, potential substances and potential preparation conditions that can be used for the preparation of antiviral agents. Sixteen different medicinal plants, their parts and two types of propolis were selected for screening. Firstly, extraction conditions of non-volatile compounds were investigated: 3 pre-selected plants were extracted with 5 different ethanol – water mixtures (96%, 75%, 60%, 40%, 20 %, vol.) and bidistilled water. Total phenolic content, total flavonoid content and radical scavenging activity was determined. The results indicated that optimal extrahent is 40%, vol. of ethanol – water mixture. Further investigations were performed with the extrahent of 40%, vol. ethanol – water mixture. All 16 of selected plants, their parts and two types of propolis were extracted using selected extrahent. Determined total phenolic content, total flavonoid content and radical scavenging activity indicated that extracts of Origanum Vulgare L., Mentha piperita L., Geranium macrorrhizum L., Melissa officinalis L. and Desmodium canadence L. contains highest amount of extractable phenolic compounds (7.31, 5.48, 7.88, 8.02 and 7.16 rutin equivalents (mg/ ml) respectively), flavonoid content (2.14, 2.23, 2.49, 0.79 and 1.51 rutin equivalents (mg/ml) respectively) and radical scavenging activity (11.98, 8.72, 13.47, 13.22 and 12.22 rutin equivalents (mg/ml) respectively). Composition of the extracts is analyzed using HPLC.

Keywords: antiviral effect, plants, propolis, phenols

Procedia PDF Downloads 324

Authors: Ying Zhu, Ning Wu, Hai-Dong Huang, Yu-Chao Dong, Qin-Ying Sun, Wei Zhang, Qin Wang, Qiang Li

Abstract:

Background and study aims: Tracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China. Patients and Methods: Retrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination. Results: 22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45 ±10.91 years old. The most frequent symptoms at presentation were chronic cough (n=14) and increased sputum production (n=10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n=2), Stage II (n=6) and Stage III(n=14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible. Conclusions: TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Keywords: airway obstruction, bronchoscopy, etiology, Tracheobronchopathia osteochondroplastica (TO), treatment

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Authors: Harukuni Tokuda, Takanari Arai, Xu FengHao, Nobutaka Suzuki

Abstract:

In our continuous search for anti-tumor promoting, chemopreventive active potency from natural source material, a kind of healthy tea, Gromwell seed (Coix lachryma-jobi) ext., and including compounds Monoolein and Trilinolein have been screened using the in vitro synergistic assay indicated by inhibitory effects on the induction of Epstein-Barr virus early antigen (EBV-EA) by TPA. In assay, Gromwell seed aqueous extract and hot aqueous extract exhibited the potential inhibitory effects on EBV-EA activation without strong cytotoxicity on Raji cells. In our experimental system, the inhibitory effects of both Gromwell extracts and compounds were greater than that of beta-carotene, which is known anti-tumor promoting agent and/or chemopreventive agent. These compounds were evaluated for their in vitro inhibitory effect on EBV-EA activation induced by TPA. The percentages of the inhibition of TPA-induced EBV-EA activation for these materials were 60% and 30% at concentration 100 μg. Based on the results obtained in vitro, we studied the inhibitory effect of compounds, in an in vivo two-stage carcinogenesis test of mouse skin papilloma using DMBA as an initiator and TPA as a potential promoter. The control animals showed a 100% incidence of papilloma at 20 weeks after DMBA-TPA tumor promotion, while treatment with compounds reduced the percentage of number of tumor to 60 % after 20 weeks. Results from in vitro and in vivo studies showing chemopreventive activity against TPA promoting stage and these data support the effective potency of carcinogenic stage in clinical evaluation of integrative oncology.

Keywords: gromwell seed, medicinal plant, chemoprevention, pharmaceutical medicine

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Authors: N. Rajendra Prasad

Abstract:

Resveratrol (RSV), a grape phytochemical, has drawn greater attention because of its beneficial ef-fects against cancer. However, RSV has some draw-backs such as unstabilization, poor water solubility and short biological half time, which limit the utili-zation of RSV in medicine, food and pharmaceutical industries. In this study, we have encapsulated RSV in gelatin nanoparticles (GNPs) and studied its anti-cancer efficacy in NCI-H460 lung cancer cells. SEM and DLS studies have revealed that the prepared RSV-GNPs possess spherical shape with a mean diameter of 294 nm. The successful encapsulation of RSV in GNPs has been achieved by the cross-linker glutaraldehyde probably through Schiff base reaction and hydrogen bond interaction. Spectrophotometric analysis revealed that the max-imum of 93.6% of RSV has been entrapped in GNPs. In vitro drug release kinetics indicated that there was an initial burst release followed by a slow and sustained release of RSV from GNPs. The prepared RSV-GNPs exhibited very rapid and more efficient cellular uptake than free RSV. Further, RSV-GNPs treatment showed greater antiproliferative efficacy than free RSV treatment in NCI-H460 cells. It has been found that greater ROS generation, DNA damage and apoptotic incidence in RSV-GNPs treated cells than free RSV treatment. Erythrocyte aggregation assay showed that the prepared RSV-GNPs formulation elicit no toxic response. HPLC analysis revealed that RSV-GNPs was more bioavailable and had a longer half-life than free RSV. Hence, GNPs carrier system might be a promising mode for controlled delivery and for improved therapeutic index of poorly water soluble RSV.

Keywords: resveratrol, coacervation, anticancer gelatin nanoparticles, lung cancer, controlled release

Procedia PDF Downloads 447

Authors: Sreeparna Majee, G. C. Shit

Abstract:

A study on targeted drug delivery is carried out in an unsteady flow of blood infused with magnetic NPs (nanoparticles) with an aim to understand the flow pattern and nanoparticle aggregation in a diseased arterial segment having stenosis. The magnetic NPs are supervised by the magnetic field which is significant for therapeutic treatment of arterial diseases, tumor and cancer cells and removing blood clots. Coupled thermal energy have also been analyzed by considering dissipation of energy because of the application of the magnetic field and the viscosity of blood. Simulation technique used to solve the mathematical model is vorticity-stream function formulations in the diseased artery. An elevation in SLP (Specific loss power) is noted in the aortic bloodstream when the agglomeration of nanoparticles is higher. This phenomenon has potential application in the treatment of hyperthermia. The study focuses on the lowering of WSS (Wall Shear Stress) with increasing particle concentration at the downstream of the stenosis which depicts the vigorous flow circulation zone. These low shear stress regions prolong the residing time of the nanoparticles carrying drugs which soaks up the LDL (Low Density Lipoprotein) deposition. Moreover, an increase in NP concentration enhances the Nusselt number which marks the increase of heat transfer from the arterial wall to the surrounding tissues to destroy tumor and cancer cells without affecting the healthy cells. The results have a significant influence in the study of medicine, to treat arterial diseases such as atherosclerosis without the need for surgery which can minimize the expenditures on cardiovascular treatments.

Keywords: magnetic nanoparticles, blood flow, atherosclerosis, hyperthermia

Procedia PDF Downloads 141