Search results for: period symptoms

Authors: Thampi Rawther, Sean O’Brien, Kamala Kanta Das

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Background: Intussusception in the adult is rarely from a benign cause and is almost always pathological. Causes include carcinomas, polyps, Meckel's diverticulum, or colonic diverticulum. Common symptoms include abdominal pain, intestinal obstruction, palpable abdominal mass, GI bleeding, and anemia. Sarcomatoid carcinoma is a rare type of small intestinal malignancy exhibiting carcinomatous and sarcomatous features. It primarily affects older patients, mean age 57, and is 1.5 times more prevalent in men. Method: This is an interesting case report of a patient presenting with intussusception secondary to a sarcomatoid tumor of the small bowel. Conclusion: Surgery is the treatment of choice in adults with intussusception due to the high malignancy potential. Furthermore, surgical resection of the affected bowel is the definitive form of therapy as small bowel sarcomatoid tumors are not responsive to chemotherapy and radiotherapy. Early surgical intervention helps reduce mortality as it allows for early staging, treatment, and monitoring of the tumor. The patient was fortunate to have presented with intussusception, facilitating early surgical intervention, and was found to have a low disease stage.

Keywords: general surgery, small bowel tumour, imaging, unique

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Authors: Muhammad Aji Fajari, Ririt Aprilin Sumarsono

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Particular instability of structural building under lateral load (e.g earthquake) will rise due to irregularity in vertical and horizontal direction as stated in SNI 03-1762-2012. The conventional slab has been considered for its less contribution in increasing the stability of the structure, except special slab system such as flat slab turned into account. In this paper, the analysis of flat slab system at Sequis Tower located in South Jakarta will be assessed its performance under earthquake. It consists of 6 floors of the basement where the flat slab system is applied. The flat slab system will be the main focus in this paper to be compared for its performance with conventional slab system under earthquake. Regarding the floor plan of Sequis Tower basement, re-entrant corner signed for this building is 43.21% which exceeded the allowable re-entrant corner is 15% as stated in ASCE 7-05 Based on that, the horizontal irregularity will be another concern for analysis, otherwise vertical irregularity does not exist for this building. Flat slab system is a system where the slabs use drop panel with shear head as their support instead of using beams. Major advantages of flat slab application are decreasing dead load of structure, removing beams so that the clear height can be maximized, and providing lateral resistance due to lateral load. Whilst, deflection at middle strip and punching shear are problems to be detail considered. Torsion usually appears when the structural member under flexure such as beam or column dimension is improper in ratio. Considering flat slab as alternative slab system will keep the collapse due to torsion down. Common seismic load resisting system applied in the building is a shear wall. Installation of shear wall will keep the structural system stronger and stiffer affecting in reduced displacement under earthquake. Eccentricity of shear wall location of this building resolved the instability due to horizontal irregularity so that the earthquake load can be absorbed. Performing linear dynamic analysis such as response spectrum and time history analysis due to earthquake load is suitable as the irregularity arise so that the performance of structure can be significantly observed. Utilization of response spectrum data for South Jakarta which PGA 0.389g is basic for the earthquake load idealization to be involved in several load combinations stated on SNI 03-1726-2012. The analysis will result in some basic seismic parameters such as period, displacement, and base shear of the system; besides the internal forces of the critical member will be presented. Predicted period of a structure under earthquake load is 0.45 second, but as different slab system applied in the analysis then the period will show a different value. Flat slab system will probably result in better performance for the displacement parameter compare to conventional slab system due to higher contribution of stiffness to the whole system of the building. In line with displacement, the deflection of the slab will result smaller for flat slab than a conventional slab. Henceforth, shear wall will be effective to strengthen the conventional slab system than flat slab system.

Keywords: conventional slab, flat slab, horizontal irregularity, response spectrum, shear wall

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Authors: Atiqah Binti Ab Aziz

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Background: It has been estimated that about 250 million people all over the world suffer from osteoarthritis (OA). Thus, OA is a major health problem in urgent need of better treatment. Problem statement: Current therapies for OA can temporarily relieve clinical symptoms and for pain management, rather than preventing or curing OA. Total knee replacement performed at the end stage of the disease is considered the only cure available. Objectives: This article aimed to explore the potential of treating osteoarthritis via the CRISPR Cas system. Methods: Articles that relate to the application of the CRISPR Cas system in osteoarthritis were extracted, categorized, and reviewed through the PRISMA method using PubMed, an engine published from November 2016 to November 2021. Results: There were 30 articles screened. Articles that fall under the categories of non-English articles, full articles that were not available, articles that were not an original articles were excluded. Ultimately, 13 articles were reviewed. Discussion: This review provides an information on the introduction of CRISPR and discussed on their mechanism of actions in extracted studies for OA treatment. Conclusions: It can be seen that not many medical research utilize the CRISPR Cas system as part of the method in the treatment of OA. Hence exploring the extent of the usage of the CRISPR Cas system in OA treatment is important to determine the research gap and point out at which of the research is needed further investigation to avoid redundancy of existing research and ensure the novelty of the research.

Keywords: osteoarthritis, treatment, CRISPR, review, therapy

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Authors: M. B. Mshelia, J. K Balogun, J. Auta, N. O. Bankole

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The current status and abundance of the genus Citharinus was carried out in Jebba Lake, Niger State, Nigeria from January to December, 2011. The aim was to determine the extent of exploitation of the genus Citharinus in Jebba Lake so as to advice the government of Nigeria on how to overcome difficulties in terms of the sustainability of the said fish in the Lake. Descriptive statistics were used to analyze the data obtained. A total of 2,389 of the genus Citharinus were caught during the sampling period. Only two species of the genus Citharinus were caught with 1,220 in number and 430.68kg total weight of Citharinus citharus and 1,169 in number and 418.56kg total weight of Citharinus latus). The current total yield estimated for the genus Citharinus in Jebba Lake in the six (6) sampling sites was calculated and pooled together to be 849.24kg. A day’s catch was calculated to be 35.38kg. The monthly and annual yields of the genus Citharinus were calculated to 1061.55 equivalents to 1 ton and 12 metric tonnes respectively. For the fecundity, June, July and August were discovered as the spawning period for the genus Citharinus and out of total experimental gillnet catch of 2, 389, only 244 (10.21%)of Citharinus citharus and 231 (9.67%) of Citharinus latus were in sexually mature stage. Out of these numbers, 113 (46.31%) were males and 121 (53.69%) were females of Citharinus citharus and 112 (48.48) were males and 119 (51.52) were females of Citharinus latus. The youngest mature males in either of the two had a standard length of 31.5 with a weight of 800.5gWhilethe youngest spawning females were having the standard length of 29.5 cm with a weight of 1,3oo.5g.It was also discovered that females started maturing earlier than the males at the standard length for females and males to be 18.0cm and 19.5cm respectively. Their fecundity ranged from 15,000 to 16, 500 eggs. The sex ratio of 1172 that were males and 1217 that were females was 1 male to 1.0383 females which was equivalent to 1:1 sex ratio of male to female. It was concluded that Jebba Lake had suffered seriously over exploitation of the genus Citharinus and proper management have to be enforced on the lake otherwise the threat of fish being extent may arise.

Keywords: Jebba Lake, Niger State, Nigeria, Citharinus citharus, Citharinus latus, fecundity, sex ratio

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Authors: Dharell B. Siano, Wendy C. Mateo, Victorino T. Taylan, Francisco D. Cuaresma

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Biofuel is one of the renewable energy sources adapted by the Philippine government in order to lessen the dependency on foreign fuel and to reduce carbon dioxide emissions. Rain tree pods were seen to be a promising source of bioethanol since it contains significant amount of fermentable sugars. The study was conducted to establish the complete procedure in processing rain tree pods for village level hydrous bioethanol production. Production processes were done for village level hydrous bioethanol production from collection, drying, storage, shredding, dilution, extraction, fermentation, and distillation. The feedstock was sundried, and moisture content was determined at a range of 20% to 26% prior to storage. Dilution ratio was 1:1.25 (1 kg of pods = 1.25 L of water) and after extraction process yielded a sugar concentration of 22 ⁰Bx to 24 ⁰Bx. The dilution period was three hours. After three hours of diluting the samples, the juice was extracted using extractor with a capacity of 64.10 L/hour. 150 L of rain tree pods juice was extracted and subjected to fermentation process using a village level anaerobic bioreactor. Fermentation with yeast (Saccharomyces cerevisiae) can fasten up the process, thus producing more ethanol at a shorter period of time; however, without yeast fermentation, it also produces ethanol at lower volume with slower fermentation process. Distillation of 150 L of fermented broth was done for six hours at 85 °C to 95 °C temperature (feedstock) and 74 °C to 95 °C temperature of the column head (vapor state of ethanol). The highest volume of ethanol recovered was established at with yeast fermentation at five-day duration with a value of 14.89 L and lowest actual ethanol content was found at without yeast fermentation at three-day duration having a value of 11.63 L. In general, the results suggested that rain tree pods had a very good potential as feedstock for bioethanol production. Fermentation of rain tree pods juice can be done with yeast and without yeast.

Keywords: fermentation, hydrous bioethanol, fermentation, rain tree pods, village level

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Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

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Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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Authors: Nur-E-Jannat Tinu

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Water is absolutely vital not only for the survival of human beings but also for plants, animals, and all other living organisms. Water bodies, such as lakes, rivers, ponds, and estuaries, are the source of water supply in domestic, industrial, agriculture, and aquaculture purposes. The Buriganga River flows through the south and west of Dhaka city. The water quality of this river has become a matter of concern due to anthropogenic intervention of vital pollutants such as industrial effluents, urban sewage, and solid wastes in this area. Buriganga River is at risk to contamination from untreated municipal wastes, industrial discharges, runoff from organic and inorganic fertilizers, pesticides, insecticides, and oil emission around the river. The residential and commercial establishments along the river discharge wastewater either directly into the river or through drains and canals into the river. However, several regulatory measures and policies have been enforced by the Government to protect the river Buriganga from pollution, in most cases to no affect. Water quality assessment reveals that the water is also not appropriate for irrigation purposes. The physical parameters (pH, TDS, EC, Temperature, DO, COD, BOD) indicated that the water is too poor to be useable for agricultural, drinking, or other purposes. Chemical concentrations showed significant seasonal variations with high-level concentrations during the monsoon season, presumably due to extreme seasonal surface runoff. A comparative study of Electrical Conductivity (EC) and Total Dissolved Solids (TDS) indicated a considerable increase over the last five years A change in trend was observed from 2020 June-July, probably due to monsoon and post-monsoon. EC values decreased from 775 to 665 mmho/cm during this period. DO increased significantly from the mid-post-monsoon months to the early monsoon period. The pH value of river water is strongly alkaline, ranging between 6.5 and 7.79. This indicates that ecological organic compounds cause the water to become alkaline after the monsoon and monsoon seasons. As the water pollution level is very high, an effective remediation and pollution control plan should be considered.

Keywords: precipitation, spatial distribution, effluent, remediation

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Authors: Nashi Khan, Amina Khalid

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Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

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Authors: Yimei Huang, Harvey Lui, Jianhua Zhao, Zhenguo Wu, Haishan Zeng

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Conventional laser treatment of skin diseases and cosmetic surgery is based on the principle of one-photon absorption selective photothermolysis which relies strongly on the difference in the light absorption between the therapeutic target and its surrounding tissue. However, when the difference in one-photon absorption is not sufficient, collateral damage would occur due to indiscriminate and nonspecific tissue heating. To overcome this problem, we developed a spatially selective photothermolysis method based on multiphoton absorption in which the heat generation is restricted to the focal point of a tightly focused near-infrared femtosecond laser beam aligned with the target of interest. A multimodal optical microscope with co-registered reflectance confocal imaging (RCM), two-photon fluorescence imaging (TPF), and second harmonic generation imaging (SHG) capabilities was used to perform and monitor the spatially selective photothermolysis. Skin samples excised from the shaved backs of euthanized NODSCID mice were used in this study. Treatments were performed by focusing and scaning the laser beam in the dermis with a 50µm×50µm target area. Treatment power levels of 200 mW to 400 mW and modulated pulse trains of different duration and period were experimented. Different treatment parameters achieved different degrees of spatial confinement of tissue alterations as visualized by 3-D RCM/TPF/SHG imaging. At 200 mW power level, 0.1 s pulse train duration, 4.1 s pulse train period, the tissue damage was found to be restricted precisely to the 50µm×50µm×10µm volume, where the laser focus spot had scanned through. The overlying epidermis/dermis tissue and the underneath dermis tissue were intact although there was light passing through these regions.

Keywords: multiphoton absorption photothermolysis, reflectance confocal microscopy, second harmonic generation microscopy, spatially selective photothermolysis, two-photon fluorescence microscopy

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Authors: Trupti Meher, Harihar Sahoo

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Premature menopause refers to the occurrence of menopause before the age of 40 years. Women who experience premature menopause either due to biological or induced reasons have a longer duration of exposure to severe symptoms and adverse health consequences when compared to those who undergo menopause at a later age, despite the fact that premature menopause has a profound effect on the health of women. This study attempted to determine the prevalence and predictors of premature menopause among women aged 25-39 years, using data from the National Family Health Survey (NFHS-4) conducted during 2015–16 in India. Descriptive statistics and multinomial logistic regression were used to carry out the result. The results revealed that the prevalence of premature menopause in India was 3.7 percent. Out of which, 2.1 percent of women had experienced natural premature menopause, whereas 1.7 percent had premature surgical menopause. The prevalence of premature menopause was highest in the southern region of India. Further, results of the multivariate model indicated that rural women, women with higher parity, early age at childbearing and women with smoking habits were at a greater risk of premature menopause. A sizeable proportion of women in India are attaining menopause prematurely. Unless due attention is given to this matter, it will emerge as a major problem in India in the future. The study also emphasized the need for further research to enhance knowledge on the problems of premature menopausal women in different socio-cultural settings in India.

Keywords: India, natural menopause, premature menopause, surgical menopause

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Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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Authors: Bih-O Lee, Hsiu-Wan Hsieh, Hsiu-Chen Liu, Mer Yu Pan

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Background: Illness perceptions are developed when people face health-threatening situations. Previous research suggests that understanding discrepancies between illness perceptions of patients and caregivers may need to improve quality of health care. Objective: This study examined the differences between illness perceptions of injured patients and those of their caregivers. Methods: Comparative study design was used. The study setting was the surgical wards of a teaching hospital in Taiwan. Participants were 127 pairs of injured patients and their caregivers. The participants completed socio-demographic data and completed the Chinese Illness Perception Questionnaire Revised-Trauma, which comprises eight subscales. Clinical data of the injured patients was obtained from medical records. Results: This study found that injured patients were more pessimistic than their caregivers about the injury. There were significant differences between patients and caregivers insofar as patients perceived more physical symptoms, scored higher in terms of reasons for their injury, had more negative emotions and experienced more consequences than caregivers. Elderly caregivers and caregivers for patients who were over 65, severely injured and admitted to an ICU perceived more negative perceptions about the injury. Conclusions: This study indicated that patients and caregivers had negative illness representations several months after injury although the intensity of their perceptions was different. The interventions should highlight the need to assist patients and caregivers after injury.

Keywords: illness representations, injury, caregivers, comparative study

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Authors: Suranath Chomcheon, Nathnarong Khajohnsaksumeth, Benchawan Wiwatanapataphee

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Carbon monoxide is one of the harmful gases which have colorless, odorless, and tasteless. Too much carbon monoxide taken into the human body causes the reduction of oxygen transportation within human body cells leading to many symptoms including headache, nausea, vomiting, loss of consciousness, and death. Carbon monoxide is considered as one of the air pollution indicators. It is mainly released as soot from the exhaust pipe of the incomplete combustion of the vehicle engine. Nowadays, the increase in vehicle usage and the slowly moving of the vehicle struck by the traffic jam has created a large amount of carbon monoxide, which accumulated in the street canyon area. In this research, we study the effect of parameters such as wind speed and aspect ratio of the height building affecting the ventilation. We consider the model of the pollutant under the Bangkok Transit System (BTS) stations in a two-dimensional geometrical domain. The convention-diffusion equation and Reynolds-averaged Navier-stokes equation is used to describe the concentration and the turbulent flow of carbon monoxide. The finite element method is applied to obtain the numerical result. The result shows that our model can describe the dispersion patterns of carbon monoxide for different wind speeds.

Keywords: air pollution, carbon monoxide, finite element, street canyon

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Authors: N. A. Ahmad Zubairi, H. Takaijudin, K. W. Yusof

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Pesticides have been used widely over the world in agriculture to protect from pests and reduce crop losses. However, it affects the environment with toxic chemicals. Exceed of toxic constituents in the ecosystem will result in bad side effects. The hydrological cycle is related to the existence of pesticides and heavy metal which it can penetrate through varieties of sources into the soil or water bodies, especially runoff. Therefore, proper mechanisms of pesticide and heavy metal removal should be studied to improve the quality of ecosystem free or reduce from unwanted substances. This paper reviews the use of treatment train and its mechanisms to minimize pesticides and heavy metal from agricultural runoff. Organochlorine (OCL) is a common pesticide that was found in the agricultural runoff. OCL is one of the toxic chemicals that can disturb the ecosystem such as inhibiting plants' growth and harm human health by having symptoms as asthma, active cancer cell, vomit, diarrhea, etc. Thus, this unwanted contaminant gives disadvantages to the environment and needs treatment system. Hence, treatment train by bioretention system is suitable because removal efficiency achieves until 90% of pesticide removal with selected vegetated plant and additive.

Keywords: pesticides, heavy metal, agricultural runoff, bioretention, mechanism removal, treatment train

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Authors: Dalal Tarfaoui, Salah Zkim

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Today, environmental sustainability is everyone’s concern as it contributes in many aspects to a country's development. Morocco is also aware of the increasing threats to its natural resources. Accordingly, many projects and research have been discussed pointing mainly to water security, pollution, desertification, and land degradation, but few studies bothered to dig into the human demeanor to disclose its ecological behavior. Human behavior is accountable for environment deterioration in the first place, but we keep fighting the symptoms instead of limiting the root causes. In the conceptual framework highlighted in the present article, semi-structured interviews have been conducted using a grounded theory approach. Initially this study will serve as a pilot study and a cornerstone to approve a bigger project now in progress. Beyond the existing general ecological measures (GEM), this study has chosen the grounded theory approach to bring out firsthand insights, and probe to which extent an ecological dimension exists in Morocco as a developing country. The discourse of the ecological behavior within the Moroccan context is seen in more realist, social, and community philosophy. The study has revealed an appreciative ecological behavior that is unfortunately repressed by variables beyond people’s control, which would prevent the people’s environmental good intentions to be translated into real ecological actions.

Keywords: ecological behavior, ecological dimension, variables beyond people’s control, Morocco

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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: K. K. Balavenkatraman, B. Bertschi, K. Bigot, A. Grevot, A. Doelemeyer, S. D. Chibout, A. Wolf, F. Pognan, N. Manevski, O. Kretz, P. Swart, K. Litherland, J. Ashton-Chess, B. Ling, R. Wettstein, D. J. Schaefer

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Skin toxicity is poorly detected during preclinical studies, and drug-induced side effects in humans such as rashes, hyperplasia or more serious events like bullous pemphigus or toxic epidermal necrolysis represent an important hurdle for clinical development. In vitro keratinocyte-based epidermal skin models are suitable for the detection of chemical-induced irritancy, but do not recapitulate the biological complexity of full skin and fail to detect potential serious side-effects. Normal healthy skin explants may represent a valuable complementary tool, having the advantage of retaining the full skin architecture and the resident immune cell diversity. This study investigated several conditions for the maintenance of good morphological structure after several days of culture and the retention of phase II metabolism for 24 hours in skin explants in vitro. Human skin samples were collected with informed consent from patients undergoing plastic surgery and immediately transferred and processed in our laboratory by removing the underlying dermal fat. Punch biopsies of 4 mm diameter were cultured in an air-liquid interface using transwell filters. Different cultural conditions such as the effect of calcium, temperature and cultivation media were tested for a period of 14 days and explants were histologically examined after Hematoxylin and Eosin staining. Our results demonstrated that the use of Williams E Medium at 32°C maintained the physiological integrity of the skin for approximately one week. Upon prolonged incubation, the upper layers of the epidermis become thickened and some dead cells are present. Interestingly, these effects were prevented by addition of EGFR inhibitors such as Afatinib or Erlotinib. Phase II metabolism of the skin such as glucuronidation (4-methyl umbeliferone), sulfation (minoxidil), N-acetyltransferase (p-toluidene), catechol methylation (2,3-dehydroxy naphthalene), and glutathione conjugation (chlorodinitro benzene) were analyzed by using LCMS. Our results demonstrated that the human skin explants possess metabolic activity for a period of at least 24 hours for all the substrates tested. A time course for glucuronidation with 4-methyl umbeliferone was performed and a linear correlation was obtained over a period of 24 hours. Longer-term culture studies will indicate the possible evolution of such metabolic activities. In summary, these results demonstrate that human skin explants maintain a normal structure for several days in vitro and are metabolically active for at least the first 24 hours. Hence, with further characterisation, this model may be suitable for the study of drug-induced toxicity.

Keywords: human skin explant, phase II metabolism, epidermal growth factor receptor, toxicity

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Authors: Mohamed Boly

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This paper investigates the link between foreign aid and environmental protection, specifically CO2 emissions, in aid recipient countries. Conflicting results exist in the literature regarding the environmental impact of foreign aid. We come to reconcile them, using Project-Level Aid Data with environment codes, over the 1980- 2010 period. The disaggregation of aid according to the environmental codes, show why the results of previous literature remain very mixed. Moreover, we find that the effect of environmental aid is conditioned by some specific characteristics of the recipient country, independently of the donor.

Keywords: foreign aid, green aid, interactive effects, pollution

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Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

Abstract:

Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

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Authors: Temosho Promise Chuene, T. Chitura

Abstract:

Background: Foot and mouth disease is a real challenge in South Africa. The disease is a serious threat to the viability of livestock farming initiatives and affects local and international livestock trade. In Limpopo Province, the Kruger National Park and other game reserves are home to the African buffalo (Syncerus caffer), a notorious reservoir of the picornavirus, which causes foot and mouth disease. Out of the virus’s seven (7) distinct serotypes, Southern African Territories (SAT) 1, 2, and 3 are commonly endemic in South Africa. The broad objective of the study was to establish the trend of foot and mouth disease in Limpopo Province over a seven-year period (2014-2020), as well as the adoption and comprehensive reporting of the measures that are taken to contain disease outbreaks in the study area. Methods: The study used secondary data from the World Organization for Animal Health (WOAH) on reported cases of foot and mouth disease in South Africa. Descriptive analysis (frequencies and percentages) and Analysis of variance (ANOVA) were used to present and analyse the data. Result: The year 2020 had the highest prevalence of foot and mouth disease (3.72%), while 2016 had the lowest prevalence (0.05%). Serotype SAT 2 was the most endemic, followed by SAT 1. Findings from the study demonstrated the seasonal nature of foot and mouth disease in the study area, as most disease cases were reported in the summer seasons. Slaughter of diseased and at-risk animals was the only documented disease control strategy, and information was missing for some of the years. Conclusion: The study identified serious underreporting of the adopted control strategies following disease outbreaks. Adoption of comprehensive disease control strategies coupled with thorough reporting can help to reduce outbreaks of foot and mouth disease and prevent losses to the livestock farming sector of South Africa and Limpopo Province in particular.

Keywords: livestock farming, African buffalo, prevalence, serotype, slaughter

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Authors: Ajay Gogia, Svs Deo, Dn Sharma, Atul Batra, Ashutash Mishra

Abstract:

Background and Aims: Breast cancer in women aged less than 25 years (defined as very young breast cancer, VYBC) is rare and accounts for 0.25% of all breast cancer in the West. There is no data available on VYBC from developing countries. The aim of this study was to analyze the clinical, pathological, and prognostic factors and outcomes in VYBC. Methods: This retrospective analysis was performed on 80 patients aged 25 years or less (screened 8000 files of female BC) who were registered at All India Institute of Medical Sciences (AIIMS), New Delhi, India, over a 15-year period between 2011 and 2023. Results: The median age was 21.5 years (range 16-25). A positive family history (siblings and parents) was elicited in 30% of cases, and breast cancer gene (BRCA1/2) mutation was found in 33% of cases patients. Ten patients (12.5%) patients have pregnancy-associated breast cancer (BC detected during pregnancy or 1 year after postpartum period). The TNM stage distribution was Stage I was 0, stage II -30%, stage III –60% and Stage IV -10 %patients. Seventy percent of tumors were high grade, and 90% had pathological node-positive disease. Estrogen, Progesterone, and human epidermal growth factor receptor 2 (HER2)/neu positivity were 25%,25% and 35%, respectively. Triple-negative breast cancer constituted 40% of patients. With a median follow-up of 42 months, 3 years, relapse-free survival (nonmetastatic disease), progression-free survival (metastatic disease) and overall survival were 30%, 15% and 50%, respectively. Conclusions: Very young women constituted 1% of all breast cancer cases. Advanced disease at presentation and high-risk pathological features result in poor outcomes. One-third of VYBCs are associated with BRCA mutation, which requires genetic counseling and risk reduction surgery if required. Due to the aggressive behavior of BC in this age group, need early diagnosis and prompt treatment

Keywords: very young, breast cancer, outcome, developing country, India

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Authors: Shivkumar Krishnamurti, Ruchi Agarwal

Abstract:

The study examines the influence of marital status on consumers of products and services using blogs as a source of information. A pre-designed questionnaire was used to collect the primary data from the respondents (experiences). Data were collected from one hundred and eighty seven respondents residing in and around the Emirates of Sharjah and Dubai of the United Arab Emirates. The collected data was analyzed with the help of statistical tools such as averages, percentages, factor analysis, student’s t-test and structural equation modeling technique. Objectives of the study are to know the reasons how married and unmarried or single consumers of products and services are motivated to use blogs as a source of information, to know whether the consumers of products and services irrespective of their marital status share their views and experiences with other bloggers and to know the respondents’ future intentions towards blogging. The study revealed the following: Majority of the respondents have the motivation to blog because they are willing to receive comments on what they post about services, convenience of blogs to search for information about services and products, by blogging respondents share information on the symptoms of a disease/ disorder that may be experienced by someone, helps to share information about ready to cook mix products and are keen to spend more time blogging in the future.

Keywords: blog, consumer, information, marital status

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Authors: Narupon Kunbootsri, J. Kraipoj, K. Phandech, P. Sirasaporn

Abstract:

Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom before physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on pain score, onset of symptom and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, pain score and obtaining physical modalities were recorded. There was a statistically significant improve in pain score, pretreatment score mean 7.24±1.52 and the last follow up pain score mean 3.88± 1.0 [mean difference 3.18 with 95%CI were [2.45- 3.92]. In addition, the onset of symptoms was 145 days before obtaining physiotherapy program. The physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the retrospective study show physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder in term of pain score. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, physiotherapy, pain score, onset of symptom, physical modality

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Authors: Maria Vinca Novenia

Abstract:

The number of school-aged children with autism in Indonesia has been increasing each year. Autism is a developmental disorder which can be diagnosed in childhood. One of the symptoms is the lack of communication skills. Music therapy is known as an effective treatment for children with autism. Music elements and structures create a good space for children with autism to express their feelings and communicate their thoughts. School-aged children are expected to be able to communicate non-verbally very well, but children with autism experience the difficulties of communicating non-verbally. The aim of this research is to analyze the significance of music therapy treatment to improve non-verbal communication tools for children with autism. This research informs teachers and parents on how music can be used as a media to communicate with children with autism. The qualitative method is used to analyze this research, while the result is described with the microanalysis technique. The result is measured specifically from the whole experiment, hours of every week, minutes of every session, and second of every moment. The samples taken are four school-aged children with autism in the age range of six to 11 years old. This research is conducted within four months started with observation, interview, literature research, and direct experiment. The result demonstrates that music therapy could be effectively used as a non-verbal communication tool for children with autism, such as changes of body gesture, eye contact, and facial expression.

Keywords: autism, improvisation, microanalysis, music therapy, nonverbal communication, school-aged

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Authors: Siphat Lim

Abstract:

The result of the study revealed that the interaction between money, exchange rate, and price level was mainly derived from the policy-induced by the central bank. Furthermore, the variation of inflation was explained weakly by exchange rate and money supply. In the period of twelfth-month, the variation of inflation which caused by exchange rate and money supply were not more than 1.78 percent and 9.77 percent, respectively.

Keywords: money supply, exchange rate, price level, VAR model

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Authors: Sagarjyoti Roy

Abstract:

Dengue is an arboviral infection, belonging to family flaviviridae, comprising of four serotypes; DENV1, DENV2, DENV3 and DENV4. All four serotypes are capable of causing full-spectrum of clinical features, ranging from self-limiting fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Complications may affect any organ system, including those involving gastrointestinal system and serositis. We report a case, of a 28 years, non-alcoholic male, presenting with a 7 day history of fever and malaise followed by abdominal pain and distension, from 4th day of fever. He was admitted in medicine department of RG KAR medical college hospital. Dengue fever was confirmed by NS1 and dengue IgM positivity. Platelet count was 30,000/cc (1.5- 4 lac/cc) and haematocrit was 52% (38- 50% for men). Clinicoradiological findings revealed bilateral pleural effusion, ascites and splenomegaly. Ascitic fluid was hemorrhagic in nature, with a high protein and RBC content. Liver function tests revealed mild transaminitis with normal coagulation profile. Patient was managed conservatively. A diagnosis of dengue fever complicated by serositis and spontaneous haemoperitoneum was made. The symptoms subsided after a hospital stay of 10 days. The case highlights haemorrhage into peritoneal cavity as a possible complication of dengue fever. Although a definite explanation requires more detailed studies, platelet or endothelial cell dysfunction might be contributory.

Keywords: ascites, dengue, haemoperitoneum, serositis

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Authors: Sameer Masood, Lucas Chartier

Abstract:

Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

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Authors: Wisit Wichitkosoom

Abstract:

Objective:The majority of the hisk-risk patients (ST-elevation myocardial infarction (STEMI), Acute cerebrovascular accident, Sepsis, Acute Traumatic patient ) are admitted to district or lacal hospitals (average 1-1.30 hr. from Udonthani general hospital, Northeastern province, Thailand) without proper facilities. The referral system was support to early care and early management at pre-hospital stage and prepare for the patient data to higher hospital. This study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral directly to Udonthani General Hospital. Methods and results: Four district or local hospitals without proper facilities for treatment the very high-risk patient were serving the study region. Pre-hospital diagnoses were established with the simple technology such as LINE, SMS, telephone and Fax for concept of LEAN process and then the telemedicine, by ambulance monitoring (ECG, SpO2, BT, BP) in both real time and snapshot mode was administrated during the period of transfer for safety transfer concept (inter-hospital stage). The standard treatment for patients with STEMI, Intracranial injury and acute cerebrovascular accident were done. From 1 October 2012 to 30 September 2013, the 892 high-risk patients transported by ambulance and transferred to Udonthani general hospital were registered. Patients with STEMI diagnosed pre-hospitally and referred directly to the Udonthani general hospital with telemedicine closed monitor (n=248). The mortality rate decreased from 11.69% in 2011 to 6.92 in 2012. The 34 patients were arrested on the way and successful to CPR during transfer with the telemedicine consultation were 79.41%. Conclusion: The proper innovation could apply for health care system. The very high-risk patients must had the closed monitoring with two-way communication for the “safety transfer period”. It could modified to another high-risk group too.

Keywords: safety transfer, telemedicine, critical patients, medical and health sciences

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Authors: Ilirian Laçi, Alketa Spahiu

Abstract:

Ageing causes an increase in the number of patients with spinal canal stenosis. Most of the patients have back pain, leg pain, numbness of the legs, as well as urinary incontinence as a very common symptoms. Urinary incontinence impairs the quality of life. Correction of the symptom of urinary incontinence is possible in the early and adequate treatment of spinal stenosis. Methods: This study observed patients with urinary incontinence and spinal canal stenosis. These patients underwent mechanical decompression of the spinal stenosis through surgery. At the same time, these patients were observed clinically with clinical consultations. Cystoscopy and urodynamic tests were conducted at intervals of 2 and 6 months. As a result of treatment, 60% of patients did recover. The patients in this group who benefit from treatment were the patients who were early diagnosed and treated. Conclusions: An important factor in the prognosis of this pathology is the early diagnosis and treatment. The proper treatment of this pathology makes it curable in most cases. An important role in this pathology is played by the neurosurgeon. Surgery accompanied by laminotomy and mechanical decompression is the best way of treatment. Other factors that played a role in this pathology are also a large number of childbirths for women, obesity, etc.

Keywords: urinary incontinence, quality of life, spinal canal stenosis, early diagnosis, treatment

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