Search results for: common treatment

Authors: Jacqueline Y. Thompson, Sam Watson, Lee Middleton, Karla Hemming

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Introduction: The odds ratio (estimated via logistic regression) is a well-established and common approach for estimating covariate-adjusted binary treatment effects when comparing a treatment and control group with dichotomous outcomes. Its popularity is primarily because of its stability and robustness to model misspecification. However, the situation is different for the relative risk and risk difference, which are arguably easier to interpret and better suited to specific designs such as non-inferiority studies. So far, there is no equivalent, widely acceptable approach to estimate an adjusted relative risk and risk difference when conducting clinical trials. This is partly due to the lack of a comprehensive evaluation of available candidate methods. Methods/Approach: A simulation study is designed to evaluate the performance of relevant candidate methods to estimate relative risks to represent conditional and marginal estimation approaches. We consider the log-binomial, generalised linear models (GLM) with iteratively weighted least-squares (IWLS) and model-based standard errors (SE); log-binomial GLM with convex optimisation and model-based SEs; log-binomial GLM with convex optimisation and permutation tests; modified-Poisson GLM IWLS and robust SEs; log-binomial generalised estimation equations (GEE) and robust SEs; marginal standardisation and delta method SEs; and marginal standardisation and permutation test SEs. Independent and identically distributed datasets are simulated from a randomised controlled trial to evaluate these candidate methods. Simulations are replicated 10000 times for each scenario across all possible combinations of sample sizes (200, 1000, and 5000), outcomes (10%, 50%, and 80%), and covariates (ranging from -0.05 to 0.7) representing weak, moderate or strong relationships. Treatment effects (ranging from 0, -0.5, 1; on the log-scale) will consider null (H0) and alternative (H1) hypotheses to evaluate coverage and power in realistic scenarios. Performance measures (bias, mean square error (MSE), relative efficiency, and convergence rates) are evaluated across scenarios covering a range of sample sizes, event rates, covariate prognostic strength, and model misspecifications. Potential Results, Relevance & Impact: There are several methods for estimating unadjusted and adjusted relative risks. However, it is unclear which method(s) is the most efficient, preserves type-I error rate, is robust to model misspecification, or is the most powerful when adjusting for non-prognostic and prognostic covariates. GEE estimations may be biased when the outcome distributions are not from marginal binary data. Also, it seems that marginal standardisation and convex optimisation may perform better than GLM IWLS log-binomial.

Keywords: binary outcomes, statistical methods, clinical trials, simulation study

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Authors: Ifeoma Anozie, Teka Apalata, Dominic Abaver

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Introduction: Despite use of Anti-retroviral therapy to reduce the incidence of opportunistic infections among HIV/AIDS patients, rapid episodes of re-infection after deworming are still common occurrences because pharmaceutical intervention alone does not prevent reinfection. Unsafe water and inadequate personal hygiene and parasitic infections are widely expected to accelerate the progression of HIV infection. This is because the chronic immunosuppression of HIV infection encourages susceptibility to opportunistic (including parasitic) infections which is linked to CD4+ cell count of <200 cells/μl. Intestinal parasites such as G. intestinalis and Entamoeba spp are ubiquitous protozoa that remain infectious over a long time in an environment and show resistance to standard disinfection. To control re-infection, the social factors that underpin the prevention need to be controlled. This study aims at prevention of intestinal parasites in people living with HIV/AIDS by using a treatment, hygiene education and sanitation (THEdS) bundle approach. Methods: This study was conducted in four clinics (Ngangelizwe health centre, Tsolo gateway clinic, Idutywa health centre and Nqamakwe health centre) across the seven districts in Eastern cape, South Africa. The four clinics were divided in two: experimental and control, for the purpose of intervention. Data was collected from March 2019 to February 2020. Six hundred participants were screened for intestinal parasitic infections. Stool samples were collected and analysed twice: before (Pre-test infection screening) and after (Post-test re-infection) THEdS bundle intervention. The experimental clinics received full intervention package, which include therapeutic treatment, health education on personal hygiene and sanitation training, while the control clinics received only therapeutic treatment for those found with intestinal parasitic infections. Results: Baseline prevalence of Intestinal Parasites isolated shows 12 intestinal parasites with overall frequency of 65, with Ascaris lumbricoides having most frequency (44.6%). The intervention had a cure rate of 60%, with odd ratio of 1.42, which indicates that the intervention group is 1.42 times more likely of parasite clearing as compared to the control group. The relative risk ratio of 1.17 signifies that there is 1.17 times more likelihood to clear intestinal parasite if there no intervention. Discussion and conclusion: Infection with multiple parasites can cause health defects, especially among HIV/AIDS patients. Efficiency of some HIV vaccines in HIV/AIDS patients is affected because treatment of re-infection amplifies drug resistance, affects the efficacy of the front-line drugs, and still permits transmission. In South Africa, treatment of intestinal parasites is usually offered to clinic attending HIV/AIDS patients upon suspicion but not as a mandate for patients being initiated into Antiretroviral (ART) program. The effectiveness of THEdS bundle advocates for inclusiveness of mandatory screening for intestinal parasitic infections among attendees of HIV/Aids clinics on regular basis.

Keywords: cure rate, , HIV/AIDS patients, intestinal parasites, intervention studies, reinfection rate

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Authors: Malith Premarathne, Shehan Bandara, Kaushalya G. Batawala, Thilini U. Ariyadasa

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The rapid depletion of fossil fuel supplies and the emission of carbon dioxide by their continued combustion have paved the way for increased production of carbon-neutral biodiesel from naturally occurring oil sources. The high biomass growth rate and lipid production of microalgae make it a viable source for biodiesel production compared to conventional feedstock. In Sri Lanka, the production of biodiesel by employing indigenous microalgae species is at its emerging stage. This work was an attempt to compare the various pre-treatment methods before extracting lipids such as autoclaving, microwaving and sonication. A mixed culture of microalgae predominantly consisting of Chlorella sp. was obtained from Beire Lake which is an algae rich, organically polluted water body located in Colombo, Sri Lanka. After each pre-treatment method, a standard solvent extraction using Bligh and Dyer’s method was used to compare the total lipid content in percentage dry weight (% dwt). The fatty acid profiles of the oils extracted with each pretreatment method were analyzed using gas chromatography-mass spectrometry (GC-MS). The properties of the biodiesels were predicted by Biodiesel Analyzer© Version 1.1, in order to compare with ASTM 6751-08 biodiesel standard.

Keywords: biodiesel, lipid extraction, microalgae, pre-treatment

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Authors: Manal A. Mohsen, Ahmed Tawfik

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Hydrogen production from cake wastewater by anaerobic dark fermentation via upflow anaerobic staged reactor (UASR) was investigated in this study. The reactor was continuously operated for four months at constant hydraulic retention time (HRT) of 21.57 hr, PH value of 6 ± 0.6, temperature of 21.1°C, and organic loading rate of 2.43 gCOD/l.d. The hydrogen production was 5.7 l H₂/d and the hydrogen yield was 134.8 ml H₂ /g COD_removed. The system showed an overall removal efficiency of TCOD, TBOD, TSS, TKN, and Carbohydrates of 40 ± 13%, 59 ± 18%, 84 ± 17%, 28 ± 27%, and 85 ± 15% respectively during the long term operation period. Based on the available results, the system is not sufficient for the effective treatment of cake wastewater, and the effluent quality of UASR is not complying for discharge into sewerage network, therefore a post treatment is needed (not covered in this study).

Keywords: cake wastewater industry, chemical oxygen demand (COD), hydrogen production, up-flow anaerobic staged reactor (UASR)

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Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

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Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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Authors: Rajesh Panda, Jimi Tjong, Sanjay K. Nayak, Mohini M. Sain

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The aim of this manuscript was to evaluate the effect of chemical treatment of sisal fibre on the mechanical and viscoelastic properties of bio based epoxy/fibre composites. The composite samples were manufactured through a vacuum infusion process by adding alkyl phenols from cashew nutshell liquid (CSNL). Changes in the chemical structure of the sisal fibres resulting from the treatments were analyzed by Fourier transform infrared spectroscopy (FTIR). Both alkali and silane treatments produced enhancements in the mechanical properties of sisal fibre bundles. The alkali treatment, when combined with the silane treatment, the mechanical properties of epoxy composites notably improved (13%) in comparison to untreated sisal fibre reinforced composites.This was attributed to an enhanced fibre/matrix interface. The incorporation of CSNL into the sisal/epoxy composite enhanced the fibre-matrix interfacial properties because of the addition of -OH groups to the epoxy matrix. The incorporation of sisal fibre imparts stiffness to the epoxy matrix.

Keywords: phenalkamine, sisal fiber, vacuum infusion, cashew nutshell liquid, cashew nutshell liquid (CSNL)

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Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

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As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

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This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

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Authors: Mohammad D. H. Beg, John O. Akindoyo, Suriati Ghazali, Abdullah A. Mamun

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In this study, composites were fabricated from oil palm empty fruit bunch fiber and poly(lactic) acid by extrusion followed by injection moulding. Surface of the fiber was pre-treated by ultrasound in an alkali medium and treatment efficiency was investigated by scanning electron microscopy (SEM) analysis and Fourier transforms infrared spectrometer (FTIR). Effect of fiber treatment on composite was characterized by tensile strength (TS), tensile modulus (TM) and impact strength (IS). Furthermore, biostrong impact modifier was incorporated into the treated fiber composite to improve its impact properties. Mechanical testing showed an improvement of up to 23.5% and 33.6% respectively for TS and TM of treated fiber composite above untreated fiber composite. On the other hand incorporation of impact modifier led to enhancement of about 20% above the initial IS of the treated fiber composite.

Keywords: fiber treatment, impact modifier, natural fibers, ultrasound

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Authors: Lintle Mohase, Ninikoe Lebusa, Mpho Stephen Mafa

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Wheat is an economically important cereal crop. However, the changing climatic conditions that intensify drought in production areas, and additional pest infestation, such as the Russian wheat aphid (RWA, Diuraphis noxia), severely hamper its production. Drought and pest management require an additional water supply through irrigation and applying inorganic nutrients (including silicon) as alternative strategies to mitigate the stress effects. Therefore, other approaches are needed to enhance wheat productivity during drought stress and aphid abundance. Two wheat cultivars were raised under greenhouse conditions, exposed to drought stress, and treated with silicon before infestation with the South African RWA biotype 2 (RWASA2). The morphological evaluations showed that severe drought or a combination of drought and infestation significantly reduced the plant height of wheat cultivars. Silicon treatment did not alleviate the growth reduction. The biochemical responses were measured using spectrophotometric assays with specific substrates. An evaluation of the enzyme activities associated with oxidative stress and defence responses indicated that drought stress increased NADPH oxidase activity, while silicon treatment significantly reduced it in drought-stressed and infested plants. At 48 and 72 hours sampling periods, a combination of silicon, drought and infestation treatment significantly increased peroxidase activity compared to drought and infestation treatment. The treatment also increased β-1,3-glucanase activity 72 hours after infestation. In addition, silicon and drought treatment increased glucose but reduced sucrose accumulation. Furthermore, silicon, drought, and infestation treatment combinations reduced the sucrose content. Finally, silicon significantly increased the trehalose content under severe drought and infestation, evident at 48 and 72-hour sampling periods. Our findings shed light on silicon’s ability to induce protective biochemical responses during drought and aphid infestation.

Keywords: drought, enzyme activity, silicon, soluble sugars, Russian wheat aphid, wheat

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Authors: M. Mathuthu, N. N. Gaxela, R. Y. Olobatoke

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A study was carried out to assess the heavy metal and radionuclide concentrations of water from the waste water treatment plant in Mafikeng Local Municipality to evaluate treatment efficiency. Ten water samples were collected from various stages of water treatment which included sewage delivered to the plant, the two treatment stages and the effluent and also the community. The samples were analyzed for heavy metal content using Inductive Coupled Plasma Mass Spectrometer. Gross α/β activity concentration in water samples was evaluated by Liquid Scintillation Counting whereas the concentration of individual radionuclides was measured by gamma spectroscopy. The results showed marked reduction in the levels of heavy metal concentration from 3 µg/L (As)–670 µg/L (Na) in sewage into the plant to 2 µg/L (As)–170 µg/L (Fe) in the effluent. Beta activity was not detected in water samples except in the in-coming sewage, the concentration of which was within reference limits. However, the gross α activity in all the water samples (7.7-8.02 Bq/L) exceeded the 0.1 Bq/L limit set by World Health Organization (WHO). Gamma spectroscopy analysis revealed very high concentrations of 235U and 226Ra in water samples, with the lowest concentrations (9.35 and 5.44 Bq/L respectively) in the in-coming sewage and highest concentrations (73.8 and 47 Bq/L respectively) in the community water suggesting contamination along water processing line. All the values were considerably higher than the limits of South Africa Target Water Quality Range and WHO. However, the estimated total doses of the two radionuclides for the analyzed water samples (10.62 - 45.40 µSv yr-1) were all well below the reference level of the committed effective dose of 100 µSv yr-1 recommended by WHO.

Keywords: gross α/β activity, heavy metals, radionuclides, 235U, 226Ra, water sample

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Authors: Mehdi Abbasi, Masoumeh Majidi Zolbin

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Varicocele is one of the common causes of infertility in 30-50% of married men which occurs within the spermatic cord. It can be considered as an abnormal dilatation and stasis of veins of the pampiniform plexus that drain the testis. It occurs in 15-20% of the male population. Inducible nitric oxide synthase (NOS) activity has been frequently reported in varicose veins. Several studies have considered the relationship between varicocele and semen NO concentrations. NOS isoforms have been shown to regulate a number of functions, e.g., sperm motility and maturation and germ cell apoptosis in the testes. In adult patients with varicocele, the amount of NO levels in the varicose veins are 25 times higher than in serum of peripheral veins. The aim of this study was to review the effect of different antioxidant that we applied so far on sperm parameters as well as sperm DNA fragmentation. The findings of this study suggest that antioxidants improve sperm parameters which are associated with infertility in varicocelized rats, and treatment can reduce damage to sperm DNA and increase the chance of fertility.

Keywords: antioxidant, rat, sperm parameter, varicocele

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Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

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Haemoglobin (HB) indicates anaemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like zidovudine are known to cause anaemia in People living with HIV/AIDS (PLWHA). A cross-sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December 2009 and July 2011 to assess the effect of zidovudine on haematologic and RNA viral load of female sex workers receiving antiretroviral treatment in north-western Nigeria. Anaemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anaemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anaemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that out of 218 patients, 26 with haemoglobin count between 5.1–10 g/dl were observed to have the highest viral load count of 300,000–350,000 copies/ml. It was also observed that most patients (190) with HB of 10.1–15.0 g/dl had viral load count of 200,000–250,000 copies/ml. An inverse relationship therefore exists, i.e. the lower the haemoglobin level, the higher the viral load count, even though the test statistics did not show any significance between the two (P=0.206). This shows that multivariate logistic regression analysis demonstrated that anaemia was associated with a CD4+ cell count below 50/µL in female sex workers with a viral load above 100,000 copies/mL who use zidovudine. Severe anaemia was less prevalent in this study population than in historical comparators; however, mild to moderate anaemia rates remain high. The study, therefore, recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: anaemia, female sex worker, haemoglobin, Zidovudine

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Authors: Yonas Lamore, Abebe Beyene, Samuel Fekadu, Moa Megersa

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Unaffordable construction cost of conventional water treatment plant and distribution system in most developing countries makes difficult to provide safe and adequate water for all households, especially for the rural setup. Water treatment at the source can be the best alternative. Solar disinfection is one alternative among point of use treatments. In this study, aqua lens, photovoltaic box and glass bottle were used subsequent to plant coagulants to evaluate microbial reduction potentials. Laboratory- and field-based experiments were conducted from May to August 2016. The Escherichia coli, total coliforms and heterotrophic plate counts were used as indicator organisms. The result indicated that aqua lens (AL), photovoltaic box (PV) and glass bottle (GB) have high inactivation rate subsequently almost for all indicator organisms in short solar exposure time. Total coliforms were inactivated in AL (SD = 15.8 °C, R2 = 0.92) followed by PV inactivation temperature associa- tion (SD = 11.6 C, R2 = 0.90), and the GB concentrator was inactivated (SD = 10.9 °C, R2 = 0.70) at turbidity level of 3.41 NTU. As the study indicated, aqua lens coupled with Moringa oleifera coagulant can be an effective with minimum cost for household water treatment system. The study also concludes heterotrophic bacteria were more resistant than other types of bacteria in SODIS with similar exposure time.

Keywords: acrylic glass, aqua lens, moringa olifera, photovoltaic box, solar disinfection, water treatment

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Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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Authors: Ladda Silanoi

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One of the main purposes in establishment of ASEAN Community is educational development. All countries in ASEAN shall then prepare for plans and strategies for country development. Therefore, Thailand set up the policy concerning educational management for all educational institutions to understand about ASEAN Community. However, some educational institutions lack of precision in determining the curriculums of ASEAN Community, especially schools in rural areas, for example, schools along the common border with Laos, and Cambodia. One of the effective methods to promote the precision in ASEAN Community is to design additional learning courses. The important process of additional learning courses design is to provide learning outcomes of ASEAN Community for course syllabus determination. Therefore, the researcher is interested in developing teachers in the schools of common border with Laos, and Cambodia to provide learning outcomes and learning process. This research has the objective of developing the learning outcomes and learning process management of basic education along Thailand, Laos, and Cambodia Common Border for the ASEAN Community Preparation. Research methodology consists of 2 steps. Step 1: Delphi Technique was used to provide guidelines in development of learning outcomes and learning process. Step 2: Action Research procedures was employed to study the result of additional learning courses design. Result of the study: By using Delphi technique, consensus is expected to be achieved, from 50 experts in the study within 3 times of the survey. The last survey found that experts’ opinions were compatible on every item (inter-quartile range = 0) leading to the arrangement of training courses in step of Action Research. The result from the workshop found that teachers in schools of Srisaket and Bueng Kan provinces could be able to provide learning outcomes of all courses.

Keywords: learning outcome and learning process, basic education, ASEAN Community preparation, Thailand Laos and Cambodia common border

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Authors: Pouya Karimi, Ramin Ghasemi Shayan

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Conclusions of the sort and setting of observational treatment for immunocompromised patients with fever are confused by the qualities of the hidden disease and the impacts of medications previously got, just as by changing microbiological examples and patterns in sedate obstruction at national and institutional levels. A few frameworks have been proposed to recognize patients who could profit by outpatient anti-infection treatment from patients who require hospitalization. Useful contemplations may choose whether the fundamental checking during the time of neutropenia can be accomplished.

Keywords: microbiology, infectious, neutropenia, epidemiology

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Authors: K. Ighilahriz, M. Taleb Ahmed, R. Maachi

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Oil industries are responsible for most cases of contamination of our ecosystem by oil and heavy metals. They are toxic and considered carcinogenic and dangerous even when they exist in trace amounts. At Algiers refinery, production, transportation, and refining of crude oil generate considerable waste in storage tanks; these residues result from the gravitational settling. The composition of these residues is essentially a mixture of hydrocarbon and lead. We propose in this work the application of electrooxidation treatment for the leachate of the leaden sludge. The effect of pH, current density and the electrolysis time were studied, the effectiveness of the processes is evaluated by measuring the chemical oxygen demand (COD). The dissolution is the best way to mobilize pollutants from leaden mud, so we conducted leaching before starting the electrochemical treatment. The process was carried out in batch mode using graphite anode and a stainless steel cathode. The results clearly demonstrate the compatibility of the technique used with the type of pollution studied. In fact, it allowed COD removal about 80%.

Keywords: electrooxidation, leaching, leaden sludge, oil industry

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Authors: Aicha Assal, El Mostapha Lotfi

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Rapid industrialization and population growth are currently the main causes of energy and environmental problems associated with wastewater treatment. Wastewater treatment plants (WWTPs) aim to treat wastewater before discharging it into the environment, but they are not yet capable of treating non-biodegradable contaminants such as heavy metals. Toxic heavy metals can disrupt biological processes in WWTPs. Consequently, it is crucial to combine additional physico-chemical treatments with WWTPs to ensure effective wastewater treatment. In this study, the authors examined the pretreatment process for urban wastewater generated by the El Jadida WWTP in order to assess its treatment efficiency. Various physicochemical and spatiotemporal parameters of the WWTP's raw and treated water were studied, including temperature, pH, conductivity, biochemical oxygen demand (BOD5), chemical oxygen demand (COD), suspended solids (SS), total nitrogen, and total phosphorus. The results showed an improvement in treatment yields, with measured performance values of 77% for BOD5, 63% for COD, and 66% for TSS. However, spectroscopic analyses revealed persistent coloration in wastewater samples leaving the WWTP, as well as the presence of heavy metals such as Zn, cadmium, chromium, and cobalt, detected by inductively coupled plasma optical emission spectroscopy (ICP-OES). To remedy these staining problems and reduce the presence of heavy metals, a new low-cost, environmentally-friendly eggshell-based solution was proposed. This method eliminated most heavy metals such as cobalt, beryllium, silver, and copper and significantly reduced the amount of cadmium, lead, chromium, manganese, aluminium, and Zn. In addition, the bioadsorbent was able to decolorize wastewater by up to 84%. This adsorption process is, therefore, of great interest for ensuring the quality of wastewater and promoting its reuse in irrigation.

Keywords: WWTP, wastewater, heavy metals, decoloration, depollution, COD, BOD5

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Authors: Naglaa A. Abd Elkader, Haithem A. Farghali

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The present study carried out on fifteen clinical cases of different species of dogs which admitted to surgical clinic of veterinary medicine with different symptoms (Acute vomiting, hematemesis and anorexia). There was diagnostic march which including plain radiograph and endoscopic examination. Treatment was including surgical interference and endoscopic retrieval followed by medicinal treatment. This study was aimed the detection of different foreign bodies by the most suitable method according to the type of the foreign bodies.

Keywords: stomach, endoscopy, foreign bodies, dogs

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Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

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Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

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Authors: Denise Ben-Porath, Tracy Masterson

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In the past, individuals who struggled with and sought treatment for mental health difficulties were stigmatized. However, the current generation holds more open attitudes around mental health issues. Indeed, public figures such as Demi Lovato, Naomi Osaka, and Simone Biles have taken to social media to break the silence around mental health, discussing their own struggles and the benefits of treatment. Thus, there is considerable reason to believe that this generation would hold fewer stigmatizing attitudes toward mental health difficulties and treatment compared to previous ones. In this study, we explored possible changes in stigma on mental health diagnosis and treatment seeking behavior between two generations: Gen Z, the current generation, and Gen X, those born between 1965-1980. It was hypothesized that Gen Z would hold less stigmatizing views on mental illness than Gen X. To examine possible changes in stigma attitudes between these two generations, we conducted a cross-generational cohort design by using the same methodology employed 20 years ago from the Ben-Porath (2002) study. Thus, participants were randomly assigned to read one of the following four case vignettes employed in the Ben-Porath (2002) study: (a) “Tom” who has received psychotherapy due to depression (b) “Tom” who has been depressed but received no psychological help, (c) “Tom” who has received medical treatment due to a back pain, or (d) “Tom” who had a back pain but did not receive medical attention. After reading the vignette, participants rated “Tom” on various personality dimensions using the IFQ Questionnaire and answered questions about their frequency of social media use and willingness to seek mental health treatment on a scale from 1-10. Identical to the results 20 years prior, a significant main effect was found for diagnosis with “Tom” being viewed in more negative terms when he was described as having depression vs. a medical condition (back pain) [F (1, 376) = 126.53, p < .001]. However, in the study conducted 20 years earlier, a significant interaction was found between diagnosis and help-seeking behavior [F (1, 376) = 8.28, p < .005]. Specifically, “Tom” was viewed in the most negative terms when described as depressed and seeking treatment. Alternatively, the current study failed to find a significant interaction between depression and help seeking behavior. These findings suggest that while individuals who hold a mental health diagnosis may still be stigmatized as they were 20 years prior, seeking treatment for mental health issues may be less so. Findings are discussed in the context of social media use and its impact on destigmatization.

Keywords: stigma, mental illness, help-seeking, social media

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Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Mehves Isiklar Ekici, Ceyda Tuna Kirsaclioglu, Zarife Kuloglu, Aydan Kansu

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Malnutrition is an important cause of morbidity and mortality as it accounts for 45% of child deaths under the age of 5 worldwide. Therefore, early recognition and effective treatment of failure to thrive and malnutrition are important. In this study, it was aimed to retrospectively evaluate the nutritional support treatment approaches (nutrition education and diet enrichment / use of enteral nutrition products) applied in children followed up with growth failure without underlying organic causes, and to compare the efficacy of nutritional support treatments. In this study, children aged 1 month to 18 years diagnosed with growth failure who were followed up for at least 12 months between January 2011 and February 2020, were included. Anthropometric measurements at baseline and during follow-up, type of nutritional support therapy and treatment compliance were evaluated based on the retrospective records. 119 children (median age:3.2, 69 girls) were included in the study. Nutrition education and dietary enrichment were provided to 28% of the patients (Group 1). In addition to dietary education and recommendations, enteral nutrition supplements was given in 78% of them (Group 2). Compliance to the treatment rates of the patients in Group 1 and Group 2 were not significantly different at both 6th and 12th month controls. At the end of the follow up children who comply with the treatment in Group 1 had significant increase in weight for age z scores (-1.74 vs 0.05, respectively, p=0.019) and body mass index z scores (-1.47 vs -0.53, respectively, p=0.034) compared with baseline measurements. Similar to Group 1, in Group 2 children with treatment compliance, had a significant increase in weight for age z scores (-2.24 vs. -0.54, respectively, p=0.00) and body mass index z scores (-2.27 vs. -1.06, respectively, p=0.00) compared with baseline measurements. The rate of patients with severe malnutrition decreased from 15% to 12%, for moderate malnutrition decreased from 54% to 33%. Moreover, it was observed that this decrease in the rate of patients with both severe and moderate malnutrition was more prominent in patients under 3 years of age. Although there was a significant increase in anthropometric measurements with treatment in both groups, there was no significant difference in between two groups terms of change in anthropometric measurements (p>0.05), therefore effectiveness. Failure to thrive and malnutrition in infancy and childhood cause health problems that can affect adult life. To conclude, nutritional education - dietary enrichment. recommendations and use of enteral nutrition supplements were both proven beneficial in this study. Researchers are willing to underline that the most important part of the treatment is to include the family to the process to ensure the treatment compliance.

Keywords: enteral nutrition supplements, failure to thrive, malnutrition, nutritional education

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Authors: Piyanud Chompookard

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This research aims to study the effect of self-compassion techniques for individuals with depression (A pilot study). A quasi-experimental research with pretest-posttest is used to design this work. The research includes 30 participants, divided into the experimental group (ten samples) and the control group (twenty samples). The experimental group received a self-compassion techniques with an appropriate treatment for a total six times. The control group received an appropriate treatment. The measurement of this study using the Hamilton Rating Scale for Depression (Thai version). There are significant differences in levels of depression after received a self-compassion techniques with an appropriate treatment (p<.01). And there are significant differences in levels of depression between the experimental group and the control group (p<.01).

Keywords: depression, self compassion techniques, psychotherapy, pilot study

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Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

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Objective: Bone marrow derived stem cells, endothelial progenitor cells (EPCs), protect against atherosclerotic vascular damage. However, EPCs are depleted in AS and contribute to the enhanced cardiovascular risk. Statins have a protective effect in CAD and diabetes by enhancing the proliferation, migration and survival of EPCs. Therapeutic potential of augmenting EPCs to treat the heightened cardiovascular risk of AS has not yet been exploited. We aimed to investigate the effect of rosuvastatin on EPCs population and inflammation in AS. Methods: 30 AS patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=15) and placebo (n=15) as an adjunct to existing stable anti-rheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures (BASDAI, BASFI, CRP and ESR), pro-inflammatory cytokines (TNF-α, IL-6 and IL-1) and lipids were measured at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin. At 6 months, BASDAI, BASFI, ESR, CRP, TNF-α, and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and BASDAI, CRP and IL-6 after rosuvastatin treatment. Conclusion: First study to show that rosuvastatin augments EPCs population in AS. This defines a novel mechanism of rosuvastatin treatment in AS: the augmentation of EPCs with improvement in proinflammatory cytokines and inflammatory disease activity. The augmentation of EPCs by rosuvastatin may provide a novel strategy to prevent cardiovascular events in AS.

Keywords: ankylosing spondylitis, Endothelial Progenitor Cells, inflammation, pro-inflammatory cytokines, rosuvastatin

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Authors: Stefan Bradu, Daniel Siegel, Jameson Loyal, Andrea Leaf, Alana Kurtti, Usha Alapati, Jared Jagdeo

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Compared with all other variants of nodular melanoma, patients with polypoid nodular melanoma have the lowest 5-year survival rate. The pathophysiology and management of polypoid melanoma are scarcely reported in the literature. Although surgical excision is the cornerstone of melanoma management, treatment of polypoid melanoma is complicated by several negative prognostic factors, including early metastasis. This report demonstrates the successful treatment of a rapidly developing red nodular polypoid melanoma with metastasis using surgery and adjuvant nivolumab in a SARS-CoV-2-positive patient who delayed seeking care due to the COVID-19 pandemic. In addition to detailing the successful treatment approach, the immunosuppressive effects of SARS-2-CoV and its possible contribution to the rapid progression of polypoid melanoma are discussed. This case highlights the complex challenges of melanoma diagnosis and management during the COVID-19 pandemic.

Keywords: covid-19, dermatology, immunotherapy, melanoma, nivolumab

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Authors: Oluyomi Stephen Adeyemi, Kentaro Kato

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Toxoplasma gondii is the etiological agent of toxoplasmosis, a common parasitic disease capable of infecting a range of hosts, including nearly one-third of the human population. Current treatment options for toxoplasmosis patients are limited. In consequence, toxoplasmosis represents a large global burden that is further enhanced by the shortcomings of the current therapeutic options. These factors underscore the need for better anti-T. gondii agents and/or new treatment approach. In the present study, we sought to find out whether preparing and capping nanoparticles (NPs) in amino acids, would enhance specificity toward the parasite versus the host cell. The selection of amino acids was premised on the fact that T. gondii is auxotrophic for some amino acids. The amino acid-nanoparticles (amino-NPs) were synthesized, purified and characterized following established protocols. Next, we tested to determine the anti-T. gondii activity of the amino-NPs using in vitro experimental model of infection. Overall, our data show evidence that supports enhanced and excellent selective action against the parasite versus the host cells by amino-NPs. The findings are promising and provide additional support that warrants exploring the prospects of NPs as alternative anti-parasite agents. In addition, the anti-parasite action by amino-NPs indicates that nutritional requirement of parasite may represent a viable target in the development of better alternative anti-parasite agents. Furthermore, data suggest the anti-parasite mechanism of the amino-NPs involves multiple cellular processes including the production of reactive oxygen species (ROS), modulation of hypoxia-inducing factor-1 alpha (HIF-1α) as well as the activation of kynurenine pathway. Taken together, findings highlight further, the prospects of NPs as alternative source of anti-parasite agents.

Keywords: drug discovery, infectious diseases, mode of action, nanomedicine

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Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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