Search results for: family therapy

Authors: Ha T. T. Ly, Truc B. Truc, Hai N. Truong, Mai P. T. Nguyen, Ngoc D. Ngo, Khanh V. Tran, Hai T. Le

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Beta thalassemia is one of the most common inherited blood disorders, which is characterized by decreased or absent in beta globin expression. Patients with Beta thalassemia whose anemia is not so severe as to necessitate transfusions are said to have thalassemia intermedia. Objective: The goal of this study is prenatal diagnosis for pregnancy woman with Beta thalassemia intermedia and her husband with Beta thalassemia carrier at high risk of Beta thalassemia major in Northern of Vietnam. Material and method: The family has a 6 years-old compound heterozygous thalassemia major for CD71/72(+A) and Hbb:c. -78A>G/nt-28(A>G) male child. The father was heterozygous for CD71/72(+A) mutation which is Beta plus type and the mother was compound heterozygosity of two different variants, namely, Hbb: c. -78A>G/nt-28(A>G) and CD26(A-G) HbE. Prenatal Beta thalassemia mutation detection in fetal DNA was carried out using multiplex Amplification-refractory mutation system ARMS-PCR and confirmed by direct Sanger-sequencing Hbb gene. Prenatal diagnoses were perfomed by amniotic fluid sampling from pregnant woman in the 16-18th week of pregnancy after the genotypes of parents of the probands were identified. Result: When amniotic fluid sample was analyzed for Beta globin gene (Hbb), we found that the genotype is heterozygous for CD71/72(+A) and CD26(A-G) HbE. This genotype is different from the 1st child of this family. Conclusion: Prenatal diagnosis helps the parents to know the genotype and the thalassemia status of the fetus, so they can have early decision on their pregnancy. Genetic diagnosis provided a useful method in diagnosis for familial members in pedigree, genetic counseling and prenatal diagnosis.

Keywords: beta thalassemia intermedia, Hbb gene, pedigree, prenatal diagnosis

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Authors: Marianna De Almeida

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Greek secondary education is a highly selective system with regard to the access of students to Greek universities. Since access from elementary to lower secondary education and afterward to upper secondary education is rather liberal and almost free of selective mechanisms, the basic selection process comes after graduating from upper secondary school into play when students go through a highly selective process for university entry. This structure is responsible for the experience of extreme stress on the part of the candidates during a period of at least two years before the entrance examination leading to a radical change in students' everyday life routines. Instead of the school being an important agent for academic and psychological support, it seems that other agents, such as the informal private preparatory school and the student's families, take on the supportive role.

Keywords: stress, entrance examinations, family support, secondary education

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Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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Authors: Abudjana Babiker

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The middle of twenty century witnessed an explosion in public housing. After the great depression, some of the capitalists and communist countries have launched policies and programs to produce public housing in the urban areas. Concurrently, modernity was the leading architecture style at the time excessively supported the production, and principally was the instrument for the success of the public housing program due to the modernism manifesto for manufactured architecture as an international style that serves the society and parallelly connect it to the other design industries which allowed for the production of the architecture elements. After the second world war, public housing flourished, especially in communist’s countries. The idea of public housing was conceived as living spaces at the time, while the Workplaces performed as the place for production and labor. Michel Foucault - At the end of the twenty century- the introduction of biopolitics has had highlighted the alteration in the production and labor inter-function. The house does not precisely perform as the sanctuary, from the production, for the family, it opens the house to be -part of the city as- a space for production, not only to produce objects but to reproduce the family as a total part of the production mechanism in the city. While the public housing kept altering from one country to another after the failure of the modernist’s public housing in the late 1970s, the society continued changing parallelly with the socio-economic condition in each political-economical system, and the public housing thus followed. The family structure in the major cities has been dramatically changing, single parenting and the long working hours, for instance, have been escalating the loneliness in the major cities such as London, Berlin, and Tokyo and the public housing for the families is no longer suits the single lifestyle for the individuals. This Paper investigates the performance of both the single/individual lifestyle and the family/society structure in Tokyo and Berlin in a relation to the utilization of public housing under economical policies and the socio-political environment that produced the individuals and the collective. The study is carried through the study of the undercurrent individual/society and case studies to examine the performance of the utilization of the housing. The major finding is that the individual/collective are revolving around the city; the city identified and acts as a system that magnetized and blurred the line between production and reproduction lifestyle. The mass public housing for families is shifting to be a combination between neo-liberalism and socialism housing.

Keywords: loneliness, production reproduction, work live, publichousing

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Authors: Elham Vojoudi, Marzieh Mehrafza, Ahmad Hosseini, Azadeh Raofi, Maryam Najafi

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Premature ovarian failure (POF) has become one of the main causes of infertility in women of childbearing age and the incidence of this disorder is increasing year by year. In these patients, poor ovarian response (POR) to gonadotropins reflects a diminished ovarian reserve (DOR) that gives place to few follicles despite aggressive stimulation. Up to now, egg donation is the only way to resolve infertility problems in POF patients. Therefore, some novel aspects such as activating (Akt signaling pathway) and inhibiting (Hippo-signaling) elements have been identified as IVA procedure that promotes primordial follicle activation. In this study, we used the newly developed technique (combination of in vitro activation of dormant follicles (IVA) and stem cell therapy) to promote ovarian follicle growth much more efficiently than the natural, in vivo process for women with POF. Transplantation of Warton Jelly-MSCs to the ovaries of POF patients rescued overall ovarian function. Participants (10 patients) were followed up monthly for a period of six months by hormonal (AMH, FSH, LH and E2), clinical (resuming menstruation), and US (folliculometry) outcomes after a laparoscopic operation. In summary, IVA/WJ-MSC transplantation may provide an effective treatment for POF.

Keywords: POF, in vitro activation, stem cell therapy, infertility

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Authors: Gadia Duhita, Noorhana, Tjhin Wiguna

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Background: ADHD is the most common behavioural disorder in Indonesia. A stimulant, specifically methylphenidate, has been the first drug of choice for an ADHD treatment more than half a century. During the last decade, non-stimulant therapy (atomoxetine) for ADHD treatment has been developing. Growing evidence of its efficacy and the difference in its side effects profile to stimulant therapy have made methylphenidate’s position as a first line therapy for ADHD in need of re-evaluation. Both methylphenidate and atomoxetine have proven themselves against placebos in reducing core symptoms of ADHD. More recent studies directly compare the efficacy of methylphenidate and atomoxetine. Objective: The objective of this paper is to find out if either methylphenidate or atomoxetine is superior to another. This paper will assess the validity, importance, and applicability of current available evidence which compare the effectivity, efficacy, and safety of methylphenidate to atomoxetine for treatment in children and adolescents with ADHD. Method: The articles were searched for through the PubMed and Cochrane databases with “attention deficit/hyperactivity disorder OR adhd”, “methylphenidate”, and “atomoxetine” as the search keywords. Two articles which were relevant and eligible were chosen by using inclusion and exclusion criterias to be critically appraised. Result: The study by Hazel et al. showed that the efficacy of methylphenidate and atomoxetine are comparable for treatment in child and adolescent ADHD. The result shows 53.6% (95% CI 48.5%-58.4%) of the patient responded to the treatment by atomoxetine and 54.4% (95% CI 47.6%-61.1%) patients responded to methylphenidate, with the difference in proportion of–0.9% (95% CI –9.2%-7.5%). The other study by Hanwella et al. also showed that the efficacy of atomoxetine was not inferior to metilphenidate (SMD = 0.09, 95% CI –0.08-0.26) (Z = 1.06, p = 0.29). However, the sub-group analysis showed that OROS methylphenidate is more effective compared to atomoxetine (SMD = 0.32, 95% CI 0.12-0.53) (Z = 3.05, p < 0.02). Conclusion: The efficacy of methylphenidate and atomoxetine in reducing symptoms of ADHD is comparable. None is proven inferior to another. The choice of pharmacological tratment children and adolescents with ADHD should be made based on contraindication and the side effects profile of each drug.

Keywords: attention deficit/hyperactivity disorder, ADHD, atomoxetine, methylphenidate

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Authors: Matthew McArthur, Margaret Friend

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The COVID-19 pandemic disrupted the stability of the home environment for families across the world. Potential disruptions include parent work modality (in-person vs. remote), levels of health anxiety, family routines, and caregiving. These disruptions may have interfered with the processes of early vocabulary acquisition, carrying lasting effects over the life course. Our justification for this research is as follows: First, early, stable, caregiver-child reciprocal interactions, which may have been disrupted during the pandemic, contribute to the development of the brain architecture that supports language, cognitive, and social-emotional development. Second, early vocabulary predicts several cognitive outcomes, such as numeracy, literacy, and executive function. Further, disruption in the home is associated with adverse cognitive, academic, socio-emotional, behavioral, and communication outcomes in young children. We are interested in how disruptions related to the COVID-19 pandemic are associated with vocabulary acquisition in children born during the first two waves of the pandemic. We are conducting a moderated online experiment to assess this question. Participants are 16 children (10F) ranging in age from 19 to 39 months (M=25.27) and their caregivers. All child participants were screened for language background, health history, and history of language disorders, and were typically developing. Parents completed a modified version of the COVID-19 Family Stressor Scale (CoFaSS), a published measure of COVID-19-related family stressors. Thirteen items from the original scale were replaced to better capture change in family organization and stability specifically related to disruptions in income, anxiety, family relations, and childcare. Following completion of the modified CoFaSS, children completed a Web-Based version of the Computerized Comprehension Task and the Receptive One Word Picture Vocabulary if 24 months or older or the MacArthur-Bates Communicative Development Inventory if younger than 24 months. We report our preliminary data as a partial correlation analysis controlling for age. Raw vocabulary scores on the CCT, ROWPVT-4, and MCDI were all negatively associated with pandemic-related disruptions related to anxiety (r12=-.321; r1=-.332; r9=-.509), family relations (r12=-.590*; r1=-.155; r9=-.468), and childcare (r12=-.294; r1=-.468; r9=-.177). Although the small sample size for these preliminary data limits our power to detect significance, this trend is in the predicted direction, suggesting that increased pandemic-related disruption across multiple domains is associated with lower vocabulary scores. We anticipate presenting data on a full sample of 50 monolingual English participants. A sample of 50 participants would provide sufficient statistical power to detect a moderate effect size, adhering to a nominal alpha of 0.05 and ensuring a power level of 0.80.

Keywords: COVID-19, early vocabulary, home environment, language acquisition, multiple measures

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Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

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Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

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Authors: Lilia Edit Aparicio Pico, Paulo Cesar Coronado Sánchez, Roberto Ferro Escobar

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This paper presents the implementation of telemedicine services for physiotherapy, occupational therapy, and speech therapy rehabilitation, utilizing telebroadcasting of audiovisual content to enhance comprehensive patient recovery in rural areas of San Vicente del Caguán municipality, characterized by high levels of social conflict in Colombia. The region faces challenges such as dysfunctional problems, physical rehabilitation needs, and a high prevalence of hearing diseases, leading to neglect and substandard health services. Limited access to healthcare due to communication barriers and transportation difficulties exacerbates these issues. To address these challenges, a research initiative was undertaken to leverage information and communication technologies (ICTs) to improve healthcare quality and accessibility for this vulnerable population. The primary objective was to develop a tele-rehabilitation system to provide asynchronous online therapies and teleconsultation services for patient follow-up during the recovery process. The project comprises two components: Communication systems and human development. A technological component involving the establishment of a wireless network connecting rural centers and the development of a mobile application for video-based therapy delivery. Communications systems will be provided by a radio link that utilizes internet provided by the Colombian government, located in the municipality of San Vicente del Caguán to connect two rural centers (Pozos and Tres Esquinas) and a mobile application for managing videos for asynchronous broadcasting in sidewalks and patients' homes. This component constitutes an operational model integrating information and telecommunications technologies. The second component involves pedagogical and human development. The primary focus is on the patient, where performance indicators and the efficiency of therapy support were evaluated for the assessment and monitoring of telerehabilitation results in physical, occupational, and speech therapy. They wanted to implement a wireless network to ensure audiovisual content transmission for tele-rehabilitation, design audiovisual content for tele-rehabilitation based on services provided by the ESE Hospital San Rafael in physiotherapy, occupational therapy, and speech therapy, develop a software application for fixed and mobile devices enabling access to tele-rehabilitation audiovisual content for healthcare personnel and patients and finally to evaluate the technological solution's contribution to the ESE Hospital San Rafael community. The research comprised four phases: wireless network implementation, audiovisual content design, software application development, and evaluation of the technological solution's impact. Key findings include the successful implementation of virtual teletherapy, both synchronously and asynchronously, and the assessment of technological performance indicators, patient evolution, timeliness, acceptance, and service quality of tele-rehabilitation therapies. The study demonstrated improved service coverage, increased care supply, enhanced access to timely therapies for patients, and positive acceptance of teletherapy modalities. Additionally, the project generated new knowledge for potential replication in other regions and proposed strategies for short- and medium-term improvement of service quality and care indicators

Keywords: e-health, medical informatics, telemedicine, telerehabilitation, virtual therapy

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Authors: Jose M. Gallardo, Nieves Jimenez, Andres Jimenez-Losada, Esperanza Lebron

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A game with a priori incompatibilities is a triple (N,v,g) where (N,v) is a cooperative game, and (N,g) is a graph which establishes initial incompatibilities between some players. In these games, the negotiation has two stages. In the first stage, players can only negotiate with others with whom they are compatible. In the second stage, the grand coalition will be formed. We introduce a value for these games. Given a game with a priori incompatibility (N,v,g), we consider the family of coalitions without incompatibility relations among their players. This family is a normal set system or coalition configuration Ig. Therefore, we can assign to each game with a priori incompatibilities (N,v,g) a game with coalition configuration (N,v, Ig). Now, in order to obtain a payoff vector for (N,v,g), it suffices to calculate a payoff vector for (N,v, Ig). To this end, we apply a value for games with coalition configuration. In our case, we will use the dual configuration value, which has been studied in the literature. With this method, we obtain a value for games with a priori incompatibilities, which is called the Owen value for a priori incompatibilities. We provide a characterization of this value.

Keywords: cooperative game, game with coalition configuration, graph, independent set, Owen value, Shapley value

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Authors: Rui Sang, Fei Deng, Alexander Engel, Ewa M. Goldys, Wei Deng

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In this study, we brought together X-ray induced photodynamic therapy (X-PDT) and chemo-drug (5-FU) for the treatment on colorectal cancer cells. This was achieved by developing a lipid-polymer hybrid nanoparticle delivery system (FA-LPNPs-VP-5-FU). It was prepared by incorporating a photosensitizer (verteporfin), chemotherapy drug (5-FU), and a targeting moiety (folic acid) into one platform. The average size of these nanoparticles was around 100 nm with low polydispersity. When exposed to clinical doses of 4 Gy X-ray radiation, FA-LPNPs-VP-5-FU generated sufficient amounts of reactive oxygen species, triggering the apoptosis and necrosis pathway of cancer cells. Our combined X-PDT and chemo-drug strategy was effective in inhibiting cancer cells’ growth and proliferation. Cell cycle analyses revealed that our treatment induced G2/M and S phase arrest in HCT116 cells. Our results indicate that this combined treatment provides better antitumour effect in colorectal cancer cells than each of these modalities alone. This may offer a novel approach for effective colorectal cancer treatment with reduced off-target effect and drug toxicity.

Keywords: pdt, targeted lipid-polymer nanoparticles, verteporfin, colorectal cancer

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Authors: Nantale Prossy Nabatte, Josephat Nyagero, Elizabeth Kemigisha

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Background: Human Papilloma Virus (HPV) is a prevalent sexually transmitted infection (STI) in the world. It is important to screen for HPV so that women found positive receive early treatment to prevent the development of cervical cancer. The broad aim of the research was to explore the types, occurrence, and associated correlates of HPV infection by genotyping Human papillomavirus among a cohort of WLHIV attending an antiretroviral therapy clinic in Mukono, Uganda. Methods: A cross-sectional study was used to collect data for socio-demographic, sexual practices, and medical history factors associated with HPV genotypes using a pretested interview guide subjected to 342 WLHIV. The respondents’ results for HPV genotypes were obtained retrospectively from respective laboratory records. Data was entered in Epidata v4.6 and analysed using STATA V14. The prevalence of hr-HPV was estimated as a proportion of the entire sample size. Analysis for the correlates of hr-HPV infection was done using a modified Poisson regression model. Results: Slightly more than a half of respondents were aged below 35 years (56.7%), married (52.6%), and with a primary level of education (51.2%). The prevalence of hr-HPV was 39.8% at a 95% confidence interval (CI: 34.40- 44.78). The hr-HPV was higher among those between 30-34 years of age (n= 41, 30.2%) than those between the age of 45-49 years (n=16, 11.8%). In terms of associated correlates, age 45-49 years (aPR: 1.95, 95% CI: 1.41- 2.69), being married (aPR: 1.30, 95% CI: 1.00, 1.69), use of condoms (aPR: 1.31, 95% CI: 1.00 -1.71) and age of sexual debut (aPR: 1.42, 95% CI: 1.08-1.87) were significantly associated with Human papillomavirus genotypes. Conclusion and Recommendation: The prevalence of hr-HPV infection was high, indicative of a risk to the health of WLHIV in Mukono, Uganda, and worldwide at large. The correlates are age 45-49 years, being married, use of condoms, and age of sexual debut. Based on the results, it is recommended that the implementing teams in such projects put more emphasis on the diagnosis of hr-HPV infection and monitoring the treatment. More research is required to determine the effect of ART therapy on hr-HPV persistence.

Keywords: human papillomavirus genotypes, and their correlates, among women living with HIV, attending antiretroviral clinic

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Authors: Merrylord Harb-Azar

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Traditionally, PTSD treatment has involved trauma-focused cognitive behaviour therapy (TF CBT) to consolidate traumatic memories. A piloted integrated treatment of TF CBT and eye movement desensitisation reprocessing therapy (EMDR) of eight phases will fasten the rate memory is being consolidated and enhance cognitive functioning in patients with PTSD. Patients spend a considerable amount of time in treatment managing their traumas experienced firsthand, or from aversive details ranging from war, assaults, accidents, abuse, hostage related, riots, or natural disasters. The time spent in treatment or as inpatient affects overall quality of life, relationships, cognitive functioning, and overall sense of identity. EMDR is being offered twice a week in conjunction with the standard prolonged exposure as an inpatient in a private hospital. Prolonged exposure for up to 5 hours per day elicits the affect response required for EMDR sessions in the afternoon to unlock unprocessed memories and facilitate consolidation in the amygdala and hippocampus. Results are indicating faster consolidation of memories, reduction in symptoms in a shorter period of time, reduction in admission time, which is enhancing the quality of life and relationships, and improved cognition. The impact of events scale (IES) results demonstrate a significant reduction in symptoms, trauma symptoms inventory (TSI), and posttraumatic stressor disorder check list (PCL) that demonstrates large effect sizes to date. An integrated treatment approach for PTSD achieves a faster resolution of memories, improves cognition, and reduces the amount of time spent in therapy.

Keywords: EMDR enhances cognitive functioning, faster consolidation of trauma memory, integrated treatment of TF CBT and EMDR, reduction in inpatient admission time

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Authors: Rochelle Alviz, Kirk Johnson

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This study explores the changing nature of gender roles in two traditional island societies. The research focuses particularly on the settler populations within each community (the Filipinos in Guam and the Javanese in Bali). The research seeks to understand the influence of both the forces of globalization and the dynamics of competing cultures on gender roles. To achieve this, a qualitative research design is used, employing in-depth interviews with individuals from both communities and field notes from participant observation. The study finds that globalization and competing cultural norms have influenced traditional gender roles and expectations in two primary areas of social life: the family and the economy. The importance of these two areas of social life to both communities has led to changes and adaptations in gender roles. In the family context, individuals reconcile their traditional gender roles from their country of origin with the dominant or indigenous gender roles of their new place of residence. In the economic context, the study finds that gender roles influence economic participation, including the types of jobs individuals pursue based on their gender roles. The results of the study provide valuable insights into the complexities and nuances of gender roles and the different factors that influence their evolution and adaptation over time. The research also highlights the influence of globalization on traditional societies and settler populations and the ways in which individuals navigate the competing cultural norms and expectations surrounding gender roles. The research contributes to a better understanding of the interplay between culture, globalization, and gender roles and the implications of these changes for individuals and communities.

Keywords: gender roles, culture, settler communities, family, economy, Guam, Bali, globalization

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Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

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Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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Authors: S. S. Silva, S. M. A. Souza, C. F. P. Oliveira

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Brazil's agriculture is a major economic base in the country; in addition, family farming is directly responsible for the production of most agricultural products in Brazil, such as cassava. The number of studies on the use of cassava and its derivatives in the food industry has been increased, which is the basis of this study. Sought to develop a food that take advantage the products from farmers, adding value to these products and to study its effects as a replacement for wheat flour. For such elaborated a gluten-free cake – aiming to meet the needs of the celiac public – containing cassava flour, cane sugar, honey, egg, soya oil, coconut desiccated, baking powder and water. For evaluation of their characteristics technological, physicochemical and texture characterizations were done. Cake showed similar characteristics of cake made with wheat flour and growth and aeration of the dough. In sum up, marketing the product is viable, in that it has a typical overall appearance of cake made of wheat flour, meet the needs of celiac people and value the family farming.

Keywords: baking, cake, cassava flour, celiac disease

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Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

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Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality

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Authors: Priyanka Dixit

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Reproductive health problem is an important public health issue in most of the developing countries like India. It is a common problem in India for women in the reproductive age group to suffer from reproductive illnesses and not seek care. Existing literatures tell us very little about the several dimensions of reproductive morbidity. In addition the general perception says, metros have better medical infrastructure, so its residents should lead a healthier life. However some of the studies reveal a very different picture. Therefore, the present study is conducted with the specific objectives to find out the prevalence of reproductive health problem and treatment seeking behavior of currently married women in four metro cities in India namely; Mumbai, Delhi, Chennai and Kolkata. In addition, this paper also examines the effect of socio-economic and demographic factors on self-reported reproductive health problems. Bi-variate and multivariate regression have been applied to achieve the proposed objectives. Study is based on National Family Health Survey 2015-16 data. The analysis shows that the prevalence of any reproductive health problem among women is the highest in Mumbai followed by Delhi, Chennai, and Kolkata. A bulk of women in all four metro cities has reported abdominal pain, itching and burning sensation as the major problems while urinating. However, in spite of the high prevalence of reproductive health problems, a huge proportion of such women in all these cities do not seek any advice or treatment for these problems. This study also investigates determinants that affect the prevalence of reproductive health problem to policy makers plan for proper interventions for improving women’s reproductive health.

Keywords: reproductive health, India, national family health survey-4, city

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Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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Authors: Aakriti Lohiya

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This study examines the commonly recognised childhood trauma that can have a significant and enduring effect on a person's cognitive and psychological health. The purpose of this study was to look at the intricate interactions that exist between negative self-identity, cognitive distortions, and early trauma. For the study, a sample of (200 women were taken, who were socially active) was gathered. Standardised measures were utilised to evaluate the participants' experiences of childhood trauma, and validated psychological tools were employed to assess negative self-identity and cognitive distortions. The links and predicting correlations between childhood trauma, negative self-identity, and cognitive distortions were investigated using statistical techniques, such as correlation analysis and multiple regression modelling. The results demonstrated that there is no correlation between the degree of early trauma and the emergence of a negative self-identity and cognitive distortions. It examines whether cognitive distortion and events in childhood have any relationship with negative self-identity using various scales. Participants completed the Childhood Trauma Questionnaire, which assessed retrospective accounts of childhood trauma; the Cognitive Distortions Scale, which measured internal attributions and perceptions of controllability; and the attachment style questionnaire, which assessed the attachment attribute of their daily life, which will lead negative. The implications for therapy were also considered.

Keywords: cognitive distortion, therapy, childhood trauma, attachment

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Authors: Ebenezer O. Ige, Funmilayo H. Oyelami, Joshua Olutayo-Irheren, Joseph T. Okunlola

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Hyperthermia therapy is an adjuvant procedure during which perfused body tissues is subjected to elevated range of temperature in bid to achieve improved drug potency and efficacy of cancer treatment. While a selected class of hyperthermia techniques is shouldered on the thermal radiations derived from single-sourced electro-radiation measures, there are deliberations on conjugating dual radiation field sources in an attempt to improve the delivery of therapy procedure. This paper numerically explores the thermal effectiveness of combined infrared hyperemia having nanoparticle recirculation in the vicinity of imposed magnetic field on subcutaneous strata of a model lesion as ablation scheme. An elaborate Spectral relaxation method (SRM) was formulated to handle equation of coupled momentum and thermal equilibrium in the blood-perfused tissue domain of a spongy fibrous tissue. Thermal diffusion regimes in the presence of external magnetic field imposition were described leveraging on the renowned Roseland diffusion approximation to delineate the impact of radiative flux within the computational domain. The contribution of tissue sponginess was examined using mechanics of pore-scale porosity over a selected of clinical informed scenarios. Our observations showed for a substantial depth of spongy lesion, magnetic field architecture constitute the control regimes of hemodynamics in the blood-tissue interface while facilitating thermal transport across the depth of the model lesion. This parameter-indicator could be utilized to control the dispensing of hyperthermia treatment in intravenous perfused tissue.

Keywords: spectra relaxation scheme, thermal equilibrium, Roseland diffusion approximation, hyperthermia therapy

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Authors: Muhammad Mustafa Jafar, Syed Ashar Mahfooz, Muhammad Ejaz Saleem, Muhammad Asif Raza, Asghar Abbas, Rao Zahid Abbas, Muhammad Kasib Khan, Hafiz Muhammad Ishaq

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The Babesia gradually attained resistance against the synthetic medicines. To overcome the drug resistance, herbal therapy has gained more attention as compared to allopathic therapy. Peganumharmala (harmal) is a plant which has shown effective results against various protozoal diseases. Therefore, the present study was planned to monitor the efficacy of Peganumharmala (aqueous extract) against Babesiosis in cattle. For this purpose, a total of forty (n=40) infected animals were randomly divided into four equal groups (A, B, C, and D). Group A was treated with aqueous extract of Peganum harmala at 7.5 mg/kg, group B at 10 mg/kg and group C at 12.5 mg/kg of body weight. Group D served as a control group (normal). It was observed that there was a stabilization in hematological parameters (white and red blood cells, hemoglobin and Packed cell volume) in infected animals treated with Peganum harmala at different doses. Results of this study hence indicated that Peganum harmala extract at 12.5mg/kg BW is more effective against Babesiosis than lower doses.

Keywords: Babesiosis, cattle, control, Peganum harmala

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Authors: Amal Raqib Shameran, Ghanim Aboud Al-Mola

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Respiratory syncytial virus (hRSV) is the major pathogens of respiratory tract infections (RTI) among infants and children in the world. They are classified in family Paramyxoviridae and sub-family Pneumovirinae. The current work aimed to detect the role of RSV in the lower respiratory tract infection (LRTI) in Hilla, Iraq. The samples were collected from 50 children who were admitted to hospital suffering from lower respiratory tract infections (LRTI). 50 nasal and pharyngeal swabs were taken from patients at the period from January 2010 till April 2011, hospitalized in Hilla Maternity and Children Hospital. The results showed that the proportion of children infected with hRSV accounted for 24% 12/50 with lower respiratory tract infections (LRTI) when they tested by polymerase chain reaction (RT-PCR).

Keywords: respiratory syncytial virus, respiratory tract infections, infants, polymerase chain reaction (PCR)

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Authors: Nabin Prasad Joshi, Samiksha Neupane

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Since its emergence in December 2019, Corona Virus disease has impacted several countries, affecting many people. The first cases were recorded in Wuhan, China, between December 2019 and January 2020. Italy is one of the affected countries in Europe. The relations between India and Nepal have reverted to the pre-pandemic period as both countries have open borders. The study focused on the overall psychosocial impact among covid-19 survivors in their life what are the changes they are facing after covid also how are their relations with friends and relatives after they have covid in different municipalities of Kathmandu valley, where people from different regions are living in rent and have their own houses. Support from friends and family during a pandemic can prevent it if it is strong enough. Nonetheless, there were risk factors for psychosocial damage, including a lack of or insufficient family and social support, psychiatric assistance, and inadequate insurance or compensation. Poorer mental health outcomes were inversely correlated with social rejection or isolation.

Keywords: stress, anxiety, depression, Kathmandu

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Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

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Authors: S. AlBustan, B. AlGhannam

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This oral presentation discusses a proposal for a study that evaluates the usability of an evidence based application named ProxTalker App. The significance of this study will inform administration and faculty staff at the Department of Communication Sciences Disorders (CDS), College of Life Sciences, Kuwait University whether the app is a suitable tool to use for CDS students. A case study will be used involving a sample of CDS students taking practicum and internship courses during the academic year 2018/2019. The study will follow a process used by previous study. The process of calculating SUS is well documented and will be followed. ProxTalker App is an alternative and augmentative tool that speech language pathologist (SLP) can use to customize boards for their clients. SLPs can customize different boards using this app for various activities. A board can be created by the SLP to improve and support receptive and expressive language. Using technology to support therapy can aid SLPs to integrate this ProxTalker App as part of their clients therapy. Supported tools, games and motivation are some advantages of incorporating apps during therapy sessions. A quantitative methodology will be used. It involves the utilization of a standard tool that was the was adapted to the Arabic language to accommodate native Arabic language users. The tool that will be utilized in this research is the Arabic Standard Usability Scale (A-SUS) questionnaire which is an adoption of System Usability Scale (SUS). Standard usability questionnaires are reliable, valid and their process is properly documented. This study builds upon the development of A-SUS, which is a psychometrically evaluated questionnaire that targets Arabic native speakers. Results of the usability will give preliminary indication of whether the ProxTalker App under investigation is appropriate to be integrated within the practicum and internship curriculum of CDS. The results of this study will inform the CDS department of this specific app is an appropriate tool to be used for our specific students within our environment because usability depends on the product, environment, and users.

Keywords: A-SUS, communication disorders practicum, evidence based app, Standard Usability Scale

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Authors: Haatembo Mooya

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Cross-culturally, exclusive maternal care of infants is an exception, rather than a rule. In most traditional non-Western societies, child care is shared within the family while in most middle class Western societies parents tend to rely more on ‘hired hands’ for support. In both contexts however, a common caregiver is the sibling. Despite this, the phenomenon of sib-care has remained relatively understudied. Cultural and gender differences in sib-care and attachment were explored using a retrospective survey instrument comparing Zambian and Dutch college students. The total study sample (N = 394) comprised of 200 Zambian students from the University of Zambia and 194 Dutch students from Leiden University, the Netherlands. We tested four main hypotheses. Firstly, we hypothesized that the Zambian subjects performed more sib-care than Dutch subjects. Secondly we hypothesized that female participants performed more sib-care than males participants, both among the Zambian and Dutch subjects, especially when parents are not at home. Thirdly, we hypothesized that larger family size was associated with more sib-care. Finally, we hypothesized that securely attached participants performed more sib-care than their less securely attached peers. Results indicated that sib-care was prevalent in both Zambian and Dutch samples. Zambian subjects performed more sib-care than Dutch subjects, with females performing more sib-care than males, both when parents were at home (F(2, 244) = 62.09, p < .01) and when parents were not at home (F(2, 237) = 51.28, p < .01). We also found that family size and attachment related avoidance and anxiety were not significant predictors of sib-care. It is concluded that sib-care is understudied, not only in Africa but also in Western societies and that females perform more sib-care than males, especially when the parents are not at home. In addition, attachment related avoidance and anxiety appear to be more related to the quality than the quantity of sib-care provided.

Keywords: sibling, sib-care, attachment, Africa, Zambia, the Netherlands

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Fakhr Eddin Alnaal, Angela Dahdal, Duaa Aladib, Sabeen Ibrahim, Ibrahim Ghoraibi, Bissan Ahmed

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Dementia is one of the diseases which had several stages and Alzheimer’s term was selected in respect for the first doctor Alzheimer who defined the first symptoms of this diseases in a woman whom was well treated by him. The fact that this is a type of a silent disease on which you have a long-term process of neurological degradation and suddenly gives symptoms which are most often irreversible, on clinical level likely we can consider it as a malignancy, one in terms of that it is sudden shocking irreversible and on the level of behavior and some mortality beside the lack of early detection tools for diagnosis. Therefore, the goal of our project is to test the concept of the ability of Statin in prevention of such disease and we investigated that both on experimental level and most importantly on clinical one, the clinical part was performed in a recognized house of aged people who had accidently a high cholesterol and were for years given Statin to treat that elevation, however after the symptoms of Alzheimer’s appeared and when diagnosed, they were well treated and rapidly recovered compared to Alzheimer’s patients in the same house who did not receive Statin had a mild improvement in their symptoms after the therapy, on the other hand we confirmed such observation by a well-organized experimental work.

Keywords: Alzheimer's, dementia, silent disease, statin

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Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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Objective: To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. Methods: This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute,Dhaka,Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Results: Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87 ± 7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032)difference in the two groups(sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statically significant (p<0.004) and diabetic, dyslipidaemic patients having true positive which were statically significant (p < 0.032 & 0.030).True positive patients had family history were 68 (83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant(p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138)and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90%), followed by LCX 42 (51.85%), RCA 36 (44.44%) and the LMCA was 9 (11.11%), .40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. Conclusion: It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients,resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetis, dyslipidaemic, family history and smoking are likely to have a true positive treadmill test result.

Keywords: exercise tolerance test, coronary artery disease, coronary angiography, true positive, false positive

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