Search results for: traumatic pain

Authors: Neena Kanojia, R. K. Kanojia

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Background: Osteoarthritis OA of the knee is one of the leading causes of disability characterized by degeneration of hyaline cartilage combined with reparative processes. Its strong association with metabolic syndrome is postulated to be due to both mechanical and biochemical factors. Our study aims to study differential effect of metabolic risk factors on cartilage degeneration and regeneration at biomarker level. Design: After screening 281 patients presenting with knee pain, 41 patients who met the selection criteria were included and were divided into metabolic MetS OA and non-metabolic Non-MetS OA phenotypes using National Cholesterol Education Programme-Adult Treatment Panel-III NCEP ATP III criteria for metabolic syndrome. Serum Cartilage Oligomeric Matrix Protein COMP and Procollagen type IIA N terminal Propeptide PIIANP levels were used as tools to assess cartilage degeneration and regeneration, respectively. Results: 22 among 41 patients 53.66% had metabolic syndrome. Covariates like age, gender, Kellgren Lawrence KL grades were comparable in both groups. MetS OA group showed significant increase in serum COMP levels (p 0.03 with no significant effect on serum PIIANP levels (p 0.46. Hypertriglyceridemia showed independent association with both cartilage anabolism (p 0.03 and catabolism (p 0.03. Conclusion: Metabolic syndrome, though has no effect on cartilage regeneration tends to shift cartilage homeostasis towards degeneration with hypertriglyceridemia showing significant independent effect on cartilage metabolism.

Keywords: metabolic, syndrome, cartilage, degernation

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Authors: Kwanputtha Arunprasert, Chaiyakarn Pornpitchanarong, Praneet Opanasopit, , Prasopchai Patrojanasophon

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Capsaicin, a recently FDA-approved drug for the topical treatment of neuropathic pain, is associated with several side effects like burning sensation and erythema leading to severe skin irritation and poor patient compliance. These unwanted side effects are due to the rapid penetration of capsaicin into the epidermis and low permeation to the dermis layer. The purpose of this study was to develop nanostructured lipid carriers (NLCs) that entrapped capsaicin for reducing dermal irritation. Solid lipid (glyceryl monostearate (GM), cetyl palmitate (CP), cetyl alcohol (COH), stearic acid (SA), and stearyl alcohol (SOH)) and surfactant (Tween®80, Tween®20, and Span®20) were varied to obtained optimal capsaicin-loaded NLCs. The formulation using CP as solid lipid and Tween®80 as a surfactant (F2) demonstrated the smallest size, excellent colloidal stability, and narrow range distribution of the particles as being analyzed using Zetasizer. The obtained capsaicin-loaded NLCs were then characterized by entrapment efficiency (EE) and loading capacity (LC). The release characteristics followed Higuchi kinetics, and the prolonged capsaicin release may result in the reduction in skin irritation. These results could demonstrate the potentials of capsaicinloaded lipid-based nanoparticles for topical drug delivery.

Keywords: capsaicin, lipid-based nanoparticles, nanostructured lipid carriers, topical drug delivery system

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Authors: Yamani Amal, Lazaae Jamila, Elachouri Mostafa

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Plants and their active agents – especially polyphenols – may have a principal role in the treatment of diseases that result from the defect of physiological antioxidant mechanisms. Bryonia dioica is well known in Moroccan traditional medicine for alleviatin pain and traiting many diseases. We have focused on plant belonging to Cucurbitaceae Family from around the world to understand their therapeutic uses and their potential antioxidant activities Although several biological activities and Chemical composition of Bryonia dioica are well characterized, no direct, in vitro study, of this natural product examined the antioxydant effect of the extract from the roots of Bryonia dioica. The aim of this study was to determine in vitro antioxidant activity of the B.dioica root, using antioxidant analysis methods based on determination of Hydroxyradical Scavenging, 1,1-diphenyl-2-picrylhydrazine (DPPH) radical scavenging, Hydrogenperoxide Scavenging and Nitric Oxide Scavenging. In this study, it was demonstrated, that, B. dioica root extract showed excellent antioxidant properties. This investigation showed that the roots of this plant contain potent natural scavengers R. It may represent an interesting source of antioxidant phenolics that may favour the extension of their cultivation as new source of natural antioxidants in addition to containing high quality proteins for human or animal nutrition. Therefore, there is need for all stakeholders on the Morocco to strive towards taking advantage of our enormous biodiversity resources to free our people from diseases, abject poverty and stagnation.

Keywords: Morocco, bryoniadioica, in vitro, antioxydant

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Authors: Zbigniew Izdebski, Alicja Kozakiewicz, Maciej Białorudzki, Joanna Mazur

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Work is an extremely important part of everyone's life and affects functioning in daily life. Healthcare workers (HCW) are suffering from negative actions in and out of the workplace, such as harassment, abuse, long working hours, mental suffering, exhaustion, and professional burnout. Staff burnout is detrimental not only in terms of individual employees but also to working with patients and to the healthcare institution as a whole. The purpose of this study was to explore the level of professional burnout among HCW working in medical institutions during the COVID-19 pandemic in Poland. The extent to which selected sociodemographic factors and perceived stress increase the risk of professional burnout was assessed. In addition, the frequency of use of professional psychological help and less formal support groups by HCW in relation to the level of professional burnout was presented. The survey was conducted as part of a larger project on the humanization of medicine and clinical communication from February-April 2022. This study used a self-administered online survey (CAWI) technique and PAPI (pen and paper interview) technique. The BAT-12 scale was used to measure burnout, the PSS-4 scale was used to measure stress, and questions formulated by the research team were also used. For the purpose of analysis, the sample was limited to 2196 HCWs who worked on a daily basis with patients during the COVID-19 pandemic. Frequency distributions were analyzed, and multivariate logistic regression was performed. The mean scores (scores) of job burnout as measured by the BAT-12 scale ranged among the professional groups from 2.15(0.69) to 2.30 (0.69) and remained highest for the nurses' group. The groups differed significantly in levels of burnout (chi-sq=17.719; d.f.=8; p<0.023). In the final model, raised stress most likely increased the risk of burnout (OR=3.88; 95%CI <3.13-3.81>; p<0,001). Other significant predictors of burnout included: traumatic work-related experience (OR=1.91, p<0.001), mobbing (OR=1.83, p<0.001), and a higher workload than before the pandemic (OR=1.41, p=0.002). Only 7% of respondents decided to use various forms of psychological support during the pandemic. HCW experiences challenges in dealing with an unpredictable pandemic. Limited preparedness can lead to physical and psychological problems such as high-stress levels, anxiety, fear, helplessness, hopelessness, anger and stigma. The workload can lead to professional burnout, as well as threaten patient safety.

Keywords: burnout, work, healthcare, healthcare worker, stress

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Authors: Klazina T. Havinga, Hilde R. H. de Geus

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Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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Authors: Ezgiamn Abraha Hagos

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The primary objective of this study was to assess the existential concerns and related manifestations of higher learning students by investigating their perception of meaningful life and evaluating their purpose in life. In addition, this study was aimed at assessing the manifestations of existential pain among the students. Data was procured using Purpose in Life test (PIL), Well-being Manifestation Measure Scale (WBMMS), and focus group discussion. The total numbers of participants was 478, of which 299 were males and the remaining 179 females. They were selected using a simple random sampling technique. Data was analyzed using two ways. SPSS-version 20 was used to analyze the quantitative part, and narrative modes were utilized to analyze the qualitative data. The research finding revealed that students are involved in risk taking behaviors like alcohol ingestion, drug use, Khat (chat) chewing, and unsafe sex. In line with this it is found out that life in campus was perceived as temporary and as a result the sense of hedonism was prevalent at any cost. Of course, the most important thing for the majority of the students was to know about the purpose of life. Regarding WBMMS, there was no statistically significant difference among males and females and with the exception of the sub-scale of happiness; in all the sub-scales the mean is low. At last, assisting adolescents to develop holistically in terms of body, mind, and spirit is recommended.

Keywords: existential concerns, higher learning institutions, Ethiopia, Aksum University

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: C. Brandt, R. Christopher, N. Damons

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Background: Soccer is one of the most common sports in the world. It is associated with a significant chance of injury either during training or during the course of an actual match. Studies on the epidemiology of soccer injuries have been widely conducted, but methodological appraisal is lacking to make evidence-based decisions. Objectives: The purpose of this study was to conduct a systematic review of common injuries in soccer and their risk factors. Methods: A systematic review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were searched. The quality of selected studies was rated, and data extracted and tabulated. Plot data analysis was done, and incidence rates and odds ratios were calculated, with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The search yielded 62 studies, of which 21 were screened for inclusion. A total of 16 studies were included for the analysis, ten for qualitative and six for quantitative analysis. The included studies had, on average, a low risk of bias and good methodological quality. The heterogeneity amongst the pooled studies was, however, statistically significant (χ²-p value < 0.001). The pooled results indicated a high incidence of soccer injuries at an incidence rate of 6.83 per 1000 hours of play. The pooled results also showed significant evidence of risk factors and the likelihood of injury occurrence in relation to these risk factors (OR=1.12 95% CI 1.07; 1.17). Conclusion: Although multiple studies are available on the epidemiology of soccer injuries and risk factors, only a limited number of studies were of sound methodology to be included in a review. There was also significant heterogeneity amongst the studies. The incidence rate of common soccer injuries was found to be 6.83 per 1000 hours of play. This incidence rate is lower than the values reported by the majority of previous studies on the occurrence of common soccer injuries. The types of common soccer injuries found by this review support the soccer injuries pattern reported in existing literature as muscle strain and ligament sprain of varying severity, especially in the lower limbs. The risk factors that emerged from this systematic review are predominantly intrinsic risk factors. The risk factors increase the risk of traumatic and overuse injuries of the lower extremities such as hamstrings and groin strains, knee and ankle sprains, and contusion.

Keywords: incidence, prevalence, risk factors, soccer injuries

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Authors: Siavash Azarbani

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Background and Objective: The side effects of NSAIDS drugs have caused the increasing interest of scientists in herbal medicines as alternative treatment. In this study, the effect of anti inflammatory of seed and fruit of date palm hydroalcolic extracts, due to having antioxidants, was studied. Materials and Methods: In this study, the extraxts of date palm seed and fruit were prepared by the maceration method in 70% alcohol. Eighty male rats Wistar, divided into 10 groups of eight in each, 4 groups received different doses (100, 200, 400, and 600 mg/kg) of seed extract, and 4 other groups different doses (100, 200, 400, and 600 mg/kg) of fruits extract of the palm, and the positive control aspirin (300mg/kg) and the negative control group saline (5ml/kg) via injection intraperitoneally. Half an hour later, all animals received 100 µl of 1% carrageenan into the rats hind paw subcutaneous. The changes in rats paw edema was measured by plethysmometer every hour for five hours. Results: The effect of all of the doses of date palm seed extract on edema were less than aspirine (P<0.05). But there was no significant difference between the group that received 400 and 600 mg/kg of date palm fruit extract when compared with the aspirin group. The Dose 400 mg/kg of fruit extract showed the most anti-inflammatory effect, and it was assignded as the best dose. Conclusion: It is likely that with further studies on different model of animals and also on the human model, the palm fruit extract could be used for pain treatment.

Keywords: palm, inflamentory, date, aspirin, karageenan

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Authors: Deok Hyun Han

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Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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Authors: Emma Carr, Jennifer Morrison, Peter Walker

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Background: Due to COVID-19, there was a significant reduction in the number of children being treated under general anaesthetic (GA) within the health board, which led to a backlog of referrals. The referrals were being triaged and added to a waiting list in order of priority -determined by the information given. By implementing a checklist, it is anticipated that at least 70% of referrals will have the majority of the information required to effectively prioritise patients. The gold standard, as defined in ‘Guidelines For The Management Of Children Referred For Dental Extractions Under General Anaesthesia’, indicates that all referrals should mention: (i) Inability of the child to cooperate, (ii) Previously tried anxiety management techniques, (iii) Existence of psychological disorders, (iv) Presence of acute dental infection, (v) Requirement for extractions in multiple quadrants. Method: 130 referrals were examined over three months and compared to the recommended standard. A letter was emailed to referring dentists within Ayrshire & Arran outlining the recommended information to be included within the referral. The second round of data collection was then carried out, which involved an examination of 105 referrals. Results: The first round revealed that only 28% of referrals mentioned at least four defined standards outlined above. Following issuing a checklist to all dentists, this increased to 72%. Conclusion: As many of the children referred for extractions under GA have suffered pain and infection because of dental caries, it is important that delay of treatment is minimised, where possible. The implementation of a standardised checklist has enabled more effective prioritisation of patients.

Keywords: caries, dentistry, general anaesthetic, paediatrics

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Authors: Thomas Geninatti, Bruno Giacomo, Alessandro Grattoni

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Nanofluidic devices have been investigated for over a decade as promising platforms for the controlled release of therapeutics. The nanochannel drug delivery system (nDS), a membrane fabricated with high precision silicon techniques, capable of zero-order release of drugs by exploiting diffusion transport at the nanoscale originated from the interactions between molecules with nanochannel surfaces, showed the flexibility of the sustained release in vitro and in vivo, over periods of time ranging from weeks to months. To improve the implantable bio nanotechnology, in order to create a system that possesses the key features for achieve the suitable release of therapeutics, the next generation of nDS has been created. Platinum electrodes are integrated by e-beam deposition onto both surfaces of the membrane allowing low voltage (<2 V) and active temporal control of drug release through modulation of electrostatic potentials at the inlet and outlet of the membrane’s fluidic channels. Hence, a tunable administration of drugs is ensured from the nanochannel drug delivery system. The membrane will be incorporated into a peek implantable capsule, which will include drug reservoir, control hardware and RF system to allow suitable therapeutic regimens in real-time. Therefore, this new nanotechnology offers tremendous potential solutions to manage chronic disease such as cancer, heart disease, circadian dysfunction, pain and stress.

Keywords: nanochannel membrane, drug delivery, tunable release, personalized administration, nanoscale transport, biomems

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Authors: Mina Dabirinezhad, Mohsen Bayat Pour, Amin Dabirinejad

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This paper is intended to introduce the technology to solve some of the deficiencies of the direct digital radiology. Nowadays, digital radiology is the latest progression in dental imaging, which has become an essential part of dentistry. There are two main parts of the direct digital radiology comprised of an intraoral X-ray machine and a sensor (digital image receptor). The dentists and the dental nurses experience afflictions during the taking image process by the direct digital X-ray machine. For instance, sometimes they need to readjust the sensor in the mouth of the patient to take the X-ray image again due to the low quality of that. Another problem is, the position of the sensor may move in the mouth of the patient and it triggers off an inappropriate image for the dentists. It means that it is a time-consuming process for dentists or dental nurses. On the other hand, taking several the X-ray images brings some problems for the patient such as being harmful to their health and feeling pain in their mouth due to the pressure of the sensor to the jaw. The author provides a technology to solve the above-mentioned issues that is called “Self-Recognition Direct Digital Radiology” (SDDR). This technology is based on the principle that the intraoral X-ray machine is capable to diagnose the location of the sensor in the mouth of the patient automatically. In addition, to solve the aforementioned problems, SDDR technology brings out fewer environmental impacts in comparison to the previous version.

Keywords: Dental direct digital imaging, digital image receptor, digital x-ray machine, and environmental impacts

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Authors: Hanan Bishara

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This study deals with the subject of Popular Arabic Proverbs and the stereotypical roles and images that they create about the woman in general and Arab woman in particular. Popular proverbs in general are considered to be essence of experiences of society and the extract of its collective thought establish wisdom in a distinguished concise tight mold or style that affects the majority of people and keep them alive by virtue of constant use and oral currency through which they are transmitted from one generation to another. Proverbs deal with different aspects and types of people, different social relations, including the society's attitude about the woman. Proverbs about women in the human heritage in general and the Arab heritage in particular are considered of a special characteristics and remarkable in their being dynamic ones that move in all directions of life. Most of them carry the essence of the social issues and are distributed in such a way that they have become part of the private life of the general public. This distribution covers all periods and fields of the woman's life, the social, the economic and psychological ones. The woman occupies a major space in the Popular Proverbs because she is the center of social life inside and outside the house. The woman's statuses and images in the provers are numerous and she is often described in parallel images but each one differs from the other. These images intertwine due to their varieties and multiplicity and ultimately, they constitute a general stereotypical image of the woman, which degrades her status as a woman, a mother and a wife. The study shows how Popular Proverbs in Arabic reflect the Arab woman's position and status in her society.

Keywords: Arab, proverb, popular, society, woman

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Authors: Priyanka Sharma, Tarkewshwar Dubey, Hemalatha Siva

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Hemorrhoids are one of the most common anorectal diseases around the world. Severalfactors are involved in causing hemorrhoids including irregularbowel function (constipation, diarrhea), exercise, gravity, low fiberdiet, pregnancy, obesity, high abdominal pressure, prolongedsitting, genetic factors, and aging. Pain, bleeding, itching,swelling and anal discharge are the symptoms of the disease. Due to limitedmodern pharmacotherapeutic options available for treatment, theherbal medicines remain the choice of therapy. Blumea lacera (Burm f.) DC. belonging to the Asteraceae family is a common plain land weed of Bangladesh. Traditionally it has been used for treatment of hemorrhoids.Considering the above fact, present study was aimed to validate the ethnomedicinal use of B. lacera leaves on experimental hemorrhoids in rats. The anti-hemorrhoid activity was performed by using croton oil induced rat models. The parameters studied were assessment of TNF-α and IL-6, Evans blue exudation, macroscopic severity score, recto-anal coefficient, histomorphological scores. Also, in vivo antioxidant parameters and histopathological studies were also performed. All paramaters exhibited significant anti-hemorrhoid activity. Moreover ethanolic extract of B. lacera (EBL) leaves 400mg/kg showed ameliorative effect oncroton oil induced hemorrhoids.In conclusion, EBL exhibitedbeneficial effect on croton oil- induced hemorrhoids and validates its ethnomedicinal use in treatment of piles.

Keywords: haemorrhoids, IL-6, piles, TNF-α

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Authors: Disaphon Boobpachat, Nuttaset Manimmanakorn, Apiwan Manimmanakorn, Worrawut Thuwakum, Michael J. Hamlin

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Objectives: To evaluate effect of kinesio tape compared to placebo tape and static stretching on recovery of anaerobic power and maximal oxygen uptake (Vo₂max) after intensive exercise. Methods: Thirty nine untrained healthy volunteers were randomized to 3 groups for each intervention: elastic tape, placebo tape and stretching. The participants performed intensive exercise on the dominant quadriceps by using isokinetic dynamometry machine. The recovery process was evaluated by creatine kinase (CK), pressure pain threshold (PPT), muscle soreness scale (MSS), maximum voluntary contraction (MVC), jump height, anaerobic power and Vo₂max at baseline, immediately post-exercise and post-exercise day 1, 2, 3 and 7. Results: The kinesio tape, placebo tape and stretching groups had significant changes of PPT, MVC, jump height at immediately post-exercise compared to baseline (p < 0.05), and changes of MSS, CK, anaerobic power and Vo₂max at day 1 post-exercise compared to baseline (p < 0.05). There was no significant difference of those outcomes among three groups. Additionally, all experimental groups had little effects on anaerobic power and Vo₂max compared to baseline and compared among three groups (p > 0.05). Conclusion: Kinesio tape and stretching did not improve recovery of anaerobic power and Vo₂max after eccentric exercise compared to placebo tape.

Keywords: stretching, eccentric exercise, Wingate test, muscle soreness

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Authors: Janaina Pereira, Barbara Gonzalez, Valentina Chitas, Teresa Molina

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Intro: The positive impact of opioid maintenance programs on the health of heroin addicts, and on public health in general, has been widely recognized, namely on the prevalence reduction of infectious diseases as HIV, and on the social reintegration of this population. Nevertheless, a part of patients in these programs cannot remain heroin abstinent, or has relapses, during the treatment. Method: Thus, this cross-sectional research aims at analyzing the relation between a set of psychological and psychosocial variables, which have been associated with the onset of heroin use, and assess if they are also associated with absence of abstinence in participants in an opioid maintenance program. A total of 62 patients, aged between 26 and 58 years old (M= 40.87, DP= 7.39) with a time in opioid maintenance program between 1 and 10 years (M= 5.42, DP= 3.05), 77.4% male and 22.6% female, participated in this research. To assess the criterion variable (heroin use) we used the mean value of positive results in urine tests during the participation in the program, weighted according to the number of months in program. The predictor variables were the coping strategies, the dispositional sensation seeking, and the existence of Posttraumatic stress disorder (PTSD). Results: The results showed that only 33.87% of the patients were totally abstinent of heroin use since the beginning of the program, and the absence of abstinence, as the number of positive heroin tests, was primarily predicted by less proactive coping, and secondarily by a higher level of sensation seeking. 16.13% of the sample fulfilled diagnosis criteria for PTSD, and 67.74 % had at least one traumatic experience throughout their lives. The total of PTSD symptoms had a positive correlation with the number of physical health problems, and with the lack of professional occupation. These results have several implications for the clinical practice in this field, and we suggest the promotion of proactive coping strategies should integrate these opioid maintenance programs, as they represent the tendency to face future events as challenges and opportunities, being positively related to positive results on several fields. The early identification of PTSD in the participants, before entering the opioid maintenance programs, would be important as it is related to negative features that hinder social reintegration, Finally, to identify individuals with a sensation seeking profile would be relevant, not only because they face a higher risk of relapse, but also because the therapeutical approaches should not ignore this dispositional feature in the alternatives they propose to the patients.

Keywords: opioid maintenance programs, proactive coping, PTSD, sensation seeking

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Authors: Lucksini Raveendran

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Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.

Keywords: mental health, youth mental health, family wellness, health equity

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Authors: Yuliya Kovalenko

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Given the social nature of people, it is interesting to explore strategies of responding to psycho-traumatic situations in individuals of different ethnic and religious identity. This would allow to substantially expand the idea of human behavior in general, and coping behavior, in particular. This paper investigated the weighted impact of ethnic and religious identities on the patterns of coping behavior. This cross-cultural research empirically revealed intergroup differences in coping strategies and behavior in the samples of young students and teachers of different ethnic identities (Egyptians N=216 and Ukrainians N=109) and different religious identities (Egyptian Muslims N=147 and Christians, including Egyptian Christians N=68 and Ukrainian Christians N = 109). The empirical data were obtained using the questionnaires SACS and COPE. Statistical analysis and interpretation of the results were performed with IBM SPSS-23.0. It was found that, compared to the religious identity, the ethnic identity of the subjects appeared more predictive of coping behavior. It was shown that the constant exchange of information and the unity of biological and social contributed to a more homogeneous picture in the society where Christians and Muslims were integrated into a single cultural space. It was concluded that depending on their ethnic identity, individuals would form a specific hierarchy of coping strategies resulting in a specific pattern of coping with certain stressors. The Egyptian subjects revealed the following pattern of coping with various kinds of academic stress: 'seeking social support', 'problem solving', 'adapting', 'seeking information'. The coping pattern demonstrated by the Ukrainian subjects could be presented as 'seeking information', 'adapting', 'seeking social support', 'problem solving'. There was a tendency in the group of Egyptians to engage in more collectivist coping strategies (with the predominant coping strategy 'religious coping'), in contrast to the Ukrainians who displayed more individualistic coping strategies (with 'planning' and 'active coping' as the mostly used coping strategies). At the same time, it was obvious that Ukrainians should not be unambiguously attributed to the individualistic coping behavior due to their reliance on 'seeking social support' and 'social contact'. The final conclusion was also drawn from the peculiarities of developing religious identity, including religiosity, in Egyptians (formal religious education of both Muslims and Christians) and Ukrainians (more spontaneous process): Egyptians seem to learn to resort to the religious coping, which could be an indication that, in principle, it is possible and necessary to train individuals in desirable coping behavior.

Keywords: coping behavior, cross-cultural research, ethnic and religious identity, hierarchical pattern of coping

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Authors: Anupam Sibal

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Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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Authors: Yu Wen Wang, Shyh Ming Kuo, Hsia Ying Cheng, Yu Chiuan Wu

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Liver fibrosis is caused by the activation of hepatic stellate cells in the liver to secrete excessive and deposition of extracellular matrix. In recent years, many treatment strategies have been developed to reduce the activation of hepatic stellate cells and therefore to increase the decomposition of extracellular matrix. Bacopa monnieri, an herbaceous plant of the scrophulariaceae, containing saponins and glycosides, which with antioxidant, anti-inflammation, pain relief and free radical scavenging characteristics. This study was to evaluate the inhibition of hepatic stellate cell activity by Bacopa monnieri extract and its therapeutic potential in treating thioacetamide-induced liver fibrosis in rats. The results showed that the IC50 of Bacopa monnieri extract was 0.39 mg/mL. Bacopa monnieri extract could effectively reduce H2O2-induced hepatic stellate cells inflammation. In the TAA-induced liver fibrosis animal studies, albumin secretion recovered to normal level after treated with Bacopa monnieri extract for 2-w, and fibrosis related proteins, α-SMA and TGF-1levels decreased indicating the extract exerted therapeutic effect on the liver fibrosis. However, inflammatory factors TNF- obviously decreased after 4-w treatment. In summary, we could successfully extract the main component-Bacopaside I from the plant and acquired a potential therapy using this component in treating TAA-induced liver fibrosis in rat.

Keywords: anti-inflammatory, Bacopa monnieri, fibrosis, hepatic stellate cells, water extract

Procedia PDF Downloads 91

Authors: Muhammad Saad Aslam

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In 2021, our organization has launched our proprietary mobile App i.e. Farm Intelligence platform, an industrial-first precision agriculture solution, to Pakistan. It was piloted at 47 locations (spanning around 1,200 hectares of land), addressing growers’ pain points by bringing the benefits of precision agriculture to their doorsteps. This year, we have extended its reach by more than 10 times (nearly 130,000 hectares of land) in almost 600 locations across the country. The project team selected highly infested areas to set up traps, which then enabled the sales team to initiate evidence-based conversations with the grower community about preventive crop protection products that includes pesticides and insecticides. Mega farmer meeting field visits and demonstrations plots coupled with extensive marketing activities, were setup to include farmer community. With the help of App real-time pest monitoring (using heat maps and infestation prediction through predictive analytics) we have equipped our growers with on spot insights that will help them optimize pesticide applications. Heat maps allow growers to identify infestation hot spots to fine-tune pesticide delivery, while predictive analytics enable preventive application of pesticides before the situation escalates. Ultimately, they empower growers to keep their crops safe for a healthy harvest.

Keywords: precision pest management, precision agriculture, real time pest tracking, pest forecasting

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Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

Procedia PDF Downloads 139

Authors: Talita Cavaignac

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Adorno's critique of totality, especially in a split society marked by reification, also rests on the impossibility of generalizing normative principles. Given the unfeasibility of normative universalizations, which conditions can justify the possibility of criticism and normativity in Adorno's thought? If reason itself is still entangled in alienation from the model of the domination of nature, how could be possible a critical theory? In political terms, if the notion of totality is challenged by the critique of identity, how can Adorno maintain the ideal of liberation and reconciliation between private interests and the possibility of some sort of ethics without giving up a materialist theory of society and without betting in a necessary link between redemption and history? Faced with this complex of questions, it is intended to reflect on the sense in which the notion of ‘suffering’ could throw help to the epistemological problem of the foundations of criticism in Adorno's work. The idea is that, in contrast to a universalizable model of justice, Adorno mobilizes in the notion of ‘suffering’ a gateway to the critical reflection of society. He would thus develop an approach to moral problems through the sensual-bodily perspective, fear, pain, and somatic factors. Nevertheless, due to the attention to the damaged experience and to the constitution of subjectivity -a sense in which the concept of mimesis continues to stand out- we understand suffering as an expression of an objective reification. Following the statement of other authors, the intention is to think how the resources linked to the idea of ‘suffering’ in Adorno's writings are engaged in the reflection of the problem of morality and of the contradictions between universal and particular (articulated in Hegel's tradition).

Keywords: ethics, morality, sensitive, Theodor Adorno

Procedia PDF Downloads 121

Authors: Rupinder Kaler, Faith Ndebele, Nadia Saleem, Hafsa Sheikh

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Background: Workplace related violence and aggression seems to be considered an acceptable occupational hazard for staff in mental health services. There is literature evidence that healthcare workers in mental health settings are at higher risk from aggression from patients. Aggressive behaviours pose a physical and psychological threat to the psychiatric staff and can result in stress, burnout, sickness, and exhaustion. Further evidence informs that health professionals are the most exposed to psychological disorders such as anxiety, depression and post-traumatic stress disorder. Fear that results from working in a dangerous environment and exhaustion can have a damaging impact on patient care and healthcare relationship. Aim: The aim of this study is to investigate the prevalence and impact of aggressive behaviour on staff working at Coventry and Warwickshire Partnership Trust. Methodology: The study methodology included carrying out a manual, anonymised, multi-disciplinary cross-sectional survey questionnaire across all clinical and non-clinical staff at CWPT from both inpatient and community settings. Findings: The unsurprising finding was that of higher prevalence of aggressive behaviours in in-patients in comparison to community staff. Conclusion: There is a high rate of verbal and physical aggression at work and this has a negative impact on the staff emotional and physical well- being. There is also a higher reliance on colleagues for support on an informal basis than formal organisational support systems. Recommendations: A workforce that is well and functioning is the biggest resource for an organisation. Staff safety during working hours is everyone's responsibility and sits with both individual staff members and the organisation. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT. The authors recommend development of preventative and practical protocols for aggression with patient and carer involvement. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT.

Keywords: safer staff, survey of staff experiences, violence and aggression, mental health

Procedia PDF Downloads 185

Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

Procedia PDF Downloads 74

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Phornchanok Motantasut, Torkamol Hunsawong, Lugkana Mato, Wanida Donpunha

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Identifying abnormal foot posture is important for prescribing appropriate management in patients with lower limb disorders and chronic non-specific low back pain. The normalized navicular height truncated (NNHt) and the foot posture index-6 (FPI-6) have been recommended as the common, simple, valid, and reliable static measures for clinical application. The NNHt is a single plane measure while the FPI-6 is a triple plane measure. At present, there is inadequate information about the correlation between the NNHt and the FPI-6 for categorizing foot posture that leads to a difficulty of choosing the appropriate assessment. Therefore, the present study aimed to determine the correlation between the NNHt and the FPI-6 measures in adult participants with asymptomatic feet. Methods: A cross-sectional descriptive study was conducted in 47 asymptomatic individuals (23 males and 24 females) aged 28.89 ± 7.67 years with body mass index 21.73 ± 1.76 kg/m². The right foot was measured twice by the experienced rater using the NNHt and the FPI-6. A sequence of the measures was randomly arranged for each participant with a 10-minute rest between the tests. The Pearson’s correlation coefficient (r) was used to determine the relationship between the measures. Results: The mean NNHt score was 0.23 ± 0.04 (ranged from 0.15 to 0.36) and the mean FPI-6 score was 4.42 ± 4.36 (ranged from -6 to +11). The Pearson’s correlation coefficient among the NNHt score and the FPI-6 score was -0.872 (p < 0.01). Conclusion: The present finding demonstrates the strong correlation between the NNHt and FPI-6 in adult feet and implies that both measures could be substituted for each other in identifying foot posture.

Keywords: foot posture index, foot type, measurement of foot posture, navicular height

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Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

Procedia PDF Downloads 336