Search results for: skin complications

Authors: Samir Dekali, David Crouzier

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Due to their new physico-chemical properties engineered nanoparticles (ENPs) are increasingly employed in numerous industrial sectors (such as electronics, textile, aerospace, cosmetics, pharmaceuticals, food industry, etc). These new physico-chemical properties can also represent a threat for the human health. Consumers can notably be exposed involuntarily by different routes such as inhalation, ingestion or through the skin. Several studies recently reported a possible biodistribution of these ENPs on the blood-brain barrier (BBB). Consequently, there is a great need for developing BBB in vitro models representative of the in vivo situation and capable of rapidly and accurately assessing ENPs toxic effects and their potential translocation through this barrier. In this study, several in vitro models established with micro-endothelial brain cell lines of different origins (bEnd.3 mouse cell line or a new human cell line) co-cultivated or not with astrocytic cells (C6 rat or C8-B4 mouse cell lines) on Transwells® were compared using different endpoints: trans-endothelial resistance, permeability of the Lucifer yellow and protein junction labeling. Impact of NIST diesel exhaust particles on BBB cell viability is also discussed.

Keywords: nanoparticles, blood-brain barrier, diesel exhaust particles, toxicology

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Authors: A. Lubis, L. Setiawati, A. R. Setyoningrum, A. Suryawan, Irwanto

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Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: asthma, chronic health problems, growth, development

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Authors: Minna Chang

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Introduction: M. pneumoniae is a respiratory pathogen, which commonly causes upper and lower respiratory infections. It primarily affects children and young adults. Respiratory symptoms are well recognized, but extrapulmonary involvement is also common. Other systems that have been implicated in the disease include: skin, mucus membranes, central, peripheral nervous systems, cardiovascular, haematological, renal, and musculoskeletal systems. Here, we report a case of an otherwise healthy, young female with M. pneumonia, who presented with right upper quadrant abdominal pain. Case presentation: a healthy 25-year-old female was referred to A&E by her general practitioner, after presenting with fever, malaise, and right upper quadrant pain. M. pneumoniae was confirmed retrospectively by serology. The patient made a full recovery after a six-day course of doxycycline 100mg. Conclusion: M. pneumonia is a well-established cause of respiratory infections in children and young adults. Febrile illness with multisystem involvement, even in the absence of respiratory symptoms, should raise suspicion of M. pneumoniae infection in healthy, young adults. Our case illustrates the multi-system involvement of M. pneumoniae, which was initially missed, due to paucity of respiratory symptoms at presentation.

Keywords: infectious diseases, mycoplasma pneumoniae, respiratory infections, extra-pulmonary manifestations

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Authors: M. Sivakumar, D. Chamundeeswari

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Glycosmis pentaphylla is one of the medicinally important plants belonging to the family Rutaceae, commonly known as “Anam or Panal” in Tamil. Traditionally, leaves are useful in fever, hepatopathy, eczema, skin disease, helminthiasis, wounds, and erysipelas. The fruits are sweet and are useful in vitiated conditions of vata, kapha, cough, and bronchitis. The roots are good for facial inflammations, rheumatism, jaundice, and anemia. The preliminary phytochemical investigations indicated the presence of alkaloids, terpenoids, flavonoids, tannins, sugar, glycoside, and phenolic compounds. In the present study, the root part of Glycosmis pentaphylla was used, and the root was collected from Western Ghats of South India. The root was sun/shade dried and pulverized to powder in a mechanical grinder. The powder was successively extracted with various solvents, and the ethyl acetate extract of Glycosmis pentaphylla has been subjected to the GC-MS analysis. Amongst the 46 chemical constituents identified from this plant, three major phytoconstituents were reported for the first time. Marmesin, a furanocumarin compound with the chemical structure 7H-Furo (3,2-G) (1)Benzopyran-7-one,2,3–dihydro–2 - (1-Hydroxy-1methylethyl)-(s) is one of the three compounds identified for the first time at the concentration of 11-60% in ethyl acetate extract of Glycosmis pentaphylla. Others include, Beta.-Fagarine (4.71%) and Paverine (13.08%).

Keywords: ethyl acetate extract, Glycosmis pentaphylla, GC-MS analysis, Phytochemicals

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Authors: Shivi Rastogi, Suman Pant

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Khadi is an Indian fabric and also known by another name “Khaddar”. During pre-independence era, the movement of khadi manufacturing gained momentum. Over the years, khadi fabrics that were generally considered as the “second skin” of the Swadesh revolutionists changed its uniqueness. It underwent a metamorphosis from that of a patriot’s fabric, and a farmer’s apparel, to become a “fashion fabric”. Drape of garment is governed by draping quality of fabric used. Drape is an essential parameter to decide both appearance and handle of fabric. It is also a secondary determinant of fabric mechanical properties as influenced by the low stress properties, like bending length, formability, tensile and shear properties and compressibility of the fabric. In finishing, fabric is treated to add something to coat the fabric or fiber and thereby temporarily or permanently fix. Film forming agents such as thermoplastic and thermosetting resins and other surface deposits alter hand. In this study, resins were used to modify fabric hand. Three types of resins have been applied on the khadi fabric at three concentration. The effect of these finishes on drapeability, crease recovery, stiffness, tearing strength and smoothness of khadi fabrics were assessed. Silicone gave good results in imparting properties specially drape, smoothness and softness and hand of cotton and khadi fabric. KES result also showed that silicone treated samples enhanced THV rating amongst all treated samples when compared to the control fabric.

Keywords: crease recovery, drapeability, KES, silicone, THV

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Authors: Arun Prasad

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Background: Robotic Bariatric Surgery is a good option for the super obese where laparoscopy demands challenging technical skills. Gastric bypass can be difficult due to inability of the robot to work in two quadrants at the same time. Lonroth technique of gastric bypass involves a totally supracolic surgery where all anastomosis are done in one quadrant only. Methods: We have done 78 robotic gastric bypass surgeries using the modified Lonroth technique. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Gastric pouch is made first followed by the gastrojejunostomy that is a four layered sutured anastomosis. Jejuno jejunostomy is then performed followed by a leak test and then the jejunum is divided. A 150 cm biliopancreatic limb and a 75 cm alimentary limb are finally obtained. Mesenteric and Petersen’s defects are then closed. Results: All patients had a successful robotic procedure. Mean time taken in the first 5 cases was 130 minutes. This reduced to a mean of 95 minutes in the last five cases. There were no intraoperative or post operative complications. Conclusions: While a hybrid technique of partly laparoscopic and partly robotic gastric bypass has been done at many centres, we feel using the modified Lonroth technique, a totally robotic gastric bypass surgery fully utilizes the potential of robotic bariatric surgery.

Keywords: robot, bariatric, totally robotic, gastric bypass

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Authors: Harukuni Tokuda, Xu FengHao, Nobutaka Suzuki

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As part of an ongoing our projects to investigate the anti-tumor promoring properties (chemopreventive potency) of Gromwell seed, dry powder materials and its active compounds were carried out through useful test systems. Gromwell seed (Coix lachryma-jobi seed) (GS) is a grass crop that has long been used and played a role in traditional medicine as a nourishing food, and for the treatment of various aliments, paticularly cancer. The application of a new screening procedure which utilizes the synergistic effect of short-chain fatty acids and phorbol esters in enable rapid and easy detection of naturally occurring substances(anti-tumor promoters chemo-preventive agents) with inhibition of Epstein-Barr virus(EBV) activation, using human lymphblastoid cells. In addition, we have now extended these investigations to a new tumorigenesis model in which we initiated the tumors with DMBA intiation and promoted with 1.7 nmol of TPA in two-stage mouse skin test and other models. these results provide a basis for further development of these botanical supplements for human cancer chemoprevention and observations seem that this materials more extensively as one of the trials for the purpose of complementary and alternative medicine.

Keywords: chemoprevention, medicinal plant, mouse, carcinogenesis systems

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Authors: Shalitha Jayasekara, Saluk Bawantha, Dinithi Anupama, Isuru Gunarathne, Pradeepa Bandara, Hansi De Silva

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Dogs have been known as "man's best friend" for generations, providing friendship and loyalty to their human counterparts. However, due to people's busy lives, they are unaware of the ailments that can affect their pets. However, in recent years, mobile technologies have had a significant impact on our lives, and with technological improvements, a rule-based expert system allows the end-user to enable new types of healthcare systems. The advent of Android OS-based smartphones with more user-friendly interfaces and lower pricing opens new possibilities for continuous monitoring of pets' health conditions, such as healthy dogs, dangerous ingestions, and swallowed objects. The proposed ‘Best Bark’ Dog care and owner consultation system is a mobile application for dog owners. Four main components for dog owners were implemented after a questionnaire was distributed to the target group of audience and the findings were evaluated. The proposed applications are widely used to provide health and clinical support to dog owners, including suggesting exercise and diet plans and answering queries about their dogs. Additionally, after the owner uploads a photo of the dog, the application provides immediate feedback and a description of the dog's skin disease.

Keywords: Convolution Neural Networks, Artificial Neural Networks, Knowledgebase, Sentimental Analysis.

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Authors: Alireza Barari, Maryam Firozi-Niyaki, Maryam Kamarlouei

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Background: Herbs have a strong anti-cancer effect. Also, exercise is one of several lifestyle factors known to lower the risk of developing cancer. The aim of this study was to investigate the effect of endurance training and taxol on cyclooxygenase-2 and prostaglandin E2 in the liver tissue of mice with cervical cancer. Materials and Methods: In this experimental study, 35 female C57 mice were randomly divided into 5 groups (n=7 in each group): control (healthy), control (cancer), complement (cancer), training-supplementary (cancer) and training (cancer). The implantation of cancerous tumors was performed under the skin of the upper pelvis. The training group completed the endurance training protocol, which included 3 sessions per week, 50 minutes per session, at a speed of 14-18 m/s for six weeks. A dose of 60 mg/kg/day of pure taxol was injected intra peritoneally. The dependent variables of this study were measured 24 hours after the last training session by ELISA. Results: The results showed that the use of taxol and endurance training reduced the levels of cyclooxygenase-2 and prostaglandin E2 in the liver tissues of C57 mice with cervical cancer. Conclusion: Induction of the cancerous tissue in mice with cervical cancer increases the levels of cyclooxygenase-2 and prostaglandin E2 and endurance training along with taxol may reduce these levels.

Keywords: cervical cancer, taxol, endurance training, cyclooxygenase-2, prostaglandin E2

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Authors: Jack S. Pullman, Daniel Wen, Avinash Sharma, Bert Van Der Werf, Richard Martin

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Background: New Zealand (NZ) melanoma incidence rates are amongst the highest in the world. Previous studies investigating the incidence of melanoma in NZ were performed for the periods 1995 – 1999 and 2000 – 2004 and suggested increasing melanoma incidence rates. Aim: The aim of the study is to provide an up-to-date review of trends in cutaneous melanoma in NZ from the New Zealand Cancer Registry (NZCR) 2010 – 2020. Methods: De-identified data were obtained from the NZCR, and relevant demographic and histopathologic information was extracted. Statistical analyses were conducted to calculate age-standardized incidence rates for invasive melanoma (IM) and melanoma in situ (MIS). Secondary results included Breslow thickness and melanoma subtype analysis. Results: There was a decline in the IM age-standardized incidence rate from 30.4 to 23.9 per 100,000 person-years between 2010 to 2020, alongside an increase in MIS incidence rate from 37.1 to 50.3 per 100,000 person-years. Men had a statistically significant higher IM incidence rate (p <0.001) and Breslow thickness (p <0.001) compared with women. Increased age was associated with a higher incidence of IM, presentation with melanoma of greater Breslow thickness and more advanced T stage. Conclusion: The incidence of IM in NZ has decreased in the last decade and was associated with an increase in MIS incidence over the same period. This can be explained due to earlier detection, dermoscopy, the maturity of prevention campaigns and/or a change in skin protection behavior.

Keywords: melanoma, incidence, epidemiology, New Zealand

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Authors: Syed M. Shahid, Rozeena Shaikh, Syeda N. Nawab, Abid Azhar

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Diabetes mellitus (DM) is a prevalent non-communicable disease worldwide. DM may lead to many vascular complications like hypertension, nephropathy, retinopathy, neuropathy and foot infections. Pathogenesis of diabetic nephropathy (DN) is implicated by the polymorphisms in genes encoding the specific components of renin angiotensin aldosterone system (RAAS) which include angiotensinogen (AGT), angiotensin-II receptor and angiotensin converting enzyme (ACE) genes. This study was designed to explore the possible association of AG (M268T) polymorphism in the patients of diabetes and nephropathy in Pakistan. Study subjects included 100 controls, 260 diabetic patients without renal insufficiency and 190 diabetic nephropathy patients with persistent albuminuria. Fasting blood samples were collected from all the subjects after getting institutional ethical approval and informed consent. The biochemical estimations, PCR amplification and direct sequencing for the specific region of AGT gene was carried out. A significantly high frequency of TT genotype and T allele of AGT (M268T) was observed in the patients of diabetes with nephropathy as compared to controls and diabetic patients without any known renal impairment. The TT genotype and T allele of AGT (M268T) polymorphism may be considered as a genetic risk factor for the development and progression of nephropathy in diabetes. Further cross sectional population studies would be of help to establish and confirm the observed possible association of AGT gene variations with development of nephropathy in diabetes.

Keywords: RAAS, AGT (M268T), diabetes, nephropathy

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Authors: Hesham A. Khalek, Shafik S. Khoury, Remon F. Aziz, Mohamed A. Hakam

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Slipforming operation’s linearity is a source of planning complications, and operation is usually subjected to bottlenecks at any point, so careful planning is required in order to achieve success. On the other hand, Discrete-event simulation concepts can be applied to simulate and analyze construction operations and to efficiently support construction scheduling. Nevertheless, preparation of input data for construction simulation is very challenging, time-consuming and human prone-error source. Therefore, to enhance the benefits of using DES in construction scheduling, this study proposes an integrated module to establish a framework for automating the generation of time schedules and decision support for Slipform construction projects, particularly through the project feasibility study phase by using data exchange between project data stored in an Intermediate database, DES and Scheduling software. Using the stored information, proposed system creates construction tasks attribute [e.g. activities durations, material quantities and resources amount], then DES uses all the given information to create a proposal for the construction schedule automatically. This research is considered a demonstration of a flexible Slipform project modeling, rapid scenario-based planning and schedule generation approach that may be of interest to both practitioners and researchers.

Keywords: discrete-event simulation, modeling, construction planning, data exchange, scheduling generation, EZstrobe

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Authors: Nadia Samantha Zuñiga-Peña, Norberto Hernández-Romero, Omar Aguilar-Mejia, Salatiel García-Nava

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Using unmanned aerial vehicles (UAVs) for load transport has gained significant importance in various sectors due to their ability to improve efficiency, reduce costs, and access hard-to-reach areas. Although UAVs offer numerous advantages for load transport, several complications and challenges must be addressed to exploit their potential fully. Complexity relays on UAVs are underactuated, non-linear systems with a high degree of coupling between their variables and are subject to forces with uncertainty. One of the biggest challenges is modeling and controlling the system formed by UAVs carrying a load. In order to solve the controller problem, in this work, a hybridization of Neural Network and Hunger Games Search (HGS) metaheuristic algorithm is developed and implemented to find the parameters of the Super Twisting Sliding Mode Controller for the 8 degrees of freedom model of UAV with payload. The optimized controller successfully tracks the UAV through the three-dimensional desired path, demonstrating the effectiveness of the proposed solution. A comparison of performance shows the superiority of the neural network HGS (NNHGS) over the HGS algorithm, minimizing the tracking error by 57.5 %.

Keywords: neural networks, hunger games search, super twisting sliding mode controller, UAVs.

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Authors: Akshay Dirisala

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Humans had developed a highly organized and efficient civilization to live in by improving the basic needs of humans like housing, transportation, and utilities. These developments have made a huge impact on major environmental factors. Air pollution is one prominent environmental factor that needs to be addressed to maintain a sustainable and healthier lifestyle. Textiles have always been at the forefront of helping humans shield from environmental conditions. With the growth in the field of electronic textiles, we now have the capability of monitoring the atmosphere in real time to understand and analyze the environment that a particular person is mostly spending their time at. Integrating textiles with the particulate matter sensors that measure air quality and pollutants that have a direct impact on human health will help to understand what type of air we are breathing. This research idea aims to develop a textile product and a process of collecting the pollutants through particulate matter sensors, which are equipped inside a smart textile product and store the data to develop a machine learning model to analyze the health conditions of the person wearing the garment and periodically notifying them not only will help to be cautious of airborne diseases but will help to regulate the diseases and could also help to take care of skin conditions.

Keywords: air pollution, e-textiles, particulate matter sensors, environment, machine learning models

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Authors: Faisal O. Al-Otaibi, Arthur T. Tucker, Richard M. Langford, Stuart Ratcliffe, Atholl Johnston, Terry D. Lee, Kenneth B. Kirby, Chandan A. Alam

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The Transdermal Delivery System (TDS®) is a proprietary liquid formulation that can be applied to intact skin via a metered pump spray to facilitate drug delivery to the circulation. The aim of this study was to assess the ability of the TDS preparation to deliver diazepam systemically, and to characterize the pharmacokinetic profile of the drug in healthy adult subjects. We conducted a randomized, single-dose, two-period, crossover phase I (pharmacokinetic) comparative study in twelve healthy volunteers. All volunteers received both 10 mg TDS-diazepam topically to the upper chest and 10 mg of the rectal diazepam preparation (Diastat®, 10 mg diazepam gel), with a minimum washout of 14 days between dosing episodes. Both formulations were well tolerated in all volunteers. Following topical application of TDS-diazepam, the mean AUC0-72h was 1241 ng/mL.h and the Cmax 34 ng/mL. The values for rectal Diastat were 4109 ng/mL.h and 300 ng/mL respectively. This proof of concept study demonstrates that the TDS preparation successfully delivered diazepam systemically to adults. As expected, the concentration of diazepam following the TDS application was lower and not bioequivalent to rectal gel. Future development of this unique system is required.

Keywords: transdermal delivery system, diazepam, seizure, bioequivalence, pharmacokinetic

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Authors: Rosemarie Basile, Maria Loizos, John Pallarino, Karen Gibbs

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Given that complications can be significant following bariatric surgery and with rates of long-term success measured in excess weight loss varying as low as 33% after five years, an understanding of the psychological factors that may mitigate findings and increase success and result in better screening and supports prior to surgery are critical. An internally oriented locus of control (LOC) has been identified as a predictor for success in obesity therapy, but has not been investigated within the context of bariatric surgery. It is hypothesized that making behavioral changes prior to surgery which mirror those that are required post-surgery may ultimately predict long-term success. 122 subjects participated in a clinical interview and completed self-report measures including the Multidimensional Health Locus of Control Scale, Overeating Questionnaire (OQ), and Lifestyle Questionnaire (LQ). Pearson correlations were computed between locus of control orientation and likelihood to make behavior changes prior to surgery. Pearson correlations revealed a positive correlation between locus of control and likelihood to make behavior changes r = 0.23, p < .05. As hypothesized, there was a significant correlation between internal locus of control and likelihood to make behavior changes. Participants with a higher LOC believe that they are able to make decisions about their own health. Future research will focus on whether this positive correlation is a predictor for future bariatric surgery success.

Keywords: bariatric surgery, behavior modification, health locus of control, overeating questionnaire

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Authors: Ananya Barui, Provas Banerjee, Jyotirmoy Chatterjee

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Application of optical technology in medicine and biology has a long track-record. In this endeavor, OCT is able to attract both engineers and biologists to work together in the field of photonics for establishing a striking non-invasive imaging technology. In contrast to other in vivo imaging modalities like Raman imaging, confocal imaging, two-photon microscopy etc. which can perform in vivo imaging upto 100-200 micron depth due to limitation in numerical aperture or scattering, however, OCT can achieve high-resolution imaging upto few millimeters of tissue structures depending on their refractive index in different anatomical location. This tomographic system depends on interference of two light waves in an interferometer to produce a depth profile of specimen. In wound healing, frequent collection of biopsies for follow-up of repair process could be avoided by such imaging technique. Real time skin OCT (the optical biopsy) has efficacy in deeper and faster illumination of cutaneou tissue to acquire high resolution cross sectional images of their internal micro-structure. Swept Source-OCT (SS-OCT), a novel imaging technique, can generate high-speed depth profile (~ 2 mm) of wound at a sweeping rate of laser with micron level resolution and optimum coherent length of 5-6 mm. Normally multi-layered skin tissue depicts different optical properties along with variation in thickness, refractive index and composition (i.e. keratine layer, water, fat etc.) according to their anatomical location. For instance, stratum corneum, the upper-most and relatively dehydrated layer of epidermis reflects more light and produces more lucid and a sharp demarcation line with rest of the hydrated epidermal region. During wound healing or regeneration, optical properties of cutaneous tissue continuously altered with maturation of wound bed. More mature and less hydrated tissue component reflects more light and becomes visible as a brighter area in comparison to immature region which content higher amount water or fat that depicts as a darker area in OCT image. Non-healing wound possess prolonged inflammation and inhibits nascent proliferative stage. Accumulation of necrotic tissues also prevents the repair of non-healing wounds. Due to high resolution and potentiality to reflect the compositional aspects of tissues in terms of their optical properties, this tomographic method may facilitate in differentiating non-healing and acute wounds in addition to clinical observations. Non-invasive OCT offers better insight regarding specific biological status of tissue in health and pathological conditions, OCT images could be associated with histo-pathological ‘gold standard’. This correlated SS-OCT and microscopic evaluation of the wound edges can provide information regarding progressive healing and maturation of the epithelial components. In the context of searching analogy between two different imaging modalities, their relative performances in imaging of healing bed were estimated for probing an alternative approach. Present study validated utility of SS-OCT in revealing micro-anatomic structure in the healing bed with newer information. Exploring precise correspondence of OCT images features with histo-chemical findings related to epithelial integrity of the regenerated tissue could have great implication. It could establish the ‘optical biopsy’ as a potent non-invasive diagnostic tool for cutaneous pathology.

Keywords: histo-pathology, non invasive imaging, OCT, wound healing

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Authors: Ronak Mishra, Sachin Kale

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Background: The clinical outcome of a new fixation device (femoral neck system, FNS) for femoral neck fractures is not described properly. The main purpose of this study was to evaluate the functional outcome of the patients of femoral neck fractures treated with FNS. Methods: A retrospective study was done among patients aged 60 years or less. On the basis of inclusion and exclusion criteria a final sample size of 30 was considered. Blood loss, type of fracture internal fixation, and length of clinical follow-up were all acquired from patient records. The volume of blood loss was calculated. The mean and standard deviation of continuous variables were reported (with range). Harris Hip score (HHS) And Post op xrays at intervals(6 weeks, 6 months ,12 months ) we used to clinically asses the patient. Results: Out of all 60% were females and 40% were males. The mean age of the patients was. 44.12(+-) years The comparison of functional outcomes of the patients treated with FNS using Harris Hip Score. It showed a highly significant comparison between the patients at post operatively , 6 weeks and 3 months and 12 months . There were no postoperative complications seen among the patients. Conclusion: FNS offers superior biomechanical qualities and greatly improved overall build stability. It allows for a significant reduction in operation time, potentially lowering risks and consequences associated with surgery.

Keywords: FNS, trauma, hip, neck femur fracture, minimally invasive surgery

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Authors: P. O. Ughachukwu, P. O. Okonkwo, P. C. Unekwe, J. O. Ogamba

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Background: The prevalence of hepatitis B viral infection is high worldwide with liver cirrhosis and hepatocellular carcinoma as important complications. Cases of poor antibody response to hepatitis B vaccination abound. Immunosuppression, especially from glucocorticoids, is often cited as a cause of poor antibody response and there are documented evidences of irrational administration of glucocorticoids to children and adults. The study was, therefore, designed to find out if administration of glucocorticoids affects immune response to vaccination against hepatitis B in mice. Methods: Mice of both sexes were randomly divided into 2 groups. Daily intramuscular methylprednisolone injections, (15 mg kg-1), were given to the test group while sterile deionized water (0.1ml) was given to control mice for 30 days. On day 6 all mice were given 2 μg (0.1ml) hepatitis B vaccine and a booster dose on day 27. On day 34, blood samples were collected and analyzed for anti-HBs titres using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was done using Graph Pad Prism 5.0 and the results taken as statistically significant at p value < 0.05. Results: There were positive serum anti-HBs responses in all mice groups but the differences in titres were not statistically significant. Conclusions: At the dosages and length of exposure used in this study, methylprednisolone injection did not significantly inhibit anti-HBs response in mice following immunization against hepatitis B virus. By extrapolation, methylprednisolone, when used in the usual clinical doses and duration of therapy, is not likely to inhibit immune response to hepatitis B vaccinations in man.

Keywords: anti-HBs, hepatitis B vaccine, immune response, methylprednisolone, mice

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Authors: Esra Bora, Alper Omeroglu, Zeynep Pelin Polat, Oguzhan Kara, Fatih Akdogan, Sema Ucak Basat

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Hyponatremia is one of the most encountered electrolyte imbalance among all medical fields. It has a wide range of symptoms as well as complications from fatigue to loss of consciousness. Although a lot of factors can cause low sodium levels in serum, combining specific medications can lead to severe hyponatremia in a rapid onset which can cause high mortality and morbidity. The objective of this case report was to underline that prescribing specific medications disregarding their side effects can cause this common electrolyte imbalance but in a more severe manner. In this case report, we present a 46-year-old male patient with a serum sodium level of 104 mEq/L who consumed hydrochlorothiazide for hypertension and was under treatment with selective serotonin reuptake inhibitors (SSRIs) for major depression. The patient had tonic-clonic seizures at the second hour of the treatment and intubation was needed due to loss of consciousness and hypoxia. After proper replacement of sodium with hypertonic solutions in intensive care unit for nine days, extubation indicated. Even in healthy young males, hyponatremia due to two separately prescribed medications can lead life-threatening hyponatremia. Physicians should be aware of the side effects of diuretics, especially hydrochlorothiazides and SSRIs and their combinations.

Keywords: diuretics, hydrochlorothiazide, hyponatremia, SSRI

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Authors: Pezhman Taghipour Birgani, Mehdi Shekarzadeh

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In this paper, the propagation of lamb waves in three-layer joints is investigated using global matrix method. Theoretical boundary value problem in three-layer adhesive joints with perfect bond and traction free boundary conditions on their outer surfaces is solved to find a combination of frequencies and modes with the lowest attenuation. The characteristic equation is derived by applying continuity and boundary conditions in three-layer joints using global matrix method. Attenuation and phase velocity dispersion curves are obtained with numerical solution of this equation by a computer code for a three-layer joint, including an aluminum repair patch bonded to the aircraft aluminum skin by a layer of viscoelastic epoxy adhesive. To validate the numerical solution results of the characteristic equation, wave structure curves are plotted for a special mode in two different frequencies in the adhesive joint. The purpose of present paper is to find a combination of frequencies and modes with minimum attenuation in high and low frequencies. These frequencies and modes are recognizable by transducers in inspections with Lamb waves because of low attenuation level.

Keywords: three-layer adhesive joints, viscoelastic, lamb waves, global matrix method

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Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

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Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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Authors: Lamia Bensissaid

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Goals: Endometriosis affects 6 to 10% of women of childbearing age. 17 to 44% of them have ovarian endometriomas. Medical and surgical treatments represent the two therapeutic axes with which PMA can be associated. Laparoscopic intraperitoneal ovarian cystectomy is described as the reference technique in the management of endometriomas by learned societies (CNGOF, ESHRE, NICE). However, it leads to a significant short-term reduction in the AMH level and the number of antral follicles, especially in cases of bilateral cystectomy, large cyst size or cystectomy after recurrence. Often, the disease is at an advanced stage with several surgical patients. Most have adhesions, which increase the risk of surgical complications and suboptimal resection and, therefore recurrence of the cyst. These results led to a change of opinion towards a conservative approach. Sclerotherapy is an old technique which acts by fibrinoid necrosis. It consists of injecting a sclerosing agent into the cyst cavity. Results : Recurrence was less than 15% for a 12-month follow-up; these rates are comparable to those of surgery. It does not seem to have a negative impact on ovarian reserve, but this is not sufficiently evaluated. It has an advantage in IVF pregnancy rates compared to cystectomy, particularly in cases of recurrent endometriomas. It has the advantages: · To be done on an outpatient basis. · To be inexpensive. · To avoid sometimes difficult and iterative surgery: · To allow an increase in pregnancy rates and the preservation of the ovarian reserve compared to iterative surgery. · of great interest in cases of bilateral endometriomas (kissing ovaries) or recurrent endometriomas. Conclusions: Ethanol sclerotherapy could be a good alternative to surgery.

Keywords: Endometrioma, Sclerotherapy, infertility, Ethanol

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Authors: Sana Ilyas, Kishalaya Mukherjee, Suresh Shetty

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Lip Augmentation has become more common in recent years. Patients do not expect to experience facial palsy after having lip augmentation. This poster will present the findings of such a presentation and will discuss the possible pathophysiology and management. (This poster has been published as a paper in the dental update, June 2022) Aim: The aim of the study was to explore the link between facial nerve palsy and lip fillers, to explore the literature surrounding facial nerve palsy, and to discuss the case of a patient who presented with facial nerve palsy with seemingly unknown cause. Methodology: There was a thorough assessment of the current literature surrounding the topic. This included published papers in journals through PubMed database searches and printed books on the topic. A case presentation was discussed in detail of a patient presenting with peripheral facial nerve palsy and associating it with lip augmentation that she had a day prior. Results and Conclusion: Even though the pathophysiology may not be clear for this presentation, it is important to highlight uncommon presentations or complications that may occur after treatment. This can help with understanding and managing similar cases, should they arise.It is also important to differentiate cause and association in order to make an accurate diagnosis. This may be difficult if there is little scientific literature. Therefore, further research can help to improve the understanding of the pathophysiology of similar presentations. This poster has been published as a paper in dental update, June 2022, and therefore shares a similar conclusiom.

Keywords: facial palsy, lip augmentation, causation and correlation, dental cosmetics

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Authors: W. Ling, Mohamed Saufi Bin Awang

Abstract:

Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

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Authors: Zahra Hassani

Abstract:

Background and Purpose: Poststroke depression (PSD) is one of the complications of a stroke that reduces the patient's chance of recovery, becomes irritable, and changes personality. Cognitive rehabilitation is one of the non-pharmacological methods that improve deficits such as attention, memory, and symptoms of depression. Therefore, the purpose of the present study is to evaluate the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke. Method: In this study, a systematic review of the databases Google Scholar, PubMed, Science Direct, Elsevier between the years 2015 and 2019 with the keywords cognitive rehabilitation therapy, post-stroke, depression Search is done. In this process, studies that examined the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke were included in the study. Results: Inclusion criteria were full-text availability, interventional study, and non-review articles. There was a significant difference between the articles in terms of the indices studied, sample number, method of implementation, and so on. A review of studies have shown that cognitive rehabilitation therapy has a significant role in reducing the symptoms of post-stroke depression. The use of these interventions is also effective in improving problem-solving skills, improving memory, and improving attention and concentration. Conclusion: This study emphasizes on the development of efficient and flexible adaptive skills through cognitive processes and its effect on reducing depression in patients after stroke.

Keywords: cognitive therapy, depression, stroke, rehabilitation

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Authors: Suresh Sharma, Neeti Goutam

Abstract:

In India abortions are legal and with the exceedingly liberal and broadened law that was passed in 1971, “Medical Termination of Pregnancy Act” had opened a new window to Women’s’ freedom and choice over their fertility. This paper would like to focus on the factors responsible for or leading to unsafe abortion as well as such high incidence of abortion in India which can help in understanding the ways in which we can prevent this apathy. To study the intricacies involved in delivering safety to womanhood in terms of safe abortion practice which includes more trained personnel, detailed explanation and consequences of conducting an abortion, fine reporting, awareness regarding family planning measures and not only pressurizing them to sterilize immediately after an abortion but also prior to that informing them and lastly easy accessibility of Contraceptives with a educated and brief information on that. Data has been drawn from various sources such as National Family Household Survey (1, 2, 3), Health Management Information System and Annual Health Survey. To safeguard the interest of women when it comes to complications resulting from unsafe abortions, Reproductive Health laid its strict adherence to it in its guidelines. The Government could induce more measures in terms of family planning measures and increase in the number of skilled medical health force, chiefly in rural areas to prevent the illegality of abortions. But before that fine reporting on the number of abortions performed will give an insight to this very issue only then policies and programs will work much better in favor of women.

Keywords: abortion, MTP act, India, women

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Authors: Mohamed Eftal Bin Mohamed Ebrahim, Alexander Varey

Abstract:

Aim: Topical negative pressure has been shown to enhance angiogenesis during wound healing, both for open and closed wounds. Since angiogenesis is a key requirement for successful fat grafting, there may be a role for topical negative pressure as a means of enhancing the take rate during autologous fat grafting to breasts. Here we present a systematic review of the literature on this topic. Methods: Ovid and Embase were utilized, with searches ranging between 1960 – 2019. Terms (“Liposculpting” OR “Fat grafting” OR “Lipofilling” OR “Lipograft” OR “Fat transfer”) AND (“Negative Pressure” OR “Brava” OR “Kiwi”) AND (“Breast”) were merged as keywords. Inclusion criteria were females, autologous fat graft to breast with topical negative pressure prior to the procedure. Studies were excluded if there was no primary endpoint or non-original article. Results: Upon reviewing 219 articles, 2 met inclusion criteria. A total of 565 and 46 breasts in each article were treated respectively using the negative pressure device BRAVA®, with each cohort having different pre-and post-operative pressure settings. Khouri et al. cohort had higher graft survival (79%) compared to Del Vecchio et al. cohort (64%); however, the latter had fewer complications compared to Khouri’s cohort, e.g., fat necrosis, pneumothorax and infection. Conclusion: There is limited evidence regarding the use of topical negative pressure for fat grafting to the breasts. However, in the two studies published, the reported rates of success are high, suggesting there may be a benefit. Consequently, a randomized controlled trial on this area is required.

Keywords: fat grafting, lipograft, negative pressure, breast, breast augmentation, brava

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Authors: Mohieldin Elmashad, Salwa Yassin

Abstract:

Expansive soils regarded as one of the most problematic unsaturated formations in the Egyptian arid zones and present a great challenge in civil engineering, in general, and geotechnical engineering, in particular. Severe geotechnical complications and consequent structural damages have been arising due to an excessive and differential volumetric change upon wetting and change in water content. Different studies have been carried out concerning the swelling performance of the expansive soils using different additives including phospho-gypsum as an industrial waste product. However, this paper describes the results of a comprehensive testing programme that was carried out to investigate the effect of phospho-gypsum (PG) and sodium chloride (NaCl), as an additive mixture, on the swelling performance of constituent samples of swelling soils. The constituent samples comprise commercial bentonite collected from a natural site, mixed with different percentages of PG-NaCl mixture. The testing programme had been scoped to cover the physical and chemical properties of the constituent samples. In addition, a mineralogical study using x-ray diffraction (XRD) was performed on the collected bentonite and the mixed bentonite with PG-NaCl mixture samples. The obtained results of this study showed significant improvement in the swelling performance of the tested samples with the increase of the proposed PG-NaCl mixture content.

Keywords: expansive soils, industrial waste, mineralogical study, swelling performance, X-ray diffraction

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Authors: Ow Tze Weng, Suhaila Isaak, Yusmeeraz Yusof

Abstract:

The trend of health care screening devices in the world is increasingly towards the favor of portability and wearability, especially in the most common electrocardiogram (ECG) monitoring system. This is because these wearable screening devices are not restricting the patient’s freedom and daily activities. While the demand of low power and low cost biomedical system on chip (SoC) is increasing in exponential way, the front end ECG sensors are still suffering from flicker noise for low frequency cardiac signal acquisition, 50 Hz power line electromagnetic interference, and the large unstable input offsets due to the electrode-skin interface is not attached properly. In this paper, a high performance CMOS amplifier for ECG sensors that suitable for low power wearable cardiac screening is proposed. The amplifier adopts the highly stable folded cascode topology and later being implemented into RC feedback circuit for low frequency DC offset cancellation. By using 0.13 µm CMOS technology from Silterra, the simulation results show that this front end circuit can achieve a very low input referred noise of 1 pV/√Hz and high common mode rejection ratio (CMRR) of 174.05 dB. It also gives voltage gain of 75.45 dB with good power supply rejection ratio (PSSR) of 92.12 dB. The total power consumption is only 3 µW and thus suitable to be implemented with further signal processing and classification back end for low power biomedical SoC.

Keywords: CMOS, ECG, amplifier, low power

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