Search results for: bipolar II disorder

Authors: Ghaleb Bin Huraib, Fahad Al Harthi, Mohammad Mustafa, Abdulrahman Al-Asmari

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Introduction: Vitiligo is an acquired pigmentary skin disorder with the regional disappearance of melanocytes. Vitiligo affects 0.1 to 2% of the global population, and the incidence varies substantially depending on ethnicity. Glutathione S-transferase (GST) is a multigene family of enzymes that detoxify oxidative stress products. The oxidative stress-related GSTM1/GSTT1 genes deletion may cause epidermal melanocytes destruction and the development of vitiligo. Hence, the present study aimed to investigate the association of GST gene polymorphisms with vitiligo in the Saudi population, if any. Materials and Methods: The present study includes 129 vitiligo cases and 130 age-matched healthy controls. The proportion of male and female patients with vitiligo is almost equal. The multiplex polymerase chain reaction (PCR) method was used for polymorphic analysis. Results: Increased odds of generalized vitiligo was observed with the null genotypes of GSTT1- gene (OR = 1.91, 95% CI = 1.07-3.42, p = 0.019). The possible genetic combinations of GSTM1/GSTT1 and their genotypic distribution showed the frequency of GSTM1+/GSTT1+ 62/130 (47.69%) and GSTM1-/GSTT1+ 52/130 (40.00%) were higher in controls than in cases 44/129 (34.11%), 43/129 (33.34%), respectively while GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were higher 22/129 (17.05%) and 20/129 (15.50%) in vitiligo patients as compared to controls 11/130 (8.46%), 5/130 (3.84%), respectively. The strength of association of different genetic combinations with cases have shown GSTM1+/GSTT1- (OR = 2.81, 95% CI = 1.24-6.40, p = 0.009) and GSTM1-/GSTT1- (OR = 5.63, 95% CI = 1.96 - 16.16, p = 0.0004) were significantly higher in vitiligo cases as compared to controls. We did not observe any significant association of age and gender of patients with GST gene polymorphisms. Conclusions: The GSTT1-, GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were significantly associated with vitiligo. These genetic polymorphisms may be the associative genetic risk factor for vitiligo among Saudis. It could be used as a genetic marker for screening vitiligo patients among Saudis. Further studies on GSTs gene polymorphism in larger sample sizes from different geographical areas and ethnicity are needed to strengthen the present findings.

Keywords: vitiligo, GSTM1, GSTT1, gene polymorphism, oxidative stress

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Authors: Wafa Al Jabri

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Sickle cell disease (SCD) is a genetic blood disorder that is characterized by a severe painful crisis. SCD among children requires long term dependencies and high caregiving demands that increase the overall family burdens. It is, therefore, essential to examine, support, and promote the well-being of families of children with SCD. Although there has been considerable progress in the international research on family quality of life (FQOL) in recent years; however, research in this field is relatively recent and diverse. Oman is a country in which family quality of life has definitely been under-researched. Therefore, the purpose of the study is to describe the FQOL in families of children with SCD in Oman. The study will also examine the relationships between child, mother, and family-related factors that may influence the overall FQOL. Theoretical Framework: The study is guided by the unified theory of family quality of life to help in understanding the concept of FQOL and the factors that shape it. Method:A convenience sample of 98 mothers of children with SCD will be recruited from the pediatric hematology clinic at Sultan Qaboos University Hospital in Oman to participate in this descriptive, cross sectional, correlational study. Data will be obtained using a self-administered questionnaire that includes child and mother socio-demographic data, questions about the number of visits and admissions to health care facilities for vaso- occlusive crises (VOCs), the Perceived Stress Scale-10, and the Beachcenter-FQOL scale. Anticipated Results: It is expected to find an association among frequency of VOCs, mother’s perceived stress level, and FQOL in families of children with SCD in Oman. Family type, socio-economic status, and number of SCD children in the family are also expected to influence the overall FQOL. Conclusion: The findings of the study might be pivotal in designing and implementing tailored family-based interventions to improve families’ wellbeing.

Keywords: family quality of life, sickle cell disaes, children, family well-being

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Authors: Prakash Chandra Dhara, Rupa Maity, Mousumi Chatterjee

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Crowbars are used for the gardening purpose. The same tools are used by both male and female gardeners. The existing crowbars are suitable for the female gardeners. The present study was aimed to design a crowbar, which was required to use by the women for the gardening purpose, from the viewpoints of ergonomics. The study was carried out on 50 women in different villages of Howrah districts in West Bengal state. Different models of existing crowbars which were commonly used by the women were collected and evaluated by examining their shape and size. The problems of using existing crowbar were assessed by direct observation during its operation. The musculoskeletal disorder of the subjects for using the crowbar was evaluated by modified Nordic questionnaire method. The anthropometric dimensions, especially hand dimension, of the subjects were taken in standardized static conditions. Considering the problems of using the existing crowbars some design concepts were developed and accordingly three prototypes models (P1, P2, P3) of crowbar were prepared for designing of a modified crowbar for women. Psychophysical analysis of those prototypes was made by paired comparison tests. In the above test subjective preference for different characteristics of the crowbar, e.g., length, weight, length and breadth of the blade, handle diameter, position of the handle, were determined. From the results of the paired comparison test and percentile values of hand dimensions, a modified design of crowbar was suggested. The prototype model P1 possessed more preferred characteristics of the tool than that of other prototype models. In the final design, the weight of the tool and length of the blade was reduced from that of the existing crowbar. Other dimensions were also changed. Two handles were suggested in the redesigned tool for better gripping and operation. The modified crowbar was evaluated by studying the body joint angles, viz., wrist, shoulder and elbow, for assessing the suitability of the design. It was concluded that the redesigned crowbar was suitable for women’s use.

Keywords: body dimension, crowbar, ergo-design, women, hand anthropometry

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

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Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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Authors: Abdolrasoul Daneshjoo

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The purpose of this research was to study the effect of aerobic exercises with 75% heart beats on the amount of urea, uric acid and creatine in blood of Iranian soccer national U-23 players. 27 players were selected according to the following demographic specifications: age: 21.4±1.60 years old; weight: 68±9.4 kg; height: 174.2±8.6 cm. Urea, uric acid and creatine in blood are considered as dependent variations where as 40 minutes running on a track with maximum 75% heart beats are independent variations. Heart beat and blood pressure in rest time, age, height, and weight are considered as the controlled variations. Maximum heart beats are recorded under maximum exercises (8 minutes and 150-250 watt energy) on ergo meter. Then, in order to determine independent variations, 75% maximum heart beats are considered for each player. Blood is taken twice (before and after determining independence variation). Moreover, the players are given a few instructions to be fulfilled 24 hours before the main exercises. Laboratory analysis method for blood urea sample is deacetyl ammoniom, for uric acid Karvy test and for creatine pyric acid. 'T' formula is applied for analyzing statistical data in dependent groups with degree of freedom 7 (d.f=7) urea and uric acid contain P>0.01 and P>0.05 for creatine. 1. Aerobic exercise can effect on the concentration of urea of blood as well as uric acid and creatine in blood serum and increase the amount of them. 2. Urea of blood serum increases from 26.75±2.59 to 28.9±2.67 (25%) with 40 minutes running and 75% heart beat. 3. Aerobic exercise causes uric acid increase 12.5% from 5.7±0.52 (before exercise) to 6.1±0.71 (after exercise). Creatine of blood serum increases from 1.36±0.27 (before exercise) to 1.85±0.49 (after exercise). We came to this result that during aerobic exercise catabolism of protein substrate increases. Moreover, augmentation of urea, uric acid and creatine in blood serum as metabolic poisons causes disorder in kidney. Also, tendons and joints are affected by these poisons. Appropriate diet and exercise can prevent production of these poisons resulted from heavy exercise.

Keywords: aerobic exercise, urea, uric acid, creatine, blood, soccer national players

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Authors: T. Marinaci, C. Venuleo

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Different conceptualizations of disease affect patient care. This study aims to address this gap. It explores how health professionals conceptualize gambling problem, addiction and the goals of recovery process. In-depth, semi-structured, open-ended interviews were conducted with Italian psychologists, psychiatrists, general practitioners, and support staff (N= 114), working within health centres for the treatment of addiction (public health services or therapeutic communities) or medical offices. A Lexical Correspondence Analysis (LCA) was applied to the verbatim transcripts. LCA allowed to identify two main factorial dimensions, which organize similarity and dissimilarity in the discourses of the interviewed. The first dimension labelled 'Models of relationship with the problem', concerns two different models of relationship with the health problem: one related to the request for help and the process of taking charge and the other related to the identification of the psychopathology underlying the disorder. The second dimension, labelled 'Organisers of the intervention' reflects the dialectic between two ways to address the problem. On the one hand, they are the gambling dynamics and its immediate life-consequences to organize the intervention (whatever the request of the user is); on the other hand, they are the procedures and the tools which characterize the health service to organize the way the professionals deal with the user’ s problem (whatever it is and despite the specify of the user’s request). The results highlight how, despite the differences, the respondents share a central assumption: understanding gambling problem implies the reference to the gambler’s identity, more than, for instance, to the relational, social, cultural or political context where the gambler lives. A passive stance is attributed to the user, who does not play any role in the definition of the goal of the intervention. The results will be discussed to highlight the relationship between professional models and users’ ways to understand and deal with the problems related to gambling.

Keywords: cultural models, health professionals, intervention models, problem gambling

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Authors: Thomas Heffernan, Nick Neave, Colin Hamilton, Gill Case

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Hoarding is the acquisition of and failure to discard possessions, leading to excessive clutter and significant psychological/emotional distress. From a cognitive-behavioural approach, excessive hoarding arises from information-processing deficits, as well as from problems with emotional attachment to possessions and beliefs about the nature of possessions. In terms of information processing, hoarders have shown deficits in executive functions, including working memory, planning, inhibitory control, and cognitive flexibility. However, this previous research is often confounded by co-morbid factors such as anxiety, depression, or obsessive-compulsive disorder. The current study adopted a cognitive-behavioural approach, specifically assessing executive deficits and working memory in a non-clinical sample of hoarders, compared with non-hoarders. In this study, a non-clinical sample of 40 hoarders and 73 non-hoarders (defined by The Savings Inventory-Revised) completed the Adult Executive Functioning Inventory, which measures working memory and inhibition, Dysexecutive Questionnaire-Revised, which measures general executive function and the Hospital Anxiety and Depression Scale, which measures mood. The participant sample was made up of unpaid young adult volunteers who were undergraduate students and who completed the questionnaires on a university campus. The results revealed that, after observing no differences between hoarders and non-hoarders on age, sex, and mood, hoarders reported significantly more deficits in inhibitory control and general executive function when compared with non-hoarders. There was no between-group difference on general working memory. This suggests that non-clinical hoarders have a specific difficulty with inhibition-control, which enables you to resist repeated, unwanted urges. This might explain the hoarder’s inability to resist urges to buy and keep items that are no longer of any practical use. These deficits may be underpinned by general executive function deficiencies.

Keywords: hoarding, memory, executive, deficits

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Authors: Shantanu Arya, Sachin Sakhuja, Gunjan Mehta, Sanjay Munjal

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Stuttering may be defined as a speech disorder affecting the fluency domain of speech and characterized by covert features like word substitution, omittance and circumlocution and overt features like prolongation of sound, syllables and blocks etc. Many etiologies have been postulated to explain stuttering based on various experiments and research. Moreover, Breathlessness has also been reported by many individuals with stuttering for which breathing exercises are generally advised. However, no studies reporting objective evaluation of the pulmonary capacity and further objective assessment of the efficacy of breathing exercises have been conducted. Pulmonary Function Test which evaluates parameters like Forced Vital Capacity, Peak Expiratory Flow Rate, Forced expiratory flow Rate can be used to study the pulmonary behavior of individuals with stuttering. The study aimed: a) To identify speech motor & physiologic behaviours associated with stuttering by administering PFT. b) To recognize possible reasons for an association between speech motor behaviour & stuttering severity. In this regard, PFT tests were administered on individuals who reported signs and symptoms of stuttering and showed abnormal scores on Stuttering Severity Index. Parameters like Forced Vital Capacity, Forced Expiratory Volume, Peak Expiratory Flow Rate (L/min), Forced Expiratory Flow Rate (L/min) were evaluated and correlated with scores of Stuttering Severity Index. Results showed significant decrease in the parameters (lower than normal scores) in individuals with established stuttering. Strong correlation was also found between degree of stuttering and the degree of decrease in the pulmonary volumes. Thus, it is evident that fluent speech requires strong support of lung pressure and requisite volumes. Further research in demonstrating the efficacy of abdominal breathing exercises in this regard is needed.

Keywords: forced expiratory flow rate, forced expiratory volume, forced vital capacity, peak expiratory flow rate, stuttering

Procedia PDF Downloads 275

Authors: Adar Pelah, Avraham Adelman, Amanda Balash, Jake Mitchell, Mattan J. Pelah, Viswadeep Sarangi, Xin Chen Cai, Zadok Storkey, Gregg B. Fields, Ximena Levy, Ali A. Danesh

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Introduction: Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 infection (PASC), or Long COVID, while primarily a respiratory disorder, can also include dizziness, lasting weeks to months in individuals who had previously tested positive for COVID-19. This study utilized gait analysis to assess the potential vestibular effects of PASC on the presentation of gait anomalies. Materials and Methods: The study included 11 participants who tested positive for COVID-19, a mean of 2.8 months prior to gait testing (PP=11), and 8 control participants who did not test positive for COVID-19 (NP=8). Participants walked 7.5m at three self-selected speeds: ‘slow,’ ‘normal,’ and ‘fast.’ Mean walking speeds were determined for each speed and overall range from four laps on an instrumented walkway using video capture. Results: A Z-test at 0.05 significance was used for speed range, ‘normal’ and ‘fast’ at the lower tail, and for ‘slow’ at the higher tail. Average speeds (m/s) were: ‘slow’ (PP=0.709, NP=0.678), ‘normal’ (PP=1.141, NP=1.170), ‘fast’ (PP=1.529, NP=1.821), average range (PP=0.846, NP=1.143). Significant speed decreases between PP and NP were observed in ‘fast’ (-17.43%) and average range (-29.86%), while changes in ‘slow’ (+2.44%) and ‘normal’ (-4.39%) speeds were not significant. Conclusions: Long COVID is a recognized disability (Americans with Disabilities Act), and although it presents variably, dizziness, vertigo, and tinnitus are not uncommon in COVID-19 infection. These results suggest that potential inner-ear damage may persist and manifest in gait changes even after recovery from acute illness. Further research with a larger sample size may indicate the need for providers to consider PASC when diagnosing patients with vestibular dysfunction.

Keywords: gait analysis, long-COVID, vestibular dysfunction, walking speed

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Authors: Manish Madappa, Madhavi Gayathri Raman

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The primary vehicle of human communication is language. A breakdown occurring in any aspect of communication may lead to frustration and isolation among the learners and the teachers. Over seven percent of the population in the world currently experience limitations and those children who exhibit a deviant/deficient language acquisition curve even when being in a language rich environment as their peers may be at risk of having a language disorder or language impairment. The difficulty may be in the word level [vocabulary/word knowledge] and/or the sentence level [syntax/morphology) Children with SLI appear to be developing normally in all aspects except for their receptive and/or expressive language skills. Thus, it is utmost importance to identify children with or at risk of SLI so that an early intervention can foster language and social growth, provide the best possible learning environment with special support for language to be explicitly taught and a step in providing continuous and ongoing support. The present study looks at Kannada English bilingual children and works towards identifying children at risk of “specific language impairment”. The study was conducted through an exploratory study which systematically enquired into the narratives of young Kannada-English bilinguals and to investigate the data for story structure in their narrative formulations. Oral narrative offers a rich source of data about a child’s language use in a relatively natural context. The fundamental objective is to ensure comparability and to be more universal and thus allows for the evaluation narrative text competence. The data was collected from 10 class three students at a primary school in Mysore, Karnataka and analyzed for macrostructure component reflecting the goal directed behavior of a protagonist who is motivated to carry out some kind of action with the intention of attaining a goal. The results show that the children exhibiting a deviation of -1.25 SD are at risk of SLI. Two learners were identified to be at risk of Specific Language Impairment with a standard deviation of more the 1.25 below the mean score.

Keywords: bilingual, oral narratives, SLI, macrostructure

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Authors: Dona Pamoda W. Jayatunga, Veer Bala Gupta, Eugene Hone, Ralph N. Martins

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Being a neurodegenerative disorder, Alzheimer’s disease (AD) affects a majority of the elderly demented worldwide. The key risk factors for AD are age, metabolic syndrome, allele status of APOE gene, head injuries and lifestyle. The progressive nature of AD is characterized by symptoms of multiple cognitive deficits exacerbated over time, leading to death within a decade from clinical diagnosis. However, it is revealed that AD originates via a prodromal phase that spans from one to few decades before symptoms first manifest. The key pathological hallmarks of AD brains are deposition of amyloid beta (Aβ) plaques and neurofibrillary tangles (NFT). However, the yet unknown etiology of the disease fails to distinguish mitochondrial dysfunction between a cause or an outcome. The absence of early diagnosis tools and definite therapies for AD have permitted recruits of nutraceutical-based approaches aimed at reducing the risk of AD by modulating lifestyle or be used as preventive tools during AD prodromal state before widespread neurodegeneration begins. The objective of the present study was to investigate beneficial effects of luteolin, a plant-based flavone compound, against AD. The neuroprotective effects of luteolin on amyloid beta (Aβ) (1-42)-induced neurotoxicity was measured using cultured human neuroblastoma BE(2)-M17 cells. After exposure to 20μM Aβ (1-42) for 48 h, the neuroblastoma cells exhibited marked apoptotic death. Co-treatment of 20μM Aβ (1-42) with luteolin (0.5-5μM) significantly protected the cells against Aβ (1-42)-induced toxicity, as assessed by the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2(4sulfophenyl)-2H-tetrazolium, inner salt; MTS] reduction assay and the lactate dehydrogenase (LDH) cell death assay. The results suggest that luteolin prevents Aβ (1-42)-induced apoptotic neuronal death. However, further studies are underway to determine its protective mechanisms in AD including the activity against tau hyperphosphorylation and mitochondrial dysfunction.

Keywords: Aβ (1-42)-induced toxicity, Alzheimer’s disease, luteolin, neuroblastoma cells

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Authors: Katalin Gocze, Vanda A Nemes, Charlotte Briest

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Introduction: Premenstrual syndrome (PMS) is a psychoneuroendocrinological disorder adversely affecting life-quality for over 80% of hormonally active women. PMS has a negative impact on women’s daily life in terms of work, interpersonal relationships and leisure time activities. The aim of our study was to evaluate the effects of a yoga intervention focusing on the female pelvic area. Materials and methods: 34 women (ages 18-40) with PMS (Premenstrual Syndrome Screening Tool) and no previous experience in yoga were recruited and randomly assigned to either the yoga or the control group. The intervention consisted of 90’ yoga sessions twice a week and a daily 15’ self-practice module with carefully chosen yogic exercises addressing the reproductive organs by toning the pelvic floor and opening the hips as well as relieving stress and improving concentration. Severity of symptoms of PMS was assessed at the beginning and after the 8-week-long intervention. Pre- and post-program data collection included physical and psychological parameters and the evaluation of ACOQ PMS questionnaire and daily symptom diary. Results: Age and educational background were similar in the control and intervention group with an overall mean age of 29.11±4.78 years. PSST scores significantly improved in the yoga group (p=0.002), while difference in the control group’s pre and post-program values were non-significant (p=0.38). Perception and tolerance of anxiety and stress was significantly better after the intervention (p=0.008). As for changes in physical symptoms distinct improvement was registered for breast tenderness (p=0.028) and for meteorism (p=0.015). Discussion: Yoga’s success originates from the synergic positive effects of stress relief and regular physical activity. Benefits (both mental and physical) of strategically planned, focused yoga practice are apparent even after shorter time periods and can help women with PMS manage or eliminate symptoms in order to improve their life-quality.

Keywords: life-quality, physical symptoms, premenstrual syndrome, psychological impact, yoga

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Authors: Fathi Kallel, Abdulelah Alabd Uljabbar, Abdulrahman Aldukhail, Abdulaziz Alomran

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The brain is an important organ in our body since it is responsible about the majority actions such as vision, memory, etc. However, different diseases such as Alzheimer and tumors could affect the brain and conduct to a partial or full disorder. Regular diagnosis are necessary as a preventive measure and could help doctors to early detect a possible trouble and therefore taking the appropriate treatment, especially in the case of brain tumors. Different imaging modalities are proposed for diagnosis of brain tumor. The powerful and most used modality is the Magnetic Resonance Imaging (MRI). MRI images are analyzed by doctor in order to locate eventual tumor in the brain and describe the appropriate and needed treatment. Diverse image processing methods are also proposed for helping doctors in identifying and analyzing the tumor. In fact, a large Computer Aided Diagnostic (CAD) tools including developed image processing algorithms are proposed and exploited by doctors as a second opinion to analyze and identify the brain tumors. In this paper, we proposed a new advanced CAD for brain tumor identification, classification and feature extraction. Our proposed CAD includes three main parts. Firstly, we load the brain MRI. Secondly, a robust technique for brain tumor extraction is proposed. This technique is based on both Discrete Wavelet Transform (DWT) and Principal Component Analysis (PCA). DWT is characterized by its multiresolution analytic property, that’s why it was applied on MRI images with different decomposition levels for feature extraction. Nevertheless, this technique suffers from a main drawback since it necessitates a huge storage and is computationally expensive. To decrease the dimensions of the feature vector and the computing time, PCA technique is considered. In the last stage, according to different extracted features, the brain tumor is classified into either benign or malignant tumor using Support Vector Machine (SVM) algorithm. A CAD tool for brain tumor detection and classification, including all above-mentioned stages, is designed and developed using MATLAB guide user interface.

Keywords: MRI, brain tumor, CAD, feature extraction, DWT, PCA, classification, SVM

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Authors: Rahaf Mandura

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Background: Idiopathic intracranial hypertension (IIH) is a disorder with elevated intracranial pressure (ICP) more than 250 mm H₂O, without evidence of meningeal inflammation, space-occupying lesion, or venous thrombosis. The aim of this research is to study the clinical profile, evaluation, management, and visual outcome in a hospital-based population of IIH cases in Jeddah. Methodology: This is a retrospective observational study that included the medical records of all patients referred to neuro-ophthalmology service for evaluation of papilledema. The medical records have been reviewed from October 2018 to February 2020 at Jeddah Eye Hospital (JEH), Saudi Arabia. A total of fifty-one patients presented with papilledema in the studied period. Forty-seven patients met our inclusion criteria and were included in the study. Results: Most of the patients were females (43, 91.5%) with a mean age of presentation of 30.83±11.40 years. The most common presenting symptom was headache (40 patients, 85.1%), followed by transient visual obscuration (20 patients, 42.6%), and reduced visual acuity (15 patients, 31.9%). All 47 patients were started on medical treatment with oral acetazolamide with four patients (8.5%) shifted to topiramate because of the lack of response or intolerance to acetazolamide while four patients (8.5%) underwent lumbar-peritoneal shunt because of inadequate control of the disease despite the treatment with medical therapy. For both eyes, the change in visual acuity across all assessment points was statistically significant. Nevertheless, there were no significant changes in the visual field findings among all of the compared assessment points. Conclusion: The present study has shown that IIH-related papilledema is common in young female patients with headaches, transient visual obscurations and reduced visual acuity. Those are the commonest symptoms in our IIH population. Medical treatment of IIH is significantly efficacious and should be considered in order to enhance the prognosis of IIH-related complications. Therefore, the visual status should be frequently monitored for these patients.

Keywords: idiopathic intracranial hypertension, intracranial hypertension, papilledema, headache

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Authors: Vidia A. Nuraini, Eugene M. H. Yee, Mohan Bhadbhade, David StC. Black, Naresh Kumar

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Flavonoids are naturally occurring compounds that have been shown to exhibit a wide range of biological properties including anticancer and anti-inflammatory activities. However, flavonoids suffer from low bioavailability, which limits their overall utility for therapeutic applications. One of the methods to overcome this limitation is through structural modification of natural flavonoids. In this study, flavanone, isoflavanone, and isoflavene, were structurally modified through the introduction of additional fused-ring systems via ortho-quinone methide intermediates (o-QMs). These intermediates can readily undergo a [4+2] cycloaddition through an inverse-electron-demand Diels–Alder reaction with electron-rich dienophiles. A regioselective Mannich reaction using bis-(N,N-dimethylamino)methane was employed to generate the o-QM precursors of flavanone, isoflavanone, and isoflavene. The o-QM intermediates were subsequently generated in situ through thermal elimination of the dimethylamine functionality and reacted with a variety of dienophiles to produce novel flavonoids with fused-ring systems. A total of 21 novel flavonoid analogs were successfully synthesized. The X-ray crystal structure of cycloaddition adducts, particularly those derived from 3,4-dihydro-2H-pyran and p-methoxystyrene revealed a special case of enantiomeric disorder, where two enantiomers in equal amounts superpose with one another, with the exception for atoms that have opposite configuration. The anticancer properties of fused-ring systems derived from isoflavene were evaluated against the neuroblastoma SKN-BE(2)C, the triple negative breast cancer MDA-MB-231, and the glioblastoma U87 cancer cell lines. One of these cycloaddition adducts had displayed improved anti-proliferative activity against MDA-MB-231 and U87 cancer cell lines as compared to the parent compound. Further anticancer and anti-inflammatory activities of the flavanone and isoflavanone analogs are currently being investigated.

Keywords: Diels-Alder reaction, flavonoids, Mannich reaction, ortho-quinone methide.

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Authors: Lindy Adoma Dampare, Marina Aferiba Tandoh

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Sickle cell disease (SCD) is an inherited blood disorder that mostly affects individuals in sub-Saharan Africa. Nutritional deficiencies have been well established in SCD patients. In Ghana, studies have revealed the prevalence of malnutrition, especially amongst children with SCD and hence the need to develop an evidence-based comprehensive nutritional therapy for SCD to improve their nutritional status. The aim of the study was to develop and assess the effect of a nutrition education material on the nutritional status of SCD patients in Ghana. This was a pre-post interventional study. Patients between the ages of 2 to 60 years were recruited from the Tema General Hospital. Following a baseline nutrition knowledge (NK), beliefs, sanitary practice and dietary consumption pattern assessment, a twice-monthly nutrition education was carried out for 3 months, followed by a post-intervention assessment. Nutritional status of SCD patients was assessed using a 3-days dietary recall and anthropometric measurements. Nutrition education (NE) was given to SCD adults and caregivers of SCD children. Majority of the caregivers (69%) and SCD adult (82%) at baseline had low NK. The level of NK improved significantly in SCD adults (4.18±1.83 vs. 10.00±1.00, p<0.001) and caregivers (5.58 ± 2.25 vs.10.44± 0.846, p<0.001) after NE. Increase in NK improved dietary intake and dietary consumption pattern of SCD patients. Significant increase in weight (23.2±11.6 vs. 25.9±12.1, p=0.036) and height (118.5±21.9 vs. 123.5±22.2, p=0.011) was observed in SCD children at post intervention. Stunting (10.5% vs. 8.6%, p=0.62) and wasting (22.1% vs. 14.4%, p=0.30) reduced in SCD children after NE although not statistically significant. Reduction (18.2% vs. 9.1%) in underweight and an increase (18.2% vs. 27.3%) in overweight SCD adults was recorded at post intervention. Fat mass remained the same while high muscle mass increased (18.2% vs. 27.3%) at post intervention in SCD adult. Anaemic status of SCD patients improved at post intervention and the improvement was statistically significant amongst SCD children. Nutrition education improved the NK of SCD caregivers and adults hence, improving the dietary consumption pattern and nutrient intake of SCD patients. Overall, NE improved the nutritional status of SCD patients. This study shows the potential of nutrition education in improving the nutritional knowledge, dietary consumption pattern, dietary intake and nutritional status of SCD patients, and should be further explored.

Keywords: sickle cell disease, nutrition education, dietary intake, nutritional status

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Authors: Siti Napsiyah, Ismet Firdaus, Lisma Dyawati Fuaida, Ellies Sukmawati

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This paper examines the existence, role, and challenge of Family Service Agency, in Bahasa Indonesia known as Lembaga Konsultasi Kesejahteraan Keluarga (LK3) of Syarif Hidayatullah State Islamic University (UIN) Jakarta. It has been established since 2012. It is an official agency under the Ministry of Social Affairs of Indonesia. The establishment of LK3 aims to provide psychosocial services for families of students who has psychosocial problem in their life. The study also aims to explore the trend of psychosocial problems of its client (student) for the past three years (2014-2016). The research method of the study is using a qualitative social work research method. A review of selected data of the client of LK3 UIN Syarif Hidayatullah Jakarta around five main issues: Family background, psychosocial mapping, potential resources, student coping mechanism strategy, client strength and network. The study also uses a review of academic performance report as well as an interview and observation. The findings show that the trend of psychosocial problems of the client of LK3 UIN Syarif Hidayatullah Jakarta vary as follow: bad academic performance, low income family, broken home, domestic violence, disability, mental disorder, sexual abuse, and the like. LK3 UIN Syarif Hidayatullah Jakarta has significant roles to provide psychosocial support and services for the survival of the students to deal with their psychosocial problems. Social worker of LK3 performs indigenous social work practice: individual counseling, family counseling, group therapy, home visit, case conference, Islamic Spiritual Approach, and Spiritual Emotional Freedom Technique (SEPT).

Keywords: psychosocial, indigenizing social work, resiliency, coping mechanism

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Authors: Galina Portnova, Kseniya Gladun

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In our EEG experiment participated 27 children with ASD with the average age of 6.13 years and the average score for CARS 32.41 and 25 healthy children (of 6.35 years). Six types of musical stimulation were presented, included Gluck, Javier-Naida, Kenny G, Chopin and other classic musical compositions. Children with autism showed orientation reaction to the music and give behavioral responses to different types of music, some of them might assess stimulation by scales. The participants were instructed to remain calm. Brain electrical activity was recorded using a 19-channel EEG recording device, 'Encephalan' (Russia, Taganrog). EEG epochs lasting 150 s were analyzed using EEGLab plugin for MatLab (Mathwork Inc.). For EEG analysis we used Fast Fourier Transform (FFT), analyzed Peak alpha frequency (PAF), correlation dimension D2 and Stability of rhythms. To express the dynamics of desynchronizing of different rhythms we've calculated the envelope of the EEG signal, using the whole frequency range and a set of small narrowband filters using Hilbert transformation. Our data showed that healthy children showed similar EEG spectral changes during musical stimulation as well as described the feelings induced by musical fragments. The exception was the ‘Chopin. Prelude’ fragment (no.6). This musical fragment induced different subjective feeling, behavioral reactions and EEG spectral changes in children with ASD and healthy children. The correlation dimension D2 was significantly lower in autists compared to healthy children during musical stimulation. Hilbert envelope frequency was reduced in all group of subjects during musical compositions 1,3,5,6 compositions compared to the background. During musical fragments 2 and 4 (terrible) lower Hilbert envelope frequency was observed only in children with ASD and correlated with the severity of the disease. Alfa peak frequency was lower compared to the background during this musical composition in healthy children and conversely higher in children with ASD.

Keywords: electroencephalogram (EEG), emotional perception, ASD, musical perception, childhood Autism rating scale (CARS)

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Authors: L. Bernabeo, T. Loftus

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Many children often experience phases of picky eating, food aversions and/or avoidance. For families with children who have special needs, these experiences are often exacerbated, which can lead to feelings that negatively impact a caregiver’s relationship with their child. Within the scope of speech language pathology practice, knowledge of both emotional and feeding development is key. This paper will explore the significance of “messy play” within typical feeding development, and the challenges that may arise if a child does not have the opportunity to engage in this type of exploratory play. This paper will consider several contributing factors that can result in a “picky eater.” Further, research has shown that individuals with special needs, including autism, possess a neurological makeup that differs from that of a typical individual. Because autism is a disorder of relating and communicating due to differences in the limbic system, an individual with special needs may respond to a typical feeding experience as if it is a traumatic event. As a result, broadening one’s dietary repertoire may seem to be an insurmountable challenge. This paper suggests that introducing new foods through exploratory play can help broaden and strengthen diets, as well as improve the feeding experience, of individuals with autism. The DIRFloortimeⓇ methodology stresses the importance of following a child's lead. Within this developmental model, there is a special focus on a person’s individual differences, including the unique way they process the world around them, as well as the significance of therapy occurring within the context of a strong and motivating relationship. Using this child-centered approach, we can support our children in expanding their diets, while simultaneously building upon their cognitive and creative development through playful and respectful interactions that include exposure to foods that differ in color, texture, and smell. Further, this paper explores the importance of exploration, self-feeding and messy play on brain development, both in the context of typically developing individuals and those with disordered development.

Keywords: development, feeding, floortime, sensory

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Authors: Haruka Ito, Toru Maruyama, Michihiro Ito, Chuya Shinzato, Hiroyuki Fujimura, Yoshikatsu Nakano, Shoichiro Suda, Sachiyo Aburatani, Haruko Takeyama

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Clarifying symbiotic relationships is one of the most important theme for understanding the marine eco-system. Coral reef has been regarded as an important environmental resource. Coral holobiont composed by coral, symbiotic microalgae zooxanthellae, and bacteria have complexed relationship. Zooxanthellae mainly supply organic matter to the host corals through their photosynthetic activity. The symbiotic relationship is indispensable for corals but may easily collapses due to the rise of seawater temperature. However, the molecular mechanism how seawater temperature influences their relationships still remain unclear. In this study, the transcriptomic analysis has applied to elucidate the coral-zooxanthellae relationships under high seawater temperature stress. To observe reactions of corals and zooxanthellae against the rise of seawater temperature, meta-gene expression in coral have been analyzed. The branches from six different colonies of a stony coral, Acropora tenuis, were sampled at nine times by 2016 at two locations, Ishikawabaru and South of Sesoko Island, Okinawa, Japan. The mRNAs extracted from the branches including zooxanthellae were sequenced by illumina HiSeq. Gene Set Enrichment Analysis (GSEA) based on hyper geometric distribution was performed. The seawater temperature at 2016 summer was unusually high, which was caused by El Niño event, and the number of zooxanthellae in coral was decreased in August. GSEA derived the several specific genes expressed in A. tenuis under heat stress conditions. The upregulated genes under heat stress highly related with infection immunity. The downregulated genes significantly contained cell cycle related genes. Thu, it is considered that heat stress cause disorder in cell metabolism of A. tenuis, resulting in serious influence to coral holobiont.

Keywords: coral, symbiosis, thermal stress response, transcriptome analysis

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Authors: I-Yun Cheng, Min-Yu Chiang, Shwu-Jen Chang, San-Yuan Chen

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Osteoarthritis (OA) is among the most challenging joint diseases, and as far as we know, there is currently no exact and effective cure for it because it has low self-repair ability due to lack of blood vessels and low cell density in articular cartilage. So far, there have been several methods developed to treat cartilage disorder. The most common method is to treat the high molecular weight of hyaluronic acid (HA) injection, but it will degrade after a period of time, so the patients need to inject HA repeatedly. In recent years, self-healing hydrogel has drawn considerable attention because it can recover its initial mechanical properties after damaged and further increase the lifetime of the hydrogel. Here, we aim to develop a self-healable composite hydrogel combined with magnetic microspheres to trigger glutathione(GSH) release for promoting cartilage repair. We use HA-cyclodextrin (CD) as host polymer and poly(acrylic acid)-ferrocene (pAA-Fc) as guest polymer to form the self-healable HA-pAA hydrogel by host and guest interaction where various graft amount of pAA-Fc (pAA:Fc= 1:2, 1:1.5, 1:1, 2:1, 4:1) was conducted to develop different mechanical strength hydrogel. The rheology analysis showed that the 4:1 of pAA-Fc has higher mechanical strength than other formulations. On the other hand, iron oxide nanoparticle, poly(lactic-co-glycolic acid) (PLGA) and polyethyleneimine (PEI) were used to synthesize porous magnetic microspheres via double emulsification water-in-oil-in-water (W/O/W) to increase GSH loading which acted as a reductant to control the hydrogel crosslink density and promote hydrogel self-healing. The results show that the porous magnetic microspheres can be loaded with 70% of GSH and sustained release about 50% of GSH after 24 hours. More importantly, the HA-pAA composite hydrogel can self-heal rapidly within 24 hours when suffering external force destruction by releasing GSH from the magnetic microspheres. Therefore, the developed the HA-pAA composite hydrogel combined with GSH-loaded magnetic microspheres can be in-vivo guided to damaged OA surface for inducing the cartilage repair by controlling the crosslinking of self-healing hydrogel via GSH release.

Keywords: articular cartilage, magnetic microsphere, osteoarthritis, self-healing hydrogel

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Authors: Isabella Lobo Sasaoka, Felipe Q. da Luz, Zubeyir Salis, Phillipa Hay, Tamiris Gaeta, Paula Costa Teixeira, Táki Cordás, Amanda Sainsbury

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Background: A significant number of people with obesity that seek weight loss treatments experience binge eating episodes. Nonetheless, it is unknown whether binge eating episodes can hinder weight loss outcomes. Objective: To compare weight change in people with or without binge eating submitted to bariatric surgery, pharmacotherapy, nutritional orientation, and/or psychological therapies. Method: We conducted a systematic review with meta-analyses by searching studies in PubMed, American Psychological Association (APA), and Embase. Results: Thirty-four studies were included in our systematic review, and 17 studies were included in the meta-analyses. Overall, we found no significant difference in weight loss between people with or without binge eating submitted to any type of weight loss treatment. Additionally, we found no statistically significant differences in body weight between people with or without binge eating at short and long follow-up assessments following any type of weight loss treatment. We also examined changes in body weight in people with or without binge eating in three additional meta-analyses categorized by the type of weight loss treatment (i.e., behavioural and/or nutritional interventions; bariatric surgery; pharmacotherapy isolated or combined with behavior interventions) and found no difference in weight loss. Eleven out of the 17 studies that were assessed qualitatively (i.e., not included in meta-analyses) did not show differences in weight loss in people with or without binge eating submitted to any type of weight loss treatment. Conclusion: This systematic review with meta-analyses showed no difference in weight loss in people with or without binge eating submitted to a variety of weight loss treatments. Nonetheless, specialized therapies can be required to address eating disorder psychopathology and recurrent binge eating in people with obesity that seek weight loss.

Keywords: obesity, binge eating, weight loss, systematic review, meta-analysis

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Authors: Reihane Mehrparvar

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Human age could exceed further by altering gene expression through food intaking, although as a consequence of recent century eating patterns, human life-span getting shorter by emerging irregulating in autophagy mechanism, insulin, leptin, gut microbiota which are important etiological factors of type-2 diabetes, obesity, infertility, cancer, metabolic and autoimmune diseases. However, restricted calorie intake and vigorous exercise might be beneficial for losing weight and metabolic regulation in a short period but could not be implementable in the long term as a way of life. Therefore, the lack of a dietary program that is compatible with the genes of the body is essential. Sweet and high-glycemic-index (HGI) foods were associated with type-2 diabetes and cancer morbidity. The neuropsychological perspective characterizes the inclination of sweet and HGI-food consumption as addictive behavior; hence this process engages preference of gut microbiota, neural node, and dopaminergic functions. Moreover, meal composition is not the only factor that affects body hemostasis. In this narrative review, it is believed to attempt to investigate how the body responded to different food intakes and represent an accurate model based on current evidence. Eating frequently and ingesting unassimilable protein and carbohydrates may not be compatible with human genes and could cause impairments in the self-renovation mechanism. This trajectory indicates our body is more adapted to starvation and eating animal meat and marrow. Here has been recommended a model that takes into account three important factors: frequent eating, meal composition, and circadian rhythm, which may offer a promising intervention for obesity, inflammation, cardiovascular, autoimmune disorder, type-2 diabetes, insulin resistance, infertility, and cancer through intensifying autophagy-mechanism and eliminate medical costs.

Keywords: metabolic disease, anti-aging, type-2 diabetes, autophagy

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Authors: Shalini Saini, Sharmila Ahuja

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Anaesthesia for caesarean section poses challenges unique to the obstetric patient due to changes in the airway and respiratory system. The choice of anaesthesia for caesarean section depends on various factors however general anaesthesia (GA) is necessary for certain situations. Supraglottic airway devices are an emerging method to secure airway, especially in difficult situations. Of these devices, proseal –LMA (PLMA) is designed to provide better protection of the airway. The use of PLMA has been reported successfully as a rescue device in difficult intubation situations and in patients undergoing elective caesarean section without any complications. The study was prospective and randomised and was designed to compare PLMA in patients undergoing elective lower segment caesarean section (LSCS) with the endotracheal tube (ETT). Patients undergoing LSCS under GA belonging to ASA grade 1 and 2 were included. Patients with the history of fewer than 6 hrs of fasting, known/predicted difficult airway, obesity, gastroesophageal reflux disease, hypertensive disorder were excluded. A standard anaesthesia protocol was followed. All patients received aspiration prophylaxis. The airway was secured with either PLMA or ETT. Parameters noted were- ease of insertion, adequacy of ventilation, hemodynamic changes at insertion and removal of device, incidence of regurgitation and aspiration. Data was analysed by unpaired t- test, Chi-square /Fisher’s test. The findings of our study indicated that PLMA was easy to insert (20.67±6.835 sec) with comparable insertion time to TT (18.33 ± 4.971, p 0.136) and adequate ventilation was achieved with very minimal hemodynamic changes seen with PLMA as compared to ETT at insertion and removal of devices (p 0.01). There was no incidence of regurgitation with the use of PLMA. The incidence of a postoperative sore throat was minimal (6.7%) with PLMA (p<0.05). PLMA appears to be a safe alternative to ETT for selected obstetric patients undergoing elective LSCS. Further study with a larger group of patients is required to establish the safety of PLMA in obstetric patients.

Keywords: caesarean section, general anaesthesia, proseal LMA, endotracheal tube

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Authors: Bliss Singhal

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Epilepsy is a prevalent neurological disorder affecting approximately 50 million individuals worldwide and 1.2 million Americans. There exist millions of pediatric patients with intractable epilepsy, a condition in which seizures fail to come under control. The occurrence of seizures can result in physical injury, disorientation, unconsciousness, and additional symptoms that could impede children's ability to participate in everyday tasks. Predicting seizures can help parents and healthcare providers take precautions, prevent risky situations, and mentally prepare children to minimize anxiety and nervousness associated with the uncertainty of a seizure. This research proposes a comprehensive framework to predict seizures in pediatric patients by evaluating machine learning algorithms on unimodal neuroimaging data consisting of electroencephalogram signals. The bandpass filtering and independent component analysis proved to be effective in reducing the noise and artifacts from the dataset. Various machine learning algorithms’ performance is evaluated on important metrics such as accuracy, precision, specificity, sensitivity, F1 score and MCC. The results show that the deep learning algorithms are more successful in predicting seizures than logistic Regression, and k nearest neighbors. The recurrent neural network (RNN) gave the highest precision and F1 Score, long short-term memory (LSTM) outperformed RNN in accuracy and convolutional neural network (CNN) resulted in the highest Specificity. This research has significant implications for healthcare providers in proactively managing seizure occurrence in pediatric patients, potentially transforming clinical practices, and improving pediatric care.

Keywords: intractable epilepsy, seizure, deep learning, prediction, electroencephalogram channels

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Authors: Baburao Ganpat Apte, Gajodhar

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Introduction: diopathic Parkinson’s disease (PD) is the most common neurodegenerative disorder. Early PD may present a diagnostic challenge with broad differential diagnoses that are not associated with striatal dopamine deficiency. This test was performed by using special type of radioactive precursor which was made available through our logistics. 131I-TOPA L-6-[131I] Iodo-3,4-Trihydroxyphenylalnine (131I -TOPA) is a positron emission tomography (PET) agent that measures the uptake of dopamine precursors for assessment of presynaptic dopaminergic integrity and has been shown to accurately reflect the sign of nervous mind going in patients suffers from monoaminergic disturbances in PD. Both qualitative and quantitative analyses of the scans were performed. Therefore, the early clinical diagnosis alone may be accurate and this reinforces the importance of functional imaging targeting the patholigically of the disease process. The patient’s medical records were then assessed for length of follow-up, response to levotopa, clinical course of sickness, and usually though of symptoms at time of 131I -TOPA PET. A respective analysis was carried out for all patients that gone through 131I -TOPA PET brain scan for motor symptoms suspicious for PD between 2000 - 2006. The eventual diagnosis by the referring neurologist, movement therapist, physiotherapist, was used as the accurate measurements in standard for further analysis. In this study, our goal to illustrate our local experience to determine the accuracy of 131I -TOPA PET for diagnosis of PD. We studied a total of 48 patients. Of the 25 scans, it found that one was a false negative, 40 were true positives, and 7 were true negatives. The resultant values are Sensitivity 90.4% (95% CI: 100%-71.3%), Specificity 100% (92% CI: 100%-58.0%), PPV 100% (91% CI 100%-75.7%), and NPV 80.5% (95% CI: 92.5%-48.5%). Result: Twenty-three patients were found in the initial query, and 1 were excluded (2 uncertain diagnosis, 2 inadequate follow-up). Twenty-eight patients (28 scans) remained with 15 males (62%) and 8 females (30%). All the patients had a clinical follow-up of at least 3 years, however the median length of follow-up was 5.5 years (range: 2-8 years). The median age at scan time was 51.2 years (range: 35-75)

Keywords: 18F-TOPA, petct, parkinson’s disease, cardiac

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Authors: Oyuntsetseg Sandag, Lkhagvadorj Khosbayar, Naidansuren Tsendeekhuu, Densenbal Dansran, Bandi Solongo

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Introduction: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of the adult population. It is estimated that nearly 80% of men and 93% of women with moderate to severe sleep apnea are undiagnosed. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA, also it’s indeed to clinical practice. Purpose of study: Determine dependence of obstructive sleep apnea between for severe risk and risk factor. Material and Methods: A cross-sectional study included 114 patients presenting from theCentral state 3th hospital and Central state 1th hospital. Patients who had obstructive sleep apnea (OSA)selected in this study. Standard StopBang questionnaire was obtained from all patients.According to the patients’ response to the StopBang questionnaire was divided into low risk, intermediate risk, and high risk.Descriptive statistics were presented mean ± standard deviation (SD). Each questionnaire was compared on the likelihood ratio for a positive result, the likelihood ratio for a negative test result of regression. Statistical analyses were performed utilizing SPSS 16. Results: 114 patients were obtained (mean age 48 ± 16, male 57)that divided to low risk 54 (47.4%), intermediate risk 33 (28.9%), high risk 27 (23.7%). Result of risk factor showed significantly increasing that mean age (38 ± 13vs. 54 ± 14 vs. 59 ± 10, p<0.05), blood pressure (115 ± 18vs. 133 ± 19vs. 142 ± 21, p<0.05), BMI(24 IQR 22; 26 vs. 24 IQR 22; 29 vs. 28 IQR 25; 34, p<0.001), neck circumference (35 ± 3.4 vs. 38 ± 4.7 vs. 41 ± 4.4, p<0.05)were increased. Results from multiple logistic regressions showed that age is significantly independently factor for OSA (odds ratio 1.07, 95% CI 1.02-1.23, p<0.01). Predictive value of age was significantly higher factor for OSA (AUC=0.833, 95% CI 0.758-0.909, p<0.001). Our study showing that risk of OSA is beginning 47 years old (sensitivity 78.3%, specifity74.1%). Conclusions: According to most of all patients’ response had intermediate risk and high risk. Also, age, blood pressure, neck circumference and BMI were increased such as risk factor was increased for OSA. Especially age is independently factor and highest significance for OSA. Patients’ age one year is increased likelihood risk factor 1.1 times is increased.

Keywords: obstructive sleep apnea, Stop-Bang, BMI (Body Mass Index), blood pressure

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Authors: Muhammad Saleem

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Background: Inattentive food choices and engagement in excessive physical activities by male athletes can potentially lead to adverse health consequences. Objective: The aim was to ascertain the occurrence of risk factors associated with the Male Athlete Triad among young elite athletes in Pakistan. Methodology: In 2018, a cross-sectional study based on questionnaires was conducted at the Pakistan Sports Board. The study aimed to explore the risk factors related to the Male Athlete Triad in young elite athletes who were part of national training camps in major metropolitan areas. The study included proficient male elite athletes aged 18 to 25 years, capable of understanding the English questionnaire. The athletes completed a survey encompassing aspects like demographic information, educational background, Body Mass Index (BMI), sports involvement, and hours of participation. Additionally, they filled out the Eating Attitude Test-26 (EAT-26) and questionnaires assessing risks of amenorrhea and low bone mineral density. The prevalence of risk factors for each of the three components was individually evaluated. The collected data underwent analysis using SPSS-20, with descriptive statistics being applied. Results: The study comprised a sample of 90 elite athletes (mean age: 23.57 ± 2.37 years, mean BMI: 21.97 ± 1.90) engaged in various sports. The EAT-26 results indicated that 50% of athletes were at risk of developing an eating disorder. Moreover, 83.3% exhibited disordered eating behaviors that necessitated referral. Risks for amenorrhea were observed in 15% of the participants, and regarding low bone mineral density, notable risks were absent except for the consumption of caffeinated beverages, which was noted in 51.7% of participants. Conclusion: The study identified a significant prevalence of disordered eating risk among male elite athletes in Pakistan. However, the risks associated with amenorrhea and low bone mineral density were not a major concern in this particular group.

Keywords: Pakistan, osteoporosis, female athlete triad, bone mineral density, athlete, amenorrhea, eating disorders

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Authors: Lateef Hakim Zai Khyber, Syed Rashid Ali

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In the post 9/11 era, a new trend has developed of terrorist profiling on the basis of the ethnic, religious, political, psychological, social, and economic background of the terrorists to anticipate and assess the possible risk and to prevent and prosecute the suspected before they commit any violent act. The same profiling approach was adopted in different militant or terrorist de-radicalization and rehabilitation programs across the world in order to evaluate and identify the reasons and causes for joining terrorism in terms of push and pull factors. This paper attempts to explore and investigate the profiles of the detainees in the Sabaoon de-radicalization and Emancipation program, which aimed at de-radicalizing the former militants of Tehrik-e-Taliban (TTP) Pakistan in the Swat valley of Pakistan. This research attempted to use qualitative methods for collecting data, including a number of formal and informal open-ended interviews with the former staff members of Sabaoon to explore various aspects of the program, such as various approaches used at Sabaoon for terrorist profiling. It conducts a thorough examination of the profiles of the terrorist through their socioeconomic, ideological, emotional, intellectual, and psychological conditions and orientations, personal details, family issues, social preferences, etc. The study finds out that the majority of the terrorists belonged to the marginalized groups or lower class, including underprivileged tenants and poor laborers, of society having no access to land. They possess almost the same profiles, including low socioeconomic status, absence of a father or strict behavior of parents, large and combined families, lack of education, lack of religious understanding, etc. They also possess some common traits such as anxiety disorder, emotional instability, aggressive impulses and insecurity, depression, inferiority complex, lack of critical thinking and logical reasoning, authority-seeking behavior, and revenge-seeking behavior.

Keywords: terrorist profiling, Sabaoon, de-radicalization, rehabilitation, Swat, Pakistan, juvenile militants

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