Search results for: respiratory distress syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1557

Search results for: respiratory distress syndrome

537 Circulating Oxidized LDL and Insulin Resistance among Obese School Students

Authors: Nayera E. Hassan, Sahar A. El-Masry, Mones M. Abu Shady, Rokia A. El Banna, Muhammad Al-Tohamy, Mehrevan M. Abd El-Moniem, Mona Anwar

Abstract:

Circulating oxidized LDL (ox-LDL) is associated with obesity, insulin resistance (HOMA), metabolic syndrome, and cardiovascular disease in adults. Little is known about relations in children. Aim: To assess association of ox-LDL with fat distribution and insulin resistance in a group of obese Egyptian children. Methods: Study is cross-sectional consisting of 68 obese children, with a mean age of 9.96 ± 1.32. Each underwent a complete physical examination; blood pressure (SBP, DBP) and anthropometric measurements (weight, height, BMI; waist, hip circumferences, waist/hip ratio), biochemical tests of fasting blood glucose (FBS), insulin levels; lipid profile (TC, LDL,HDL, TG) and ox-LDL; calculated HOMA. Sample was classified according to waist/hip ratio into: group I with and group II without central obesity. Results: ox-LDL showed significant positive correlation with LDL and TC in all groups of obesity. After adjustment for age and sex, significant positive correlation was detected between ox-LDL with SBP, DBP, TC, LDL, insulin, and HOMA in group II and with TC and FBS in group I. Insignificant association was detected between ox-LDL and other anthropometric parameters including BMI in any group of obese children (p > 0.05). Conclusions: ox-LDL, as a marker of oxidative stress is not correlated with BMI among all studied obese children (aged 6-12 years). Increased oxidative stress has causal effects on insulin resistance in obese children without central obesity and on fasting blood sugar in those with central obesity. These findings emphasize the importance of obesity during childhood and suggest that the metabolic complications of obesity and body fat distribution are detectable early in life.

Keywords: ox-LDL, obesity, insulin resistance, children

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536 Teaching Basic Life Support in More Than 1000 Young School Children in 5th Grade

Authors: H. Booke, R. Nordmeier

Abstract:

Sudden cardiac arrest is sometimes eye-witnessed by kids. Mostly, their (grand-)parents are affected by sudden cardiac arrest, putting these kids under enormous psychological pressure: Although they are more than desperate to help, they feel insecure and helpless and are afraid of causing harm rather than realizing their chance to help. Even years later, they may blame themselves for not having helped their beloved ones. However, the absolute majority of school children - at least in Germany - is not educated to provide first aid. Teaching young kids (5th grade) in basic life support thus may help to save lives while washing away the kids' fear from causing harm during cardio-pulmonary resuscitation. A teaching of circulatory and respiratory (patho-)physiology, followed by hands-on training of basic life support for every single child, was offered to each school in our district. The teaching was performed by anesthesiologists, and the program was called 'kids can save lives'. However, before enrollment in this program, the entire class must have had lessons in biology with a special focus on heart and circulation as well as lung and gas exchange. More than 1.000 kids were taught and trained in basic life support, giving them the knowledge and skills to provide basic life support. This may help to reduce the rate of failure to provide first aid. Therefore, educating young kids in basic life support may not only help to save lives, but it also may help to prevent any feelings of guilt because of not having helped in cases of eye-witnessed sudden cardiac arrest.

Keywords: teaching, children, basic life support, cardiac arrest, CPR

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535 Analgesia in Acute Traumatic Rib Fractures

Authors: A. Duncan, A. Blake, A. O'Gara, J. Fitzgerald

Abstract:

Introduction: Acute traumatic rib fractures have significant morbidity and mortality and are a commonly seen injury in trauma patients. Rib fracture pain can often be acute and can prove challenging to manage. We performed an audit on patients with acute traumatic rib fractures with the aim of composing a referral and treatment pathway for such patients. Methods: From January 2021 to January 2022, the pain medicine service encouraged early referral of all traumatic rib fractures to the pain service for a multi-modal management approach. A retrospective audit of analgesic management was performed on a select cohort of 24 patients, with a mean age of 67, of which 19 had unilateral rib fractures. Results: 17 of 24 patients (71%) underwent local, regional block as part of a multi-modal analgesia regime. Only one regional complication was observed, seen with hypotension occurring in one patient with a thoracic epidural. The group who did not undergo regional block had a length of stay (LOS) 17 days longer than those who did (27 vs. 10) and higher rates of pneumonia (29% vs. 18%). Conclusion: Early referral to pain specialists is an important component of the effective management of acute traumatic rib fractures. From our audit, it is evident that regional blocks can be effectively used in these cases as part of a multi-modal analgesia regime and may confer benefits in terms of respiratory complications and length of stay.

Keywords: rib fractures, regional blocks, thoracic epidural, erector spina block

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534 Psychological Characteristic Patients with Takotsubo - Etiology of Stress and Family Functioning

Authors: Treder Natalia, Siemiński Mariusz

Abstract:

Takotsubo cardiomyopathy (TC) is a recently defined clinical entity. First described by Japanese researchers, today is diagnosed worldwide in 1-2% of patients admitted with the preliminary diagnosis of Acute Coronary Syndrome. The etiology of takotsubo cardiomyopathy remains still largely unknown. Currently, the most likely cause of takotsubo is direct cytotoxicity caused by catecholamine surge triggered by emotional stress. There is a strong relation between recent severe emotional stress and TC. The aim of this study was to analysis the role of stress and personality as a risk factor of TT. The presented research involves 35 people who are diagnosed TC. All patients were women, mean age 60 years. The methods used in the research are popular psychological tests: Perceived Stress Scale, DS14 scale to measure type D personality, The Neo-Five Factor Inventory of Personality and psychological interview. The obtained results prove that stress events may directly precede or even release TC. The stressful events occurred directly before the symptoms in 75% examined. 65% assessed their family life as very stressful. Examiners have also a high level of experienced stress. Only 25% of the TC were classified as having type D personality but they have a high level of negative affectivity. The subjects had a high level of extraversion, openness to experiences and an average level of neuroticism. The results suggested that such a type of personality profile may predispose to the development of takotsubo cardiomyopathy. Patients with TT are the individuals who reveal joint tendency to the experience of negative emotions and very stressful family life.

Keywords: stress, personality trails, familiar problems, Takotsubo cardiomyopathy

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533 Artificial Neural Networks and Hidden Markov Model in Landslides Prediction

Authors: C. S. Subhashini, H. L. Premaratne

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Landslides are the most recurrent and prominent disaster in Sri Lanka. Sri Lanka has been subjected to a number of extreme landslide disasters that resulted in a significant loss of life, material damage, and distress. It is required to explore a solution towards preparedness and mitigation to reduce recurrent losses associated with landslides. Artificial Neural Networks (ANNs) and Hidden Markov Model (HMMs) are now widely used in many computer applications spanning multiple domains. This research examines the effectiveness of using Artificial Neural Networks and Hidden Markov Model in landslides predictions and the possibility of applying the modern technology to predict landslides in a prominent geographical area in Sri Lanka. A thorough survey was conducted with the participation of resource persons from several national universities in Sri Lanka to identify and rank the influencing factors for landslides. A landslide database was created using existing topographic; soil, drainage, land cover maps and historical data. The landslide related factors which include external factors (Rainfall and Number of Previous Occurrences) and internal factors (Soil Material, Geology, Land Use, Curvature, Soil Texture, Slope, Aspect, Soil Drainage, and Soil Effective Thickness) are extracted from the landslide database. These factors are used to recognize the possibility to occur landslides by using an ANN and HMM. The model acquires the relationship between the factors of landslide and its hazard index during the training session. These models with landslide related factors as the inputs will be trained to predict three classes namely, ‘landslide occurs’, ‘landslide does not occur’ and ‘landslide likely to occur’. Once trained, the models will be able to predict the most likely class for the prevailing data. Finally compared two models with regards to prediction accuracy, False Acceptance Rates and False Rejection rates and This research indicates that the Artificial Neural Network could be used as a strong decision support system to predict landslides efficiently and effectively than Hidden Markov Model.

Keywords: landslides, influencing factors, neural network model, hidden markov model

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532 Development of a Diagnostic Device to Predict Clinically Significant Inflammation Associated with Cardiac Surgery

Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

Abstract:

Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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531 Investigation of the Effects of Dry Needling With Stretching Upper Trapezius Muscle on Clinical Outcomes in Participants With Active Myofascial Trigger Point.

Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

Abstract:

Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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530 Nitric Oxide: Role in Immunity and Therapeutics

Authors: Anusha Bhardwaj, Shekhar Shinde

Abstract:

Nitric oxide (NO•) has been documented in research papers as one of the most versatile player in the therapeutics. It is identified as a biological multifunctional messenger molecule which is synthesized by the action of nitric oxide synthase (NOS) enzyme from L-arginine. The protective and the toxic effect in conjunction form the complete picture of the biological function of nitric oxide in humans. The dual nature is because of various factors such as concentration of NO, the isoform of NOS involved, type of cells in which it is synthesized, reaction partners like proteins, reactive oxygen intermediates, prosthetic groups, thiols etc., availability of the substrate L-arginine, intracellular environment in which NO is produced and generation of guanosine 3, 5’- cyclic monophosphate (cGMP). Activation of NOS through infection or trauma leads to one or more systemic effects including enhanced immune activity against invading pathogens, vaso/bronchodilatation in the cardiovascular and respiratory systems and altered neurotransmission which can be protective or toxic. Hence, NO affects the balance between healthy signaling and neurodegeneration in the brain. In lungs, it has beneficial effects on the function of airways as a bronchodilator and acts as the neurotransmitter of bronchodilator nerves. Whereas, on the other hand, NO may have deleterious effects by amplifying the asthmatic inflammatory response and also act as a vasodilator in the airways by increasing plasma exudation. But NOS Inhibitors and NO donors hamper the signalling pathway and hence a therapeutic application of NO is compromised.

Keywords: nitric oxide, multifunctional, dual nature, therapeutic applications

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529 Interaction between Kazal-Type Serine Proteinase Inhibitor SPIPm2 and Cyclophilin A from the Black Tiger Shrimp Penaeus monodon

Authors: Sirikwan Ponprateep, Anchalee Tassanakajon, Vichien Rimphanitchayakit

Abstract:

A Kazal-type serine proteinase inhibitor, SPIPm2, was abundantly expressed in the hemocytes and secreted into shrimp plasma has anti-viral property against white spot syndrome virus (WSSV). To discover the molecular mechanism of antiviral activity, the binding assay showed that SPIPm2 bind to the components of viral particle and shrimp hemocyte. From our previous report, viral target protein of SPIPm2 was identified, namely WSV477 using yeast two-hybrid screening. WSV477 is an early gene product of WSSV and involved in viral propagation. In this study, the co-immunoprecipitation technique and Tandem Mass Spectrometry (LC-MS/MS) was used to identify the target protein of SPIPm2 from shrimp hemocyte. The target protein of SPIPm2 was cyclophilin A. In vertebrate, cyclophilin A or peptidylprolyl isomerase A was reported to be the immune suppressor interacted with cyclosporin A involved in immune defense response. The recombinant cyclophilin A from Penaeus monodon (rPmCypA) was produced in E.coli system and purified using Ni-NTA column to confirm the protein-protein interaction. In vitro pull-down assay showed the interaction between rSPIPm2 and rPmCypA. To study the biological function of these proteins, the expression analysis of immune gene in shrimp defense pathways will be investigated after rPmCypA administration.

Keywords: cyclophilin A, protein-protein interaction, Kazal-type serine proteinase inhibitor, Penaeus monodon

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528 Nursing Experience of Providing Nursing Care to a Lung Transplantation Patient by Applying the Self-Efficacy Theory

Authors: Hsin-Yi Huang

Abstract:

This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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527 Analysis of Impact of Air Pollution over Megacity Delhi Due to Agricultural Biomass Burning in the Neighbouring States

Authors: Ankur P. Sati, Manju Mohan

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The hazardous combination of smoke and pollutant gases, smog, is harmful for health. There are strong evidences that the Agricultural waste burning (AWB) in the Northern India leads to adverse air quality in Delhi and its surrounding regions. A severe smog episode was observed over Delhi, India during November 2012 which resulted in very low visibility and various respiratory problems. Very high values of pollutants (PM10 as high as 989 µg m-3, PM2.5 as high as 585 µg m-3 an NO2 as high as 540 µg m-3) were measured all over Delhi during the smog episode. Ultra Violet Aerosol Index (UVAI) from Aura satellite and Aerosol Optical Depth (AOD) are used in the present study along with the output trajectories from HYSPLIT model and the in-situ data. Satellite data also reveal that AOD, UVAI are always at its highest during the farmfires duration in Punjab region of India and the extent of these farmfires may be increasing. It is observed that during the smog episode all the AOD, UVAI, PM2.5 and PM10 values surpassed those of the Diwali period (one of the most polluted events in the city) by a considerable amount at all stations across Delhi. The parameters used from the remote sensing data and the ground based observations at various stations across Delhi are very well in agreement about the intensity of Smog episode. The analysis clearly shows that regional pollution can have greater contributions in deteriorating the air quality than the local under adverse meteorological conditions.

Keywords: smog, farmfires, AOD, remote sensing

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526 The Utilization of FSI Technique and Two-Way Particle Coupling System on Particle Dynamics in the Human Alveoli

Authors: Hassan Athari, Abdurrahim Bolukbasi, Dogan Ciloglu

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This study represented the respiratory alveoli system, and determined the trajectory of inhaled particles more accurately using the modified three-dimensional model with deformable walls of alveoli. The study also considered the tissue tension in the model to demonstrate the effect of lung. Tissue tensions are transferred by the lung parenchyma and produce the pressure gradient. This load expands the alveoli and establishes a sub-ambient (vacuum) pressure within the lungs. Thus, at the alveolar level, the flow field and movement of alveoli wall lead to an integrated effect. In this research, we assume that the three-dimensional alveolus has a visco-elastic tissue (walls). For accurate investigation of pulmonary tissue mechanical properties on particle transport and alveolar flow field, the actual relevance between tissue movement and airflow is solved by two-way FSI (Fluid Structure Interaction) simulation technique in the alveolus. Therefore, the essence of real simulation of pulmonary breathing mechanics can be achieved by developing a coupled FSI computational model. We, therefore conduct a series of FSI simulations over a range of tissue models and breathing rates. As a result, the fluid flows and streamlines have changed during present flexible model against the rigid models and also the two-way coupling particle trajectories have changed against the one-way particle coupling.

Keywords: FSI, two-way particle coupling, alveoli, CDF

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525 Peer Bullying and Mentalization from the Perspective of Pupils

Authors: Anna Siegler

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Bullying among peers is not uncommon; however, adults can notice only a fragment of the cases of harassment during everyday life. The systemic approaches of bullying investigation put the whole school community in the focus of attention and propose that the solution should emerge from the culture of the school. Bystanders are essential in the prevention and intervention processes as an active agent rather than passive. For combating exclusion, stigmatization and harassment, it is important that the bystanders have to realize they have the power to take action. To prevent the escalation of violence, victims must believe that students and teachers will help them and their environment is able to provide safety. The study based on scientific narrative psychological approach, and focuses on the examination of the different perspectives of students, how peers are mentalizing with each other in case of bullying. The data collection contained responses of students (N = 138) from three schools in Hungary, and from three different area of the country (Budapest, Martfű and Barcs). The test battery include Bullying Prevalence Questionnaire, Interpersonal Reactivity Index and an instruction to get narratives about bullying, which effectiveness was tested during a pilot test. The obtained results are in line with the findings of previous bullying research: the victims are mentalizing less with their peers and experience greater personal distress when they are in identity threatening situations, thus focusing on their own difficulties rather than social signals. This isolation is an adaptive response in short-term although it seems to lead to a deficit in social skills later in life and makes it difficult for students to become socially integrated to society. In addition the results also show that students use more mental state attribution when they report verbal bullying than in case of physical abuse. Those who witness physical harassment also witness concrete answers to the problem from teachers, in contrast verbal abuse often stays without consequences. According to the results students mentalizing more in these stories because they have less normative explanation to what happened. To expanding bullying literature, this research helps to find ways to reduce school violence through community development.

Keywords: bullying, mentalization, narrative, school culture

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524 Development of Pothole Management Method Using Automated Equipment with Multi-Beam Sensor

Authors: Sungho Kim, Jaechoul Shin, Yujin Baek, Nakseok Kim, Kyungnam Kim, Shinhaeng Jo

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The climate change and increase in heavy traffic have been accelerating damages that cause the problems such as pothole on asphalt pavement. Pothole causes traffic accidents, vehicle damages, road casualties and traffic congestion. A quick and efficient maintenance method is needed because pothole is caused by stripping and accelerates pavement distress. In this study, we propose a rapid and systematic pothole management by developing a pothole automated repairing equipment including a volume measurement system of pothole. Three kinds of cold mix asphalt mixture were investigated to select repair materials. The materials were evaluated for satisfaction with quality standard and applicability to automated equipment. The volume measurement system of potholes was composed of multi-sensor that are combined with laser sensor and ultrasonic sensor and installed in front and side of the automated repair equipment. An algorithm was proposed to calculate the amount of repair material according to the measured pothole volume, and the system for releasing the correct amount of material was developed. Field test results showed that the loss of repair material amount could be reduced from approximately 20% to 6% per one point of pothole. Pothole rapid automated repair equipment will contribute to improvement on quality and efficient and economical maintenance by not only reducing materials and resources but also calculating appropriate materials. Through field application, it is possible to improve the accuracy of pothole volume measurement, to correct the calculation of material amount, and to manage the pothole data of roads, thereby enabling more efficient pavement maintenance management. Acknowledgment: The author would like to thank the MOLIT(Ministry of Land, Infrastructure, and Transport). This work was carried out through the project funded by the MOLIT. The project name is 'development of 20mm grade for road surface detecting roadway condition and rapid detection automation system for removal of pothole'.

Keywords: automated equipment, management, multi-beam sensor, pothole

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523 The Relevance of Family Involvement in the Journey of Dementia Patients

Authors: Akankunda Veronicah Karuhanga

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Dementia is an age mental disorder that makes victims lose normal functionality that needs delicate attention. It has been technically defined as a clinical syndrome that presents a number of difficulties in speech and other cognitive functions that change someone’s behaviors and can also cause impairments in activities of daily living, not forgetting a range of neurological disorders that bring memory loss and cognitive impairment. Family members are the primary healthcare givers and therefore, the way how they handle the situation in its early stages determines future deterioration syndromes like total memory loss. Unfortunately, most family members are ignorant about this condition and in most cases, the patients are brought to our facilities when their condition was already mismanaged by family members and we thus cannot do much. For example, incontinence can be managed at early stages through potty training or toilet scheduling before resorting to 24/7 diapers which are also not good. Professional Elderly care should be understood and practiced as an extension of homes, not a dumping place for people considered “abnormal” on account of ignorance. Immediate relatives should therefore be sensitized concerning the normalcy of dementia in the context of old age so that they can be understanding and supportive of dementia patients rather than discriminating against them as present-day lepers. There is a need to skill home-based caregivers on how to handle dementia in its early stages. Unless this is done, many of our elderly homes shall be filled with patients who should have been treated and supported from their homes. This skilling of home-based caregivers is a vital intervention because until elderly care is appreciated as a human moral obligation, many transactional rehabilitation centers will crop up and this shall be one of the worst moral decadences of our times.

Keywords: dementia, family, Alzheimers, relevancy

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522 Protective Effect of Malva sylvestris L. against Sodium Fluoride-Induced Nephrotoxicity in Rat

Authors: Ali Babaei Zarch, S. Kianbakht, H. Fallah Huseini, P. Changaei, A. Mirjalili, J. Salehi

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Background: Malva sylvestris L. is widely used in the traditional medicine of Iran and other countries to treat gastrointestinal, respiratory, skin and urological Disorders. Moreover, it has antioxidant property. Objective: In this study the protective effect of Malva sylvestris against sodium fluoride-induced nephrotoxicity in rats were evaluated. Methods: The Malva sylvestris flower extract was injected intraperitoneally at the doses of 100, 200, 400 mg/kg/day to groups of rats ( 10 in each group) for 1 week and subsequently 600 ppm sodium fluoride was added daily to the rats drinking water for 1 additional week. After these steps, the rats’ serum levels of urea, creatinine, reduced glutathione, catalase and malondialdehyde were determined. The histopathology of the rats’ kidney was also studied. Results: Malva sylvesteries extract with doses of 400 mg/kg/day significantly decreased the urea and creatinine levels (P<0.05). Moreover, the levels of catalase and glutathione were increased by this dose, but only the catalase increase was statistically significant (P<0.05). All three extract doses of Malva decreased the malondialdehyde level, but it was significant only for the dose 400 mg/kg/day (P<0.05). Histopathological findings also showed a protective effect of Malva against renal damage induced by sodium fluoride. Conclusion: The results suggest that Malva sylvestris has a protective effect against sodium fluoride-induced nephrotoxicity through its antioxidant property.

Keywords: Malva sylvestris, mephrotoxicity, sodium fluoride, rat  

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521 Tempo-Spatial Pattern of Progress and Disparity in Child Health in Uttar Pradesh, India

Authors: Gudakesh Yadav

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Uttar Pradesh is one of the poorest performing states of India in terms of child health. Using data from the three round of NFHS and two rounds of DLHS, this paper attempts to examine tempo-spatial change in child health and care practices in Uttar Pradesh and its regions. Rate-ratio, CI, multivariate, and decomposition analysis has been used for the study. Findings demonstrate that child health care practices have improved over the time in all regions of the state. However; western and southern region registered the lowest progress in child immunization. Nevertheless, there is no decline in prevalence of diarrhea and ARI over the period, and it remains critically high in the western and southern region. These regions also poorly performed in giving ORS, diarrhoea and ARI treatment. Public health services are least preferred for diarrhoea and ARI treatment. Results from decomposition analysis reveal that rural area, mother’s illiteracy and wealth contributed highest to the low utilization of the child health care practices consistently over the period of time. The study calls for targeted intervention for vulnerable children to accelerate child health care service utilization. Poor performing regions should be targeted and routinely monitored on poor child health indicators.

Keywords: Acute Respiratory Infection (ARI), decomposition, diarrhea, inequality, immunization

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520 Antifungal Susceptibility of Yeasts Isolated from Clinical Samples from a Tertiary Hospital from State of Puebla

Authors: Ricardo Munguia-Perez, Nayeli Remigio-Alvarado, M.Miriam Hernandez-Arroyo, Elsa Castañeda-Roldan

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Fungi have emerged as important pathogens causing morbidity and mortality mainly in immunosuppressed, malnourished and elderly patients. It has detected an increase in resistance to azoles primarily to fluconazol. The fungal infections have become a problem of public health for the resistance to antifungal agents, they have developed new antifungals with broad-spectrum. The aim of this study was determine the antifungal susceptibility of yeasts isolated from clinical samples (respiratory secretions, exudates, wounds, blood cultures, urine cultures) obtained from inpatients and outpatients of a tertiary hospital from State of Puebla. The antifungal susceptibility of the yeast from several clinical samples were determined by the CLS M44-A disk diffusion methods. 149 samples of yeast were analyzed. All species were 100% susceptible to nystatin and amphotericin B. Candida albicans showed resistance of 95.5 % to fluconazole, 50.7 % to 5-flurocytosine and 55.2 % intermediate susceptibility to ketoconazole. Candida glabrata 81.3 % was susceptibility to ketoconazole and 75 % to fluconazole, for the case of 5-flurocytosine the 56.3 % was susceptible. Candida krusei 100 % was susceptible to ketoconazole, 50 % to fluconazole and 37.5 % to 5-flurocytosine. The internal medicine have greater diversity of yeast, the samples have susceptibility of 64.7% to ketoconazole, 47.1 % to fluconazole and 27.5 % to 5-flurocytosine. Hospitalized patients are more resistant to fluconazole and nystatin, but in the case of outpatients presents resistance to ketoconazole.

Keywords: antifungal, susceptibility, yeast, clinical samples

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519 90-Day Strength Training Intervention Decreases Incidence of Sarcopenia: A Pre- and Posttest Pilot Study of Older Adults in a Skilled Nursing Facility

Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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518 Demographic Variations of Multiple Sclerosis Patients between Britain and Kuwait

Authors: Ali Fuad Ashour

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Introduction: Multiple sclerosis (MS) is a chronic, progressive and degenerative disease that affects the central nervous system (CNS). MS has been described to result in the debilitating symptom of the disease. It is reported to have a negative impact on the patient’s mental activities, brings a lower quality of life, leads to unemployment, causes distress and psychological disorders, generates low levels of motivation and self-esteem, and result in disability and neurological impairment. The aim of this study was to compare the effects of MS on patients from Britain and Kuwait. Methodology: A questionnaire was distributed to 200 individuals with MS (100 Kuwaiti and 100 British). The questionnaire consists of three parts; 1. General demographics, 2. Disease-specific data (symptoms, severity levels, relapse frequency, and support system), and 3. Attitudes towards physical exercise. Results: A response rate of 62% from the British sample and 50% from the Kuwaiti sample was achieved. 84% of the sample (n=52) were 41 years old or over. The duration of the disease was less than 10 years in 43.4% of British and 68% of Kuwaiti respondents. The majority of British respondents (56.5%) reported the disease severity to be moderate, while the majority of Kuwaitis was mild (72%). The annual relapse rates in Kuwait were relatively low, with 82% of the Kuwaiti sample had one relapse per year, compared to the 64.5% of British. The most common symptoms reported by British respondents were balance (75.8%), fatigue (74.2%), and weakness (71%), and by Kuwaiti respondents were fatigue (86%), balance (76%), and weakness (66%). The help and support for MS were by far more diverse for the British than Kuwaiti respondents. Discussion: The results unveiled marked differences between two groups of British and Kuwaiti MS patients in terms of patients’ age and disease duration, and severity. The overwhelming majority of Kuwaiti patients are young individuals who have been with the disease for a relatively short period of time, and their MS in most cases was mild. On the other hand, British patients were relatively older, many have been with the disease for a long period of time, and their average MS condition was more serious than that of their Kuwaiti counterparts. The main support in Kuwait comes from the neurologist, who primarily prescribe medications and advise patients to try to be active. The Kuwaiti respondents thought that lack of encouragement was the main reason for them not to engage in social activities.

Keywords: multiple sclerosis, Kuwait, exercise, demographic

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517 Isotretinoin and Psychiatric Adverse Events: A Review of the Evidence

Authors: Thodoris Tsagkaris, Marios Stavropoulos, Panagiotis Theodosis-Nobelos, Charalampos Triantis

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Isotretinoin is a widely used therapeutic for the treatment of acne vulgaris and various other skin disorders. However, since its approval, many side effects and contraindications have been described, particularly important, such as teratogenicity as well as liver disease and dermal deterioration. In a very important allegation, isotretinoin has been linked with psychiatric symptoms like depression, suicidal ideation, schizophrenia, and hypervitaminosis A syndrome characteristics. These adverse effects have raised significant concerns regarding the safety of isotretinoin. Numerous studies and research have associated isotretinoin with side effects on the mental health of patients and have proposed plausible mechanisms regarding this suspected causative relationship. However, the evidence is still contradicting, and the data disperse, making their validity less valuable. Thus, in the present study, we aim to analyze further the available literature and present a complete analysis of the side effects of isotretinoin, with particular emphasis on the effects it may have on the mental health of patients. The review is based on international articles from broad scientific electronic databases like PubMed and Scopus. This review concludes that although many studies have associated isotretinoin with mental effects like depression, bipolar disorder, schizophrenia, and suicidal ideation, the data are still insufficient and often contradictory. In fact, additional studies with accurate data and larger double-blinded samples, and more analytic systematic reviews are required. It is especially important to monitor the dose and the intervals that isotretinoin has to be administered in order to potentially cause mental health problems, as well as the duration of treatment and the role that the patient's medical and pharmaceutical history may play.

Keywords: acne, depression, isotretinoin, mental health

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516 Laboratory Investigation of the Pavement Condition in Lebanon: Implementation of Reclaimed Asphalt Pavement in the Base Course and Asphalt Layer

Authors: Marinelle El-Khoury, Lina Bouhaya, Nivine Abbas, Hassan Sleiman

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The road network in the north of Lebanon is a prime example of the lack of pavement design and execution in Lebanon.  These roads show major distresses and hence, should be tested and evaluated. The aim of this research is to investigate and determine the deficiencies in road surface design in Lebanon, and to propose an environmentally friendly asphalt mix design. This paper consists of several parts: (i) evaluating pavement performance and structural behavior, (ii) identifying the distresses using visual examination followed by laboratory tests, (iii) deciding the optimal solution where rehabilitation or reconstruction is required and finally, (iv) identifying a sustainable method, which uses recycled material in the proposed mix. The asphalt formula contains Reclaimed Asphalt Pavement (RAP) in the base course layer and in the asphalt layer. Visual inspection of the roads in Tripoli shows that these roads face a high level of distress severity. Consequently, the pavement should be reconstructed rather than simply rehabilitated. Coring was done to determine the pavement layer thickness. The results were compared to the American Association of State Highway and Transportation Officials (AASHTO) design methodology and showed that the existing asphalt thickness is lower than the required asphalt thickness. Prior to the pavement reconstruction, the road materials were tested according to the American Society for Testing and Materials (ASTM) specification to identify whether the materials are suitable. Accordingly, the ASTM tests that were performed on the base course are Sieve analysis, Atterberg limits, modified proctor, Los Angeles, and California Bearing Ratio (CBR) tests. Results show a CBR value higher than 70%. Hence, these aggregates could be used as a base course layer. The asphalt layer was also tested and the results of the Marshall flow and stability tests meet the ASTM specifications. In the last section, an environmentally friendly mix was proposed. An optimal RAP percentage of 30%, which produced a well graded base course and asphalt mix, was determined through a series of trials.

Keywords: asphalt mix, reclaimed asphalt pavement, California bearing ratio, sustainability

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515 Characterization of Emissions from the open burning of Municipal Solid Waste (MSW) under Tropical Environment

Authors: Anju Elizbath Peter, S. M. Shiva Nagendra, Indumathi M.Nambi

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The deliberate fires initiated by dump managers and human scavengers to reduce the volume of waste and recovery of valuable metals/materials are common at municipal solid waste (MSW) disposal sites in developed country. A large amount of toxic gases released due to this act is responsible for the deterioration of regional and local air quality, which causes visibility impairment and acute respiratory diseases. The present study was aimed at the characterization of MSW and emission characteristics of burning of MSW in the laboratory. MSW samples were collected directly from the one of the open dumpsite located in Chennai city. Solid waste sampling and laboratory analysis were carried out according to American Society of Testing and Materials (ASTM) standards. Results indicated the values of moisture content, volatile solids (VS) and calorific values of solid waste samples were 16.67%,8%,9.17MJ/kg, respectively. The elemental composition showed that the municipal solid waste contains 25.84% of carbon, 3.69% of hydrogen, 1.57% of nitrogen and 0.26% of sulphur. The calorific value of MSW was found to be 9.17 MJ/Kg which is sufficient to facilitate self-combustion of waste. The characterization of emissions from the burning of 1 kg of MSW in the test chamber showed a total of 90 mg/kg of PM10 and 243 mg/kg of PM2.5. The current research study results will be useful for municipal authorities to formulate guideline and policy structure regarding the MSW management to reduce the impact of air emissions at an open dump site.

Keywords: characterization, MSW, open burning, PM10, PM2.5

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514 High Efficacy of Combined Therapy with Microbicide BASANT and Triple Combination of Selected Probiotics for Treatment of Vaginosis and Restoration of Vaginal Health

Authors: Nishu Atrey, Priyanka Singh, G. P. Talwar, Jagdish Gupta, Alka Kriplani, Rohini Sehgal, Indrani Ganguli, Soni Sinha

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Background: Vaginosis is a widely prevalent syndrome in India and elsewhere. Recurrence is frequent in women treated with antibiotics, whose vagina pH remains above 5.0 indicative of the loss of resident lactobacilli. The objective of the present trial was to determine whether a Polyherbal microbicide BASANT can regress Vaginosis. Another objective was to determine whether the three selected strains of Probiotics endowed with making high amounts of lactic acid can colonise and restore the pH of the vagina to the acidic healthy range. Materials and Procedure: BASANT, was employed in powder form in veg (cellulose) capsules. TRF#36 strain of Lactobacillus fermentum, TRF#8 strain of L.gasseri, and TRF#30 strain of L.salivarius (combination termed as Pro-vag-Health) were employed at 3x109 bacilli lyophilized, packaged in capsules. The trials were conducted in women suffering from vaginosis with vaginal pH above 5.0. Women were given intravaginally either BASANT, Pro-vag-Health or a combination of the two intravaginally for seven days and thereafter once weekly as a maintenance dose. Results: BASANT cleared vaginosis in 14/20 women and Pro-vag-Health in 13/20 women. Interestingly, the combination of BASANT plus Pro-vag-Health was effective in 19/20 women, in contrast to Placebo capsules effective only in 1/20 women. Interpretation and Conclusion: The combination of BASANT and Pro-veg-Health Probiotics taken together intravaginally for seven days relieves 19 out of 20 women from vaginosis to restore acidic pH and healthy vagina. Extension of trial with this combination in larger number is indicated.

Keywords: microbicide, probiotics, vaginal pH, vaginosis

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513 The Effectiveness of Laughing Qigong for Women with Breast Cancer in Community

Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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512 An Electromyographic Study of Muscle Coordination during Dynamic Glenohumeral Joint Elevation

Authors: Omid Khaiyat, David Hawkes

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Introduction: There remains a lack of information on sophisticated coordination patterns across shoulder girdle muscles. Considering the stability of the shoulder being heavily dependent on coordinated muscle activity during its wide-ranging movements, it is important that key intermuscular relationships are well-defined for a better understanding of underlying pathology. This study investigated shoulder intermuscular coordination during different planes of shoulder elevation. Materials and Methods: EMG was recorded from 14 shoulder muscles in 20 healthy participants during shoulder flexion, scapula plane elevation, abduction, and extension. Cross-correlation by means of Pearson Correlation Coefficient (PCC) was used to examine the coordination between different muscles and muscle groups. Results: Coordination between rotator cuff and deltoid muscle groups was significantly higher (p =0.020-0.035) during the initial (PCC) = 0.79) and final (PCC = 0.74) phases of elevation compared to the mid-range (PCC = 0.34). Furthermore, a high level of coordination (PCC = 0.89) was noted between the deltoid group and the adductor group (latissimus dorsi and teres major) during the initial stage of shoulder elevation. Conclusion: The destabilising force of the deltoid during the initial stage of shoulder elevation is balanced by coordinated activity of rotator cuff, latissimus dorsi, and teres major. This is also the case for the end-range of movement, where increased demand for stability again leads to higher coordination between the deltoid and rotator cuff muscle groups. Appreciation of the sophistication of normal shoulder function evidence-based rehabilitation strategies for conditions such as subacromial impingement syndrome or shoulder instability can be developed.

Keywords: shoulder, coordination, EMG, muscle activity, upper limb

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511 The Effect of a Probiotic: Leuconostoc mesenteroides B4, and Its Products on Growth Performance and Disease Resistance of Orange-Spotted Grouper Epinephelus coioides

Authors: Mei-Ying Huang, Huei-Jen Ju, Liang-Wei Tseng, Chin-Jung Hsu

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The aim of this study was to investigate a probiotic, Leuconostoc mesenteroides B4, and its products, isomaltooligosaccharide and dextran, on growth performance, digestive enzymes, immune responses, and pathogen resistance of spotted grouper Epinephelus coioides. The grouper were fed control and diets supplemented with L. mesenteroides B4 (107 CFU/g), isomaltooligosaccharide (0.15%), isomaltooligosaccharide (0.15%) + L. mesenteroides B4 (107 CFU/g) (I + B4), and dextran (0.15%) + L. mesenteroides B4 (107 CFU/g) (D + B4) for 8 weeks. The result showed that final weights and percent weight gains of the grouper fed diets supplemented with L. mesenteroides B4 and I + B4 were significantly higher than that of the control group (p < 0.05). The activities of digestive enzymes in the grouper fed with I + B4 were significantly higher than the control group (p < 0.05), too. After challenge with Vibrio harveyi, the enzyme activities of antiprotease and lysozyme as well as of respiratory burst of the fish fed with I + B4 and D + B4 were significantly higher than that of the control group (p < 0.05). The grouper fed with the both diets also had higher survival rates than that of the control group after the challenge. Overall, the study indicated that feeding diets supplemented with L. mesenteroides B4, and its products, isomaltooligosaccharide, and dextran could be an effective method for enhancing the growth performance and disease resistance in orange-spotted grouper.

Keywords: orange-spotted grouper, probiotic Leuconostoc mesenteroides B4, isomaltooligosaccharide, dextran, growth performance, pathogen resistance

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510 Impact of Ozone Produced by Vehicular Emission on Chronic Obstructive Pulmonary Disease

Authors: Mohd Kamil Vakil

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Air Pollution is caused by the introduction of chemicals in the biosphere. Primary pollutants on reaction with the components of the earth produce Secondary Pollutants like Smog. Ozone is the main ingredient of Smog. The ground level ozone is created by the chemical reactions between Nitrogen Oxides (NOx) and Volatile Organic Compounds (VOCs) in the presence of Sunlight. This ozone can enter inside and call as indoor ozone. The automobile emissions in both moving and idling conditions contribute to the indoor ozone formation. During engine ignition and shutdown, motor vehicles emit the ozone forming pollutants like NOx and VOCs, and the phenomena are called Cold Start and Hot-Soak respectively. Subjects like Chronic Obstructive Pulmonary Disease (COPD) and asthma associated with chronic respiratory diseases are susceptible to the harmful effects of Indoor Ozone. The most common cause of COPD other than smoking is the long-term contract with harmful pollutants like ground-level ozone. It is estimated by WHO that COPD will become the third leading cause of all deaths worldwide by 2030. In this paper, the cold-start and hot-soak vehicle emissions are studied in the context of accumulation of oxides of nitrogen at the outer walls of the building which may cause COPD. The titanium oxide coated building material is further discussed as an absorber of NOx when applied to the walls and roof.

Keywords: indoor air quality, cold start emission, hot-soak, ozone

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509 Environmental Impact Assessment of Conventional Tyre Manufacturing Process

Authors: G. S. Dangayach, Gaurav Gaurav, Alok Bihari Singh

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The popularity of vehicles in both industrialized and developing economies led to a rise in the production of tyres. People have become increasingly concerned about the tyre industry's possible environmental impact in the last two decades. The life cycle assessment (LCA) methodology was used to assess the environmental impacts of industrial tyres throughout their life cycle, which included four stages: manufacture, transportation, consumption, and end-of-life. The majority of prior studies focused on tyre recycling and disposal. Only a few studies have been conducted on the environmental impact of tyre production process. LCA methodology was employed to determine the environmental impact of tyre manufacture process (gate to gate) at an Indian firm. Comparative analysis was also conducted to identify the environmental hotspots in various stages of tire manufacturing. This study is limited to gate-to-gate analysis of manufacturing processes with the functional unit of a single tyre weighing 50 kg. GaBi software was used to do both qualitative and quantitative analysis. Different environmental impact indicators are measured in terms of CO2, SO2, NOx, GWP (global warming potential), AP (acidification potential), EP (eutrophication potential), POCP (photochemical oxidant formation potential), and HTP (toxic human potential). The results demonstrate that the major contributor to environmental pollution is electricity. The Banbury process has a very high negative environmental impact, which causes respiratory problems to workers and operators.

Keywords: life cycle assessment (LCA), environmental impact indicators, tyre manufacturing process, environmental impact assessment

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508 Psychometric Properties of Several New Positive Psychology Measures

Authors: Lauren Benyo Linford, Jared Warren, Jeremy Bekker, Gus Salazar

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In order to accurately identify areas needing improvement and track growth, the availability of valid and reliable measures of different facets of well-being is vital. Because no specific measures currently exist for many facets of well-being, the purpose of this study was to construct and validate measures of the following constructs: Purpose, Values, Mindfulness, Savoring, Gratitude, Optimism, Supportive Relationships, Interconnectedness, Compassion, Community, Contribution, Engaged Living, Personal Growth, Flow Experiences, Self-Compassion, Exercise, Meditation, and an overall measure of subjective well-being—the Survey on Flourishing. In order to assess their psychometric properties, each measure was examined for internal consistency estimates, and items with poor item-test correlations were dropped. Additionally, the convergent validity of the Survey on Flourishing (SURF) was assessed. Total score correlations of SURF and other commonly used measures of well-being such as the Positive and Negative Affect Schedule (PANAS), The Satisfaction with Life Scale (SWLS), the PERMA Profiler (measure of Positive Emotion, Engagement, Relationships, Meaning, and Achievement) were examined to establish convergent validity. The Kessler Psychological distress scale (K6) was also included to determine the divergent validity of the SURF measure. Three week test-retest reliability was also assessed for the SURF measure. Additionally, normative data from general population samples was collected for both the Self-Compassion and Survey on Flourishing (SURF) measures. The purpose of this study is to introduce each of these measures, divulge the psychometric findings of this study, as well as explore additional psychometric properties of the SURF measure in particular. This study will highlight how these measures can be used in future research exploring these positive psychology constructs. Additionally, this study will discuss the utility of these measures to guide individuals in their use of the online self-directed, self-administered My Best Self 101 positive psychology resources developed by the researchers. The goal of My Best Self 101 is to disseminate real, research-based measures and tools to individuals who are seeking to increase their well-being.

Keywords: measurement, psychometrics, test validation, well-Being

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