Search results for: respiratory medicine

Authors: Dian Ariyawati, Romi Sukoco, Sinung Agung Joko

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Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of orthostatic intolerance caused by autonomic dysfunction. POTS predominantly occurs in young women. Regular exercise has proven to improve the organ system functions, including autonomous systems. The aim of this research was to determine the correlation between exercise frequency and POTS in young women. Method: 510 young women (16-23 years of age) were screened. They were obtained by interview and physical examination. The diagnosis of POTS was performed with Active Stand Test (AST) and heart rate measurement using a pulsemeter. There were 29 young women who suffered from POTS. The exercise frequency was obtained by interview. Data was statistically analyzed using Spearman Correlation test. Result: The subjects’, who tested positive for POTS didn’t perform regular exercise. The Spearman correlation test showed there was a moderate negative correlation between exercise frequency and POTS in young women (r = -0.487, p < 0.00). Conclusion: There is a moderate reverse correlation between exercise frequency and POTS in young women. Further studies are suggested to develop an exercise program for young who suffered from POTS.

Keywords: POTS, autonomic dysfunction, exercise frequency, young woman

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Authors: Theodorus Holtzhausen

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With a growing number of professionals in healthcare moving freely between countries and also in general a more mobile global workforce, awareness of cultural differences have become more urgent for health care workers to apply proper care. There is a slowly emerging trend in health care due to globalisation that may create a more uniform cultural base for administering healthcare, but it is still very vulnerable to being hijacked and misdirected by major commercial interests. Veterinary clinics and medical clinics promoting alternative remedies lacking evidence based support and simultaneously practicing medicine as a science have become more common. Such ‘holistic’ clinics see these remedies more as a belief system causing no harm with minimal impact but with added financial benefit to the facility. With the inarguable acceptance and realisation of the interconnection between evolutionary aspects of cognition, knowledge and culture as a global but vulnerable cognition-gaining process affecting us all, we can see the enormous responsibility we carry. Such a responsibility for creating global well-being calling for an universally applicable ethic. Such an ethic with the potential of having significant impact on our cognition gaining process.

Keywords: veterinary health care, ethics, wellbeing, veterinary clinics

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Authors: Watchareewan Thongsaard, Ratirat Sangpayap, Maneekarn Namsa-Aid

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Thunbergia laurifolia Linn. (TL) is a herbal medicine which has been used as an antidote for several poisonous agents including insecticides and as a component of a mixture of crude extracts to treat drug addicted patients. The aim of this study is to examine the level of dopamine in nucleus accumbens after chronic pre-administration of TL in ethanol addicted rats. Male Wistar rats weigh 200-250 g received TL methanol extract (200mg/kg, orally) 60 minutes before 20% ethanol (1 g/kg, i.p.) for 30 days. The nucleus accumbens was removed and tested for dopamine by HPLC-ECD. The level of dopamine was significantly increased by chronic ethanol administration, whereas the chronic TL extract administration did not cause a difference in dopamine level when compared to control. Moreover, the pre-treatment of TL extract before ethanol significantly reduced the dopamine level in nucleus accumbens to normal level when compared with chronic ethanol administration alone. These results suggested that the increase in dopamine level in the nucleus accumbens by chronic ethanol administration is the cause of ethanol addiction, and this effect is prevented by chronic TL pre-administration. Furthermore, chronic TL extract administration alone did not cause the changes in dopamine level in the nucleus accumbens, indicating that TL itself did not cause addiction.

Keywords: Thunbergia laurifolia Linn., alcohol addiction, dopamine, nucleus accumbens

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Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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Authors: Magdalena Barbara Kaziuk

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Introduction: In December 2019, the first case of an acute infectious disease of the respiratory system caused by the SARS-CoV-2 virus was recorded in Wuhan in Central China. On March 11, 2020, the World Health Organization restrictions, among others, in the travel industry. Aim: The aim of the study was the assessment of the preparedness of European cultural institutions and catering establishments within the sanitary and epidemiological dimension during the COVID-19 pandemic by Polish tourists and their sense of safety in selected destinations. Material and methods: The study involved 300 Polish tourists (125 females, 175 males, age 46.5+/-12.9 years) who traveled during the COVID-19 pandemic to Southern European countries. 5 most popular travel destinations were selected: Italy, Austria, Greece, Croatia, and Mediterranean islands. The tourists assessed cultural institutions and catering establishments with the use of a proprietary questionnaire which concerned the preparedness regarding the sanitary and epidemiological requirements and the tourists' sense of safety. The number of respondents was deliberate - 60 persons per each country. Results: The more stringent sanitary regimes, the higher the sense of safety in the study group of females aged 45-50 (p<0.005), while the more stringent sanitary and epidemiological issues are implemented, the shorter the stay (p<0.001). Less stringent restrictions resulted in increased sense of freedom and mental rest in the group of studied males (p<0.005). Conclusions: The respondents' opinions revealed that the highest level of safety with regard to sanitary and epidemiological requirements (masks covering mouth and nose worn by both personnel and society, the necessity to present the COVID passport, the possibility to disinfect hands) was observed in Austria and Italy, while shorter length of the stay in these countries resulted from high prices, particularly in catering establishments. According to the respondents, less stringent restrictions, among others lack of the necessity to own the COVID passport, were linked to Croatia and Mediterranean islands. The sense of safety was satisfying, while the sense of freedom and mental rest was high. declared a string of COVID-19 cases a pandemic. Most countries implemented numerous sanitary and epidemiological

Keywords: sanitary and epidemiological regimes, tourist facilities, COVID-19 pandemic, sense of safety

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Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

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Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

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Authors: Rosna Mat Taha, Sakinah Abdullah, Sadegh Mohajer, Asmah Awal

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Lycium barbarum L. (Goji) belongs to Solanaceae family and native to some areas of China. Ethnobotanical studies have shown that this plant has been consumed by the Chinese since ancient times. It has been used as medicine in providing excellent effects on cardiovascular system and cholesterol level, besides contains high antioxidant and antidiabetic properties. In the present study, some tissue culture work has been carried out to induce callus, in vitro regeneration from various explants of Goji and also some acclimatization protocols were followed to transfer the regenerated plants to soil. The main aims being to establish high efficient regeneration system for mass production and commercialization for future uses, since the growth of this species is very limited in Malaysia. The optimum hormonal regime and the most suitable and responsive explants were identified. It was found that leaves and stems gave good responses. Murashige and Skoog’s (MS) medium supplemented with 2.0 mg/L NAA and 0.5 mg/L BAP was the best for callus induction and MS media fortified with 1.0 mg/L NAA and 1.0 mg/L BAP was optimum for in vitro regeneration. The survival rates of plantlets after acclimatization was 63±1.5 % on black soil and 50±1.3 % on mixed soil (combination of black and red soil at a ratio of 2 to 1), respectively.

Keywords: callus, acclimatization, in vitro culture, regeneration

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Authors: Zahra Sokar, Sara Oufquir, Brahim Eddafali, Abderrahman Chait

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Fenugreek is one of the oldest plants used in traditional herbal medicine. Several studies have demonstrated the anticancer effects of seeds by inhibiting the proliferation, angiogenesis, invasion and metastasis of various cancers. While there is plenty of research demonstrating the antineoplastic effects of dormant seeds, little is known about the potential of sprouts in fighting cancer. Therefore, we propose to study the chemoprotective effect of germinating fenugreek seeds on keratoacanthoma skin cancer induced by cutaneous exposure to DMA/Croton oil in mice. The results obtained show that oral administration of 250 and 500 mg/kg aqueous sprout seed extract reduces the incidence, rate, volume, and tumor weight in a very significant manner. Histological examination revealed that mice treated with 250 mg/kg showed strong inhibition of squamous cell carcinoma formation with thickening of the epithelial layer and mild acanthosis and hyperkeratosis. A dose of 500 mg/kg prevented invasion and the occurrence of hyperkeratosis. Fenugreek sprouts appear to be a promising natural product for preventing keratoacanthoma skin cancer. Nevertheless, further studies in the same field need to be developed to evaluate the antineoplastic potential of germinated seeds.

Keywords: anticancer, fenugreek, keratoacanthoma, sprouts

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Authors: Dilani Wimalasiri, Robert Brkljaca, Sylvia Urban, Terrence Piva, Tien Huynh

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Momordica cochinchinensis (Cucurbitaceae) is used as food and traditional medicine in South East Asia and is commonly known as Red Gac. The fruit aril consists 70 times higher lycopene and 10 times higher β-carotene than all known fruits and vegetables. Despite its nutritional value there is little information available on its genetic variation and its influence on nutritional value. In this study; genetic and nutritional variation (lycopene and β-carotene) was investigated among 47 M. cochinchinensis samples collected from Australia, Thailand and Vietnam using molecular markers (RAPD and ISSR) and HPLC, respectively. UPGMA based cluster analysis of genetic data grouped Northern and Central Vietnam samples together but were separated from Australia, Thailand and Southern Vietnam samples. The concentration of lycopene was significantly higher among the samples collected from Central Vietnam (p<0.05) and the concentration of β-carotene was significantly higher among the samples collected from Northern Vietnam (p<0.05) indicating the existence of best varieties. This study provides vital information in genetic diversity and facilitates the selection and breeding for nutritious M. cochinchinensis varieties.

Keywords: momordica cochinchinensis, lycopene, beta carotene, genetic diversity

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Authors: Fakhrosadat Sajjadian, Ramin Ghasemi Shayan

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The tumor microenvironment plays an fundamental part in tumor start, movement, metastasis, and treatment resistance. It varies from ordinary tissue in terms of its extracellular network, vascular and lymphatic arrange, as well as physiological conditions. The clinical application of atomic cancer imaging is regularly prevented by the tall commercialization costs of focused on imaging operators as well as the constrained clinical applications and little showcase measure of a few operators. . Since numerous cancer types share comparable characteristics of the tumor microenvironment, the capacity to target these biomarkers has the potential to supply clinically translatable atomic imaging advances for numerous types encompassing cancer and broad clinical applications. Noteworthy advance has been made in focusing on the tumor microenvironment for atomic cancer imaging. In this survey, we summarize the standards and methodologies of later progresses in atomic imaging of the tumor microenvironment, utilizing distinctive imaging modalities for early discovery and conclusion of cancer. To conclude, The tumor microenvironment (TME) encompassing tumor cells could be a profoundly energetic and heterogeneous composition of safe cells, fibroblasts, forerunner cells, endothelial cells, flagging atoms and extracellular network (ECM) components.

Keywords: molecular, imaging, TME, medicine

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Authors: Jonathan Gong

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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deep learning, image processing, machine learning

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Authors: Dalave S. C., S. G. Auti, B. J. Apparao

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Centella asiatica (L) Urban, commonly known as Brahmi and Mandookaparni is a valuable medicinal plant highly valued for its asiaticoside and madecassoside. It is widely used in Ayurveda and Unani systems of medicine. Attempts are made in the present investigation to improve the genotype of Centella plant that can yield higher amount of the therapeutically active compounds viz., asiaticosides and madecassosides, employing techniques of polyploidy breeding. Young developing shoots of Centella were treated with different concentrations of colchicine for varying time intervals. 0.4 % colchicine for 6 hours duration at room temperature was effective in inducing autopolyploidy in this plant. The colchicine treated plants were allowed to reproduce vegetatively for several generations in a polyhouse. The colchicine treated plants showed significant increase in plant size, fresh & dry weights, vigorous growth, broad leaves and double the number of chromosomes. HPTLC analysis of dried leaves of control and polyploid plants, even after 9th generations, revealed that the tetraploids synthesized at two times more asiaticoside and madecassoside, as compared to control, untreated diploid plants.

Keywords: Centella asiatica, polyploidy, asiaticosides, madecassoside, HPTLC

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Authors: Vijay nandmer, Ajay Nandmer

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Stigmatized psycho-social perception poses a serious challenge and source of discrimination which impedes stroke patients from attaining a satisfactory quality of life. The present study was aimed to obtain information on knowledge, attitudes and practices (KAP) of stroke patients in the institute. We included 1000 people in our random sampling survey. Demographic details and responses to a questionnaire assessing the knowledge, attitude and practices were recorded. Although the majority of the patients belonged to low socioeconomic strata, the literacy rate was reasonably high (96.3%). A large majority (91.3%) of people had heard about stroke and (85.2%) knew that stroke can be treated with modern drugs. However, a negative attitude was reflected in the belief that stroke happens due to supernatural powers (hawa lagne se) (50.6%). Analysis of the data revealed regional differences in KAP which could be attributed to local Factors, such as literacy, awareness about stroke, and practice of different systems of medicine. Some of the differences can also be attributed to a category of study population whether it included patients or non-stroke individuals since the former are likely to have less negative attitudes than the public. There is a need to create awareness about stroke on a nation-wide basis to dispel the misconceptions and stigma through effective and robust programs with the aim to lessen the disease burden.

Keywords: epidemiology, sroke, literacy, stroke

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Authors: Mohamad Ammar Ayass, Natalya Griko, Victor Pashkov, Wanying Cao, Kevin Zhu, Jin Zhang, Lina Abi Mosleh

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Respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus disease 2019 (COVID-19). Early evidence pointed at the angiotensin-converting enzyme 2 (ACE-2) expressed on the epithelial cells of the lung as the main entry point of SARS-CoV-2 into the cells. The viral entry is mediated by the binding of the Receptor Binding Domain (RBD) of the spike protein that is expressed on the surface of the virus to the ACE-2 receptor. As the number of SARS-CoV-2 variants continues to increase, mutations arising in the RBD of SARS-CoV-2 may lead to the ineffectiveness of RBD targeted neutralizing antibodies. To address this limitation, the objective of this study is to develop a combination of aptamers that target different regions of the RBD, preventing the binding of the spike protein to ACE-2 receptor and subsequent viral entry and replication. A safe and innovative biomedical tool was developed to inhibit viral infection and reduce the harms of COVID-19. In the present study, DNA aptamers were developed against a recombinant trimer S protein using the Systematic Evolution of Ligands by Exponential enrichment (SELEX). Negative selection was introduced at round number 7 to select for aptamers that bind specifically to the RBD domain. A series of 9 aptamers (ADI2010, ADI2011, ADI201L, ADI203L, ADI205L, ADIR68, ADIR74, ADIR80, ADIR83) were selected and characterized with high binding affinity and specificity to the RBD of the spike protein. Aptamers (ADI25, ADI2009, ADI203L) were able to bind and pull down endogenous spike protein expressed on the surface of SARS-CoV-2 virus in COVID-19 positive patient samples and determined by liquid chromatography- tandem mass spectrometry analysis (LC-MS/MS). LC-MS/MS data confirmed that aptamers can bind to the RBD of the spike protein. Furthermore, results indicated that the combination of the 9 best aptamers inhibited the binding of the purified trimer spike protein to the ACE-2 receptor found on the surface of Vero E6 cells. In the same experiment, the combined aptamers displayed a better neutralizing effect than antibodies. The data suggests that the selected aptamers could be used in therapy to neutralize the effect of the SARS-CoV-2 virus by inhibiting the interaction between the RBD and ACE-2 receptor, preventing viral entry into target cells and therefore blocking viral replication.

Keywords: aptamer, ACE-2 receptor, binding inhibitor, COVID-19, spike protein, SARS-CoV-2, treatment

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Authors: Hailiang Liu, Yan Ni, Jie Zheng, Xiaoyan Jiang, Min Hong

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Allergic contact dermatitis (ACD) is a commonly clinical type IV allergic skin disease, with the pathological features of infiltration by mononuclear cells and tissue necrosis. Traditional Chinese medicine Radix Saposhnikoviae (RS) is traditionally employed to treat exogenous evils, rubella, itching, rheumatism and tetanus. Meanwhile, it is an important component of the commonly used anti-allergy compound. It’s now widely used as an immuno-modulating agent in mixed herbal decoctions to treat inflammation. However, its mechanism of anti-allergy remains unknown. RS was found to reduce ear thickness, as well as the infiltration of eosinophils. The proliferation of T lymphocytes was inhibited significantly by RS, markedly decreased IFN-γ levels in the supernatant of cells cultured and serum were detected with the treatment of RS. RS significantly decreased the amount of DCs in the mouse lymph nodes, and inhibited the expression of CD4 0 and CD86. Meanwhile, T-bet mRNA expression was down remarkably regulated by RS. These results indicate that RS cures Th1-induced allergic skin inflammation by regulating Th1/Th2 balance with decreasing Th1 differentiation, which might be associated with DCs.

Keywords: allergic contact dermatitis, Radix saposhnikoviae, dendritic cells, T-bet, GATA-3, CD4+ CD25+ Foxp3+ treg cells

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Muhammad Waqar Ashraf

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Selected heavy metals, namely Cu, Zn, Fe, Mn, Cd, Pb, and As, in seven popular varieties of edible vegetable oils collected from Saudi Arabia, were determined by graphite furnace atomic absorption spectrometry (GF-AAS) using microwave digestion. The accuracy of procedure was confirmed by certified reference materials (NIST 1577b). The concentrations for copper, zinc, iron, manganese, lead and arsenic were observed in the range of 0.035 - 0.286, 0.955 - 3.10, 17.3 - 57.8, 0.178 - 0.586, 0.011 - 0.017 and 0.011 - 0.018 µg/g, respectively. Cadmium was found to be in the range of 2.36 - 6.34 ng/g. The results are compared internationally and with standards laid down by world health agencies. A risk assessment study has been carried out to assess exposure to these metals via consumption of vegetable oils. A comparison has been made with safety intake levels for these heavy metals recommended by Institute of Medicine of the National Academies (IOM), US Environmental Protection Agency (US EPA) and Joint FAO/WHO Expert Committee on Food Additives (JECFA). The results indicated that the dietary intakes of the selected heavy metals from daily consumption of 25 g of edible vegetable oils for a 70 kg individual should pose no significant health risk to local population.

Keywords: vegetable oils, heavy metals, contamination, health risk assessment

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Authors: R. L. Shirole, N. L. Shirole, R. B. Patil, M. N. Saraf

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The present investigation aimed to elucidate the probable mechanism of antiasthmatic action of essential oil of Pistacia integerrima J.L. Stewart ex Brandis galls (EOPI). EOPI was investigated for its potential antiasthmatic action using in vitro antiallergic assays mast cell degranulation and soyabean lipoxidase enzyme activit, and spasmolytic action using isolated guinea pig ileum preparation. In vivo studies included lipopolysaccharide-induced bronchial inflammation in rats and airway hyperresponsiveness in ovalbumin in sensitized guinea pigs using spirometry. Data was analysed by GraphPad Prism 5.01 and results were expressed as means ± SEM. P < 0.05 was considered to be significant. EOPI inhibits 5-lipoxidase enzyme activity, DPPH scavenging activity and erythropoietin- induced angiogenesis. It showed dose dependent anti-allergic activity by inhibiting compound 48/80 induced mast cell degranulation. The finding that essential oil induced inhibition of transient contraction of acetylcholine in calcium free medium, and relaxation of S-(-)-Bay 8644-precontracted isolated guinea pig ileum jointly suggest that suggesting that the L-subtype Cav channel is involved in spasmolytic action of EOPI. Treatment with EOPI dose dependently (7.5, 15 and 30 mg/kg i.p.) inhibited lipopolysaccharide- induced increased in total cell count, neutrophil count, nitrate-nitrite, total protein, albumin levels in bronchoalveolar fluid and myeloperoxidase levels in lung homogenates. Mild diffused lesions involving focal interalveolar septal, intraluminal infiltration of neutrophils were observed in EOPI (7.5 &15 mg/kg) pretreated while no abnormality was detected in EOPI (30 mg/kg) and roflumilast (1mg/kg) pretreated rats. Roflumilast was used as standard. EOPI reduced the respiratory flow due to gasping in ovalbumin sensitized guinea pigs. The study demonstrates the effectiveness of EOPI in bronchial asthma possibly related to its ability to inhibit L-subtype Cav channel, mast cell stabilization, antioxidant, angiostatic and through inhibition of 5-lipoxygenase enzyme.

Keywords: asthma, lipopolysaccharide, spirometry, Pistacia integerrima J.L. Stewart ex Brandis, essential oil

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Riteesh Bookun

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Patients with carotid stenosis, which may be asymptomatic or symptomatic in the form of transient ischaemic attack (TIA), amaurosis fugax, or stroke, often require an endarterectomy to reduce stroke risk. Risks of this procedure include stroke, death, myocardial infarction, and cranial nerve damage. Carotid endarterectomy is most commonly performed under general anaesthetic, however, it can also be undertaken with a regional anaesthetic approach. Our tertiary centre generally performs carotid endarterectomy under regional anaesthetic. Our major tertiary hospital mostly utilises regional anaesthesia for carotid endarterectomy. We completed a cross-sectional analysis of all cases of carotid endarterectomy performed under regional anaesthesia across a 10-year period between January 2010 to March 2020 at our institution. 350 patients were included in this descriptive analysis, and demographic details for patients, indications for surgery, procedural details, length of surgery, and complications were collected. Data was cross tabulated and presented in frequency tables to describe these categorical variables. 263 of the 350 patients in the analysis were male, with a mean age of 71 ± 9. 172 patients had a history of ischaemic heart disease, 104 had diabetes mellitus, 318 had hypertension, and 17 patients had chronic kidney disease greater than Stage 3. 13.1% (46 patients) were current smokers, and the majority (63%) were ex-smokers. Most commonly, carotid endarterectomy was performed conventionally with patch arterioplasty 96% of the time (337 patients). The most common indication was TIA and stroke in 64% of patients, 18.9% were classified as asymptomatic, and 13.7% had amaurosis fugax. There were few general complications, with 9 wound complications/infections, 7 postoperative haematomas requiring return to theatre, 3 myocardial infarctions, 3 arrhythmias, 1 exacerbation of congestive heart failure, 1 chest infection, and 1 urinary tract infection. Specific complications to carotid endarterectomy included 3 strokes, 1 postoperative TIA, and 1 cerebral bleed. There were no deaths in our cohort. This analysis of a large cohort of patients from a major tertiary centre who underwent carotid endarterectomy under regional anaesthesia indicates the safety of such an approach for these patients. Regional anaesthesia holds the promise of less general respiratory and cardiac events compared to general anaesthesia, and in this vulnerable patient group, calls for comparative research between local and general anaesthesia in carotid surgery.

Keywords: anaesthesia, carotid endarterectomy, stroke, carotid stenosis

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Authors: Anton Bahtiar, Lukas Tjandra Leksana, Fransiscus D. Suyatna

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Hypercholesterolemia is one of the major risk factors that can trigger the development of cardiovascular disease, especially coronary heart disease. One of the traditional drugs used for hypercholesterolemia is a combination of herbs celery (Apium graveolens) and garlic (Allium sativum). This study aimed to investigate the effects of the extract on lipid profile in hypercholesterolemic subjects. Subjects consisted of patients with traditional medicine clinic in Jakarta. Each subject received treatment capsules containing herbal extract and placebo capsules. On the 44 subjects, the lipid profile was examined blood levels of total cholesterol, HDL, LDL, and triglycerides. Paired two-tailed t-test was used for the difference between lipid profile of the therapy group and the placebo group. The changes in the lipid profile between the treatment groups and the placebo group for total cholesterol, HDL, LDL, and triglycerides was 14,82 ± 6,946;1.45 ± 2,945;6,98 ± 8,105;2,48 ± 6,504 mg/dL. The herbal extract decrease blood cholesterol and LDL levels significantly (P <0.05).

Keywords: Allium sativum, Apium graveolens, hypercholesterolemia, cholesterol, HDL, LDL

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Authors: T. Rakhi, Thrivikram Shenoy

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Esophageal atresia is a disorder of maldevelopment of esophagus with or without a connection to the trachea. Radiological reviews are needed in consultation with the pediatric surgeon and neonatologist and we report a rare case of esophageal atresia associated with atrial septal defect-patent ductus arteriosus complex. A 2-day old female baby born at term, weighing 3.010kg, admitted to the Neonatal Intensive Care Unit with respiratory distress and excessive oral secretions. On examination, continuous murmur and cyanosis were seen. Esophageal atresia was suspected, after a failed attempt to pass a nasogastric tube. Chest radiograph showed coiling of the nasogastric tube and absent gas shadow in the abdomen. Echocardiography confirmed Patent Ductus Arteriosus with Atrial Septal Defect not in failure and was diagnosed with esophageal atresia with suspected fistula posted for surgical repair. After preliminary management with oxygenation, suctioning in prone position and antibiotics, investigations revealed Hb 17gms serum biochemistry, coagulation profile and C-Reactive Protein Test normal. The baby was premedicated with 5mcg of fentanyl and 100 mcg of midazolam and a rapid awake laryngoscopy was done to rule out difficult airway followed by induction with o2 air, sevo and atracurium 2 mg. Placement of a 3.5 tube was uneventful at first attempt and after confirming bilateral air entry positioned in the lateral position for Right thoracotomy. A pulse oximeter, Echocardiogram, Non-invasive Blood Pressure, temperature and a precordial stethoscope in left axilla were essential monitors. During thoracotomy, both the ends of the esophagus and the fistula could not be located after thorough search suggesting an on table finding of type A esophageal atresia. The baby was repositioned for gastrostomy, and cervical esophagostomy ventilated overnight and extubated uneventful. Absent gas shadow was overlooked and the purpose of this presentation is to create an awareness between the neonatologist, pediatric surgeons and anesthesiologist regarding variation of typing of Tracheoesophageal fistula pre and intraoperatively. A need for imaging modalities warranted for a definitive diagnosis in the presence of a gasless stomach.

Keywords: anesthetic, atrial septal defects, esophageal atresia, patent ductus arteriosus, perioperative, chest x-ray

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Authors: Pratap Sriram Sundar, Chandan Chowdhury, Sagar Kamarthi

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Nature has perfected her designs over 3.5 billion years of evolution. Research fields such as biomimicry, biomimetics, bionics, bio-inspired computing, and nature-inspired designs have explored nature-made artifacts and systems to understand nature’s mechanisms and intelligence. Learning from nature, the researchers have generated sustainable designs and innovation in a variety of fields such as energy, architecture, agriculture, transportation, communication, and medicine. Axiomatic design offers a method to judge if a design is good. This paper analyzes design aspects of one of the nature’s amazing object: chicken egg. The functional requirements (FRs) of components of the object are tabulated and mapped on to nature-chosen design parameters (DPs). The ‘independence axiom’ of the axiomatic design methodology is applied to analyze couplings and to evaluate if eggs’ design is good (i.e., uncoupled design) or bad (i.e., coupled design). The analysis revealed that eggs design is a good design, i.e., uncoupled design. This approach can be applied to any nature’s artifacts to judge whether their design is a good or a bad. This methodology is valuable for biomimicry studies. This approach can also be a very useful teaching design consideration of biology and bio-inspired innovation.

Keywords: uncoupled design, axiomatic design, nature design, design evaluation

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Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

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Authors: Vikas Sharma, V. K. Dixit

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The roots of Anacyclus pyrethrum DC (AP) (Asteraceae) are frequently used in traditional medicine as Vajikarana Rasayana. An ethanolic extract of root of Anacyclus pyrethrum demonstrated its potential to enhance the sexual behaviour of male rats, with a dose dependent effect on sperm count and androgens concentration. Phytochemical analysis of ethanolic extract of Anacyclus pyrethrum revealed that it is rich in N-alkylamide. This study therefore sought to assess characterization of ethanolic extract of Anacyclus pyrethrum root. Root extract was performed using a gradient reversed phase high performance liquid chromatography/UV/electrospray ionization ion trap mass spectrometry (HPLC/ESI-MS) method on an embedded polar column. MS1 and MS2 fragmentation data were used for identification purposes, while UV was used for quantification. Thirteen N-alkylamides (five N-isobutylamides, three N-methyl isobutylamides, four tyramides, and one 2-phenylethylamide) were detected. Five of them identified as undeca-2E,4E-diene-8,10-diynoic acid N-methyl isobutylamide, tetradeca-2E,4E-diene-8,10-diynoic acid tyramide, deca-2E,4E-dienoic acid N-methyl isobutylamide, tetradeca-2E,4E,XE/Z-trienoic acid tyramide and tetradeca-2E,4E,8Z,10Z-tetraenoic isobutylamide are novel compounds, which have never been identified in Anacyclus pyrethrum.

Keywords: Anacyclus pyrethrum (Asteraceae), LC-MS plant profiling, N-alkylamides, pellitorine, anacycline

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Authors: M. P. Sebastian

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Health for all is considered as a sign of well-being and inclusive growth. New healthcare technologies are contributing to the quality of human lives by promoting health education and awareness, leading to the prevention, early diagnosis and treatment of the symptoms of diseases. Healthcare technologies have now migrated from the medical and institutionalized settings to the home and everyday life. This paper explores these new technologies and investigates how they contribute to health education and awareness, promoting the objective of high-value health system for all. The methodology used for the research is literature review. The paper also discusses the opportunities and challenges with futuristic healthcare technologies. The combined advances in genomics medicine, wearables and the IoT with enhanced data collection in electronic health record (EHR) systems, environmental sensors, and mobile device applications can contribute in a big way to high-value health system for all. The promise by these technologies includes reduced total cost of healthcare, reduced incidence of medical diagnosis errors, and reduced treatment variability. The major barriers to adoption include concerns with security, privacy, and integrity of healthcare data, regulation and compliance issues, service reliability, interoperability and portability of data, and user friendliness and convenience of these technologies.

Keywords: big data, education, healthcare, information communication technologies (ICT), patients, technologies

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Authors: Kalin Ivanov, Stanislava Ivanova

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Actoprotectors are substances with hight performance enchasing potential and hight antioxidant activity. Most of these drugs have been developed in USSR for military medicine purposes. Based on their chemical composition actoprotectors could be classified into three categories: benzimidazole derivatives (ethomersol, bemitil); adamantane derivatives (bromantane), other chemical classes. First data for intake of actoprotectors from professional athletes is from 1980. The daily intake of actoprotectors demonstrate many benefits for athletes like: positive effect on the efficiency of physical work, antihypoxic effects, antioxidant effects, nootropic effects, rapid recovery. Since 1997, bromantane is considered as doping. This is a result of Summer Olympic Games in Athlanta (1996) when several Russian athletes tested positive for bramantane. Even the drug is safe for athletes health its use is considered as violation of anti- doping rules. More than 37 years bemetil has been used by professional athletes with no risk but currently it is included in WADA monitoring programme for 2018. Current perspectives are that most used actoprotectors would be considered as doping. Many clinical studies have confirmed that intake of bemitil and bromantan demonstrate positive influence on the physical work capacity but data for other actoprotectors like chlodantane, ademol, ethomersol is limited.

Keywords: actoprotector, sport, doping, bemitil

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Authors: Andrew Anis Fakhrey Mosaad

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Introduction: Sports- and physical activity-related injuries may be more likely if there is a genetic predisposition, improper coaching and/or training, and no follow-up care from sports medicine. Goal: To evaluate the frequency of injuries among athletes receiving care at a sportsfocused physical therapy clinic. Methods: The survey of injuries in athletes' treatment records over a period of eight years of activity was done to obtain data. The data collected included: the patient's features, the sport, the type of injury, the injury's characteristics, and the body portion injured. Results: The athletes were drawn from 1090 patient/athlete records, had an average age of 25, participated in 44 different sports, and were 75% men on average. Joint injuries were the most frequent type of injury, then damage to the muscles and bones. The most prevalent type of injury was chronic (47%), while the knee, ankle, and shoulder were the most frequently damaged body parts. The most injured athletes were seen in soccer, futsal, and track and field, respectively, out of all the sports. Conclusion: The most popular sport among injured players was soccer, and the most common injury type was joint damage, with the knee being the most often damaged body area. The majority of the injuries were chronic.

Keywords: sports injuries, athletes, joint injuries, injured players

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Authors: Tsai Su Hui

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Background: Hyperphosphatemia in patients receiving dialysis can cause hyperparathyroidism, which can lead to renal osteodystrophy, cardiovascular disease and mortality. Data showed that 26% of patients receiving dialysis had blood phosphate levels of >6.0 mg/dl at this unit from January to March 2017, higher than the Taiwan Society of Nephrology evaluation criteria of < 20%. After analysis, possible reasons included: 1. Incomprehensive education for nurse and lack of relevant training. 2. Insufficient assistive aids for nursing health education instruction. 3. Patients were unsure which foods are high or low in phosphate. 4. Patients did not have habits of taking medicine with them and how to correctly administer the medication. Purpose: To reduce the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl to less than 20% at this unit. Method: (1) Improve understanding of hyperphosphatemia and food for patients receiving dialysis and their families, (2) Acquire more nursing instruction assistive aids and improve knowledge of hyperphosphatemia for nurse. Results: After implementing the project, the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl decreased from 26.0% to 18.8% at this unit. By implementing the project, the professional skills of nurse improved, blood phosphate levels of patients receiving dialysis were reduced, and the quality of care for patients receiving dialysis at this unit was enhanced.

Keywords: hemodialysis, hyperphosphatemia, incidence, reducing

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Authors: Nadir Sidiqi

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Biodiversity conservation is humanity’s building block to sustain lives - ultimately allowing all living and nonliving creatures to interact in a balanced proportion. Humanity’s challenge in the 21st century is to maintain biodiversity without harming the natural habitat of plants, animals and beneficial microorganisms. There are many good reasons to consider why biodiversity is important to every nation around the world, especially for a nation like Afghanistan. One of the major values of biodiversity is its economic value: biodiversity provides goods and services to the Afghan nation directly through links and components such as the maintenance of traditional crops, medicine, fruits, animals, grazing, fuel, timber, harvesting, fishing, hunting and related supplies. Biodiversity is the variety of the living components, such as humans, plants, animals, and microorganisms, and nonliving components interaction, including air, water, sunlight, soil, humidity and environmental factors in an area. There are many ways of gauging the value of biodiversity. As an ecosystem, biodiversity includes such benefits as soil fertility, erosion control, crop pollination, crop rotation, and pest control. The conservation of biodiversity is crucial for these benefits, which would be impossible to replace. Biodiversity conservation also has heritage values; this wealth of genetic diversity provides backup to rural people living close together.

Keywords: Afghanistan, biodiversity, conservation, economy, environment

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Authors: Dulanjali Ranasinghe, Isuru Supasan, Kaushalya Premachandra, Ranjan Dissanayake, Ajith Rajapaksha, Eustace Fernando

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Proteomics studies of organisms are considered to be significantly information-rich compared to their genomic counterparts because proteomes of organisms represent the expressed state of all proteins of an organism at a given time. In modern top-down and bottom-up proteomics workflows, the primary analysis methods employed are gel–based methods such as two-dimensional (2D) electrophoresis and mass spectrometry based methods. Machine learning (ML) and artificial intelligence (AI) have been used increasingly in modern biological data analyses. In particular, the fields of genomics, DNA sequencing, and bioinformatics have seen an incremental trend in the usage of ML and AI techniques in recent years. The use of aforesaid techniques in the field of proteomics studies is only beginning to be materialised now. Although there is a wealth of information available in the scientific literature pertaining to proteomics workflows, no comprehensive review addresses various aspects of the combined use of proteomics and machine learning. The objective of this review is to provide a comprehensive outlook on the application of machine learning into the known proteomics workflows in order to extract more meaningful information that could be useful in a plethora of applications such as medicine, agriculture, and biotechnology.

Keywords: proteomics, machine learning, gel-based proteomics, mass spectrometry

Procedia PDF Downloads 136