Search results for: postmortem examination

Authors: Hester Fass, Ofir Pinto

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Research indicates gaps in education, employment rates and wages between people with disabilities and those without disabilities. One of the main tools available to reduce these gaps is vocational rehabilitation. In order to examine the effects of vocational rehabilitation, a follow-up study, based on comprehensive administrative data, was conducted. The study included 88,286 people with disabilities who participated in vocational rehabilitation of the National Insurance Institute of Israel (NII), and completed the process between 1999 and 2012. Research variables included: employment rates, job persistence and wage levels. This research, the first of its kind in Israel, has several unique aspects: a)a long-range follow-up study on people who completed vocational rehabilitation; b) examination of a broad population spectrum, including also people that are not eligible to disability pensions ; c) a comparison among those with work-related injuries, those injured in hostile acts and those injured in other circumstances; and finally d) the identification of the characteristics of those who are entitled to vocational rehabilitation but who do not participate in any vocational rehabilitation plan. The most notable results include: 1. Vocational rehabilitation contributed to employment, job persistence and wage levels. Participation in vocational rehabilitation resulted in an employment rate of 65% within two years after completing the program, and 73% eventually. Participation in a vocational rehabilitation plan also contributed to job persistence and wage levels. 2. Vocational rehabilitation plans aimed at integration in universal frameworks increased the chances of being employed, persisting at the job and receiving a higher wage than did the vocational rehabilitation aimed at selective frameworks (such as sheltered workshops). 3. The type of disability affected the chances of integration in a vocational rehabilitation plan and in the labor market. People with a disability from birth had greater chances of integration in a vocational rehabilitation plan, while the type of disability and its severity affected the chances of the person with disabilities to find employment.

Keywords: vocational rehabilitation, employment, job persistence, wages

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: Kai Pei Huang, Ting Chung Hung, Li Ching Wu

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Amyloidosis refers to a variety of conditions wherein amyloid proteins are abnormally deposited in organ or tissues and cause harm. Among the several forms of amyloidosis, the principal types of that in inpatient medical services are the AL amyloidosis (primary) and AA amyloidois (secondary). AL Amyloidois is due to deposition of protein derived from overproduction of immunoglobulin light chain in plasma cell myeloma. Furthermore, it is a systemic disorder that can present with a variety of symptoms, including heavy proteinemia and edema, heptosplenomegaly, otherwise unexplained heart failure. We reported a 78-year-old female presenting dysuria, oliguria and leg edema for several months. Laboratory data showed proteinuria (UPCR:1679.8), leukocytosis (WBC:16.2 x 10^3/uL), results of serum urea nitrogen (39mg/dL), creatinine (0.76 mg/dL), IgG (748 mg/dL.), IgA (635 mg/dL), IgM (63 mg/dL), kappa light chain(18.8 mg/dL), lambda light chain (110.0 mg/dL) and kappa/lambda ratio (0.17). Renal biopsy found amyloid fibrils in glomerular mesangial area, and Congo red stain highlights amyloid deposition in glomeruli. Additional lab studies included serum protein electrophoresis, which shows a major monoclonal peak in β region and minor small peak in gamma region, and the immunotyping studies for serum showed two IgA/λ type. We treated sample with beta-mercaptoethanol which reducing the polymerized immunoglobulin to clarify two IgA/λ are secreted from the same plasma cell clone in bone marrow. Later examination confirmed it existed plasma cell infiltration in bone marrow, and the immunohistochemical staining showed monotypic for λ light chain and are positive for IgA. All findings mentioned above reveal it is a case of plasma cell myeloma with λ Light Chain Amyloidosis.

Keywords: amyloidosis, immunoglobulin light chain, plasma cell myeloma, serum protein electrophoresis

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Authors: Khaled M. Ali, Ayman A. Mostafa, Soliman M. Soliman

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Objectives: To describe the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats, and to determine the short-term outcomes after surgical treatment of these cats. Animals Eighteen client-owned cats of different breeds (52 females and 28 males), ranging in age from 3 months to 6 years, with corneal ulcers. Procedures: Cats were clinically evaluated to initially determine the concurrent corneal abnormalities. Endoscopic examination was performed to determine the anterior and posterior segments abnormalities. Superficial and deep stromal ulcers were treated using conjunctival flap. Corneal sequestrum was treated by partial keratectomy and conjunctival flap. Anterior synechia was treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon was treated by removal of the adhered conjunctival membrane from the cornea. Incurable endophthalmitis was treated surgically by extirpation. Short-term outcomes after surgical managements of selected corneal abnormalities were then assessed clinically and endoscopically. Results: Deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechia with secondary glaucoma and corneal scarring were the most common complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechia, and corneal sequestration. Conclusions: Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Immediate management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats.

Keywords: cats, complicated corneal ulceration, clinical, endoscopic diagnosis, FHV-1

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Authors: M. Shaheed Hartley

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Science and mathematics are regarded as gateway subjects in South Africa as they are the perceived route to careers in science, engineering, technology and mathematics (STEM). One of the biggest challenges that the country faces is the poor achievement of learners in these two learning areas in the external high school exit examination. To compound the problem many national and international benchmark tests paint a bleak picture of the state of science and mathematics in the country. In an attempt to address this challenge, the education department of the Eastern Cape Province invited the Science Learning Centre of the University of the Western Cape to provide training to their science teachers in the form of a structured course conducted on a part-time basis in 2010 and 2011. The course was directed at improving teachers’ content knowledge, pedagogical strategies and practical and experimental skills. A total of 41 of the original 50 science teachers completed the course and received their certificates in 2012. As part of their continuous professional development, 31 science teachers enrolled for BEd Hons in science education in 2013 and 28 of them completed the course in 2014. These students graduated in 2015. Of the 28 BEd Hons students who completed the course 23 registered in 2015 for Masters in Science Education and were joined by an additional 3 students. This paper provides a reflection by science educators on the training, supervision and mentorship provided to them as students of science education. The growth and development of students through their own reflection and understanding as well as through the eyes of the lecturers and supervisors that took part in the training provide the evaluation of the professional development process over the past few years. This study attempts to identify the merits, challenges and limitations of this project and the lessons to be learnt on such projects. It also documents some of the useful performance indicators with a view to developing a framework for good practice for such programmes.

Keywords: reflection, science education, professional development, rural schools

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Authors: I. Wardana Ketut, I. Suparwa Nyoman

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This study investigated the form and characteristic of speech sound produced by three Balinese subjects who have recovered from aphasia as well as intervened their language impairment on side of linguistic and neuronal aspects of views. The failure of judging the speech sound was caused by impairment of motor cortex that indicated there were lesions in left hemispheric language zone. Sound articulation phenomena were in the forms of phonemes deletion, replacement or assimilation in individual words and meaning building for anomic aphasia. Therefore, the Balinese sound patterns were stimulated by showing pictures to the subjects and recorded to recognize what individual consonants or vowels they unclearly produced and to find out how the sound disorder occurred. The physiology of sound production by subject’s speech organs could not only show the accuracy of articulation but also any level of severity the lesion they suffered from. The subjects’ speech sounds were investigated, classified and analyzed to know how poor the lingual units were and observed to clarify weaknesses of sound characters occurred either for place or manner of articulation. Many fricative and stopped consonants were replaced by glottal or palatal sounds because the cranial nerve, such as facial, trigeminal, and hypoglossal underwent impairment after the stroke. The phonological intervention was applied through a technique called phonemic articulation drill and the examination was conducted to know any change has been obtained. The finding informed that some weak articulation turned into clearer sound and simple meaning of language has been conveyed. The hierarchy of functional parts of brain played important role of language formulation and processing. From this finding, it can be clearly emphasized that this study supports the role of right hemisphere in recovery from aphasia is associated with functional brain reorganization.

Keywords: aphasia, intervention, phonology, stroke

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Authors: Barbara Pittau, Piergiorgio Palla, Antonio Mastino

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Communication is fundamental to health education. The proper use of medicinal products is a crucial aspect of the health of citizens that affects both safety and health care spending. Therefore, encouraging/promoting communication, concerning the importance of proper use of pharmaceuticals, has substantial implications in terms of individual health, health care, and health care system sustainability. In view of these considerations, in the context of two projects, one of which is still in progress, a relational database-backed web application named COLLABORAFARMACISOLA has been designed and developed as a tool to analyze and visualize how people approach the use of medicinal products, with the aim of improving and enhancing communication efficacy. The software application is being used to collect information (anonymously and voluntarily) from the citizens of Sardinia, an Italian region, regarding their knowledge, experiences, and opinions towards pharmaceuticals. This study that was conducted to date on thousand of interviewed people, has focused on different aspects such as: the treatment interruption and the "self-prescription” without medical consultation, the attention paid to reading the leaflets, the awareness of the economic value of the pharmaceuticals, the importance of avoiding the waste of medicinal products and the attitudes towards the use of generics. To this purpose, our software application provides a set of ad hoc parsing routines, to store information into the structure of a relational database and to process and visualize it through a set of interactive tools aimed to emphasize the findings and the insights obtained. The results of our preliminary analysis show the efficacy of the awareness plan and, at the same time, the criticality and the needs of the territory under examination. The ultimate goal of our study is to provide a contribution to the community by improving communication that can result in a benefit for public health in a context strictly connected to the reality of the territory.

Keywords: communication, pharmaceuticals, public health, relational database, tool, web application

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Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti

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Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.

Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology

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Authors: Lovorka Galetic, Zeljko Vukelic

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The advanced concepts of strategic and innovation management in the sphere of company dynamic and innovation capabilities, and achieving their mutual alignment and a synergy effect, are important elements in business today. This paper analyses the theory and empirically investigates the influence of a company’s dynamic capabilities on its innovation capabilities. A new multidimensional model of dynamic capabilities is presented, consisting of five factors appropriate to real time requirements, while innovation capabilities are considered pursuant to the official OECD and Eurostat standards. After examination of dynamic and innovation capabilities indicated their theoretical links, the empirical study testing the model and examining the influence of a company’s dynamic capabilities on its innovation capabilities showed significant results. In the study, a research model was posed to relate company dynamic and innovation capabilities. One side of the model features the variables that are the determinants of dynamic capabilities defined through their factors, while the other side features the determinants of innovation capabilities pursuant to the official standards. With regard to the research model, five hypotheses were set. The study was performed in late 2014 on a representative sample of large and very large Croatian enterprises with a minimum of 250 employees. The research instrument was a questionnaire administered to company top management. For both variables, the position of the company was tested in comparison to industry competitors, on a fivepoint scale. In order to test the hypotheses, correlation tests were performed to determine whether there is a correlation between each individual factor of company dynamic capabilities with the existence of its innovation capabilities, in line with the research model. The results indicate a strong correlation between a company’s possession of dynamic capabilities in terms of their factors, due to the new multi-dimensional model presented in this paper, with its possession of innovation capabilities. Based on the results, all five hypotheses were accepted. Ultimately, it was concluded that there is a strong association between the dynamic and innovation capabilities of a company. 

Keywords: dynamic capabilities, innovation capabilities, competitive advantage, business results

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Authors: Emmanuel K. Aziz Saba, Sarah S. El-Tawab

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Objectives: Carpal tunnel syndrome (CTS) was found to be associated with high pressure within the Guyon’s canal. The aim of this study was to assess the involvement of sensory and/or motor ulnar nerve fibers in patients with CTS and whether this affects the accuracy of the median versus ulnar sensory and motor comparative tests. Patients and methods: The present study included 145 CTS hands and 71 asymptomatic control hands. Clinical examination was done for all patients. The following tests were done for the patients and control: (1) Sensory conduction studies: median nerve, ulnar nerve, dorsal ulnar cutaneous nerve and median versus ulnar digit (D) four sensory comparative study; (2) Motor conduction studies: median nerve, ulnar nerve and median versus ulnar motor comparative study. Results: There were no statistically significant differences between patients and control group as regards parameters of ulnar motor study and dorsal ulnar cutaneous sensory conduction study. It was found that 17 CTS hands (11.7%) had ulnar sensory abnormalities in 17 different patients. The median versus ulnar sensory and motor comparative studies were abnormal among all these 17 CTS hands. There were statistically significant negative correlations between median motor latency and both ulnar sensory amplitudes recording D5 and D4. There were statistically significant positive correlations between median sensory conduction velocity and both ulnar sensory nerve action potential amplitude recording D5 and D4. Conclusions: There is ulnar sensory nerve abnormality among CTS patients. This abnormality affects the amplitude of ulnar sensory nerve action potential. The presence of abnormalities in ulnar nerve occurs in moderate and severe degrees of CTS. This does not affect the median versus ulnar sensory and motor comparative tests accuracy and validity for use in electrophysiological diagnosis of CTS.

Keywords: carpal tunnel syndrome, ulnar nerve, median nerve, median versus ulnar comparative study, dorsal ulnar cutaneous nerve

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Authors: Noryani Natasha Yahaya, Anas Ibrahim, Juraidah Ahmad, Azura Ahmad, Mohd Ikmal Fazlan Rosli, Zailan Ramli, Muhd Sidek Muhd Norhasri

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The subgrade formation is an important element of the railway structure which holds overall track stability. Conventional track maintenance involves many substructure component replacements, as well as track re-ballasting on a regular basis is partially contributed to the embankment's long-term settlement problem. For subgrade long-term stability analysis, the geophysical method is commonly being used to diagnose those hidden sources/mechanisms of track deterioration problems that the normal visual method is unable to detect. Electrical resistivity tomography (ERT) is one of the applicable geophysical tools that are helpful in railway subgrade inspection/track monitoring due to its flexibility and reliability of the analysis. The ERT was conducted at KM 23.0 of Pinang Tunggal track to investigate the subgrade of railway track through the characterization/mapping on track formation profiling which was directly generated using 2D analysis of Res2dinv software. The profiles will allow examination of the presence and spatial extent of a significant subgrade layer and screening of any poor contact of soil boundary. Based on the finding, there is a mix/interpretation/intermixing of an interlayer between the sub-ballast and the sand. Although the embankment track considered here is at no immediate risk of settlement effect or any failure, the regular monitoring of track’s location will allow early correction maintenance if necessary. The developed data of track formation clearly shows the similarity of the side view with the assessed track. The data visualization in the 2D section of the track embankment agreed well with the initial assumption based on the main element structure general side view.

Keywords: ground track, assessment, resistivity, geophysical railway, method

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Authors: Norbert Tribl

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European contemporary scientific public opinion considers the concept of constitutional identity as a highlighted issue. Some scholars interpret the matter as the manifestation of a conflict of Europe. Nevertheless, constitutional identity is a bridge between the Member States and the EU rather than a river that will wash away the achievements of the integration. In accordance with the opinion of the author, the main problem of constitutional identity in Europe is the undetermined nature: the exact concept of constitutional identity has not been defined until now. However, this should be the first step to understand and use identity as a legal institution. Having regard to this undetermined nature, the legal-theoretical examination of constitutional identity is the main purpose of this study. The concept of constitutional identity appears in the Anglo-Saxon legal systems by a different approach than in the supranational system of European Integration. While the interpretation of legal institutions in conformity with the constitution is understood under it, the European concept is applied when possible conflicts arise between the legal system of the European supranational space and certain provisions of the national constitutions of the member states. The European concept of constitutional identity intends to offer input in determining the nature of the relationship between the constitutional provisions of the member states and the legal acts of the EU integration. In the EU system of multilevel constitutionalism, a long-standing central debate on integration surrounds the conflict between EU legal acts and the constitutional provisions of the member states. In spite of the fact that the Court of Justice of the European Union stated in Costa v. E.N.E.L. that the member states cannot refer to the provisions of their respective national constitutions against the integration. Based on the experience of more than 50 years since the above decision, and also in light of the Treaty of Lisbon, we now can clearly see that EU law has itself identified an obligation for the EU to protect the fundamental constitutional features of the Member States under Article 4 (2) of Treaty on European Union, by respecting the national identities of member states. In other words, the European concept intends to offer input for the determination of the nature of the relationship between the constitutional provisions of the member states and the legal acts of the EU integration.

Keywords: constitutional identity, EU law, European Integration, supranationalism

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Authors: Afshin Zohdi, Selçuk Özdemir, Mustafa Aksoy

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Tungsten carbide-cobalt (WC-Co) is a widely utilized material for cold forming dies, including those employed in fastener production. In this study, we investigated the effectiveness of the pack boriding method in improving the surface properties of WC-Co cold forging dies. The boriding process involved embedding WC-Co samples, along with a steel control sample, within a chamber made of H13 tool steel. A boriding powder mixture was introduced into the chamber, which was then sealed using a paste. Subsequently, the samples were subjected to a temperature of 700°C for 5 hours in a furnace. Microstructural analysis, including cross-sectional examination and scanning electron microscopy (SEM), confirmed successful boron diffusion and its presence on the surface of the borided samples. The microhardness of the borided layer was significantly increased (3980 HV1) compared to the unborided sample (1320 HV3), indicating enhanced hardness. The borided layer exhibited an acceptable thickness of 45 microns, with a diffusion coefficient of 1.125 × 10-7 mm²/s, signifying a moderate diffusion rate. Energy-dispersive X-ray spectroscopy (EDS) mapping revealed an increase in boron content, desirable for the intended purpose, while an undesired increase in oxygen content was observed. Furthermore, the pin-on-disk wear test demonstrated a reduction in friction coefficient, indicating improved mechanical and tribological properties of the surface. The successful implementation of the pack boriding process highlights its potential for enhancing the performance of WC-Co cold forging dies.

Keywords: WC-Co, cold forging dies, pack boriding, surface hardness, wear resistance, microhardness, diffusion coefficient, scanning electron microscopy, energy-dispersive X-ray spectroscopy

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Authors: Rezvan Hosseinian

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: disease subsets, hand radiography, joint erosion, sclerosis

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Authors: Nasrin Azarbani

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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Authors: H. A. Algahtani, A. S. Khan, O. Alzahrani, N. Hussein, M. A. Khan, Loudhi Y. I. Soliman

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Objective: To report on the Saudi experience (developing country) of neurological complications from bariatric surgery. The literature on the subject is reviewed. Method: This is a cross sectional study done in King Abdul Aziz Medical City Jeddah, WR, where we reviewed all charts of the patients who underwent bariatric surgery between January 1st, 2009 to December 31st , 2014. Personal and clinical data including age, sex, BMI, comorbidities, type of procedure, duration of stay in hospital, complications and postoperative follow up were collected. In addition follow up visit and remote complication if present were collected. All patients with neurological complications were reviewed in details including their clinical examination, laboratory and imaging results, treatment and prognosis. This report is essentially descriptive with no statistical analysis performed. Results: Fifteen cases were collected in this study (3%). Axonal polyneuropathy was the most frequent neurological complica¬tion, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and cupper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms but unfortunately one patient died. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications. A clear education, guidelines and follow-up program should be planned and practiced. Facts should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Keywords: bariatric surgery, neurological complications, neuropathy, Wenicke syndrome

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Authors: Andra-Iulia Ursa

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James Joyce employs several unconventional stylistic features in this landmark novel meant to experiment with language. The episode known as “Sirens” is entirely conceived around music and linguistic structures subordinated to sound. However, the aspiration to the condition of music is reflected throughout this entire literary work, as musical effects are echoed systematically. The numerous melodies scattered across the narrative play an important role in enhancing the thoughts and feelings that pass through the minds of the characters. Often the lyrics are distorted or interweaved with other words, preoccupations or memories, intensifying the stylistic effect. The Victorian song “Love’s old sweet song” is one of the most commonly referred to and meaningful musical allusions in Ulysses, becoming a leitmotif of infidelity. The lyrics of the song “M’appari”, from the opera “Martha”, are compared to an event from Molly and Bloom’s romantic history. Moreover, repeated phrases using words from “The bloom is on the rye” or “The croppy boy” serve as glances into the minds of the characters. Therefore, the central purpose of this study is to shed light on the way musical allusions flit through the episodes from the point of view of the stream of consciousness technique and to compare and analyse how these constructions are rendered into Romanian. Mircea Ivănescu, the single Romanian translator who succeeded in carrying out the translation of the entire ‘stylistic odyssey’, received both praises and disapprovals from the critics. This paper is not meant to call forth eventual flaws of the Romanian translation, but rather to elaborate the complexity of the task. Following an attentive examination and analysis of the two texts, from the point of view of form and meaning of the references to various songs, the conclusions of this study will be able to point out the intricacies of the process of translation.

Keywords: Joyce, melodious constructions, stream of consciousness, style, translation

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Authors: Karun Karki

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The Lhotshampa are Bhutanese people of Nepali origin who have been in Bhutan since the early 1600s. A significant number of these people migrated to Bhutan in the nineteenth century. The 1958 Nationality Law of Bhutan granted citizenship to many Lhotshampa people; however, in the late 1970s, the government of Bhutan introduced a series of laws and policies intended for the socio-political and cultural exclusion of the Lhotshampa due to their ancestry. These exclusionary policies and ethnic and racial injustices not only removed the rights and citizenship of the Lhotshampa but also forcibly displaced thousands of families with no choice but to seek refuge in Nepal. In this context, racism becomes a biopolitical tool designed to govern and regulate populations in a way that determines who may live and who must die. The governance and the management of the population, what Stephan Scheel terms as biopolitical bordering, depends on boundaries between residents and non-residents, citizens and non-citizens, and emigrants and immigrants. Drawing on Foucault’s biopolitics and Mbembe’s necropolitics, this paper argues that the concept of racism should be examined within the context of political discourses because it is intertwined with the colonial project, enslavement, and diaspora. This paper critically explores ethnic and racial injustices the Lhotshampa people experienced and the ways in which they negotiated and resisted such injustices in their resettlement processes, including before displacement, in refugee camps, and after the third-country resettlement. Critical examination of these issues helps shed light on the notion of racial difference that justifies dehumanization, discrimination, and racist attitudes against the Lhotshampa people. The study's findings are critical in promoting human rights, social justice, and the health and well-being of the Lhotshampa community in the context of trauma and stressors in their resettlement processes.

Keywords: lhotshampa people, bhutanese refugees, racism, dehumanization, social justice, biopower, necropower

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Authors: Omur F. Karakullukcu, Bilal Okudan, Yusuf Can

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The aim of this study is to analyze sports managers’ managerial competence levels and job satisfaction’s correlation with career satisfaction. In the study, it has also been analyzed if there is any significant difference in sports managers’ managerial competence, job and career satisfaction in terms of gender, age, duty status, year of service and level of education. 256 sports managers, who work at department of sports service’s central and field organization at least as a chief in the manager position, have been chosen with random sampling method and they have voluntarily participated in the study. In the study, the managerial competence scale which was developed by Cetinkaya (2009), job satisfaction scale developed by Weiss at al.(1967) and Career Satisfaction Scale developed by Vatansever (2008) have been used as a data collection tool. The questionnaire form used as a data collection tool in the study includes a personal information form consisting of 5 questions; questioning gender, age, duty status, years of service and level of education. In the study, pearson correlation analysis has been used for defining the correlation of managerial competence levels, job satisfaction, and career satisfaction levels of sports managers. T-test analysis for binary grouping and anova analysis for more than binary groups have been used in the level of self-efficacy, collective and managerial competence in terms of the participants’ duty status, year of service and level of education. According to the research results, it has been found that there is a positive correlation between sports managers’ managerial competence levels, job satisfaction, and career satisfaction levels. Also, the results show that there is a significant difference in managerial competence levels, job satisfaction and career satisfaction of sports managers in terms of duty status, year of service and level of education; however, the results reveal that there is no significant difference in terms of age groups and gender.

Keywords: sports manager, managerial competence, job satisfaction, career satisfaction

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Authors: Hatem Abou-Senna, Essam Radwan

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Transportation agencies and researchers in the past have estimated emissions using one average speed and volume on a long stretch of roadway. Other methods provided better accuracy utilizing annual average estimates. Travel demand models provided an intermediate level of detail through average daily volumes. Currently, higher accuracy can be established utilizing microscopic analyses by splitting the network links into sub-links and utilizing second-by-second trajectories to calculate emissions. The need to accurately quantify transportation-related emissions from vehicles is essential. This paper presents an examination of four different approaches to capture the environmental impacts of vehicular operations on a 10-mile stretch of Interstate 4 (I-4), an urban limited access highway in Orlando, Florida. First, (at the most basic level), emissions were estimated for the entire 10-mile section 'by hand' using one average traffic volume and average speed. Then, three advanced levels of detail were studied using VISSIM/MOVES to analyze smaller links: average speeds and volumes (AVG), second-by-second link drive schedules (LDS), and second-by-second operating mode distributions (OPMODE). This paper analyzes how the various approaches affect predicted emissions of CO, NOx, PM2.5, PM10, and CO2. The results demonstrate that obtaining precise and comprehensive operating mode distributions on a second-by-second basis provides more accurate emission estimates. Specifically, emission rates are highly sensitive to stop-and-go traffic and the associated driving cycles of acceleration, deceleration, and idling. Using the AVG or LDS approach may overestimate or underestimate emissions, respectively, compared to an operating mode distribution approach.

Keywords: limited access highways, MOVES, operating mode distribution (OPMODE), transportation emissions, vehicle specific power (VSP)

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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Authors: Samira Bensoltane, Smina Ait Hamlet, Samti Meriem, Semmasel Asma

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Living organisms in the soil are subject to regular fluctuations of abiotic parameters, as well as a chemical contamination of the environment due to human activities. They are subject to multiple stressors they face. The aim of our work was to study the effects of insecticide: thiamethoxam (neonicotinoid), and the potential reversibility of the effects by an antioxidant: ginger on a bioindicator species in ecotoxicology, the land snail Helix aspersa. The effects were studied by a targeted cell approach of evaluating the effect of these molecules on tissue and cellular aspect of hepatopancreas through histological study. Treatment with thiamethoxam concentrations 10, 20, and 40 mg/l shows signs of inflammation even at low concentrations and from the 5th day of treatment. Histological examination of the hepatopancreas of snails treated with thiamethoxam showed significant changes from the lowest concentrations tested , note intertubular connective tissue enlargement, necrosis deferent types of cells (cells with calcium , digestive, excretory) , also damage acini, alteration of the apical membrane and lysis of the basement membrane in a dose- dependent manner. After 10 days of treatment and with 40 mg/l, the same changes were observed with a very advanced degeneration of the wall of the member that could be confused with the cell debris. For cons, the histological study of the hepatopancreas in Helix aspersa treated with ginger for a period of 15 days after stopping treatment with thiamethoxam has shown a partial regeneration of hepatopancreatic tissue snails treated with all concentrations of thiamethoxam and especially in the intertubular connective tissue of the wall and hepatopancreatic digestive tubules. Finally, we can conclude that monitoring the effect of the insecticide thiamethoxam showed significant alterations, however, treatment with ginger shows regeneration of damaged cells themselves much sharper at low concentration (10 mg/L).

Keywords: Helix aspersa, insecticides, thiamethoxam, ginger, hepatopancreas

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Authors: Nasrud Din, Fawad Saeed, Sajid Hussain, Rai Muhammad Dawood Sultan, Premkumar Sellan, Qasim Khan, Wei Lei

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The continuously increasing external quantum efficiencies of Perovskite light-emitting diodes (LEDs) have received significant interest in the scientific community. The need for monitoring and medical diagnostics has experienced a steady growth in recent years, primarily caused by older people and an increasing number of heart attacks, tumors, and cancer disorders among patients. The application of Perovskite near-infrared light-emitting diode (PeNIRLEDs) has exhibited considerable efficacy in bioimaging, particularly in the visualization and examination of blood arteries, blood clots, and tumors. PeNIRLEDs exhibit exciting potential in the field of blood vessel imaging because of their advantageous attributes, including improved depth penetration and less scattering in comparison to visible light. In this study, we synthesized FAPbI₃ Perovskite doped with different concentrations of 5-Aminovaleric acid (5-AVA) 1-6 mg. The incorporation of 5-AVA as a dopant during the FAPbI₃ Perovskite formation influences the FAPbI3 Perovskite’s structural and optical properties, improving its stability, photoluminescence efficiency, and charge transport characteristics. We found a resulting PL emission peak wavelength of 850 nm and bandwidth of 44 nm, along with a calculated quantum yield of 75%. The incorporation of 5-AVA-modified FAPbI₃ Perovskite into LEDs will show promising results, enhancing device efficiency, color purity, and stability. Making it suitable for various medical applications, including subcutaneous deep vein imaging, blood flow visualization, and tumor illumination.

Keywords: perovskite light-emitting diodes, deep vein imaging, blood flow visualization, tumor illumination

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Teklay Gebrecherkos, Dawit Wolday, Muhamud Abdulkader

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Background: COVID-19 symptomatology in Africa appears significantly less serious than in the industrialized world. Our hypothesis for this phenomenon, being a different, more activated immune system due to parasite infections contributes to reduced COVID-19 outcome. We investigated this hypothesis in an endemic area in sub sub-saharan Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. SARS-CoV-2 infection was confirmed by RT-PCR on samples obtained from nasopharyngeal swabs, while direct microscopic examination, modified Ritchie concentration, and Kato-Katz methods were used to identify parasites and ova from a fresh stool sample. Ordinal logistic regression models were used to estimate the association between parasite infection and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results: A total of 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37•8%) had an intestinal parasitic infection. Only 27/255 (10•6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51•8%) non-severe COVID-19 patients appeared parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (AOR) of 0•14 (95% CI 0•09–0•24; p<0•0001) for all parasites, AOR 0•20 ([95% CI 0•11–0•38]; p<0•0001) for protozoa, and AOR 0•13 ([95% CI 0•07–0•26]; p<0•0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolopis nana, and Schistosoma mansoni implied a lower probability of developing severe COVID-19. There were 11 deaths (1•5%), and all were among patients without parasites (p=0•009). Conclusions: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19.

Keywords: COVID-19, SARS-COV-2, intestinal parasite, RT-PCR, co-infection

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Authors: Yazeed Al-Sheikh

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Pregnancy represents a risk factor in the occurrence of vulvovaginal candidiasis. To investigate the prevalence rate of vaginal carriage of Candida species in Saudi pregnant and non-pregnant women, high vaginal swab (HVS) specimens (707) were examined by direct microscopy (10% KOH and Giemsa staining) and parallel cultured on Sabouraud Dextrose Agar (SDA) as well as on “CHROM agar Candida” medium. As expected, Candida-positive cultures were frequently observed in pregnant-test group (24%) than in non-pregnant group (17%). The frequency of culture positive was correlated to pregnancy (P=0.047), parity (P=0.001), use of contraceptive (P=0.146), or antibiotics (P=0.128), and diabetic-patients (P < 0.0001). Out of 707 HVS examined specimens, 157 specimens were yeast-positive culture (22%) on Sabouraud Dextrose Agar or “CHROM agar Candida”. In comparison, the sensitivities of the direct 10% KOH and the Giemsa stain microscopic examination methods were 84% (132/157) and 95% (149/157) respectively but both with 100% specificity. As for the identity of recovered 157 yeast isolates, based on API 20C biotype carbohydrate assimilation, germ tube and chlamydospore formation, C. albicansand C. glabrata constitute 80.3 and 12.7% respectively. Rates of C. tropicalis, C. kefyr, C. famata or C. utilis were 2.6, 1.3, and 0.6% respectively. Sachromyces cerevisiae and Rhodotorula mucilaginosa yeasts were also encountered at a frequency of 1.3 and 0.6% respectively. Finally, among all recovered 157 yeast-isolates, strains resistant to ketoconazole were not detected, whereas 5% of the C. albicans and as high as 55% of the non-albicans yeast isolates (majority C. glabrata) showed resistance to fluconazole. Our findings may prove helpful for continuous determination of the existing vaginal candidiasis causative species during pregnancy, its lab-diagnosis and/or control and possible measures to minimize the incidence of the disease-associated pre-term delivery.

Keywords: vaginal candidiasis, Candida spp., pregnancy, risk factors, API 20C-yeast biotypes, giemsa stain, antifungal agents

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Authors: Fatima Saab

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This paper attempts to study colloquialism in audio-visual translation, with particular emphasis given to investigating the difficulties and challenges encountered by subtitlers in translating Lebanese colloquial into English. To achieve the main objectives of this study, ample and thorough cultural and translational analysis of examples drawn from the subtitled movie Capernaum are presented in order to identify the strategies used to overcome cultural barriers and differences and to show the process of decision-making by the translator. Also, special attention is given to explain the technicalities in translating subtitles and how they affect the translation process. The research is a descriptive analytical study whereby the writer sets out empirical observations, consisting of descriptive and analytical examination of the difficulties and problems associated with translating Arabic colloquialisms, specifically Lebanese, into English in the subtitled film, Capernaum. The research methodology utilizes a qualitative approach to group the selected data into the subtitling strategies presented by Gottlieb under the domesticating or foreignizing strategies according to Venuti's Model. It is shown that producing the same meanings to a foreign audience is not an easy task. The background of cultural elements and the stories that make up the history and mindset of the Lebanese and Arabic peoples leads to the use of the transfer and paraphrase methodologies most of the time (81% of the sample used for analysis). The research shows that translating and subtitling colloquialism needs special skills by the translators to overcome the challenges imposed by the limited presentation space as well as cultural differences. Translation of colloquial Arabic/Lebanese can be achieved to a certain extent and delivering the meaning and effect of the source language culture is accomplished in as much as the translator investigates and relates to the target culture.

Keywords: Lebanese colloquial, audio-visual translation, subtitling, Capernaum

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Authors: Nader Nciri, Suil Song, Namho Kim, Namjun Cho

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Properties and compositions of bitumen and bitumen-derived liquids have significant influences on the selection of recovery, upgrading and refining processes. Optimal process conditions can often be directly related to these properties. The end uses of bitumen and bitumen products are thus related to their compositions. Because it is not possible to conduct a complete analysis of the molecular structure of bitumen, characterization must be made in other terms. The present paper focuses on physico-chemical analysis of two different types of bitumens. These bitumen samples were chosen based on: the original crude oil (sand oil and crude petroleum), and mode of process. The aim of this study is to determine both the manufacturing effect on chemical species and the chemical organization as a function of the type of bitumen sample. In order to obtain information on bitumen chemistry, elemental analysis (C, H, N, S, and O), heavy metal (Ni, V) concentrations, IATROSCAN chromatography (thin layer chromatography-flame ionization detection), FTIR spectroscopy, and 1H NMR spectroscopy have all been used. The characterization includes information about the major compound types (saturates, aromatics, resins and asphaltenes) which can be compared with similar data for other bitumens, more importantly, can be correlated with data from petroleum samples for which refining characteristics are known. Examination of Asphalt Ridge froth bitumen showed that it differed significantly from representative petroleum pitches, principally in their nonhydrocarbon content, heavy metal content and aromatic compounds. When possible, properties and composition were related to recovery and refining processes. This information is important because of the effects that composition has on recovery and processing reactions.

Keywords: froth bitumen, oil sand, asphalt ridge, petroleum pitch, thin layer chromatography-flame ionization detection, infrared spectroscopy, 1H nuclear magnetic resonance spectroscopy

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Authors: Cigdem Gul, Murat Tosunoglu, Nurcihan Hacioglu

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The contamination or desiccation of fresh waters also has a negative effect on freshwater turtles like other fresh water-dependent species. In order to conserve those species, which are confronted with such negative conditions, it is necessary to know beforehand the biology and the physiology of species. In this study, a comprehensive health assessment was conducted on a total of 20 clinically normal individuals free living Western Caspian Turtle (Mauremys rivulata) captured from two different freshwater localities in the Biga stream (Çanakkale-Turkey). When comparing our findings with the Turkish legislation (Water pollution control regulation), the 1. Locality of the Biga stream in terms of total coliform classified as "high quality water" (Coliform: 866.66 MPN/100 mL), while the 2. Locality was a “contaminated water" (Coliform: 53266.66 MPN/100 mL). Blood samples for hematological and biochemical analyses were obtained from the dorsal coccygeal vein. A total of 1-2 mL of blood was collected from each of the specimens via needle. After the required procedures had been performed, the turtles were put back in the same localities. Hematological and biochemical analyses based on high quality water and contaminated water, respectively, are as follows: Red blood cell count (512600-582666.66 per cubic millimeter of blood), white blood cell count (5920-5980 per cubic millimeter of blood), hematocrit value (24-24.66 %), hemoglobin concentration (6.52-6.35 g/dl), mean corpuscular volume (466.20-468.98 fl), mean corpuscular hemoglobin (125.77-113.84 pg), mean corpuscular hemoglobin concentration (28.25-26.49 %), glucose (94.43-87.43 mg/dl), creatinine (0.23-0.3241 mg/dl), uric acid (12.59-10.48 mg/L), albumin (1.46-1.25 g/dl), calcium (8.67-9.59 mg/dl), triglyceride (95.55-75.21 mg/dl), and total protein (4.85-3.45 g/dl). When an examination was made depending on the water quality of freshwater, variations were detected in hematology and biochemistry values, but not found significant difference.

Keywords: biochemistry, freshwater quality, hematological parameters, Mauremys rivulata.

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Authors: Kalsoom Rani

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Tobacco contains nicotine, which causes addiction to many toxic chemicals. In the world, people consume it in the form of smoke, chew, and sniffing, smoke of it is composed of almost 7000 active chemicals, which are very harmful to human health as well as for eye health, inhalation of tobacco smoke and fumes can accelerate and cause many blinding eye diseases. Dry eye and smoking have not been covered extensively in researches; more studies are required to unveil the relationship between smoking and dry eye. This study was conducted to determine the quantity and quality of tears in smokers. 60 subjects participated in the study, which was divided into two groups on the basis of consumption of cigarettes per day with age matched non smokers of 15-50 years. All participants have gone through a study based questioner, eye examination, and diagnostic 'Dry Eye Tests' for evaporative tears evaluation and measurement of basal tear secretion. Subjects were included in the criteria of 10 cigarettes per day with a minimum duration of 1 year; passive smokers for control groups were excluded. The study was carried out in a Medina Teaching Hospital, Faisalabad, Pakistan, ophthalmology department for the duration of 8 months. Mean values for tear break up time (TBUT), was reported 10sec with SD of +3.74 in controlled group, 5sec with SD + 2.32 in smokers and 4sec SD +3.77 heavy smokers in right eye (RE) and left eye (LE) 10.35sec with SD of +3.88 in controlled 5sec with SD + 2.3 in smokers and much reduced TBUT in heavy smokers was 3.85sec SD+2.20. Smoking has a very strong association with TRUT with a significance of P=.00 both eyes. Mean Schirmer-I value of the subjects was reported 12.6mm with SD + 8.37 in RE and 12.59mm with SD + 8.96 LE. The mean Schirmer-II test value was reported in the right, and left eye with a mean value for control was 20.23mm with SD + 8.93, 20.75mm with SD + 8.84 respectively, and in Smokers 9.90mm with SD + 5.74, and 10.07mm with SD + 6.98, and in heavy smokers 7.7mm, SD + 3.22 and 6.9, SD + 3.50 mm, association with smoking showed p=.001 in RE and .003 in LE. Smoking has deteriorated effect on both evaporative tear and aqueous tear secretion and causing symptoms of dry eye burning, itching, redness, and watering with epithelial cell damage.

Keywords: tear break-up time, basal tear secretion, smokers, dry eye

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