Search results for: therapy and follow-up in a periodontitis
842 Multi-Granularity Feature Extraction and Optimization for Pathological Speech Intelligibility Evaluation
Authors: Chunying Fang, Haifeng Li, Lin Ma, Mancai Zhang
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Speech intelligibility assessment is an important measure to evaluate the functional outcomes of surgical and non-surgical treatment, speech therapy and rehabilitation. The assessment of pathological speech plays an important role in assisting the experts. Pathological speech usually is non-stationary and mutational, in this paper, we describe a multi-granularity combined feature schemes, and which is optimized by hierarchical visual method. First of all, the difference granularity level pathological features are extracted which are BAFS (Basic acoustics feature set), local spectral characteristics MSCC (Mel s-transform cepstrum coefficients) and nonlinear dynamic characteristics based on chaotic analysis. Latterly, radar chart and F-score are proposed to optimize the features by the hierarchical visual fusion. The feature set could be optimized from 526 to 96-dimensions.The experimental results denote that new features by support vector machine (SVM) has the best performance, with a recognition rate of 84.4% on NKI-CCRT corpus. The proposed method is thus approved to be effective and reliable for pathological speech intelligibility evaluation.Keywords: pathological speech, multi-granularity feature, MSCC (Mel s-transform cepstrum coefficients), F-score, radar chart
Procedia PDF Downloads 276841 A Sports-Specific Physiotherapy Center Treats Sports Injuries
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
Procedia PDF Downloads 65840 A Fortunate Presentation of Intestinal Obstruction Secondary to a Sarcomatoid Tumour of the Small Bowel
Authors: Thampi Rawther, Sean O’Brien, Kamala Kanta Das
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Background: Intussusception in the adult is rarely from a benign cause and is almost always pathological. Causes include carcinomas, polyps, Meckel's diverticulum, or colonic diverticulum. Common symptoms include abdominal pain, intestinal obstruction, palpable abdominal mass, GI bleeding, and anemia. Sarcomatoid carcinoma is a rare type of small intestinal malignancy exhibiting carcinomatous and sarcomatous features. It primarily affects older patients, mean age 57, and is 1.5 times more prevalent in men. Method: This is an interesting case report of a patient presenting with intussusception secondary to a sarcomatoid tumor of the small bowel. Conclusion: Surgery is the treatment of choice in adults with intussusception due to the high malignancy potential. Furthermore, surgical resection of the affected bowel is the definitive form of therapy as small bowel sarcomatoid tumors are not responsive to chemotherapy and radiotherapy. Early surgical intervention helps reduce mortality as it allows for early staging, treatment, and monitoring of the tumor. The patient was fortunate to have presented with intussusception, facilitating early surgical intervention, and was found to have a low disease stage.Keywords: general surgery, small bowel tumour, imaging, unique
Procedia PDF Downloads 74839 Challenging Airway Management for Tracheal Compression Due to a Rhabdomyosarcoma
Authors: Elena Parmentier, Henrik Endeman
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Introduction: Large mediastinal masses often present with diagnostic and clinical challenges due to compression of the respiratory and hemodynamic system. We present a case of a mediastinal mass with symptomatic mechanical compression of the trachea, resulting in challenging airway management. Methods: We present a case of 66-year-old male, complaining of progressive dysphagia. Initial esophagogastroscopy revealed a stenosis secondary to external compression, biopsies were inconclusive. Additional CT scan showed a large mediastinal mass of unknown origin, situated between the vertebrae and esophagus. Symptoms progressed and patient developed dyspnea and stridor. A new CT showed quick growth of the mass with compression of the trachea, subglottic to just above the carina. A tracheal covered stent was successfully placed. Endobronchial ultrasound revealed a large irregular mass without tracheal invasion, biopsies were taken. 4 days after stent placement, the patients’ condition deteriorated with worsening of stridor, dyspnea and desaturation. Migration of the tracheal stent into the right main bronchus was seen on chest X ray, with obstruction of the left main bronchus and secondary atelectasis. Different methods have been described in the literature for tracheobronchial stent removal (surgical, endoscopic, fluoroscopyguided), our first choice in this case was flexible bronchoscopy. However, this revealed tracheal compression above the migrated stent and passage of the scope occurred impossible. Patient was admitted to the ICU, high-flow nasal oxygen therapy was started and the situation stabilized, giving time for extensive assessment and preparation of the airway management approach. Close cooperation between the intensivist, pulmonologist, anesthesiologist and otorhinolaryngologist was essential. Results: In case of sudden deterioration, a protocol for emergency situations was made. Given the increased risk of additional tracheal compression after administration of neuromuscular blocking agents, an approach with awake fiberoptic intubation maintaining spontaneous ventilation was proposed. However, intubation without retrieval of the tracheal stent was found undesirable due to expected massive shunting over the left atelectatic lung. As rescue option, assistance of extracorporeal circulation was considered and perfusionist was kept on standby. The patient stayed stable and was transferred to the operating theatre. High frequency jet ventilation under general anesthesia resulted in desaturations up to 50%, making rigid bronchoscopy impossible. Subsequently an endotracheal tube size 8 could be placed successfully and the stent could be retrieved via bronchoscopy over (and with) the tube, after which the patient was reintubated. Finally, a tracheostomy (Shiley™ Tracheostomy Tube With Cuff, size 8) was placed, fiberoptic control showed a patent airway. Patient was readmitted to the ICU and could be quickly weaned of the ventilator. Pathology was positive for rhabdomyosarcoma, without indication for systemic therapy. Extensive surgery (laryngectomy, esophagectomy) was suggested, but patient refused and palliative care was started. Conclusion: Due to meticulous planning in an interdisciplinary team, we showed a successful airway management approach in this complicated case of critical airway compression secondary to a rare rhabdomyosarcoma, complicated by tracheal stent migration. Besides presenting our thoughts and considerations, we support exploring other possible approaches of this specific clinical problem.Keywords: airway management, rhabdomyosarcoma, stent displacement, tracheal stenosis
Procedia PDF Downloads 96838 Two Weeks of Multi-Modal Inpatient Treatment: Patients Suffering from Chronic Musculoskeletal Pain for over 12 Months
Authors: D. Schafer, H. Booke, R. Nordmeier
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Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain
Procedia PDF Downloads 157837 A Systematic Review on The Usage of CRISPR-Cas System in The Treatment of Osteoarthritis(OA)
Authors: Atiqah Binti Ab Aziz
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Background: It has been estimated that about 250 million people all over the world suffer from osteoarthritis (OA). Thus, OA is a major health problem in urgent need of better treatment. Problem statement: Current therapies for OA can temporarily relieve clinical symptoms and for pain management, rather than preventing or curing OA. Total knee replacement performed at the end stage of the disease is considered the only cure available. Objectives: This article aimed to explore the potential of treating osteoarthritis via the CRISPR Cas system. Methods: Articles that relate to the application of the CRISPR Cas system in osteoarthritis were extracted, categorized, and reviewed through the PRISMA method using PubMed, an engine published from November 2016 to November 2021. Results: There were 30 articles screened. Articles that fall under the categories of non-English articles, full articles that were not available, articles that were not an original articles were excluded. Ultimately, 13 articles were reviewed. Discussion: This review provides an information on the introduction of CRISPR and discussed on their mechanism of actions in extracted studies for OA treatment. Conclusions: It can be seen that not many medical research utilize the CRISPR Cas system as part of the method in the treatment of OA. Hence exploring the extent of the usage of the CRISPR Cas system in OA treatment is important to determine the research gap and point out at which of the research is needed further investigation to avoid redundancy of existing research and ensure the novelty of the research.Keywords: osteoarthritis, treatment, CRISPR, review, therapy
Procedia PDF Downloads 166836 Depth of Penetration and Nature of Interferential Current in Cutaneous, Subcutaneous and Muscle Tissues
Authors: A. Beatti, L. Chipchase, A. Rayner, T. Souvlis
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The aims of this study were to investigate the depth of interferential current (IFC) penetration through soft tissue and to investigate the area over which IFC spreads during clinical application. Premodulated IFC and ‘true’ IFC at beat frequencies of 4, 40 and 90Hz were applied via four electrodes to the distal medial thigh of 15 healthy subjects. The current was measured via three Teflon coated fine needle electrodes that were inserted into the superficial layer of skin, then into the subcutaneous tissue (≈1 cm deep) and then into muscle tissue (≈2 cm deep). The needle electrodes were placed in the middle of the four IFC electrodes, between two channels and outside the four electrodes. Readings were taken at each tissue depth from each electrode during each treatment frequency then digitized and stored for analysis. All voltages were greater at all depths and locations than baseline (p < 0.01) and voltages decreased with depth (P=0.039). Lower voltages of all currents were recorded in the middle of the four electrodes with the highest voltage being recorded outside the four electrodes in all depths (P=0.000).For each frequency of ‘true’ IFC, the voltage was higher in the superficial layer outside the electrodes (P ≤ 0.01).Premodulated had higher voltages along the line of one circuit (P ≤ 0.01). Clinically, IFC appears to pass through skin layers to depth and is more efficient than premodulated IFC when targeting muscle tissue.Keywords: electrotherapy, interferential current, interferential therapy, medium frequency current
Procedia PDF Downloads 340835 Detection of Telomerase Activity as Cancer Biomarker Using Nanogap-Rich Au Nanowire SERS Sensor
Authors: G. Eom, H. Kim, A. Hwang, T. Kang, B. Kim
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Telomerase activity is overexpressed in over 85% of human cancers while suppressed in normal somatic cells. Telomerase has been attracted as a universal cancer biomarker. Therefore, the development of effective telomerase activity detection methods is urgently demanded in cancer diagnosis and therapy. Herein, we report a nanogap-rich Au nanowire (NW) surface-enhanced Raman scattering (SERS) sensor for detection of human telomerase activity. The nanogap-rich Au NW SERS sensors were prepared simply by uniformly depositing nanoparticles (NPs) on single-crystalline Au NWs. We measured SERS spectra of methylene blue (MB) from 60 different nanogap-rich Au NWs and obtained the relative standard deviation (RSD) of 4.80%, confirming the superb reproducibility of nanogap-rich Au NW SERS sensors. The nanogap-rich Au NW SERS sensors enable us to detect telomerase activity in 0.2 cancer cells/mL. Furthermore, telomerase activity is detectable in 7 different cancer cell lines whereas undetectable in normal cell lines, which suggest the potential applicability of nanogap-rich Au NW SERS sensor in cancer diagnosis. We expect that the present nanogap-rich Au NW SERS sensor can be useful in biomedical applications including a diverse biomarker sensing.Keywords: cancer biomarker, nanowires, surface-enhanced Raman scattering, telomerase
Procedia PDF Downloads 339834 National Agency for Control of HIV/AIDS and International Response to its Scourge in Nigeria, 2000-2010
Authors: Ugwu Blessing Nkiruka
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This paper seeks to examine Nigerian National Agency for the control of AIDS (NACA) and international response to the control of HIV/AIDS in Nigeria. The paper adopted the Functionalist theory alongside Liberalism and Idealism, but anchored extensively on functionalism. On the response of HIV/AIDS, Functionalist theory advocated for international corporation of both intergovernmental and non-governmental organisations as the basis for the reduction of the virus. the study adopted secondary source of data i.e journals, articles, newspapers and policy briefs to discuss the reduction of the pandemic (HIV/AIDS).This paper discovered that although HIV/AIDS is a global threat, especially to developing countries where the prevalence rate is still very high, yet international governmental and non-governmental organisation have been able to collaborate with National agencies like NACA in Nigeria and respond speedily through diverse initiatives and action plans to curb the spread of the virus. The study therefore recommends greater awareness on testing and early introduction of antiretroviral therapy, proper screening of blood before transfusion, absolute faithfulness among partners. Similarly, sharing of sharp objects like needles, knives and syringes should be avoided at all cost.Keywords: HIV/AIDS, developing countries, Nigeria, international organizations, NACA
Procedia PDF Downloads 177833 Synthesis of New Anti-Tuberculosis Drugs
Authors: M. S. Deshpande, Snehal D. Bomble
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Tuberculosis (TB) is a deadly contagious disease that is caused by a bacterium called Mycobacterium tuberculosis. More than sixty years ago, the introduction of the first anti-TB drugs for the treatment of TB (streptomycin (STR), p-aminosalcylic acid (PAS), isoniazid (INH), and then later ethambutol (EMB) and rifampicin (RIF)) gave optimism to the medical community, and it was believed that the disease would be completely eradicated soon. Worldwide, the number of TB cases has continued to increase, but the incidence rate has decreased since 2003. Recently, highly drug-resistant forms of TB have emerged worldwide. The prolonged use of classical drugs developed a growing resistance and these drugs have gradually become less effective and incapable to meet the challenges, especially those of multi drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB, and HIV-TB co-infections. There is an unmet medical need to discover newer synthetic molecules and new generation of potent drugs for the treatment of tuberculosis which will shorten the time of treatment, be potent and safe while effective facing resistant strains and non-replicative, latent forms, reduce adverse side effect and not interfere in the antiretroviral therapy. This paper attempts to bring out the review of anti-TB drugs, and presents a novel method of synthesizing new anti-tuberculosis drugs and potential compounds to overcome the bacterial resistance and combat the re-emergence of tuberculosis.Keywords: tuberculosis, mycobacterium, multi-drug resistant (MDR)-TB, extensively drug resistant (XDR)-TB
Procedia PDF Downloads 375832 Application of Single Subject Experimental Designs in Adapted Physical Activity Research: A Descriptive Analysis
Authors: Jiabei Zhang, Ying Qi
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The purpose of this study was to develop a descriptive profile of the adapted physical activity research using single subject experimental designs. All research articles using single subject experimental designs published in the journal of Adapted Physical Activity Quarterly from 1984 to 2013 were employed as the data source. Each of the articles was coded in a subcategory of seven categories: (a) the size of sample; (b) the age of participants; (c) the type of disabilities; (d) the type of data analysis; (e) the type of designs, (f) the independent variable, and (g) the dependent variable. Frequencies, percentages, and trend inspection were used to analyze the data and develop a profile. The profile developed characterizes a small portion of research articles used single subject designs, in which most researchers used a small sample size, recruited children as subjects, emphasized learning and behavior impairments, selected visual inspection with descriptive statistics, preferred a multiple baseline design, focused on effects of therapy, inclusion, and strategy, and measured desired behaviors more often, with a decreasing trend over years.Keywords: adapted physical activity research, single subject experimental designs, physical education, sport science
Procedia PDF Downloads 460831 Yawning and Cortisol as a Potential Biomarker for Early Detection of Multiple Sclerosis
Authors: Simon B. N. Thompson
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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis
Procedia PDF Downloads 371830 Epidemiological, Clinical, Histopathological Profile and Management of Breast Cancer at Kinshasa University Clinics
Authors: Eddy K. Mukadi
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This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa
Procedia PDF Downloads 210829 Herbal Medicines Used for the Cure of Jaundice among the Some Tribal Populations of Madhya Pradesh, India
Authors: Awdhesh Narayan Sharma
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The use of herbal medicines for the cure of various ailments among the tribal population is as old as human origin itself. Most of the tribal populations of Madhya Pradesh inhabit in remote and inaccessible ecological setup. From long back, tribals and forests are interrelated to each other. They use an enormous range of wild plants for their basic needs and medicines. The tribal developed a unique understanding with wild plants, herbs, etc., and earned specialized knowledge of disease pattern and curative therapy-through hard experiences, common sense, trial, and error methods. They have passed this knowledge through traditions, taboos, totems, folklore by words of mouth from generation to generation. Here, an attempt has been made to study the possible aspects of herbal medicine for the cure of Jaundice among the tribal populations of Madhya Pradesh, India, through primary data as well as available secondary data. The data have been collected from the 305 Bharias of Patalkot, Madhya Pradesh, India, and included available secondary source of data by various investigators. It may be concluded that a sizable herbal medicinal plants' wealth exists in Madhya Pradesh, India, which still awaits for scientific exploration. The existing herbal medicines used for the cure of jaundice need an extensive investigation from the pharmaceutical point of view.Keywords: Bharias, herbal medicine, tribal, Madhya Pradesh
Procedia PDF Downloads 168828 Optimal Rest Interval between Sets in Robot-Based Upper-Arm Rehabilitation
Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun
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Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90, and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of elbow flexion and extension task was investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76%, and 0.82% when using muscle relaxation periods of 60, 90, and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity, and knowing the optimal resting period will make the automation more effective.Keywords: rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue
Procedia PDF Downloads 181827 The Effect of Expressive Therapies on Children and Youth Impacted by Refugee Trauma: A Meta-Analysis
Authors: Brian Kristopher Cambra
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Millions of displaced families are seeking refuge in countries that are not their own due to war, violence, persecution, political unrest, and natural disasters. This global crisis is forcing researchers and practitioners to consider how refugees are coping with the trauma associated with their migration process. Effective therapeutic approaches are needed in a global effort to address the traumatic impact of forced migration. This meta-analytical study investigates the effectiveness of expressive therapeutic modalities, including play, art, music, sandplay, theatre, and writing therapies, in helping children and adolescents cope with refugee trauma. Seventeen pre-post and between-group comparison studies were analyzed using a random-effects model. The combined effect size for pre-post comparisons was medium (g = 0.58), whereas the combined effect size for between-group comparisons was small (g = 0.32). Overall, art therapy was found to be most effective in treating stress symptoms. Heterogeneity tests, however, suggest effect sizes cannot be interpreted as meaningful due to substantial variance. Nevertheless, findings of this meta-analysis indicate that expressive therapies may be among beneficial modalities to integrate with other trauma-informed approaches.Keywords: expressive therapies, forced migration, meta-analysis, refugees, trauma
Procedia PDF Downloads 139826 Advanced Eales’ Disease with Neovascular Glaucoma at First Presentation: Case Report
Authors: Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Mahdi H. Almubarak
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Purpose: Eales’ disease is an idiopathic vasculitis that affects the peripheral retina. It is characterized by recurrent vitreous hemorrhage as a complication of retinal neovascularization. It is more prevalent in India and affects young males. Here we present a patient with neovascular glaucoma as a rare first presentation of Eales’ disease. Observations: This is a 24-year-old Indian gentleman, who complained of a sudden decrease in vision in the left eye over less than 24 hours, along with frontal headache and eye pain for the last three weeks. Ocular examination revealed peripheral retinal ischemia in the right eye, very high intraocular pressure, rubeosis iridis, vitreous hemorrhage and extensive retinal ischemia in the left eye, vascular sheathing and neovascularization in both eyes. Purified protein derivative skin test was positive. The patient was managed with anti-glaucoma, intravitreal anti-vascular endothelial growth factor and laser photocoagulation. Systemic steroids and anti-tuberculous therapy were also initiated. Conclusions: Neovascular glaucoma is an infrequent complication of Eales’ disease. However, the lack of early detection of the disease in the early stages might lead to such serious complication.Keywords: case report, Eales’ disease, mycobacterium tuberculosis, neovascular glaucoma
Procedia PDF Downloads 121825 Correlation of IFNL4 ss469415590 and IL28B rs12979860 with the Hepatitis C Virus Treatment Response among Tunisian Patients
Authors: Khaoula Azraiel, Mohamed Mehdi Abassi, Amel Sadraoui, Walid Hammami, Azouz Msaddek, Imed Cheikh, Maria Mancebo, Elisabet Perez-Navarro, Antonio Caruz, Henda Triki, Ahlem Djebbi
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IL28B rs12979860 genotype is confirmed as an important predictor of response to peginterferon/ribavirin therapy in patients with chronic hepatitis C (CHC). IFNL4 ss469415590 is a newly discovered polymorphism that could also affect the sustained virological response (SVR). The aim of this study was to evaluate the association of IL28B and IFNL4 genotypes with peginterferon/ribavirin treatment response in Tunisians patients with CHC and to determine which of these SNPs, was the stronger marker. A total of 120 patients were genotyped for both rs12979860 and ss469415590 polymorphisms. The association of each genetic marker with SVR was analyzed and comparison between the two SNPs was calculated by logistic regression models. For rs12979860, 69.6% of patients with CC, 41.8% with CT and 42.8% with TT achieved SVR (p = 0.003). Regarding ss469415590, 70.4% of patients with TT/TT genotype achieved SVR compared to 42.8% with TT/ΔG and 37.5% with ΔG /ΔG (p = 0.002). The presence of CC and TT/TT genotypes was independently associated with treatment response with an OR of 3.86 for each. In conclusion, both IL28B rs12979860 and IFNL4 ss469415590 variants were associated with response to pegIFN/RBV in Tunisian patients, without any additional benefit in performance for IFNL4. Our results are different from those detected in Sub-Saharan Africa countries.Keywords: Hepatitis C virus, IFNL4, IL28B, Peginterferon/ribavirin, polymorphism
Procedia PDF Downloads 335824 The Contribution of Diet and Lifestyle Factors in the Prevalence of Irritable Bowel Syndrome
Authors: Alexander Dao, Oscar Wambuguh
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Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.Keywords: irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder
Procedia PDF Downloads 80823 Lipoic Acid Accelerates Wound Healing by Diminishing Pro-Inflammatory Markers and Chemokine Expression in Rheumatoid Arthritis Mouse Model
Authors: Khairy M. A. Zoheir
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One of the most severe complications of Rheumatoid arthritis is delayed recovery. lipoic acid possesses antioxidant, hypoglycemic, and anti-inflammatory activity. In the present study, the effects of lipoic acid was investigated on the key mediators of Rheumatoid arthritis, namely, CD4+CD25+ T cell subsets, GITR expressing cells, CD4+CD25+Foxp3+ regulatory T (Treg) cells, T-helper-17 (Th17) cells, and pro-inflammatory cytokines Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and Tumor Necrosis Factor- α (TNF-α)] through flow-cytometry and qPCR analyses. Lipoic acid treated mice showed a significant decrease in the Rheumatoid arthritis, the frequency of GITR-expressing cells, and Th1 cytokines (IL-17A, TNF-αand Interferon- γ (IFN-γ) compared with positive and negative controlled mice. Lipoic acid treatment also down regulated the mRNA expression of the inflammatory mediators compared with the Rheumatoid arthritis mouse model and untreated mice. The number of Tregs also found to be significantly upregulated in lipoic acid treated mice. Our results were confirmed by the histopathological examination. This study showed the beneficial role of lipoic acid in promoting a well-balanced tool for therapy Rheumatoid arthritis.Keywords: lipoic acid, chemokines, inflammatory, rheumatoid arthritis
Procedia PDF Downloads 168822 Evaluation of Uniformity for Gafchromic Sheets for Film Dosimetry
Authors: Fayzan Ahmed, Saad Bin Saeed, Abdul Qadir Jangda
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Gafchromic™ sheet are extensively used for the QA of intensity modulated radiation therapy and other in-vivo dosimetry. Intra-sheet Non-uniformity of scanner as well as film causes undesirable fluctuations which are reflected in dosimetry The aim of this study is to define a systematic and robust method to investigate the intra-sheet uniformity of the unexposed Gafchromic Sheets and the region of interest (ROI) of the scanner. Sheets of lot No#: A05151201 were scanned before and after the expiry period with the EPSON™ XL10000 scanner in the transmission mode, landscape orientation and 72 dpi resolution. ROI of (8’x 10’ inches) equal to the sheet dimension in the center of the scanner is used to acquire images with full transmission, block transmission and with sheets in place. 500 virtual grids, created in MATALB® are imported as a macros in ImageJ (1.49m Wayne Rasband) to analyze the images. In order to remove the edge effects, the outer 86 grids are excluded from the analysis. The standard deviation of the block transmission and full transmission are 0.38% and 0.66% confirming a higher uniformity of the scanner. Expired and non-expired sheets have standard deviations of 2.18% and 1.29%, show that uniformity decreases after expiry. The results are promising and indicates a good potential of this method to be used as a uniformity check for scanner and unexposed Gafchromic sheets.Keywords: IMRT, film dosimetry, virtual grids, uniformity
Procedia PDF Downloads 485821 Magnetic Single-Walled Carbon Nanotubes (SWCNTs) as Novel Theranostic Nanocarriers: Enhanced Targeting and Noninvasive MRI Tracking
Authors: Achraf Al Faraj, Asma Sultana Shaik, Baraa Al Sayed
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Specific and effective targeting of drug delivery systems (DDS) to cancerous sites remains a major challenge for a better diagnostic and therapy. Recently, SWCNTs with their unique physicochemical properties and the ability to cross the cell membrane show promising in the biomedical field. The purpose of this study was first to develop a biocompatible iron oxide tagged SWCNTs as diagnostic nanoprobes to allow their noninvasive detection using MRI and their preferential targeting in a breast cancer murine model by placing an optimized flexible magnet over the tumor site. Magnetic targeting was associated to specific antibody-conjugated SWCNTs active targeting. The therapeutic efficacy of doxorubicin-conjugated SWCNTs was assessed, and the superiority of diffusion-weighted (DW-) MRI as sensitive imaging biomarker was investigated. Short Polyvinylpyrrolidone (PVP) stabilized water soluble SWCNTs were first developed, tagged with iron oxide nanoparticles and conjugated with Endoglin/CD105 monoclonal antibodies. They were then conjugated with doxorubicin drugs. SWCNTs conjugates were extensively characterized using TEM, UV-Vis spectrophotometer, dynamic light scattering (DLS) zeta potential analysis and electron spin resonance (ESR) spectroscopy. Their MR relaxivities (i.e. r1 and r2*) were measured at 4.7T and their iron content and metal impurities quantified using ICP-MS. SWCNTs biocompatibility and drug efficacy were then evaluated both in vitro and in vivo using a set of immunological assays. Luciferase enhanced bioluminescence 4T1 mouse mammary tumor cells (4T1-Luc2) were injected into the right inguinal mammary fat pad of Balb/c mice. Tumor bearing mice received either free doxorubicin (DOX) drug or SWCNTs with or without either DOX or iron oxide nanoparticles. A multi-pole 10x10mm high-energy flexible magnet was maintained over the tumor site during 2 hours post-injections and their properties and polarity were optimized to allow enhanced magnetic targeting of SWCNTs toward the primary tumor site. Tumor volume was quantified during the follow-up investigation study using a fast spin echo MRI sequence. In order to detect the homing of SWCNTs to the main tumor site, susceptibility-weighted multi-gradient echo (MGE) sequence was used to generate T2* maps. Apparent diffusion coefficient (ADC) measurements were also performed as a sensitive imaging biomarker providing early and better assessment of disease treatment. At several times post-SWCNT injection, histological analysis were performed on tumor extracts and iron-loaded SWCNT were quantified using ICP-MS in tumor sites, liver, spleen, kidneys, and lung. The optimized multi-poles magnet revealed an enhanced targeting of magnetic SWCNTs to the primary tumor site, which was found to be much higher than the active targeting achieved using antibody-conjugated SWCNTs. Iron-loading allowed their sensitive noninvasive tracking after intravenous administration using MRI. The active targeting of doxorubicin through magnetic antibody-conjugated SWCNTs nanoprobes was found to considerably decrease the primary tumor site and may have inhibited the development of metastasis in the tumor-bearing mice lung. ADC measurements in DW-MRI were found to significantly increase in a time-dependent manner after the injection of DOX-conjugated SWCNTs complexes.Keywords: single-walled carbon nanotubes, nanomedicine, magnetic resonance imaging, cancer diagnosis and therapy
Procedia PDF Downloads 323820 Cloning and Expression of Human Interleukin 15: A Promising Candidate for Cytokine Immunotherapy
Authors: Sadaf Ilyas
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Recombinant cytokines have been employed successfully as potential therapeutic agent. Some cytokine therapies are already used as a part of clinical practice, ranging from early exploratory trials to well established therapies that have already received approval. Interleukin 15 is a pleiotropic cytokine having multiple roles in peripheral innate and adaptive immune cell function. It regulates the activation, proliferation and maturation of NK cells, T-cells, monocytes/macrophages and granulocytes, and the interactions between them thus acting as a bridge between innate and adaptive immune responses. Unraveling the biology of IL-15 has revealed some interesting surprises that may point toward some of the first therapeutic applications for this cytokine. In this study, the human interleukin 15 gene was isolated, amplified and ligated to a TA vector which was then transfected to a bacterial host, E. coli Top10F’. The sequence of cloned gene was confirmed and it showed 100% homology with the reported sequence. The confirmed gene was then subcloned in pET Expression system to study the IPTG induced expression of IL-15 gene. Positive expression was obtained for number of clones that showed 15 kd band of IL-15 in SDS-PAGE analysis, indicating the successful strain development that can be studied further to assess the potential therapeutic intervention of this cytokine in relevance to human diseases.Keywords: Interleukin 15, pET expression system, immune therapy, protein purification
Procedia PDF Downloads 407819 The Effect of Tai Chi Exercises on Postural Stability and Control in Older Patients with Knee Osteoarthritis
Authors: Elham Ghandali, Saeed Talebian Moghadam, Mohammad Reza Hadian, Gholamreza Olyaei, Shohreh Jalaie, Elaheh Sajjadi
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Purpose: A few studies have examined the effect of Tai Chi on balance in elderly patients with knee osteoarthritis (OA). The aim of this study was to determine the balance measures in elderly patients with knee OA after Tai Chi exercises. For this purpose, 14 females and 6 males with knee OA were chosen. The area and mean velocity of the center of pressure movements (CoP) were measured by force plate in standing positions (on foam and rigid surfaces). The measurements of area and mean velocity of CoP were performed before and after 60 min of Tai Chi sessions (twice a week for 8 weeks). Results: The results showed that the area of CoP in a standing position on a rigid surface was significantly decreased (P < 0.01) after Tai Chi exercises. Furthermore, the mean velocity of CoP was significantly decreased after Tai Chi exercises on both rigid and foam surfaces (P < 0.001). Our study also indicated that changes in surfaces (rigid and foam) would cause significant differences regarding the area of CoP in standing positions. How- ever, similar findings were not found regarding the mean velocity of CoP. Considering the effects of Tai Chi on the mean velocity of CoP, it might be concluded that motor control and Postural stability improvements have occurred. Conclusions: Therefore, based on these results, Tai Chi exercises could be recommended for elderly patients with knee OA as part of their rehabilitation and physical therapy protocols.Keywords: Tai Chi, balance, knee osteoarthritis, elderly patients, different surfaces
Procedia PDF Downloads 85818 Numerical Simulation of Heating Characteristics in a Microwave T-Prong Antenna for Cancer Therapy
Authors: M. Chaichanyut, S. Tungjitkusolmun
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This research is presented with microwave (MW) ablation by using the T-Prong monopole antennas. In the study, three-dimensional (3D) finite-element methods (FEM) were utilized to analyse: the tissue heat flux, temperature distributions (heating pattern) and volume destruction during MW ablation in liver cancer tissue. The configurations of T-Prong monopole antennas were considered: Three T-prong antenna, Expand T-Prong antenna and Arrow T-Prong antenna. The 3D FEMs solutions were based on Maxwell and bio-heat equations. The microwave power deliveries were 10 W; the duration of ablation in all cases was 300s. Our numerical result, heat flux and the hotspot occurred at the tip of the T-prong antenna for all cases. The temperature distribution pattern of all antennas was teardrop. The Arrow T-Prong antenna can induce the highest temperature within cancer tissue. The microwave ablation was successful when the region where the temperatures exceed 50°C (i.e. complete destruction). The Expand T-Prong antenna could complete destruction the liver cancer tissue was maximized (6.05 cm³). The ablation pattern or axial ratio (Widest/length) of Expand T-Prong antenna and Arrow T-Prong antenna was 1, but the axial ratio of Three T-prong antenna of about 1.15.Keywords: liver cancer, T-Prong antenna, finite element, microwave ablation
Procedia PDF Downloads 318817 Study the Effect of Lipoid Acid as a Protective Against Rheumatoid Arthritis Through Diminishing Pro-inflammatory Markers and Chemokine Expression
Authors: Khairy Mohamed Abdalla Zoheir
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One of the most severe complications of Rheumatoid arthritis is delayed recovery. lipoic acid possesses antioxidant, hypoglycemic, and anti-inflammatory activity. In the present study, the effects of lipoic acid were investigated on the key mediators of Rheumatoid arthritis, namely, CD4+CD25+ T cell subsets, GITR expressing cells, CD4+CD25+Foxp3+ regulatory T (Treg) cells, T-helper-17 (Th17) cells and pro-inflammatory cytokines Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and Tumor Necrosis Factor- α (TNF-α)] through flow-cytometry and qPCR analyses. Lipoic acid-treated mice showed a significant decrease in Rheumatoid arthritis, the frequency of GITR-expressing cells, and Th1 cytokines (IL-17A, TNF-αand Interferon- γ (IFN-γ) compared with positive and negative controlled mice. Lipoic acid treatment also downregulated the mRNA expression of the inflammatory mediators compared with the Rheumatoid arthritis mouse model and untreated mice. The number of Tregs was also found to be significantly upregulated in lipoic acid-treated mice. Our results were confirmed by the histopathological examination. This study showed the beneficial role of lipoic acid in promoting a well-balanced tool for the therapy of Rheumatoid arthritis.Keywords: lipoic acid, inflammatory markers, rheumatoid arthritis, qPCR
Procedia PDF Downloads 94816 The Orthodontic Management of Multiple Tooth Agenesis with Macroglossia in Adult Patient: Case Report
Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning
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Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.Keywords: general diastema, macroglossia, space closure, tooth agenesis
Procedia PDF Downloads 173815 Development a Fine Motor and Executive Function Assessment (FiM&EF) for Assessing School Aged Children with Attention Deficit/Hyperactivity Disorder (AD/HD)
Authors: Negar Miri-Lavasani
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Background: Children with Attention-deficit/hyperactivity disorder (ADHD) show fine motor skills difficulties, and it is controversial whether this difficulty is based on problems in their fine motor skills or their executive function impairments. Objectives of Study: The Fine Motor and Executive Function assessment tool (FiM&EF) was developed to answer the question, ‘Do the fine motor skill deficits in children with ADHD come from their fine motor problems or is it caused by their executive function problems?’. This paper describes the development of a new assessment of Fine Motor and Executive Function (FiM &EF) needed by primary school students with ADHD aged 6-12 years with ADHD. Methods: A study on the content validity established through a survey of a panel of nine experts is explained in detail. Findings: Most the experts agreed such an assessment was needed and two items were deleted as a result of experts’ feedback. Relevance to Clinical Practice: Distinguishing the main reason of fine motor problem in these children could help the clinician for their therapy plans. Knowledge on the influence of executive functioning on fine motor ability in selected age children with ADHD would provide a clearer clinical picture of the fine motor capabilities and executive function for these children.Keywords: children with ADHD, executive function, fine motor, test
Procedia PDF Downloads 285814 Spectrum of Acute Kidney Injury in Obstetrics
Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla
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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.Keywords: AKI, dialysis, hypertension, sepsis, renal parameters
Procedia PDF Downloads 157813 Underdiagnosis of Supraclavicular Brachial Plexus Metastasis in the Shadow of Cervical Disc Herniation: Insights from a Lung Cancer Case Study
Authors: Eunhwa Jun
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This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer
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