Search results for: ethnic group

Authors: Radwa Elshorbagy, Alaa Elden Balbaa, Khaled Ayad, Waleed Reda

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Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System. Results: Repeated measures MANOVA was used to compare between and within group differences, in group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to rely more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: hip strategy, ankle strategy, postural control, dynamic balance

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Authors: A. Djahbar, M. Aillerie, E. Bounadja

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In this paper we treat a new structure of a high-power actuator which is used to either industry or electric traction. Indeed, the actuator is constituted by two induction motors, the first is a six-phase motor connected in series with another three-phase motor via the stators. The whole is supplied by a single static converter. Our contribution in this paper is the optimization of the system supply source. This is feeding the multimotor group by a direct converter frequency without using the DC-link capacitor. The modelling of the components of multimotor system is presented first. Only the first component of stator currents is used to produce the torque/flux of the first machine in the group. The second component of stator currents is considered as additional degrees of freedom and which can be used for power conversion for the other connected motors. The decoupling of each motor from the group is obtained using the direct vector control scheme. Simulation results demonstrate the effectiveness of the proposed structure.

Keywords: induction machine, motor drives, scalar modulation technique, three-to-six phase matrix converter

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh

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Background: E-interventions as a universal approach to prevent a high-risk behavior, such as alcohol drinking. This study was conducted to evaluate web-based alcohol drinking preventative intervention efficiency among medical university students in Iran. Methods: Overall, 150 freshman and sophomore male student’s college students participated in this study as intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to alcohol drinking prevention among college students. Cross-tabulation, t-test, repeated measures, and GEE by using SPSS statistical package, version 21 was used for the statistical analysis. The participants were followed up for 6 months with data collection scheduled at baseline, 3 and 6 months. The primary outcomes are attitude, self-control, and sensation seeking. Furthermore, the secondary outcome is comparing alcohol drinking among the study groups. Results: It was found significant reduce in average response for an attitude towards alcohol drinking and sensation seeking among intervention group (P < 0.05). But after intervention not significant difference between intervention and control group of improve self-control and reduce alcohol drinking (P > 0.05). Conclusion: Our intervention has been accompanied with reducing alcohol use rate. These findings indicate that e-intervention may be effectiveness approach to address the alcohol prevention among college students.

Keywords: e-interventions, alcohol drinking, students, Iran

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Authors: Moustafa Ali Elwan, Ibrahim Salem Abdelrafa, Ashraf Moharm

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed oral and topical drugs worldwide. Moreover, NSAIDs are responsible for most of all adverse drug reactions. For several decades, there are numerous attempts to use the cutaneous layers as a gate into the body for the local delivery of the therapeutic agent. Transdermal drug delivery is a validated technology contributing significantly to global pharmaceutical care. Transdermal Drug Delivery systems can be improved by using therapeutic agents. Moreover, Transdermal Drug Delivery systems can be improved by using chemical enhancers like ultrasound or iontophoresis. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. Objective: to compare the drug administration by ‘iontophoresis’ versus the oral rule. Methods: This study was conducted at the Faculty of Physical Therapy, Modern University for technology and information, Cairo, Egypt, on 20 participants (8 female & 12 male) who complained of tennis elbow. Their mean age was (25.45 ± 3.98) years, and all participants were assessed in many aspects: Pain threshold was assessed by algometer. Range of motion was assessed by electro goniometer, and isometric strength was assessed by a portable hand-held dynamometer. Then Participants were randomly assigned into two groups: group A was treated with oral NSAID (diclofenac) while group B was treated via administration of NSAIDs (diclofenac) via an iontophoresis device. All the participants were subjected to blood samples analysis in both pre-administration of the drug and post-administration of the drug for 24 hours (sample/every 6 hours). Results: The results demonstrated that there was a significant improvement in group b, “iontophoresis NSAIDs group,” more than in group B,” oral NSAIDs group,” in all measurements ‘ pain threshold, strength, and range of motion. Also, the iontophoresis method shows higher maximum plasma concentrations (Cmax) and concentration-time curves than the oral method.

Keywords: diclofenac, iontophoresis, NSAIDs, oral, tennis elbow

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Authors: Julia Gontar, Natalia Buderatskaya, Igor Ilyin, Olga Parnitskaya, Sergey Lavrynenko, Eduard Kapustin, Ekaterina Ilyina, Yana Lakhno

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Introduction: It is well known that oocytes obtained from older reproductive women have accumulated mitochondrial DNA mutations, which negatively affects the morphology of a developing embryo and may lead to the birth of a child with mitochondrial disease. Special techniques have been developed to allow a donor oocyte cytoplasmic transfer with the parents’ biological nuclear DNA retention. At the same time, it is important to understand whether the procedure affects the future embryonic chromosome sets as the nuclear DNA is the transfer subject in this new complex procedure. Material and Methods: From July 2015 to July 2016, the investigation was carried out in the Medical Centre IGR. 34 donor oocytes (group A) were used for the manipulation with the aim of donating cytoplasm: 21 oocytes were used for zygotes pronuclear transfer and oocytes 13 – for the spindle transfer. The mean age of the oocyte donors was 28.4±2.9 years. The procedure was performed using Nikon Ti Eclipse inverted microscope equipped with the micromanipulators Narishige system (Japan), Saturn 3 laser console (UK), Oosight imaging systems (USA). For the preimplantation genetic screening (PGS) blastocyst biopsy was performed, trophectoderm samples were diagnosed using fluorescent in situ hybridization on chromosomes 9, 13, 15, 16, 17, 18, 21, 22, X, Y. For comparison of morphological characteristics and euploidy, was chosen a group of embryos (group B) with the amount of 121 blastocysts obtained from 213 oocytes, which were gotten from the donor programs of assisted reproductive technologies (ART). Group B was not subjected to donor oocyte cytoplasmic transfer procedure and studied on the above mentioned chromosomes. Statistical analysis was carried out using the criteria t, x^2 at a significance levels p<0.05, p<0.01, p<0.001. Results: After the donor cytoplasm transfer process the amount of the third day developing embryos was 27 (79.4%). In this stage, the group B consisted of 189 (88.7%) developing embryos, and there was no statistically significant difference (SSD) between the two groups (p>0.05). After a comparative analysis of the morphological characteristics of the embryos on the fifth day, we also found no SSD among the studied groups (p>0.05): from 34 oocytes exposed to manipulation, 14 (41.2%) blastocysts was obtained, while the group B blastocyst yield was 56.8% (n=121) from 213 oocytes. The following results were obtained after PGS performing: in group A euploidy in studied chromosomes were 28.6%(n=4) blastocysts, whereas in group B this rate was 40.5%(n=49), 28.6%(n=4) and 21.5%(n=26) of mosaic embryos and 42.8%(n=6) and 38.0%(n=46) aneuploid blastocysts respectively were identified. None of these specified parameters had an SSD (p>0.05). But attention was drawn by the blastocysts in group A with identified mosaicism, which was chaotic without any cell having euploid chromosomal set, in contrast to the mosaic embryos in group B where identified chaotic mosaicism was only 2.5%(n=3). Conclusions: According to the obtained results, there is no direct procedural effect on the chromosome in embryos obtained following donor oocyte cytoplasmic transfer. Thus, the technology introduction will enhance the infertility treating effectiveness as well as avoiding having a child with mitochondrial disease.

Keywords: donor oocyte cytoplasmic transfer, embryos’ chromosome set, oocyte spindle transfer, pronuclear transfer

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Authors: Azza M. Atya, Mahmoud M. Nasser

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Background/ /Significance: Peripheral neuropathy is one of the long term serious complications of diabetes, which may attribute to postural instability and alteration of planter pressure. Whole body vibration (WBV) is a somatosensory stimulation type of exercise that has been emerged in sport training and rehabilitation of neuromuscular disorders. Purpose: The aim of this study was to investigate the effect of whole Body Vibration on antroposterior (AP), mediolateral (ML) posture stability and planter foot pressure in patients with diabetic neuropathy. Subjects: forty diabetic patients with moderate peripheral neuropathy aged from 35 to 50 years, were randomly assigned to WBV group (n=20) and control group (n=20). Methods and Materials: the WBV intervention consisted of three session weekly for 8 weeks (frequency 20 Hz, peak-to peak displacement 4mm, acceleration 3.5 g). Biodex balance system was used for postural stability assessment and the foot scan plate was used to measure the mean peak pressure under the first and lesser metatarsals. The main Outcome measures were antroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI),and mean peak foot pressure. Analyses: Statistical analysis was performed using the SPSS software package (SPSS for Windows Release 18.0). T-test was used to compare between the pre- and post-treatment values between and within groups. Results: For the 40 study participants (18male and 22 females) there were no between-group differences at baseline. At the end of 8 weeks, Subjects in WBV group experienced significant increase in postural stability with a reduction of mean peak of planter foot pressure (P<0.05) compared with the control group. Conclusion: The result suggests that WBV is an effective therapeutic modality for increasing postural stability and reducing planter pressure in patients with diabetic neuropathy.

Keywords: whole body vibration, diabetic neuropathy, posture stability, foot pressure

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Authors: Milda Nainyte, Viktoras Masevicius

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Biological methylation is a methyl group transfer from S-adenosyl-L-methionine (AdoMet) onto N-, C-, O- or S-nucleophiles in DNA, RNA, proteins or small biomolecules. The reaction is catalyzed by enzymes called AdoMet-dependent methyltransferases (MTases), which represent more than 3 % of the proteins in the cell. As a general mechanism, the methyl group from AdoMet replaces a hydrogen atom of nucleophilic center producing methylated DNA and S-adenosyl-L-homocysteine (AdoHcy). Recently, DNA methyltransferases have been used for the sequence-specific, covalent labeling of biopolymers. Two types of MTase catalyzed labeling of biopolymers are known, referred as two-step and one-step. During two-step labeling, an alkylating fragment is transferred onto DNA in a sequence-specific manner and then the reporter group, such as biotin, is attached for selective visualization using suitable chemistries of coupling. This approach of labeling is quite difficult and the chemical hitching does not always proceed at 100 %, but in the second step the variety of reporter groups can be selected and that gives the flexibility for this labeling method. In the one-step labeling, AdoMet analog is designed with the reporter group already attached to the functional group. Thus, the one-step labeling method would be more comfortable tool for labeling of biopolymers in order to prevent additional chemical reactions and selection of reaction conditions. Also, time costs would be reduced. However, effective AdoMet analog appropriate for one-step labeling of biopolymers and containing cleavable bond, required for reduction of PCR interferation, is still not known. To expand the practical utility of this important enzymatic reaction, cofactors with activated sulfonium-bound side-chains have been produced and can serve as surrogate cofactors for a variety of wild-type and mutant DNA and RNA MTases enabling covalent attachment of these chains to their target sites in DNA, RNA or proteins (the approach named methyltransferase-directed Transfer of Activated Groups, mTAG). Compounds containing hex-2-yn-1-yl moiety has proved to be efficient alkylating agents for labeling of DNA. Herein we describe synthetic procedures for the preparation of N-biotinoyl-N’-(pent-4-ynoyl)cystamine starting from the coupling of cystamine with pentynoic acid and finally attaching the biotin as a reporter group. The synthesis of the first AdoMet based cofactor containing a cleavable reporter group and appropriate for one-step labeling was developed.

Keywords: adoMet analogs, DNA alkylation, cofactor, methyltransferases

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Authors: Kanyakorn Sujarittnetikarn, Surangkana Pipatchokchaiyo

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The objective of this research was to study the pro-active public relations of according to the characteristic of Faculty of Management Science, Suan Sunandha Rajabhat University. The sample group for this research report was students from 4 year curriculum and continued / extended curriculum, made a random distribution proportion as follows: a group of 400 students who are working while studying and a group of non – working students. The tools used in this research were questionnaires, asking about the acknowledgement of public relations information of Faculty of Management Science in the academic year 2007. The result found that friends were the most influential in choosing the education institute. The differences of method to receive information of non-working student and working student were the entertainment magazine which was interested mostly by working students and they preferred to search the information on the website after 24:00 O’clock. However, the non-working students preferred 21:00-24:00 O’clock the most.

Keywords: development guidelines systems, faculty of management science, public relation planning, proactive public relations

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Authors: Somayeh Negahdari, Mohsen Ghanbarzadeh, Masoud Nikbakht, Heshmatolah Tavakol

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Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.

Keywords: asthma, respiratory cardiac index, exercise tolerance, aerobic, overweight

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Authors: Qiong Li

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This study investigated in which condition computer-mediated communication (CMC) could promote pragmatic development. The focal feature included four Chinese sentence final particles (SFPs), a, ya, ba, and ne. They occur frequently in Chinese, and function as mitigators to soften the tone of speech. However, L2 acquisition of SFPs is difficult, suggesting the necessity of additional exposure to or explicit instruction on Chinese SFPs. This study follows this line and aims to explore two research questions: (1) Is CMC combined with data-driven instruction more effective than CMC alone in promoting L2 Chinese learners’ SFP use? (2) How does L2 Chinese learners’ SFP use change over time, as compared to the production of native Chinese speakers? The study involved 19 intermediate-level learners of Chinese enrolled at a private American university. They were randomly assigned to two groups: (1) the control group (N = 10), which was exposed to SFPs through CMC alone, (2) the treatment group (N = 9), which was exposed to SFPs via CMC and data-driven instruction. Learners interacted with native speakers on given topics through text-based CMC over Skype. Both groups went through six 30-minute CMC sessions on a weekly basis, with a one-week interval after the first two CMC sessions and a two-week interval after the second two CMC sessions (nine weeks in total). The treatment group additionally received a data-driven instruction after the first two sessions. Data analysis focused on three indices: token frequency, type frequency, and acceptability of SFP use. Token frequency was operationalized as the raw occurrence of SFPs per clause. Type frequency was the range of SFPs. Acceptability was rated by two native speakers using a rating rubric. The results showed that the treatment group made noticeable progress over time on the three indices. The production of SFPs approximated the native-like level. In contrast, the control group only slightly improved on token frequency. Only certain SFPs (a and ya) reached the native-like use. Potential explanations for the group differences were discussed in two aspects: the property of Chinese SFPs and the role of CMC and data-driven instruction. Though CMC provided the learners with opportunities to notice and observe SFP use, as a feature with low saliency, SFPs were not easily noticed in input. Data-driven instruction in the treatment group directed the learners’ attention to these particles, which facilitated the development.

Keywords: computer-mediated communication, data-driven instruction, pragmatic development, second language Chinese, sentence final particles

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Authors: Noman Shahzad, Amyn Pardhan, Hasnain Zafar

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Introduction: Though short term survival advantage of damage control laparotomy in management of critically ill trauma patients is established, there is little known about the long-term quality of life of these patients. Facial closure rate after damage control laparotomy is reported to be 20-70 percent. Abdominal wall reconstruction in those who failed to achieve facial closure is challenging and can potentially affect quality of life of these patients. Methodology: We conducted retrospective matched cohort study. Adult patients who underwent damage control laparotomy from Jan 2007 till Jun 2013 were identified through medical record. Patients who had concomitant disabling brain injury or limb injuries requiring amputation were excluded. Age, gender and presentation time matched non exposure group of patients who underwent laparotomy for trauma but no damage control were identified for each damage control laparotomy patient. Quality of life assessment was done via telephonic interview at least one year after the operation, using Urdu version of EuroQol Group Quality of Life (QOL) questionnaire EQ5D after permission. Wilcoxon signed rank test was used to compare QOL scores and McNemar test was used to compare individual parameters of QOL questionnaire. Study was approved by institutional ethical review committee. Results: Out of 32 patients who underwent damage control laparotomy during study period, 20 fulfilled the selection criteria for which 20 matched controls were selected. Median age of patients (IQ Range) was 33 (26-40) years. Facial closure rate in damage control laparotomy group was 40% (8/20). One third of those who did not achieve facial closure (4/12) underwent abdominal wall reconstruction. Self-reported QOL score of damage control laparotomy patients was significantly worse than non-damage control group (p = 0.032). There was no statistically significant difference in two groups regarding individual QOL measures. Significantly, more patients in damage control group were requiring use of abdominal binder, and more patients in damage control group had to either change their job or had limitations in continuing previous job. Our study was not adequately powered to detect factors responsible for worse QOL in damage control group. Conclusion: Quality of life of damage control patients is worse than their age and gender matched patients who underwent trauma laparotomy but not damage control. Adequately powered studies need to be conducted to explore factors responsible for this finding for potential improvement.

Keywords: damage control laparotomy, laparostomy, quality of life

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Authors: Ayat Bani Rashaid, Zain Khasawneh, Mazin Alqhazo, Shreen Nusair, Mohammad El-Khateeb, Mahmoud Bashtawi

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Autism Spectrum disorder (ASD) is a psychiatric disorder with unknown etiology that mainly affects children in the first three years of life. Alterations of amino acid levels are believed to contribute to ASD. The levels of six essential amino acids (methionine, histidine, valine, leucine, threonine, and phenylalanine), five conditional amino acids (proline, tyrosine, glutamine, cysteine, and cystine), and five non-essential amino acids (asparagine, aspartic acid, alanine, serine, and glutamic acid) in hair samples of children with ASD (n = 25) were analyzed and compared to corresponding levels in healthy age-matched controls (n = 25). The results showed that the levels of methionine, alanine, and asparagine were significantly lower in the hair samples of ASD group compared to those of the control group (p ≤ 0.05). However, the levels of glutamic acid were significantly higher in the ASD group than the control group (p ≤ 0.05). The current findings could contribute towards further understanding of ASD etiology and provide specialists with a hair amino acid profile utilized as a biomarker for early diagnosis of ASD. Such biomarkers could participate in future developments of therapies that reduce ASD-related symptoms.

Keywords: autism spectrum disorder, amino acids, liquid chromatography-tandem mass spectrometry, human hair

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Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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Authors: Umar Bello

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Literature has become an invaluable subject which has added a great value and contribution to the teaching of English language and the discovery of many other developed ideas. Literature produces an exhilarating impulse that imprints a lasting picture on the mind of a learner. Many researchers have devised various means and approaches to language Teaching methods which remain unconvinging and which yield little result, but it has remained unconvincing because it has only produced little results. Devicing a method that eliminates monotony and boredome to learners is a good factor that enhances students’ motivation to learning. In this sense, literature and language become unavoidable components that aid intellectual development. This study examines the indispensability of literature as a means of English Language teaching to secondary school classes. The researcher has developed many instructive activities which are believed will help students to improve their study in grammar and vocabulary. The researcher has used quasi-experimental approach using experimental group and control group to find out how literature enhances the students grammar as well as their vocabulary. The findings revealed a positive performance in the experimental group doing better than the control group using simple percentage. The results make it clear that literature allows learners to pay more attention and develop more interest to their studies. In giving a perspicacious linguistic development, literature therefore remains an essential tool for language teaching classrooms, thereby enhancing their grammatical and vocabulary usage.

Keywords: teaching vocabulary, integration, poetry, classroom

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Authors: Nehal Adel Khalil, Amel Foad Ketat, Fairouz Elsayed Mohamed Ali, Nahla Abdelmoneim Hamid, Hazem Farag Manaa

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Background: Chronic myeloid leukemia (CML) represents 15% of adult leukemias. Imatinib Mesylate (IM) is the gold standard treatment for new cases of CML. Treatment with IM results in improvement of the majority of cases. However, about 25% of cases may develop resistance. Sensitive and specific early predictors of IM resistance in CML patients have not been established to date. Aim: To investigate the value of miR-451 in CML as an early predictor for IM resistance in Egyptian CML patients. Methods: The study employed Real time Polymerase Reaction (qPCR) technique to investigate the leucocytic expression of miR-451 in fifteen newly diagnosed CML patients (group I), fifteen IM responder CML patients (group II), fifteen IM resistant CML patients (group III) and fifteen healthy subjects of matched age and sex as a control group (group IV). The response to IM was defined as < 10% BCR-ABL transcript level after 3 months of therapy. The following parameters were assessed in subjects of all the studied groups: 1- Complete blood count (CBC). 2- Measurement of plasma level of miRNA 451 using real-time Polymerase Chain Reaction (qPCR). 3- Detection of BCR-ABL gene mutation in CML using qPCR. Results: The present study revealed that miR-451 was significantly down-regulated in leucocytes of newly diagnosed CML patients as compared to healthy subjects. IM responder CML patients showed an up-regulation of miR- 451 compared with IM resistant CML patients. Conclusion: According to the data from the present study, it can be concluded that leucocytic miR- 451 expression is a useful additional follow-up marker for the response to IM and a promising prognostic biomarker for CML.

Keywords: chronic myeloid leukemia, imatinib resistance, microRNA 451, Polymerase Chain Reaction

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Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

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Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System Results: Repeated measures MANOVA was used to compare between and within group differences, In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p= 0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to relay more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance

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Authors: Lennon Furtado, Sandro Oliveira

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The importance of an effective measurement program lies in the ability to control and predict what can be measured. Thus, the measurement program has the capacity to provide bases in decision-making to support the interests of an organization. Therefore, it is only possible to apply for an effective measurement program with a team of software engineers well trained in the measurement area. However, the literature indicates that are few computer science courses that have in their program the teaching of the software measurement process. And even these, generally present only basic theoretical concepts of said process and little or no measurement in practice, which results in the student's lack of motivation to learn the measurement process. In this context, according to some experts in software process improvements, one of the most used approaches to maintaining the motivation and commitment to software process improvements program is the use of the gamification. Therefore, this paper aims to present a proposal of teaching the measurement process by gamification. Which seeks to improve student motivation and performance in the assimilation of tasks related to software measurement, by incorporating elements of games into the practice of measurement process, making it more attractive for learning. And as a way of validating the proposal will be made a comparison between two distinct groups of 20 students of Software Quality class, a control group, and an experiment group. The control group will be the students that will not make use of the gamification proposal to learn software measurement process, while the experiment group, will be the students that will make use of the gamification proposal to learn software measurement process. Thus, this paper will analyze the objective and subjective results of each group. And as objective result will be analyzed the student grade reached at the end of the course, and as subjective results will be analyzed a post-course questionnaire with the opinion of each student about the teaching method. Finally, this paper aims to prove or refute the following hypothesis: If the gamification proposal to teach software measurement process does appropriate motivate the student, in order to attribute the necessary competence to the practical application of the measurement process.

Keywords: education, gamification, software measurement process, software engineering

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Authors: Seemab Zehra, A. H. W. Mohammed, E. Pantanella, J. L. Q. Laranja, P. H. De Mello, R. Saleh, A. A. Siddik, A. Al Shaikhi, A. M. Al-Suwailem

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Two separate feeding trials were conducted to determine the effects of using different commercial diets and water temperatures on the growth performance, feed intake, feed conversion ratio (FCR) and condition factor of sobaity seabream Sparidentex hasta. In experiment I, growth performance, feed intake, protein efficiency ratio (PER), feed conversion ratio (FCR) and survival (%) of sobaity seabream Sparidentex hasta (330.5±2.6 g; 26.9±1.0 cm) were evaluated by four different commercial diets (1, 2, 3 and 4) for 80 days. The daily weight gain was around 3.2 g day-1 with an SGR of 0.7% day-1. Both the FCR and PER in the fish were significantly better in diet 2 that contained 46.36% crude protein and 12.54% crude fat. In experiment II, (99±2.6 g; 17.1±1.0 cm). The fish were cultured in 1m3 tanks supplied with seawater from the Red Sea wherein three different rearing temperatures were set as treatments (24, 28 and 32°C). Fish were fed with a commercial diet based on the results of experiment I (46.4% protein; 20.1 MJ kg-1 energy) to satiation for 96 days. Total weight gain was significantly higher for the fish reared in the 32°C group (158.57 g) followed by the 28°C group (138.25 g), while the lowest weight gain was observed in the 24°C group (116.98 g). The FCR was significantly lower in the 32°C group (1.62) as compared to 28 (1.8) and 24°C (1.85) groups. Based on the results obtained from these preliminary studies (experiment I and II), sobaity seabream can attain better growth performance, FCR and PER at 32°C in the Red Sea by feeding commercial diet 2.

Keywords: Sparidentex hasta, nutrition, FCR, Red Sea, growth performance

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Authors: Celso L. Fernando, Toshio Yoshii, Takahiro Tsubota

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Understanding the causes of a road accident and predicting their occurrence is key to preventing deaths and serious injuries from road accident events. Traditional statistical methods such as the Poisson and the Logistics regressions have been used to find the association of the traffic environmental factors with the accident occurred; recently, an artificial neural network, ANN, a computational technique that learns from historical data to make a more accurate prediction, has emerged. Although the ability to make accurate predictions, the ANN has difficulty dealing with highly unbalanced attribute patterns distribution in the training dataset; in such circumstances, the ANN treats the minority group as noise. However, in the real world data, the minority group is often the group of interest; e.g., in the road traffic accident data, the events of the accident are the group of interest. This study proposes a combination of the k-means with the ANN to improve the predictive ability of the neural network model by alleviating the effect of the unbalanced distribution of the attribute patterns in the training dataset. The results show that the proposed method improves the ability of the neural network to make a prediction on a highly unbalanced distributed attribute patterns dataset; however, on an even distributed attribute patterns dataset, the proposed method performs almost like a standard neural network.

Keywords: accident risks estimation, artificial neural network, deep learning, k-mean, road safety

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Authors: John White

Abstract:

This study investigated the effects of practice schedules on learning and performance in golf putting, specifically focusing on the impact of increasing contextual interference (CI). University students (n=7) were randomly assigned to blocked, random, or increasing practice schedules. During acquisition, participants performed 135 putting trials using different weighted golf balls. The blocked group followed a specific sequence of ball weights, while the random group practiced with the balls in a random order. The increasing group started with a blocked schedule, transitioned to a serial schedule, and concluded with a random schedule. Retention and transfer tests were conducted 24 hours later. The results indicated that high levels of CI (random practice) were more beneficial for learning than low levels of CI (blocked practice). The increasing practice schedule, incorporating blocked, serial, and random practice, demonstrated advantages over traditional blocked and random schedules. Additionally, EEG was used to explore the neurophysiological effects of the increasing practice schedule.

Keywords: skill acquisition, motor control, learning, contextual interference

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Authors: Kalbiye Konanc, Ergin Ozturk

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To examine the effects of an ethanol liquid extract obtained from raw bee propolis (PE) on fattening performance and physiology such as vaccine-antibody relationship, microbial profile, immune status and some blood parameters of broiler chickens were used a total of 600 broiler (Ross 308) chicks, obtained from eggs of 288, 38-weeks-old broiler breeding. There were 6 groups: CC (Parent-Control and Offspring-Control, CP (Parent-Control and Offspring-propolis extract, Cip (Parent-Control and Offspring-in-ovo propolis extract), Cis (Parent-Control and Chickens-in-ovo saline), PeC (Parent-propolis extract and Offspring-Control), PeP (Parent-Propolis extract and Offspring-Propolis extract). Each group was consisted of 10 replications with 10 broiler offspring, and the experiment was lasted for 6 weeks with ethanol-extracted propolis concentration is 400 ppm/kg diet. While the highest feed consumptions at 0-21 days and 0-42 days were found in PeC, the best feed conversion ratio at 0-42 days was found in CP group. The live weight gains were found not to be different among the groups. The highest alanine aminotransferase activities were found in CC and CP and aspartate aminotransferase activities in PeP and PeC groups. The highest triglyceride and total antioxidant levels were found highest in CC and the highest total oxidant level in Cip group. IgA level in hatched eggs and IgM value after slaughtering were highest in Cip group. The best immune response was obtained for 21st day Newcastle Disease vaccine in CC and Cis groups and for 28th day Infectious Bursal Disease vaccine in CP group. The highest total aerobic microorganism and the lowest total fungi count were found in PeP group. In conclusion, it was determined that in-ovo propolis ethanol extract (Cip) increased the maternal antibody levels, that had not consistent effects on blood biochemical parameters except for triglyceride, that led to decrease in E. coli counts and that it can provide strong immune response against Infectious Bursal Disease.

Keywords: bee propolis, in-ovo feeding, immune parameters, poultry, maternal antibody, microorganisms

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Authors: Vilasinee Jintalikhitdee, Saowapa Phaithayawat

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The research on “The Way of Life of the Civil Servant Community under the Bureau of the Royal Household” aims to study 1) the way of life of the people who live in the civil servant community in Tha Wasukri, and 2) the model of community administration of civil servants under the Bureau of the Royal Household. This research is conducted qualitatively and quantitatively by collecting data from interviews, focus group discussion, participant and non-participant observation along with the data from the questionnaire based on age groups which include elder group, working age group and youth group. The result of the research shows that the origin of this community is related to the history during the Rama V’s reign. It has been a harbor for the king to boat in any royal ceremonies; this custom is still maintained until today. The status or position of person who serves the king in terms of working is often inherited from the bureau of the Royal Household based on his/her consanguinity and, hence, further receives the rights to live in the Tha Wasukri area. Therefore, this community has some special characteristics demonstrating the way of living influenced by the regulation of the Bureau of the Royal Household such as respecting elders and interdependence in which there is internal social organization with the practice of bureaucracy in going in and out the community. The person who has rights to live here must be friendly to everybody so that this community will be a safe place for lives and property. The administration based on the model of Bangkok for local administration was used as an external structure only, but the way of living still follows the practice of the Bureau of the Royal Household.

Keywords: way of life, community, Tha Wasukri, Bureau of the Royal Household

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Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

Abstract:

Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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Authors: Aklima Jesmin, Ubaidur Rob, M. Ashrafur Rahman

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Rohingya population of Arakan state in Myanmar are one the most persecuted ethnic minorities in this 21st century. According to the Universal Declaration of Human Rights (UDHR), all human beings are born free, equal in dignity and rights. However, these populations are systematically excluded from this universal proclamation of human rights as they are Rohingya, which signify ‘other’. Based on the accessible and available literatures about Rohingya issue, this study firstly found there are chronological pattern of human rights violations against the ethnic Rohingya which follows the pathology of the Holocaust in this 21st century of human civilization. These violations have been possible due to modern technology, bureaucracy which has been performed through authorization, routinization and dehumanization; not only in formal institutions but in the society as a whole. This kind of apparently never-ending situation poses any author with the problem of available many scientific articles. The most important sources are, therefore the international daily newspapers, social media and official webpage of the non-state actors for nitty-gritty day to day update. Although it challenges the validity and objectivity of the information, but to address the critical ongoing human rights violations against Rohingya population can become a base for further work on this issue. One of the aspects of this paper is to accommodate all the social movements since August 2017 to date. The findings of this paper is that even though it seemed only human rights violations occurred against Rohingya historically but, simultaneously the process of social movements had also started, can be traced more after the military campaign in 2017. Therefore, the Rohingya crisis can be conceptualized within one ‘campaign’ movement for justice, not as episodic events, especially within the Political Process Model than any other social movement theories. This model identifies that the role of international political movements as well as the role of non-state actors are more powerful than any other episodes of violence conducted against Rohinyga in reframing issue, blaming and shaming to Myanmar government and creating the strategic opportunities for social changes. The lack of empowerment of the affected Rohingya population has been found as the loop to utilize this strategic opportunity. Their lack of empowerment can also affect their capacity to reframe their rights and to manage the campaign for their justice. Therefore, this should be placed at the heart of the international policy agenda within the broader socio-political movement for the justice of Rohingya population. Without ensuring human rights of Rohingya population, achieving the promise of the united nation’s sustainable development goals - no one would be excluded – will be impossible.

Keywords: civilization, holocaust, human rights violation, military campaign, political process model, Rohingya population, sustainable development goal, social justice, social movement, strategic opportunity

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Authors: Eric Beyegue, Boris Azantza, Judith Laure Ngondi, Julius E. Oben

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Background: Insulin resistance (IR) and oxidative stress are associated with obesity, diabetes mellitus, and other cardio metabolic disorders. The aim of this study was to investigate the effect of Coula edulis extracts (CEE) on insulin resistance and oxidative stress markers in high-fat/high sucrose diet-induced insulin resistance in rats. Materials and Methods: Thirty male rats were divided into 6 groups of 5 rats each fed, received daily oral administration of CE extracts for 8 weeks as follows: Group 1 or negative control group, fed with standard diet (SD); Group 2 fed with high-fat/high sucrose diet (HFHS) only; Group3 fed with HFHS + CEAq 200; Group 4 fed with HFHS + CEAq 400; Group 5 fed with HFHS + CEEt 200; Group 6 fed with HFHS + CEEt 400. At the end of the experiment (8 weeks), animals were sacrificed plasma lipid profile, glucose, insulin, oxidative marker and digestive enzyme activities were measured. The homeostasis model assessment for insulin resistance (HOMA-IR) was determined. Results: Feedings with HFHS significantly (p < 0.01) induced plasma hyperglycaemia, hyperinsulinaemia, increased triglyceride, total cholesterol, and low-density lipoprotein levels, decreased high-density lipoprotein levels, alterations of α amylase, and glucose-6-phosphatase activities, and oxidative stress. Daily oral administration with CEE for eight weeks after insulin resistance induction had a hypolipidaemic action, antioxidative activities and modulated metabolic markers. Ethanolic extract at the higher dose had the best effect on body weight gain and insulin resistance, whereas aqueous extract showed the better activity on hyperlipidemia. Conclusion: These results suggest that CEAq and CEEt at 400mg/kg are promising complementary supplements that can be used to protect better from metabolic disorders associated with HFHS.

Keywords: Coula edulis Baill, high-fat / high sucrose diet, insulin resistance, oxidative stress

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Authors: Mariam Azam, Sajjad Ur Rahman, Mukarram Bashir, Muhammad Tahir, Seemal Javaid, Jawad, Aoun Muhammad, Muhammad Zohaib, Hannan Khan

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Products of microbial origin are of great importance as they have proved their value in healthcare and nutrition, use of these microbial metabolites acquired from partially fermented soya hulls and wheat bran along with Saccharomyces cerevisiae (DL-22 S/N) substantiates to be a great source for an increase in the total milk production and quality yield.1×109 CFU/ml cells of Saccharomyces cerevisiae (DL-22 S/N) were further grown under in-vivo conditions for the assessment of quality milk production. Two groups with twelve cows, each having the same physical characteristics (Group A and Group B), were under study, Group A was daily fed with 12gm of biological metabolites and 22% protein-pelleted feed. On the other hand, the animals of Group B were provided with no metabolites in their feed. In thirty days of trial, improvement in the overall health, body score, milk protein, milk fat, yield, incidence rate of mastitis, ash, and solid not fat (SNF) was observed. The collected data showed that the average quality milk production was elevated up to 0.45 liter/h/d. However, a reduction in the milk fats up to 0.45% and uplift in the SNF value up to 0.53% of cow milk was also observed. At the same time, the incidence rate of mastitis recorded for the animals under trial was reduced to half, and improved non specific immunity was reported.

Keywords: microbial metabolites, post-biotics, animal supplements, animal nutrition, proteins, animal production, fermentation

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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Authors: Lindsey Carruthers, Alexandra Willis, Rory MacLean

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Introduction: It has been proposed that distractibility, a key diagnostic criterion of Attention Deficit Hyperactivity Disorder (ADHD), may be associated with higher creativity levels in some individuals. Anecdotal and empirical evidence has shown that ADHD is therefore beneficial to creative problem-solving, and the generation of new ideas and products. Previous studies have only used one or two measures of attention, which is insufficient given that it is a complex cognitive process. The current study aimed to determine in which ways performance on creative problem-solving tasks and a range of attention tests may be related, and if performance differs between adults with and without ADHD. Methods: 150 adults, 47 males and 103 females (mean age=28.81 years, S.D.=12.05 years), were tested at Edinburgh Napier University. Of this set, 50 participants had ADHD, and 100 did not, forming the control group. Each participant completed seven attention tasks, assessing focussed, sustained, selective, and divided attention. Creative problem-solving was measured using divergent thinking tasks, which require multiple original solutions for one given problem. Two types of divergent thinking task were used: verbal (requires written responses) and figural (requires drawn responses). Each task is scored for idea originality, with higher scores indicating more creative responses. Correlational analyses were used to explore relationships between attention and creative problem-solving, and t-tests were used to study the between group differences. Results: The control group scored higher on originality for figural divergent thinking (t(148)= 3.187, p< .01), whereas the ADHD group had more original ideas for the verbal divergent thinking task (t(148)= -2.490, p < .05). Within the control group, figural divergent thinking scores were significantly related to both selective (r= -.295 to -.285, p < .01) and divided attention (r= .206 to .290, p < .05). Alternatively, within the ADHD group, both selective (r= -.390 to -.356, p < .05) and divided (r= .328 to .347, p < .05) attention are related to verbal divergent thinking. Conclusions: Selective and divided attention are both related to divergent thinking, however the performance patterns are different between each group, which may point to cognitive variance in the processing of these problems and how they are managed. The creative differences previously found between those with and without ADHD may be dependent on task type, which to the author’s knowledge, has not been distinguished previously. It appears that ADHD does not specifically lead to higher creativity, but may provide explanation for creative differences when compared to those without the disorder.

Keywords: ADHD, attention, creativity, problem-solving

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Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

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Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

Abstract:

Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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