Search results for: degree-days methods

Authors: Mohamed Salaheldien Mohamed Alayat, Ahmed Mohamed Elsoudany, Roaa Abdulghani Sroge, Bayan Muteb Aldhahwani

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Background: Neck pain is a common illness that could affect individual’s daily activities. Class IV laser with longer wavelength can stimulate tissues and penetrate more than the classic low-level laser therapy. Objectives: The aim of the study was to investigate the efficacy of class IV diode laser in the treatment of patients with chronic neck pain (CNP). Methods: Fifty-two patients participated and completed the study. Their mean age (SD) was 50.7 (6.2). Patients were randomized into two groups and treated with laser plus exercise (laser + EX) group and placebo laser plus exercise (PL+EX) group. Treatment was performed by Class IV laser in two phases; scanning and trigger point phases. Scanning to the posterior neck and shoulder girdle region with 4 J/cm2 with a total energy of 300 J applied to 75 cm2 in 4 minutes and 16 seconds. Eight trigger points on the posterior neck area were treated by 4 J/cm2 and the time of application was in 30 seconds. Both groups received exercise two times per week for 4 weeks. Exercises included range of motion, isometric, stretching, isotonic resisted exercises to the cervical extensors, lateral bending and rotators muscles with postural correction exercises. The measured variables were pain level using visual analogue scale (VAS), and neck functional activity using neck disability index (NDI) score. Measurements were taken at baseline and after 4 weeks of treatment. The level of statistical significance was set as p < 0.05. Results: There were significant decreases in post-treatment VAS and NDI in both groups as compared to baseline values. Laser + EX effectively decreased VAS (mean difference -6.5, p = 0.01) and NDI scores after (mean difference -41.3, p = 0.01) 4 weeks of treatment compared to PL + EX. Conclusion: Class IV laser combined with exercise is effective treatment for patients with CNP as compared to PL + EX therapy. The combination of laser + EX effectively increased functional activity and reduced pain after 4 weeks of treatment.

Keywords: chronic neck pain, class IV laser, exercises, neck disability index, visual analogue scale

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Authors: Cenza Rhoda, Falone Sunda, Elvis Kidzeru, Nonhlanhla P. Khumalo, Afolake Arowolo

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Introduction: The human FAM111B gene mutations are associated with POIKTMP, a rare multi-organ fibrosing disease. Recent studies also reported the overexpression of FAM111B in specific cancers. However, the role of FAM111B in these pathologies, particularly fibrosarcoma, remains unknown. Materials and Methods: FAM111B RNA expression in some cancer cell lines was assessed in silico and validated in vitro in these cell lines and skin fibroblasts derived from the South African family member affected by POIKTMP with the heterozygous FAM111B gene mutation: NM_198947.4: c.1861T>G (p. Tyr621Asp or Y621D) by qPCR and western blot. The cellular function of FAM111B was also studied in HT1080 using various cell-based functional assays and a simple and cost-effective PCR-RFLP method for genotyping/screening FAM111B gene mutations described. Results: Expression studies showed upregulated FAM111B mRNA and protein in the cancer cells. High FAM111B expression with robust nuclear localization occurred in HT1080. Additionally, expression data and cell-based assays indicated that FAM111B led to the upregulation of cell migration and decreased cell apoptosis and cell proliferation modulation. FAM111B Y621D mutation showed similar effects on cell migration but minimal impact on cell apoptosis. FAM111B mRNA and protein expression were markedly downregulated (p ≤ 0.05) in the patient's skin-derived fibroblasts. Lastly, the PCR-RFLP method successfully genotyped FAM111B Y621D gene mutation. Discussion: FAM111B is a cancer-associated nuclear protein: Its modulation by mutations may enhance cell migration and proliferation and decrease apoptosis, as seen in cancers and POIKTMP/fibrosis, thus representing a viable therapeutic target in these disorders. Furthermore, the PCR-RFLP method could prove a valuable tool for FAM111B mutation validation or screening in resource-constrained laboratories.

Keywords: FAM111B, POIKTMP, cancer, fibrosis, PCR-RFLP

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Authors: Buhari Samaila, Sabiu Abdullahi, Buhari Maidamma

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Background: Contrast-enhanced computed tomography (CE-CT) is a technique that uses contrast media to improve image quality and diagnostic accuracy. It is a widely used imaging modality in medical diagnostics, offering high-resolution images for accurate diagnosis. However, concerns regarding the potential adverse effects of contrast media and radiation dose exposure have prompted ongoing investigation and assessment. It is important to assess the effects of contrast media and radiation dose in CE-CT procedures. Objective: This study aims to assess the effects of contrast media and radiation dose in contrast-enhanced computed tomography (CECT) procedures. Methods: A comprehensive review of the literature was conducted to identify studies related to contrast media effects and radiation dose assessment in CECT. Relevant data, including location, type of research, objective, method, findings, conclusion, authors, and year of publications, were extracted, analyzed, and reported. Results: The findings revealed that several studies have investigated the impacts of contrast media and radiation doses in CECT procedures, with iodinated contrast agents being the most commonly employed. Adverse effects associated with contrast media administration were reported, including allergic reactions, nephrotoxicity, and thyroid dysfunction, albeit at relatively low incidence rates. Additionally, radiation dose levels varied depending on the imaging protocol and anatomical region scanned. Efforts to minimize radiation exposure through optimization techniques were evident across studies. Conclusion: Contrast-enhanced computed tomography (CECT) remains an invaluable tool in medical imaging; however, careful consideration of contrast media effects and radiation dose exposure is imperative. Healthcare practitioners should weigh the diagnostic benefits against potential risks, employing strategies to mitigate adverse effects and optimize radiation dose levels for patient safety and effective diagnosis. Further research is warranted to enhance the understanding and management of contrast media effects and radiation dose optimization in CECT procedures.

Keywords: CT, contrast media, radiation dose, effect of radiation

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: Auwal Abubakar, Shazril Imran Shaukat, Noor Khairiah A. Karim, Mohammed Zakir Kassim, Gokula Kumar Appalanaido, Hafiz Mohd Zin

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Background: Voluntary deep inspiration breath-hold radiotherapy (vDIBH-RT) is an effective cardiac dose reduction technique during left breast radiotherapy. This study aimed to assess the accuracy of the implementation of the vDIBH technique among left breast cancer patients without the use of a special device such as a surface-guided imaging system. Methods: The vDIBH-RT technique was implemented among thirteen (13) left breast cancer patients at the Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia. Breath-hold monitoring was performed based on breath-hold skin marks and laser light congruence observed on zoomed CCTV images from the control console during each delivery. The initial setup was verified using cone beam computed tomography (CBCT) during breath-hold. Each field was delivered using multiple beam segments to allow a delivery time of 20 seconds, which can be tolerated by patients in breath-hold. The data were analysed using an in-house developed MATLAB algorithm. PTV margin was computed based on van Herk's margin recipe. Results: The setup error analysed from CBCT shows that the population systematic error in lateral (x), longitudinal (y), and vertical (z) axes was 2.28 mm, 3.35 mm, and 3.10 mm, respectively. Based on the CBCT image guidance, the Planning target volume (PTV) margin that would be required for vDIBH-RT using CCTV/Laser monitoring technique is 7.77 mm, 10.85 mm, and 10.93 mm in x, y, and z axes, respectively. Conclusion: It is feasible to safely implement vDIBH-RT among left breast cancer patients without special equipment. The breath-hold monitoring technique is cost-effective, radiation-free, easy to implement, and allows real-time breath-hold monitoring.

Keywords: vDIBH, cone beam computed tomography, radiotherapy, left breast cancer

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Authors: Neha Toppo

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Method and strategies of teaching instruction highly influence learning of students. In second language teaching, number of ways and methods has been suggested by different scholars and researchers through times. The present article deals with the role of teaching instruction in developing compositional ability of students in writing. It focuses on the secondary level students of rural areas, whose exposure to English language is limited and they face challenges even in simple compositions. The students till high school suffer with their disability in writing formal letter, application, essay, paragraph etc. They face problem in note making, writing answers in examination using their own words and depend fully on rote learning. It becomes difficult for them to give language to their own ideas. Teaching writing composition deserves special attention as writing is an integral part of language learning and students at this level are expected to have sound compositional ability for it is useful in numerous domains. Effective method of instruction could help students to learn expression of self, correct selection of vocabulary and grammar, contextual writing, composition of formal and informal writing. It is not limited to school but continues to be important in various other fields outside the school such as in newspaper and magazine, official work, legislative work, material writing, academic writing, personal writing, etc. The study is based on the experimental method, which hypothesize that guided instruction will be more effective in teaching writing compositions than usual instruction in which students are left to compose by their own without any help. In the test, students of one section are asked to write an essay on the given topic without guidance and another section are asked to write the same but with the assistance of guided instruction in which students have been provided with a few vocabulary and sentence structure. This process is repeated in few more schools to get generalize data. The study shows the difference on students’ performance using both the instructions; guided and unguided. The conclusion of the study is followed by the finding that writing skill of the students is quite poor but with the help of guided instruction they perform better. The students are in need of better teaching instruction to develop their writing skills.

Keywords: composition, essay, guided instruction, writing skill

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Authors: Tulika Malviya, Ritesh Chandra Shukla, Praveen Kumar Tandon

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Traditional methods of synthesis are hazardous for the environment and need nature friendly processes for the treatment of industrial effluents and contaminated water. Use of plant parts for the synthesis provides an efficient alternative method. In this paper, we report an ecofriendly and nonhazardous biobased method to prepare zerovalent iron nanoparticles (ZVINPs) using the liquor of commercially available tea. Tea liquor as the reducing agent has many advantages over other polymers. Unlike other polymers, the polyphenols present in tea extract are nontoxic and water soluble at room temperature. In addition, polyphenols can form complexes with metal ions and thereafter reduce the metals. Third, tea extract contains molecules bearing alcoholic functional groups that can be exploited for reduction as well as stabilization of the nanoparticles. Briefly, iron nanoparticles were prepared by adding 2.0 g of montmorillonite K10 (MMT K10) to 5.0 mL of 0.10 M solution of Fe(NO3)3 to which an equal volume of tea liquor was then added drop wise over 20 min with constant stirring. The color of the mixture changed from whitish yellow to black, indicating the formation of iron nanoparticles. The nanoparticles were adsorbed on montmorillonite K10, which is safe and aids in the separation of hazardous arsenic species simply by filtration. Particle sizes ranging from 59.08±7.81 nm were obtained which is confirmed by using different instrumental analyses like IR, XRD, SEM, and surface area studies. Removal of arsenic was done via batch adsorption method. Solutions of As(III) of different concentrations were prepared by diluting the stock solution of NaAsO2 with doubly distilled water. The required amount of in situ prepared ZVINPs supported on MMT K10 was added to a solution of desired strength of As (III). After the solution had been stirred for the preselected time, the solid mass was filtered. The amount of arsenic [in the form of As (V)] remaining in the filtrate was measured using ion chromatograph. Stirring of contaminated water with zerovalent iron nanoparticles supported on montmorillonite K10 for 30 min resulted in up to 99% removal of arsenic as As (III) from its solution at both high and low pH (2.75 and 11.1). It was also observed that, under similar conditions, montmorillonite K10 alone provided only <10% removal of As(III) from water. Adsorption at low pH with precipitation at higher pH has been proposed for As(III) removal.

Keywords: arsenic removal, montmorillonite K10, tea liquor, zerovalent iron nanoparticles

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Authors: Dorottya Horváth, Tímea Harmath-Tánczos

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Attention deficit hyperactivity disorder (ADHD) and learning disabilities are common neurocognitive disorders that can have a significant impact on a child's academic performance. ADHD is characterized by inattention, hyperactivity, and impulsivity, while learning disabilities are characterized by difficulty with specific academic skills, such as reading, writing, or math. The aim of this study was to investigate the working memory, executive, and attention functions of neurotypical children and children with ADHD and learning disabilities in order to fill the gaps in the Hungarian mean test scores of these cognitive functions in children with neurocognitive disorders. Another aim was to specify the neuropsychological differential diagnostic toolkit in terms of the relationships and peculiarities between these cognitive functions. The research question addressed in this study was: How do the working memory, executive, and attention functions of neurotypical children compare to those of children with ADHD and learning disabilities? A self-administered test battery was used as a research tool. Working memory was measured with the Non-Word Repetition Test, the Listening Span Test, the Digit Span Test, and the Reverse Digit Span Test; executive function with the Letter Fluency, Semantic Fluency, and Verb Fluency Tests; and attentional concentration with the d2-R Test. The data for this study was collected from 115 children aged 9-14 years. The children were divided into three groups: neurotypical children (n = 44), children with ADHD without learning disabilities (n = 23), and children with ADHD with learning disabilities (n = 48). The data was analyzed using a variety of statistical methods, including t-tests, ANOVAs, and correlational analyses. The results showed that the performance of children with neurocognitive involvement in working memory, executive functions, and attention was significantly lower than the performance of neurotypical children. However, the results of children with ADHD and ADHD with learning disabilities did not show a significant difference. The findings of this study are important because they provide new insights into the cognitive profiles of children with ADHD and learning disabilities and suggest that working memory, executive functions, and attention are all impaired in children with neurocognitive involvement, regardless of whether they have ADHD or learning disabilities. This information can be used to develop more effective diagnostic and treatment strategies for these disorders.

Keywords: ADHD, attention functions, executive functions, learning disabilities, working memory

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Authors: Chinedu F. Anochie

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The deterioration of materials as a result of their interaction with the environment has been a huge challenge to engineering. Many steps have been taking to tackle corrosion and its effects on harmful effects on engineering materials and structures. Corrosion inhibition, coating, passivation, materials selection, and cathodic protection are some of the methods utilized to curtail the rate at which materials corrode. The use of sacrificial anodes (magnesium, aluminum, or zinc) to protect the metal of interest is a widespread technique used to prevent corrosion in underground structures, ship hauls, and other structures susceptible to corrosion attack. However, certain factors, like resistivity, affect the performance of sacrificial anodes. To establish the effect of soil resistivity on the effectiveness of a cathodic protection system, a mild steel specimen was cathodically protected around Workshop 2 area, Federal University of Technology, Owerri, Nigeria. Design calculations showed that one zinc anode was sufficient to protect the pipe. The specimen (mild steel pipe) was coated with white and black polykene tapes and was subsequently buried in a high resistivity soil. The pipe-to-soil potential measurements were obtained using a digital fluke multimeter. The protection potential obtained on installation was higher than the minimum protection criteria. However, the potential results obtained over a fourteen-day intervals continually decreased to a value significantly lower than the minimum protection criteria. This showed that the sacrificial anode (zinc) was rendered ineffective by the high resistivity of the area of installation. It has been shown that the resistivity of the soil has a marked effect on the feasibility of cathodic protection systems. This work justified that zinc anode cannot be used for cathodic protection around Workshop 2 area, Federal University of Technology, Owerri, Nigeria, because of the high resistivity of the area. An experimental data which explains the effectiveness of galvanic anode cathodic protection system on corrosion control of a small steel structure, exposed to a soil of high resistivity has been established.

Keywords: cathodic protection, corrosion, pipe, sacrificial anode

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Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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Authors: A. Aslihan Gokaltun, Martin L. Yarmush, Ayse Asatekin, O. Berk Usta

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Poly(dimethylsiloxane) (PDMS) is one of the most widely used materials in the fabrication of microfluidic devices. It is easily patterned and can replicate features down to nanometers. Its flexibility, gas permeability that allows oxygenation, and low cost also drive its wide adoption. However, a major drawback of PDMS is its hydrophobicity and fast hydrophobic recovery after surface hydrophilization. This results in significant non-specific adsorption of proteins as well as small hydrophobic molecules such as therapeutic drugs limiting the utility of PDMS in biomedical microfluidic circuitry. While silicon, glass, and thermoplastics have been used, they come with problems of their own such as rigidity, high cost, and special tooling needs, which limit their use to a smaller user base. Many strategies to alleviate these common problems with PDMS are lack of general practical applicability, or have limited shelf lives in terms of the modifications they achieve. This restricts large scale implementation and adoption by industrial and research communities. Accordingly, we aim to tailor biocompatible PDMS surfaces by developing a simple and one step bulk modification approach with novel smart materials to reduce non-specific molecular adsorption and to stabilize long-term cell analysis with PDMS substrates. Smart polymers that blended with PDMS during device manufacture, spontaneously segregate to surfaces when in contact with aqueous solutions and create a < 1 nm layer that reduces non-specific adsorption of organic and biomolecules. Our methods are fully compatible with existing PDMS device manufacture protocols without any additional processing steps. We have demonstrated that our modified PDMS microfluidic system is effective at blocking the adsorption of proteins while retaining the viability of primary rat hepatocytes and preserving the biocompatibility, oxygen permeability, and transparency of the material. We expect this work will enable the development of fouling-resistant biomedical materials from microfluidics to hospital surfaces and tubing.

Keywords: cell culture, microfluidics, non-specific protein adsorption, PDMS, smart polymers

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Authors: Lubna M. A. Hassan, Nasir Brema, Abdallah Mamy, Insaf Yahya, Tanzil A. G., Ahmed M. M. Hasoba, Omer A. Suliman

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The Nubian ibex species has been categorized as vulnerable by the International Union for Conservation of Nature (IUCN) due to a lack of population data in specific regions within their habitat. This species faces numerous challenges, including habitat loss caused by agricultural practices, livestock rearing, mining activity, and infrastructure development. Additionally, competition with non-native species and hunting pose significant threats to their survival. Unfortunately, studies on the distribution, conservation status, ecology, and health of the ibex are limited and primarily descriptive in nature. In order to bridge this knowledge gap, recent surveys were conducted in the Red Sea State of Sudan during specific periods in 2015, 2016, 2019, and 2021. These surveys have provided valuable insights into the distribution, habitats, and conservation status of the Nubian ibex in the Red Sea State. The findings indicate that the Capra nubiana ibex can be found across more than 17 mountains in the Red Sea State. However, the total population estimate from recent years suggests that there are fewer than 250 individuals remaining. The study has also identified the highest altitude at which the Nubian ibex habitats existed in Sudan's Red Sea State, measuring 1675 m. This area harbors a diverse array of Nubian ibex habitats, encompassing a total of 21 wild plant species from 10 distinct families. The region experiences an average annual temperature ranging from 20.64°C in January to 33.30°C in August. Precipitation occurs in November and December, although it is characterized by unreliability and erratic patterns. It is important to note that these population estimates were obtained through surveys conducted in collaboration with rangers and local communities, and adjustments to survey methods are necessary to accommodate the challenging mountainous terrain, such as utilizing aerial surveys. To effectively address these threats, it is imperative to establish comprehensive long-term monitoring programs.

Keywords: Nubian ibex, distribution, population, habitats

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Authors: Jinlai Bian, Zailin Yang, Guanxixi Jiang, Xinzhu Li

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The problem of elastic wave propagation in inhomogeneous medium has always been a classic problem. Due to the frequent occurrence of earthquakes, many economic losses and casualties have been caused, therefore, to prevent earthquake damage to people and reduce damage, this paper studies the dynamic response around the circular inclusion in the whole space with inhomogeneous modulus, the inhomogeneity of the medium is reflected in the shear modulus of the medium with the spatial position, and the density is constant, this method can be used to solve the problem of the underground buried pipeline. Stress concentration phenomena are common in aerospace and earthquake engineering, and the dynamic stress concentration factor (DSCF) is one of the main factors leading to material damage, one of the important applications of the theory of elastic dynamics is to determine the stress concentration in the body with discontinuities such as cracks, holes, and inclusions. At present, the methods include wave function expansion method, integral transformation method, integral equation method and so on. Based on the complex function method, the Helmholtz equation with variable coefficients is standardized by using conformal transformation method and wave function expansion method, the displacement and stress fields in the whole space with circular inclusions are solved in the complex coordinate system, the unknown coefficients are solved by using boundary conditions, by comparing with the existing results, the correctness of this method is verified, based on the superiority of the complex variable function theory to the conformal transformation, this method can be extended to study the inclusion problem of arbitrary shapes. By solving the dynamic stress concentration factor around the inclusions, the influence of the inhomogeneous parameters of the medium and the wavenumber ratio of the inclusions to the matrix on the dynamic stress concentration factor is analyzed. The research results can provide some reference value for the evaluation of nondestructive testing (NDT), oil exploration, seismic monitoring, and soil-structure interaction.

Keywords: circular inclusions, complex variable function, dynamic stress concentration factor (DSCF), inhomogeneous medium

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Authors: Auwal Ibrahim Amba

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Bilingualism is the use/existence of two languages in the repertoire of an individual or a community. This linguistic phenomenon may encourage the use of Bilingual Education/Instruction for the teaching of English as a Second Language. Bilingual Education is the teaching of academic content in two languages in most cases simultaneously in multilingual/bilingual communities. This study is an attempt at investigating the impact of Bilingual Education for the teaching of English as a Second Language. The study examines the performance of students in English language examinations in two selected secondary schools that employ Monolingual and Bilingual Education respectively. The schools: Demonstration Secondary School and Higher Islamic Studies Secondary School are public schools that exist side by side at A.D.Rufa’i College of Education, Legal and General Studies Misau, Bauchi State, Nigeria. The choice of the two schools is deliberate because of their existence in the same learning environment, the same public status and bein managed by the same administration. The only difference lies in the use of Bilingual Education for classroom instruction by the former and Monolingual Education by the latter. While Demonstration Secondary School uses English Language as the only Language of instruction, Higher Islamic Studies Secondary School employs English and Arabic for classroom instruction. The study employs qualitative research methods for the collection, presentation and analysis of data. Purposive sampling is employed in selecting students of Senior Secondary School 3 (SS3) from each school as the only participants in the research and a questionnaire was administered on fifty students each in addition to analyzing and comparing the students’ performance based on the Final Certificate Examinations Results. The findings of this study reveal that Bilingual Education slows the rate of learning English as a Second Language and affects learning proficiency. The study recommends the intensive use of the Target Language (English) for the teaching of English as a Second Language. It suggests the adequate use of Language Laboratory, constant listening of international English media organizations like British Broadcasting Corporation (BBC), practical communicative engagement of learners in the Target Language in classroom and outside among other strategies for effective learning.

Keywords: bilingualism, bilingual education, target language, second language

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Authors: Gülcan Taşkıran, Ülkü Tatar Baykal

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Aim: To identify nurses’ perceived competencies for disaster preparedness. Background: Recently, the number of disasters has increased worldwide. Since disasters often strike without warning, healthcare providers, especially nurses must be prepared with appropriate competencies for disaster procedures. Nurses’ perceptions of their own competencies for disaster preparedness need to be evaluated to aid in the creation of effective national plans and educational programs. Design: This study was conducted with a descriptive and cross-sectional design. Methods: Nurses’ perceptions were assessed using the 13-item Demographic Profile Questionnaire that is based on previous literature and the 45-item Nurses’ Perception of Core Competencies for Disaster Preparedness Scale (NPCDPS). Data were collected from June to September 2014 from 406 (79.9% return rate) Turkish nurses working in the western region of Turkey. Results: At the end of the study, it was found that out of the nurses whose mean age was 31.27 ± 5.86 and mean of working time was 8.07 ± 6.60 by the time vast majority of the nurses were women (85.7%), married (59.4%), bachelor’s degree holder (88.2%) and service nurses (56.2%). The most potential disaster that nurses think is an earthquake (70.9%) by the time majority of nurses consider having a role as a nurse at every stage of disasters. The mean total point score of nurses’ perception of disaster preparedness was 4.62. The mean total point score of the nurses from the Nurses’ Perception of Core Competencies for Disaster Preparedness Scale was 133.96. When the subscales’ mean scores are examined, the highest average of the mean score is for Technical Skills (44.52), and the lowest is for Critical Thinking Skills (10.47). When the subscales of Nurses’ Perception of Core Competencies for Disaster Preparedness Scale compared with sex, marital status and education level out of independent variable of nurses there is no significant difference (p > 0.05); compared with age group, working years, duty and being with a disaster out of independent variable of nurses there is a significant difference (p ≤ 0.05). Conclusion: Nurses generally perceive themselves as sufficient at a ‘medium level’ in terms of meeting the core competencies that are required for disaster preparedness. Nurses are not adequately prepared for disasters, but they are aware of the need for such preparation and disaster education. Disaster management training should be given to all nurses in their basic education.

Keywords: disaster competencies, disaster management, disaster nursing, disaster preparedness, nursing, nursing administration, Turkish nurses

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Authors: Phill-Seung Jung, Dae-Yeon Kim

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Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

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Authors: Balkibekova Venera Serikpaevna

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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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Authors: Deog-Gyu Seo, Jin-Soo Ahn

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Objectives: Recently, the development of adhesive primers on stable bonding between zirconia and resin cement has been on the increase. The bond strength of zirconia-resin cement can be effectively increased with the treatment of primer composed of the adhesive monomer that can chemically bond with the oxide layer, which forms on the surface of zirconia. 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) that contains phosphate ester and acidic monomer 4-methacryloxyethyl trimellitic anhydride(4-META) have been suggested as monomers that can form chemical bond with the surface oxide layer of zirconia. Also, these suggested monomers have proved to be effective zirconia surface treatment for bonding to resin cement. The purpose of this study is to evaluate the effects of primer treatment on the bond strength of Zirconia-resin cement by using three different kinds of primers on the market. Methods: Zirconia blocks were prepared into 60 disk-shaped specimens by using a diamond saw. Specimens were divided into four different groups: first three groups were treated with zirconiaLiner(Sun Medical Co., Ltd., Furutaka-cho, Moriyama, Shiga, Japan), Alloy primer (Kuraray Noritake Dental Inc., Sakaju, Kurashiki, Okayama, Japan), and Universal primer (Tokuyama dental Corp., Taitou, Taitou-ku, Tokyo, Japan) respectively. The last group was the control with no surface treatment. Dual cured resin cement (Biscem, Bisco Inc., Schaumburg, IL, USA) was luted to each group of specimens. And then, shear bond strengths were measured by universal tesing machine. The significance of the result was statistically analyzed by one-way ANOVA and Tukey test. The failure sites in each group were inspected under a magnifier. Results: Mean shear bond strength were 0.60, 1.39, 1.03, 1.38 MPa for control, Zirconia Liner (ZL), Alloy primer (AP), Universal primer (UP), respectively. Groups with application of each of the three primers showed significantly higher shear bond strength compared to the control group (p < 0.05). Among the three groups with the treatment, ZL and UP showed significantly higher shear bond strength than AP (p < 0.05), and there were no significant differences in mean shear bond strength between ZL and UP (p < 0.05). While the most specimens of control groups showed adhesive failure (80%), the most specimens of three primer-treated groups showed cohesive or mixed failure (80%).

Keywords: primer, resin cement, shear bond strength, zirconia

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Authors: Afsha Shaikh, Mohammed Azizur Rahman, Ibrahim Hassan, Mayur Pal

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Student engagement in learning is instantly affected by the sources of learning methods available for them, such as videos showing the applications of the concept or showing a practical demonstration. Specific to the engineering discipline, there exist enormous challenging concepts that can be simplified when they are connected to real-world scenarios. For this study, the concept of heat exchangers was used as it is a part of multidisciplinary engineering fields. To make the learning experience enjoyable and impactful, 3-D printed heat exchanger models were created for students to use while working on in-class activities and assignments. Students were encouraged to use the 3-D printed heat exchanger models to enhance their understanding of theoretical concepts associated with its applications. To assess the effectiveness of the method, feedback was received by students pursuing undergraduate engineering via an anonymous electronic survey. To make the feedback more realistic, unbiased, and genuine, students spent nearly two to three weeks using the models in their in-class assignments. The impact of these tools on their learning was assessed through their performance in their ungraded assignments as well as their interactive discussions with peers. ‘Having to apply the theory learned in class whilst discussing with peers on a class assignment creates a relaxed and stress-free learning environment in classrooms’; this feedback was received by more than half the students who took the survey and found 3-D models of heat exchanger very easy to use. Amongst many ways to enhance learning and make students more engaged through interactive models, this study sheds light on the importance of physical tools that help create a lasting mental representation in the minds of students. Moreover, in this technologically enhanced era, the concept of augmented reality was considered in this research. E-drawings application was recommended to enhance the vision of engineering students so they can see multiple views of the detailed 3-D models and cut through its different sides and angles to visualize it properly. E-drawings could be the next tool to implement in classrooms to enhance students’ understanding of engineering concepts.

Keywords: student engagement, life-long-learning, visual demonstration, 3-D printed models, engineering education

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Authors: Eman Ahmed Ahmed, Ghada Abdelmoneim Mohamed, Hamada Ahmed Hamada, Nagui Sobhi Nassif

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Impaired skeletal muscle endurance may be an important causal factor in the development of patellofemoral pain syndrome (PFPS). However, there is lack of information regarding the effect of hip versus knee muscle fatigue on isokinetic parameters, and myoelectric activity of hip and knee muscles in these patients. Purpose: The study was conducted to investigate the effect of hip abductors versus knee extensors fatigue protocol on knee proprioception, hip and knee muscle strength and their myoelectric activity in patients with PFPS. Methods: Fifteen female patients with PFPS participated in the study. They were tested randomly under two fatiguing conditions; hip abductors and knee extensors fatigue protocols. Isolated muscle fatigue of two muscles was induced isokinetically on the affected side in a two separate sessions with a rest interval of at least three days. After determining peak torque, patients performed continuous maximal concentric-eccentric contraction of the selected muscle until the torque output dropped below 50% of peak torque value for 3 consecutive repetitions. Knee proprioception, eccentric hip abductors' peak torque, eccentric knee extensors' peak torque, EMG ratio of vastus medialis obliquus (VMO) / vastus lateralis (VL), and EMG activity of gluteus medius (GM) muscle, were recorded before and immediately after each fatigue protocol using the Biodex Isokinetic system and EMG Myosystem. Results: Two-way within subject MANOVA revealed that eccentric knee extensors’ peak torque decreased significantly after hip abductors fatigue protocol compared to pre fatigue condition (p<0.05). On the other hand, there was no statistically significant difference in the eccentric hip abductors’ peak torque after admitting knee extensors fatigue protocol (p > 0.05). Moreover, no significant difference was found in knee proprioception, EMG ratio of VMO/VL, and EMG activity of GM muscle, after either hip or knee fatigue protocol (p>0.05). Conclusion: A hip focused rehabilitation program may be beneficial in improving knee function through correcting faulty kinematics and hence decrease knee loading in patients with PFPS.

Keywords: electromyography, knee proprioception, mechanical responses, muscle fatigue, patellofemoral pain syndrome

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Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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Authors: Sonda Jallouli, Omar Hammouda, Imen Ben Dhia, Salma Sakka, Chokri Mhiri, Mohamed Habib Elleuch, Abedlmoneem Yahia, Sameh Ghroubi

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Multiple sclerosis (MS) is characterized by gender differences with affecting women two to four times more than men, but the disease progression is faster and more severe in men. Fatigue represents one of the most frequent and disabling symptoms related to MS. Results of previous studies regarding gender differences in fatigue perception in MS persons are contradictory. Besides, fatigue has been shown to affect negatively postural balance and functional mobility in MS persons. However, no study has taken into account gender differences in the response of these physical parameters to a fatiguing protocol in MS persons. Given the reduction of autonomy due to the alteration of these parameters induced by fatigue and the importance of gender differences in postural balance training programs in fatigued men and women with MS, the aim of this study was to investigate the effect of gender difference on unipedal postural balance and functional mobility after performing a fatiguing task in MS adults. Methods: Eleven women (30.29 ± 7.99 years) and seven men (30.91 ± 8.19 years) with relapsing-remitting MS performed a fatiguing protocol: three sets of the 5×sit to stand test (5-STST), six-minute walk test (6MWT) followed by three sets of the 5-STST. Unipedal balance, functional mobility, and fatigue perception were measured prefatigue (T0) and post fatigue (T3) using a clinical unipedal balance test, timed up and go test (TUGT), and analogic visual scale of fatigue (VASF), respectively. Heart rate (HR) and rate of perceived exertion (RPE) were recorded before, during and after the fatiguing task. Results: Compared to women, men showed an impairment of unipedal balance on the dominant leg (p<0.001, d=0.52) and mobility (p<0.001, d=3) via reducing unipedal stance time and increasing duration of TUGT execution, respectively. No gender differences were observed in 6MWT, 5-STST, HR, RPE and VASF scores. Conclusion: Fatiguing protocol negatively affected unipedal postural balance and mobility only in men. These gender differences were inconclusive but can be taken into account in postural balance rehabilitation programs for persons with MS.

Keywords: functional mobility, fatiguing exercises, multiple sclerosis, sex differences, unipedal balance

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Authors: Shanker Kalakotla, Krishna Mohan Gottumukkala

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Diabetes is a metabolic disorder characterized by hyperglycemia, carbohydrates, altered lipids and proteins metabolism. In recent research nanotechnology is a blazing field for the researchers; latterly there has been prodigious excitement in the nanomedicine and nano pharmacological area for the study of silver nanoparticles synthesis using natural products. Biological methods have been used to synthesize silver nanoparticles in presence of medicinally active antidiabetic plants, and this intention made us assess the biologically synthesized silver nanoparticles from the seed extract of Psoralea corylfolia using 1 mM silver nitrate solution. The synthesized herbal mediated silver nanoparticles (HMSNP’s) then subjected to various characterization techniques such as XRD, SEM, EDX, TEM, DLS, UV and FT-IR respectively. In current study, the silver nanoparticles tested for in-vitro anti-diabetic activity and possible toxic effects in healthy female albino mice by following OECD guidelines-425. Herbal mediated silver nanoparticles were successfully obtained from bioreduction of silver nitrate using Psoralea corylifolia plant extract. Silver nanoparticles have been appropriately characterized and confirmed using different types of equipment viz., UV-vis spectroscopy, XRD, FTIR, DLS, SEM and EDX analysis. From the behavioral observations of the study, the female albino mice did not show sedation, respiratory arrest, and convulsions. Test compounds did not cause any mortality at the dose level tested (i.e., 2000 mg/kg body weight) doses till the end of 14 days of observation and were considered safe. It may be concluded that LD50 of the HMSNPs was 2000mg/kg body weight. Since LD50 of the HMSNPs was 2000mg/kg body weight, so the preferred dose range for HMSNPs falls between the levels of 200 and 400 mg/kg. Further In-vivo pharmacological models and biochemical investigations will clearly elucidate the mechanism of action and will be helpful in projecting the currently synthesized silver nanoparticles as a therapeutic target in treating chronic ailments.

Keywords: herbal mediated silver nanoparticles, HMSNPs, toxicity of silver nanoparticles, PTP1B in-vitro anti-diabetic assay female albino mice, 425 OECD guidelines

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Authors: Nadwah Onwi, Puspa Maniam, Azmawanie A. Aziz, Fairus Mukhtar, Nor Azrita Mohamed Zin, Nurul Haslina Mohd Zin, Nurul Fatehah Ismail, Mohamad Safwan Yusoff, Susilidianamanalu Abd Rahman, Siti Munirah Harris, Maryam Aizuddin

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Objective: Malaysia has a growing number of individuals with complex communication needs (CCN). The initiation of augmentative and alternative communication (AAC) intervention may facilitate individuals with CCN to understand and express themselves optimally and actively participate in activities in their daily life. AAC is defined as multimodal use of communication ability to allow individuals to use every mode possible to communicate with others using a set of symbols or systems that may include the symbols, aids, techniques, and strategies. It is consequently critical to evaluate the deficits to inform treatment for AAC intervention. However, no known measurement tools are available to evaluate the user with CCN available locally. Design: A systematic review (SR) is designed to analyze the psychometric properties of AAC assessment for adolescents with CCN published in peer-reviewed journals. Tools are rated by the methodological quality of studies and the psychometric measurement qualities of each tool. Method: A literature search identifying AAC assessment tools with psychometrically robust properties and conceptual framework was considered. Two independent reviewers screened the abstracts and full-text articles and review bibliographies for further references. Data were extracted using standardized forms and study risk of bias was assessed. Result: The review highlights the psychometric properties of AAC assessment tools that can be used by speech-language therapists applicable to be used in the Malaysian context. The work outlines how systematic review methods may be applied to the consideration of published material that provides valuable data to initiate the development of Malay Language AAC assessment tools. Conclusion: The synthesis of evidence has provided a framework for Malaysia Speech-Language therapists in making an informed decision for AAC intervention in our standard operating procedure in the Ministry of Health, Malaysia.

Keywords: augmentative and alternative communication, assessment, adolescents, complex communication needs

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Authors: Tom Nakotte, Hongmei Luo

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Lead chalcogenide-based (PbS, PbSe, and PbTe) quantum dots (QDs) were synthesized for the purpose of implementing them in radiation detectors. Pb based materials have long been of interest for gamma and x-ray detection due to its high absorption cross section and Z number. The emphasis of the studies was on exploring how to control charge carrier transport within thin films containing the QDs. The properties of QDs itself can be altered by changing the size, shape, composition, and surface chemistry of the dots, while the properties of carrier transport within QD films are affected by post-deposition treatment of the films. The QDs were synthesized using colloidal synthesis methods and films were grown using multiple film coating techniques, such as spin coating and doctor blading. Current QD radiation detectors are based on the QD acting as fluorophores in a scintillation detector. Here the viability of using QDs in solid-state radiation detectors, for which the incident detectable radiation causes a direct electronic response within the QD film is explored. Achieving high sensitivity and accurate energy quantification in QD radiation detectors requires a large carrier mobility and diffusion lengths in the QD films. Pb chalcogenides-based QDs were synthesized with both traditional oleic acid ligands as well as more weakly binding oleylamine ligands, allowing for in-solution ligand exchange making the deposition of thick films in a single step possible. The PbS and PbSe QDs showed better air stability than PbTe. After precipitation the QDs passivated with the shorter ligand are dispersed in 2,6-difloupyridine resulting in colloidal solutions with concentrations anywhere from 10-100 mg/mL for film processing applications, More concentrated colloidal solutions produce thicker films during spin-coating, while an extremely concentrated solution (100 mg/mL) can be used to produce several micrometer thick films using doctor blading. Film thicknesses of micrometer or even millimeters are needed for radiation detector for high-energy gamma rays, which are of interest for astrophysics or nuclear security, in order to provide sufficient stopping power.

Keywords: colloidal synthesis, lead chalcogenide, radiation detectors, quantum dots

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Nupur Karmaker, Hasin Aupama Azhari, Abdul Al Mortuza, Abhijit Chanda, Golam Abu Zakaria

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Purpose: The purpose of gait analysis is to determine the biomechanics of the joint, phases of gait cycle, graphical and analytical analysis of degree of rotation, analysis of the electrical activity of muscles and force exerted on the hip joint at different locomotion during walking, running and cart pulling. Methods and Materials: Visual gait analysis and electromyography method has been used to detect the degree of rotation of joints and electrical activity of muscles. In cinematography method an object is observed from different sides and takes its video. Cart pulling length has been divided into frames with respect to time by using video splitter software. Phases of gait cycle, degree of rotation of joints, EMG profile and force analysis during walking and running has been taken from different papers. Gait cycle and degree of rotation of joints during cart pulling has been prepared by using video camera, stop watch, video splitter software and Microsoft Excel. Results and Discussion: During the cart pulling the force exerted on hip is the resultant of various forces. The force on hip is the vector sum of the force Fg= mg, due the body of weight of the person and Fa= ma, due to the velocity. Maximum stance phase shows during cart pulling and minimum shows during running. During cart pulling shows maximum degree of rotation of hip joint, knee: running, and ankle: cart pulling. During walking, it has been observed minimum degree of rotation of hip, ankle: during running. During cart pulling, dynamic force depends on the walking velocity, body weight and load weight. Conclusions: 80% people suffer gait related disease with increasing their age. Proper care should take during cart pulling. It will be better to establish the gait laboratory to determine the gait related diseases. If the way of cart pulling is changed i.e the design of cart pulling machine, load bearing system is changed then it would possible to reduce the risk of limb loss, flat foot syndrome and varicose vein in lower limb.

Keywords: kinematic, gait, gait lab, phase, force analysis

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Authors: Arojojoye Oluwatosin Adetola, Nwaechefu Olajumoke Olufunlayo, Ademola Adetokunbo Oyagbemi, Jeremiah Moyinoluwalogo Afolabi, Asaolu Racheal Oluwabukola

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The effects of man’s activities on the environment include depletion of natural resources alongside pollution of water bodies. Petroleum exploration in the Niger Delta region of Nigeria has compromised the aquatic environment with grave consequences on the entire ecosystem. In this study, we assessed the environmental safety of Araromi River, located in an oil-producing area in Ondo State, in the Niger Delta region of Nigeria by determining the levels of heavy metals (copper, cadmium, chromium, nickel, lead) and some biomarkers of oxidative stress (malondialdehyde, glutathione-S-transferase, glutathione peroxidase, catalase, superoxide dismutase, myeloperoxidase and reduced glutathione) in Clarias gariepinus (350-400g) from the river using standard methods. Clarias gariepinus from a clean fish farm in the same geographical location as the reference site (Ilesannmi fishery) was used as a control. Water samples from both sites were also analysed for some physicochemical parameters, heavy metals, and bacterial contamination. Our findings show a significant increase in malondialdehyde level (index of lipid peroxidation) as well as alterations in antioxidant status in the organs of Clarias gariepinus from Araromi River compared with control. A significant increase in bacterial contaminants, heavy metal pollutants, and particulate matter deposits were also observed in the water sample from Araromi River compared with control. In conclusion, high levels of indicators of environmental pollution observed in the water sample from Araromi River coupled with induction of oxidative stress in Clarias gariepinus from the river show that Araromi River is polluted; therefore, consumption of fishes and other aquatic organisms from the river may be unsafe for the people in that community.

Keywords: Araromi River, Clarias gariepinus, environmental pollution, heavy metals, oxidative stress

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