Search results for: acute encephalitis syndrome
Commenced in January 2007
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Edition: International
Paper Count: 1723

Search results for: acute encephalitis syndrome

493 Evaluation of Immunology of Asthma Chronic Obstructive

Authors: Milad Gholizadeh

Abstract:

Asthma and chronic obstructive pulmonary disease (COPD) are very shared inflammatory diseases of the airlines. They togethercause airway tapering and are cumulative in occurrence throughout the world, imposing huge burdens on health care. It is currently recognized that some asthmatic inflammation is neutrophilic, controlled by the TH17 subset of helper T cells, and that some eosinophilic inflammation is controlled by type 2 innate lymphoid cells (ILC2 cells) temporary together with basophils. Patients who have plain asthma or are asthmatic patients who smoke with topographies of COPD-induced inflammation and might advantage from treatments targeting neutrophils, countingmacrolides, CXCR2 antagonists, phosphodiesterase 4 inhibitors, p38 mitogen-activating protein kinase inhibitors, and antibodies in contradiction of IL-1 and IL-17.Viral and bacterial infections, not only reason acute exacerbations of COPD, but also intensify and continue chronic inflammation in steady COPD through pathogen-associated molecular patterns. Present treatment plans are absorbed on titration of inhaled therapies such as long-acting bronchodilators, with cumulative interest in the usage of beleaguered biologic therapies meant at the underlying inflammatory devices. Educationssuggest that the mucosal IgA reply is abridged in COPD, and a lacking conveyance of IgA across the bronchial epithelium in COPD has been recognized, perhaps involving neutrophil proteinases, which may damage the Ig receptor mediating this transepithelialdirection-finding. Future instructions for investigation will emphasis elucidating the diverse inflammatory signatures foremost to asthma and chronic obstrucive, the development of reliable analytic standards and biomarkers of illness, and refining the clinical organization with an eye toward targeted therapies.

Keywords: imminology, asthma, COPD, CXCR2 antagonists

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492 Prevalence and Distribution of Verocytotoxigenic Escherichia coli (Vtec) Non-O157 Serotypes in Cattle in Abuja, Nigeria

Authors: S. I. Enem, S. I. Oboegbulem

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Objective: The most frequently implicated E. coli serotype causing haemorrhagic colitis and haemorrhagic uraemic syndrome (HUS) is VTEC 0157. However, non-O157 VTEC is now known to be as prevalent as VETC O157 infection (or even more) in most parts of the world. The objective of the study was to establish the occurrence of non-O157 VTEC serotypes in cattle in the Federal Capital Territory (FCT) Abuja, Nigeria. The level of significance of the infection with sex, age and season were also tested. Methods: The study was carried out in the FCT, Abuja, Nigeria which is located between latitude 8o and 90 25` North of the equator and longitude 60 45` and 7045` East of the Greenwich meridian. The cross sectional epidemiological method and multi-staged sampling technique were used in this study. Samples were collected from the freshly voided faeces of both apparently healthy and diarrhoeic cattle in selected abattoirs and cattle herds. Enriched samples were analyzed bacteriologically and biochemically after which they were characterised using commercially prepared latex agglutination test kits. Results: A total of 718 faecal samples from cattle were analyzed for the presence of VTEC non-O157. Thirty eight (5.23%) were positive for non-O157. There was no significant association (p > 0.05) between sex and infection with non-O157 VTEC in cattle. There was a significant association (P < 0.05) between age and infection with non-O157 VTEC in cattle. Calves were more associated than the adults. There was also a significant association (P < 0.05) between season and infection with non-O157 VTEC in cattle. The dry season was more associated than the wet season. Conclusion: The study established the occurrence and prevalence of non-O157 VTEC in cattle in FCT, Abuja, Nigeria. As a major food animal in Nigeria, infection in cattle provides an epidemiological causal association to the infection in humans. The result showed that warmer seasons (dry season) stimulate the presence of VTEC infection in animals and thus, as a consequence, increases the number of human cases. The prevalence was also higher in younger calves (< 6 months) probably as a result of undeveloped immune system.

Keywords: prevalence, distribution, Verocytotoxigenic escherichia coli (VTEC), non-O157 serotypes, cattle

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491 Development of a Telemedical Network Supporting an Automated Flow Cytometric Analysis for the Clinical Follow-up of Leukaemia

Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

Abstract:

In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: data security, flow cytometry, leukaemia, telematics platform, telemedicine

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490 Nurse Practitioner Led Pediatric Primary Care Clinic in a Tertiary Care Setting: Improving Access and Health Outcomes

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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489 Effects of Handgrip Isometric Training in Blood Pressure of Patients with Peripheral Artery Disease

Authors: Raphael M. Ritti-Dias, Marilia A. Correia, Wagner J. R. Domingues, Aline C. Palmeira, Paulo Longano, Nelson Wolosker, Lauro C. Vianna, Gabriel G. Cucato

Abstract:

Patients with peripheral arterial disease (PAD) have a high prevalence of hypertension, which contributes to a high risk of acute cardiovascular events and cardiovascular mortality. Strategies to reduce cardiovascular risk of these patients are needed. Meta-analysis studies have shown that isometric handgrip training promotes reductions in clinical blood pressure in normotensive, pre-hypertensive and hypertensive individuals. However, the effect of this exercise training on other cardiovascular function indicators in PAD patients remains unknown. Thus, the aim of this study was to analyze the effects of isometric handgrip training on blood pressure in patients with PAD. In this clinical trial, 28 patients were randomly allocated into two groups: isometric handgrip training (HG) and control (CG). The HG conducted the unilateral handgrip training three days per week (four sets of two minutes, with 30% of maximum voluntary contraction with an interval of four minutes between sets). CG was encouraged to increase their physical activity levels. At baseline and after eight weeks blood pressure and heart rate were obtained. ANOVA two-way for repeated measures with the group (GH and GC) and time (pre- and post-intervention) as factors was performed. After 8 weeks of training there were no significant changes in systolic blood pressure (HG pre 141 ± 24.0 mmHg vs. HG post 142 ± 22.0 mmHg; CG pre 140 ± 22.1 mmHg vs. CG post 146 ± 16.2 mmHg; P=0.18), diastolic blood pressure (HG pre 74 ± 10.4 mmHg vs. HG post 74 ± 11.9 mmHg; CG pre 72 ± 6.9 mmHg vs. CG post 74 ± 8.0 mmHg; P=0.22) and heart rate (HG pre 61 ± 10.5 bpm vs. HG post 62 ± 8.0 bpm; CG pre 64 ± 11.8 bpm vs. CG post 65 ± 13.6 bpm; P=0.81). In conclusion, our preliminary data indicate that isometric handgrip training did not modify blood pressure and heart rate in patients with PAD.

Keywords: blood pressure, exercise, isometric, peripheral artery disease

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488 Clinical Prediction Score for Ruptured Appendicitis In ED

Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

Abstract:

Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

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487 Elucidation of Mechanism of Action of Antidepressant-Like Effect of Valeriana wallichii Maaliol Chemotype in Mice

Authors: Sangeeta Pilkhwal Sah, C. S. Mathela, Kanwaljit Chopra

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Valeriana wallichii DC, an ayurvedic traditional medicine, popularly named as Indian valerian exist as three chemotypes. GC-MS analysis of V. wallichii essential oil in present study showed maaliol as the major constituent followed by the presence of β-gurjunene, acoradiene, guaiol and α-santalene. The results thus confirmed it to be a maaliol chemotype. Further, the antidepressant-like effect of root essential oil (10, 20 and 40 mg/kg p.o.) was investigated in both acute and chronic treatment study using forced swim test in mice. Single administration of different doses produced an inverted U shaped curve and significantly inhibited the immobility period (39.7% and 58%) at doses 10 and 40 mg/kg respectively. Standard drug imipramine significantly decreased immobility period (59.8%). None of the doses altered locomotor activity except a significant decrease of 44.9% was observed with 40 mg/kg (p < 0.05). Similarly, daily administration of essential oil for 14 days produced a dose dependent effect with significantly reduced immobility period (70.9%) at 40 mg/kg dose only whereas imipramine produced 86% decrease (p < 0.05). The neurotransmitter levels in mouse brain were estimated on day 14 after the behavioral study. Significant increase in the level of norepinephrine (10%) and dopamine (23%) (p < 0.05) was found at 40 mg/kg dose, while no change was observed at 10 and 20 mg/kg doses. The antidepressant-like effect of essential oil (40 mg/kg) was prevented by pretreatment of mice with L-arginine (750 mg/kg i.p.) and sildenafil (5 mg/kg i.p). On the contrary, pretreatment of mice with L-NAME (10 mg/kg i.p.) or methylene blue (10 mg/kg i.p.) potentiated the antidepressant action of essential oil (20 mg/kg). The findings thus demonstrated that nitric oxide pathway is involved in mediating antidepressant like effect of essential oil from this chemotype.

Keywords: Valeriana wallichii DC chemotype, essential oil, forced swim test, nitric oxide modulators, neurotransmitters

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486 A Case Report on Diaphragm Disease of Small Bowel Following Usage of Non-Steroidal Anti-Inflammatory Drugs

Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

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Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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485 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance

Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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484 The 10,000 Fold Effect Retrograde Neurotransmission: A Newer Concept for Paraplegia’s Physiological Revival by the Use of Intrathecal Sodium Nitroprusside

Authors: V. K. Tewari, M. Hussain, H. K. D. Gupta

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B-Methylprednisolone-level-1-benefit (20%) usually given in paraplegia (but within 8hrs). Patients wait-long-duration for physiological-recovery. Intrathecal-Sodium-Nitroprusside(ITSNP) has been used-in vasospasm-due-to-subarachnoid-hemorrhage. ITSNP-has been studied-here for wide-window-period-range for-treatment, fast-recovery/affordability. 2- for acute-cases-and 1-mechanism-for chronic-cases, which-are-interrelated, are being-proposed-for-physiological-recovery. retrograde-neurotransmission, vasospasm and long-term-potentiation-(ltp) mechanisms are proposed here for recovery. It’s a case-control-prospective-study. 82paraplegia-patients(10patients taken as control-no superfusion or dextrose5% superfusion and 72patients as ITSNP-group). The mean time for superfusion was 14.11 days. ITSNP administered at a dosage of 0.2 mg/kg bo wt. Pre/post ITSNP monitored by SSEP/MEP. After-2-Hours in ITSNP-group Mean-Change-From-Baseline-Asia Motor/Sensory-Score 13.84%/13.10%, after-24-hours MOTOR-1.27-points decrease(3.77%) and SENSORY 10.5points-increase(6.22%)as compared to Control-group no-change noted upto 24-hours, At-7days ITSNP motor/sensory;11.56%/6.22% as compared to Control-group 7.60/4.48%, At-2-months in ITSNP 27.69%/6.22% as compared to Control-group 16.02/4.5%. SSEP/MEP-documented-improvements-noted. ITSNP, a-swift-acting-drug in treatment-of-paraplegia, is effective within-two-hours(mean-change-MOTOR-13.84% and SENSORY-13.10%) on-mean14.11th postparaplegia-day with a small-detrimental-response after-24-hours which-recovers-fast.

Keywords: paraplegias, intrathecal sodium nitroprusside, retrograde transmission, the 10, 000 fold effect, perforators, vasodilatations, long term potenciations

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483 Evaluation of Apolipoprotein Profile in HIV/Aids Subjects in Pre and Post 12 Months Antiretroviral Therapy Using 1.5 NG/ML Troponin Diagnostic Cut-off for Myocardial Infarction in Nauth Nnewi, South Eastern Nigeria

Authors: I. P. Ezeugwunne, C. C. Onyenekwe, J. E. Ahaneku, G. I. Ahaneku

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Introduction: It has been reported that acute myocardial infarction (AMI) might occur at 1.5 ng/ml troponin level. HIV infection has been documented to influence antiviral drugs, stimulate the production of proteins that enhance fatty acids synthesis. Information on cardiac status in HIV-infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein profile of HIV subjects in pre-and-post 12 months of antiretroviral therapy (ART) using 1.5 ng/ml troponin diagnostic cut-off for myocardial infarction (MI) in Nnewi, South Eastern, Nigeria. Methodology: A total of 30 symptomatic HIV subjects without malaria co-infection with a mean age of 40.70 ±10.56 years were randomly recruited for this prospective case-controlled study. Serum apolipoproteins (Apo A1, A2, B, C2,C3 and Apo E), troponin and CD4 counts were measured using standard laboratory methods. Parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for MI. Analysis of variance and student paired t-tests were used for data analyses. Results: paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels of ApoA1, ApoB and ApoC3 in symptomatic HIV subjects before antiretroviral therapy (ART) when compared with after therapy at p<0.05 respectively. The troponin value was significantly higher amongst the group studied at p<0.05, respectively. Conclusion: The increased values of troponin observed among the groups were higher than the diagnostic cut-off for AMI. This may imply that AMI may occur at any group of studies. But the significant reduction in the serum levels of Apo A2, Apo B, Apo C3, Apo E and a significant increase in serum levels of Apo A1, Apo C2 and blood CD4 counts as the length of therapy lengthened may indicate possible cardio-protective effects of the ART on the heart, which may connote recovery.

Keywords: ART, apolipoprotein, HIV, myocardial infarction

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482 Double-Spear 1-H2-1 Oncolytic-Immunotherapy for Refractory and Relapsing High-Risk Human Neuroblastoma and Glioma

Authors: Lian Zeng

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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.

Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma

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481 Time-dependent Association between Recreational Cannabinoid Use and Memory Performance in Healthy Adults: A Neuroimaging Study of Human Connectome Project

Authors: Kamyar Moradi

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Background: There is mixed evidence regarding the association between recreational cannabinoid use and memory performance. One of the major reasons for the present controversy is different cannabinoid use-related covariates that influence the cognitive status of an individual. Adjustment of these confounding variables provides accurate insight into the real effects of cannabinoid use on memory status. In this study, we sought to investigate the association between recent recreational cannabinoid use and memory performance while correcting the model for other possible covariates such as demographic characteristics and duration, and amount of cannabinoid use. Methods: Cannabinoid users were assigned to two groups based on the results of THC urine drug screen test (THC+ group: n = 110, THC- group: n = 410). THC urine drug screen test has a high sensitivity and specificity in detecting cannabinoid use in the last 3-4 weeks. The memory domain of NIH Toolbox battery and brain MRI volumetric measures were compared between the groups while adjusting for confounding variables. Results: After Benjamini-Hochberg p-value correction, the performance in all of the measured memory outcomes, including vocabulary comprehension, episodic memory, executive function/cognitive flexibility, processing speed, reading skill, working memory, and fluid cognition, were significantly weaker in THC+ group (p values less than 0.05). Also, volume of gray matter, left supramarginal, right precuneus, right inferior/middle temporal, right hippocampus, left entorhinal, and right pars orbitalis regions were significantly smaller in THC+ group. Conclusions: this study provides evidence regarding the acute effect of recreational cannabis use on memory performance. Further studies are warranted to confirm the results.

Keywords: brain MRI, cannabis, memory, recreational use, THC urine test

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480 Cerebral Venous Thrombosis at High Altitude: A Rare Presentation by Sub-Arachnoid Hemorrhage

Authors: Eman G. Alayad, Mazen G. Aleyad, Mohammed Alshahrani, Ibrahim Alnaami

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Introduction: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age. Patients with CVT commonly present with headache, focal neurological deficit, decreased level of consciousness and seizures. Many etiologic risk factors have been reported for CVT, high altitude and oral contraceptive pill some of them. Case Presentation: A 37-year-old woman living in Abha city in the southeastern area of Saudi Arabia. (about 10,000 feet-3000 m) over the sea. complaining acute onset of severe diffuse headache and generalized tonic clonic convulsions. Followed by loss of consciousness. She was on contraceptive pills for the last 3 years. No significant Medical or surgical history. Brain CT revealed subarachnoid hemorrhage, with MRI findings showing thrombosis in transvers sinus. There was no vascular malformations such as aneurysm, arteriovenous malformation (AVM), or dural arteriovenous fistula. A CVT with subarachnoid hemorrhage was our final diagnosis based on clinical presentation and radiographic findings. Discussion: Patients with CVT had evidence of cortical SAH by 10 of 233, others found 3% of SAH was caused by CVT, indicating that the presence of cortical SAH without involvement of the basal cisterns may provide an early sign of underlying CVT. However, what is more interesting in this case, is the relationship of high altitude with CVT and SAH, which previously undescribed. Conclusion: High-altitude climbing per se was described as a risk factor for the development of CVT, though its occurrence was probably rare. Whether it is primary in etiology due to high altitude induced hypercoagulable state of unknown origin or due to cerebrovascular disturbances there is a need for further investigation especially at this unusual presentation of subarachnoid hemorrhage.

Keywords: cerebral venous thrombosis, high-altitude, subarachnoid hemorrhage, stroke

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479 Normal Weight Obesity among Female Students: BMI as a Non-Sufficient Tool for Obesity Assessment

Authors: Krzysztof Plesiewicz, Izabela Plesiewicz, Krzysztof Chiżyński, Marzenna Zielińska

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Background: Obesity is an independent risk factor for cardiovascular diseases. There are several anthropometric parameters proposed to estimate the level of obesity, but until now there is no agreement which one is the best predictor of cardiometabolic risk. Scientists defined metabolically obese normal weight, who suffer from metabolic abnormalities, the same as obese individuals, and defined this syndrome as normal weight obesity (NWO). Aim of the study: The aim of our study was to determine the occurrence of overweight and obesity in a cohort of young, adult women, using standard and complementary methods of obesity assessment and to indicate those, who are at risk of obesity. The second aim of our study was to test additional methods of obesity assessment and proof that body mass index using alone is not sufficient parameter of obesity assessment. Materials and methods: 384 young women, aged 18-32, were enrolled into the study. Standard anthropometric parameters (waist to hips ratio (WTH), waist to height ratio (WTHR)) and two other methods of body fat percentage measurement (BFPM) were used in the study: electrical bioimpendance analysis (BIA) and skinfold measurement test by digital fat body mass clipper (SFM). Results: In the study group 5% and 7% of participants had waist to hips ratio and accordingly waist to height ratio values connected with visceral obesity. According to BMI 14% participants were overweight and obese. Using additional methods of body fat assessment, there were 54% and 43% of obese for BIA and SMF method. In the group of participants with normal BMI and underweight (not overweight, n =340) there were individuals with the level of BFPM above the upper limit, for the BIA 49% (n =164) and for the SFM 36 % (n=125). Statistical analysis revealed strong correlation between BIA and SFM methods. Conclusion: BMI using alone is not a sufficient parameter of obesity assessment. High percentage of young women with normal BMI values seem to be normal weight obese.

Keywords: electrical bioimpedance, normal weight obesity, skin-fold measurement test, women

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478 Issues in Organizational Assessment: The Case of Frustration Tolerance Measurement in Mexico

Authors: David Ruiz, Carlos Nava, Roberto Carbajal

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The psychological profile has become one of the most important sources of information when it comes to individual selection and the hiring process in any organization. Psychological instruments are used to collect data about variables that are considered critically important for performance in work. However, because of conceptual chaos in organizational psychology, most of the information provided by psychological testing is not directly useful for Mexican human resources professionals to take hiring decisions. The aims of this paper are 1) to underline the lack of conceptual precision in theoretical testing foundations in Mexico and 2) presenting a reliability and validity analysis of a frustration tolerance instrument created as an alternative to a heuristically conduct individual assessment in organizations. First, a description of assessment conditions in Mexico is made. Second, an instrument and a theoretical framework is presented as an alternative to the assessment practices in the country. A total of 65 Psychology Iztacala Superior Studies Faculty students were assessed. Cronbach´s alpha coefficient was calculated and an exploratory factor analysis was carried out to prove the scale unidimensionality. Reliability analysis revealed good internal consistency of the scale (Cronbach’s α = 0.825). Factor analysis produced 4 factors for the scale. However, factor loadings and explained variation give proof to the scale unidimensionality. It is concluded that the instrument has good psychometric properties that will allow human resources professionals to collect useful data. Different possibilities to conduct psychological assessment are suggested for future development.

Keywords: psychological assessment, frustration tolerance, human resources, organizational psychology

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477 Family Planning Programming for Youths and Adolescents in Nigeria

Authors: Ashimolowo Olubunmi

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Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

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476 External Validation of Risk Prediction Score for Candidemia in Critically Ill Patients: A Retrospective Observational Study

Authors: Nurul Mazni Abdullah, Saw Kian Cheah, Raha Abdul Rahman, Qurratu 'Aini Musthafa

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Purpose: Candidemia was associated with high mortality in critically ill patients. Early candidemia prediction is imperative for preemptive antifungal treatment. This study aimed to externally validate the candidemia risk prediction scores by Jameran et al. (2021) by identifying risk factors of acute kidney injury, renal replacement therapy, parenteral nutrition, and multifocal candida colonization. Methods: This single-center, retrospective observational study included all critically ill patients admitted to the intensive care unit (ICU) in a tertiary referral center from January 2018 to December 2023. The study evaluated the candidemia risk prediction score performance by analyzing the occurrence of candidemia within the study period. Patients’ demographic characteristics, comorbidities, SOFA scores, and ICU outcomes were analyzed. Patients who were diagnosed with candidemia before ICU admission were excluded. Results: A total of 500 patients were analyzed with 2 dropouts due to incomplete data. Validation analysis showed that the candidemia risk prediction score has a sensitivity of 75.00% (95% CI: 59.66-86.81), specificity of 65.35% (95% CI: 60.78-69.72), positive predictive value of 17.28, and negative predictive value of 96.44. The incidence of candidemia was 8.86% with no significant differences in the demographic and comorbidities except higher SOFA scoring in the candidemia group. The candidemia group showed significantly longer ICU and hospital LOS and higher ICU and in-hospital mortality. Conclusion: This study concluded the candidemia risk prediction score by Jameran et al (2021) had good sensitivity and a high negative prediction value.

Keywords: candidemia, intensive care, clinical prediction rule, incidence

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475 Protective Effect of the Histamine H3 Receptor Antagonist DL77 in Behavioral Cognitive Deficits Associated with Schizophrenia

Authors: B. Sadek, N. Khan, D. Łażewska, K. Kieć-Kononowicz

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The effects of the non-imidazole histamine H3 receptor (H3R) antagonist DL77 in passive avoidance paradigm (PAP) and novel object recognition (NOR) task in MK801-induced cognitive deficits associated with schizophrenia (CDS) in adult male rats, and applying donepezil (DOZ) as a reference drug were investigated. The results show that acute systemic administration of DL77 (2.5, 5, and 10 mg/kg, i.p.) significantly improved MK801-induced (0.1 mg/kg, i.p.) memory deficits in PAP. The ameliorating activity of DL77 (5 mg/kg, i.p.) in MK801-induced deficits was partly reversed when rats were pretreated with the centrally-acting H2R antagonist zolantidine (ZOL, 10 mg/kg, i.p.) or with the antimuscarinic antagonist scopolamine (SCO, 0.1 mg/kg, i.p.), but not with the CNS penetrant H1R antagonist pyrilamine (PYR, 10 mg/kg, i.p.). Moreover, the memory enhancing effect of DL77 (5 mg/kg, i.p.) in MK801-induced memory deficits in PAP was strongly reversed when rats were pretreated with a combination of ZOL (10 mg/kg, i.p.) and SCO (1.0 mg/kg, i.p.). Furthermore, the significant ameliorative effect of DL77 (5 mg/kg, i.p.) on MK801-induced long-term memory (LTM) impairment in NOR test was comparable to the DOZ-provided memory-enhancing effect, and was abrogated when animals were pretreated with the histamine H3R agonist R-(α)-methylhistamine (RAMH, 10 mg/kg, i.p.). However, DL77(5 mg/kg, i.p.) failed to provide procognitive effect on MK801-induced short-term memory (STM) impairment in NOR test. In addition, DL77 (5 mg/kg) did not alter anxiety levels and locomotor activity of animals naive to elevated-plus maze (EPM), demonstrating that improved performances with DL77 (5 mg/kg) in PAP or NOR are unrelated to changes in emotional responding or spontaneous locomotor activity. These results provide evidence for the potential of H3Rs for the treatment of neurodegenerative disorders related to impaired memory function, e.g. CDS.

Keywords: histamine H3 receptor, antagonist, learning, memory impairment, passive avoidance paradigm, novel object recognition

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474 Neuropsychological Deficits in Drug-Resistant Epilepsy

Authors: Timea Harmath-Tánczos

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Drug-resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs (ASD) used at efficacious daily doses. About a third of patients with epilepsy suffer from drug resistance. Cognitive assessment has a crucial role in the diagnosis and clinical management of epilepsy. Previous studies have addressed the clinical targets and indications for measuring neuropsychological functions; best to our knowledge, no studies have examined it in a Hungarian therapy-resistant population. To fill this gap, we investigated the Hungarian diagnostic protocol between 18 and 65 years of age. This study aimed to describe and analyze neuropsychological functions in patients with drug-resistant epilepsy and identify factors associated with neuropsychology deficits. We perform a prospective case-control study comparing neuropsychological performances in 50 adult patients and 50 healthy individuals between March 2023 and July 2023. Neuropsychological functions were examined in both patients and controls using a full set of specific tests (general performance level, motor functions, attention, executive facts., verbal and visual memory, language, and visual-spatial functions). Potential risk factors for neuropsychological deficit were assessed in the patient group using a multivariate analysis. The two groups did not differ in age, sex, dominant hand and level of education. Compared with the control group, patients with drug-resistant epilepsy showed worse performance on motor functions and visuospatial memory, sustained attention, inhibition and verbal memory. Neuropsychological deficits could therefore be systematically detected in patients with drug-resistant epilepsy in order to provide neuropsychological therapy and improve quality of life. The analysis of the classical and complex indices of the special neuropsychological tasks presented in the presentation can help in the investigation of normal and disrupted memory and executive functions in the DRE.

Keywords: drug-resistant epilepsy, Hungarian diagnostic protocol, memory, executive functions, cognitive neuropsychology

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473 Physiotherapy Assessment of People with Neurological Conditions in Australia: A National Survey of Clinical Practice

Authors: Jill Garner, Belinda Lange, Sheila Lennon, Maayken van den Berg

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Currently, there are approximately one billion people worldwide affected by a neurological condition. Many of whom are assessed and treated by a physiotherapist in a variety of settings. There is a lack of consensus in the literature related to what is clinically assessed by physiotherapists in people with neurological conditions. This study aimed to explore assessment in people with neurological conditions, including how health care setting, experience, and therapeutic approach, may influence neurological assessment. A national survey targeted Australian physiotherapists who assess adults with neurological conditions as part of their clinical practice. The survey consisted of 39 questions and was distributed to physiotherapists through the Australian Physiotherapy Association, and Chief Allied Health Officers across Australia and advertised on the National Neurological Physiotherapy Facebook page. In total, 395 respondents consented to the survey from all states within Australia. Most respondents were female (85.4%) with a mean (SD) age of 35.7 years. Respondents reported working clinically in acute, community, outpatients, and community settings. Stroke was the most assessed condition (58.0%). There is variability in domains assessed by Australian physiotherapists, with common inclusions of balance, muscle strength, gait, falls and safety, function, goal setting, range of movement, pain, coordination, activity tolerance, postural alignment and symmetry and upper limb. There is little evidence to support what physiotherapists assess in practice, in different settings, and in different states within Australia and not enough information to develop a decision tree regarding what is important for assessment in different settings. Further research is needed to explore this area and develop a consensus around best practices.

Keywords: physiotherapy, neurological, assessment, domains

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472 Characterization of Bovine SERPIN- Alpha-1 Antitrypsin (AAT)

Authors: Sharique Ahmed, Khushtar Anwar Salman

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Alpha-1-antitrypsin (AAT) is a major plasma serine protease inhibitor (SERPIN). Hereditary AAT deficiency is one of the common diseases in some part of the world. AAT is mainly produced in the liver and functions to protect the lung against proteolytic damage (e.g., from neutrophil elastase) acting as the major inhibitor for neutrophil elastase. α (1)-Antitrypsin (AAT) deficiency is an under recognized genetic condition that affects approximately 1 in 2,000 to 1 in 5,000 individuals and predisposes to liver disease and early-onset emphysema. Not only does α-1-antitrypsin deficiency lead to disabling syndrome of pulmonary emphysema, there are other disorders too which include ANCA (antineutrophilic cytoplasmic antibody) positive Wegener's granulomatosis, diffuse bronchiectasis, necrotizing panniculitis in α-1-antitrypsin phenotype (S), idiopathic pulmonary fibrosis and steroid dependent asthma. Augmentation therapy with alpha-1 antitrypsin (AAT) from human plasma has been available for specific treatment of emphysema due to AAT deficiency. Apart from this several observations have also suggested a role for endogenous suppressors of HIV-1, alpha-1 antitrypsin (AAT) has been identified to be one of those. In view of its varied important role in humans, serum from a mammalian source was chosen for the isolation and purification. Studies were performed on the homogeneous fraction. This study suggests that the buffalo serum α-1-antritrypsin has characteristics close to ovine, dog, horse and more importantly to human α-1-antritrypsin in terms of its hydrodynamic properties such as molecular weight, carbohydrate content, etc. The similarities in the hydrodynamic properties of buffalo serum α-1-antitrypsin with other sources of mammalian α-1-antitrypsin mean that it can be further studied and be a potential source for "augmentation therapy", as well as a source of AAT replacement therapy to raise serum levels above the protective threshold. Other parameters like the amino acid sequence, the effect of denaturants, and the thermolability or thermostability of the inhibitor will be the interesting basis of future studies on buffalo serum alpha-1 antitrypsin (AAT).

Keywords: α-1-antitrypsin, augmentation therapy , hydrodynamic properties, serine protease inhibitor

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471 Use of a Symptom Scale Based on Degree of Functional Impairment for Acute Concussion

Authors: Matthew T. McCarthy, Sarah Janse, Natalie M. Pizzimenti, Anthony K. Savino, Brian Crosser, Sean C. Rose

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Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical or functional impairment. This is a retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists at the initial visit – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a scale based on the degree of clinical impairment for each symptom (22 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician. 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 14.7 (SD 11.9) for the functional impairment scale. Pearson’s correlation between the two scales was 0.98 (p < 0.001). After adjusting for patient and injury characteristics, an equivalent increase in score on each scale was associated with longer time to clearance (SCAT-3 hazard ratio 0.885, 95%CI 0.835-0.938, p < 0.001; functional impairment scale hazard ratio 0.851, 95%CI 0.802-0.902, p < 0.001). A concussion symptom scale based on degree of functional impairment correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.

Keywords: checklist, concussion, neurology, scale, sports, symptoms

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470 A Systematic Review and Meta-Analysis of Diabetes Ketoacidosis in Ethiopia

Authors: Addisu Tadesse Sahile, Mussie Wubshet Teka, Solomon Muluken Ayehu

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Background: Diabetes is one of the common public health problems of the century that was estimated to affect one in a tenth of the world population by the year 2030, where diabetes ketoacidosis is one of its common acute complications. Objectives: The aim of this review was to assess the magnitude of diabetes ketoacidosis among patients with type 1 diabetes in Ethiopia. Methods: A systematic data search was done across Google Scholar, PubMed, Web of Science, and African Online Journals. Two reviewers carried out the selection, reviewing, screening, and extraction of the data independently by using a Microsoft Excel Spreadsheet. The Joanna Briggs Institute's prevalence critical appraisal tool was used to assess the quality of evidence. All studies conducted in Ethiopia that reported diabetes ketoacidosis rates among type 1 diabetes were included. The extracted data was imported into the comprehensive meta-analysis version 3.0 for further analysis. Heterogeneity was checked by Higgins’s method, whereas the publication bias was checked by using Beggs and Eggers’s tests. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled prevalence. Furthermore, subgroup analysis based on the study area (Region) and the sample size was carried out. Result and Conclusion: After review made across a total of 51 articles, of which 12 articles fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of diabetes ketoacidosis among type 1 diabetes in Ethiopia was 53.2% (95%CI: 43.1%-63.1%). The highest prevalence of DKA was reported in the Tigray region of Ethiopia, whereas the lowest was reported in the Southern region of Ethiopia. Concerned bodies were suggested to work on the escalated burden of diabetes ketoacidosis in Ethiopia.

Keywords: DKA, Type 1 diabetes, Ethiopia, systematic review, meta-analysis

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469 Data Mining Model for Predicting the Status of HIV Patients during Drug Regimen Change

Authors: Ermias A. Tegegn, Million Meshesha

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Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major cause of death for most African countries. Ethiopia is one of the seriously affected countries in sub Saharan Africa. Previously in Ethiopia, having HIV/AIDS was almost equivalent to a death sentence. With the introduction of Antiretroviral Therapy (ART), HIV/AIDS has become chronic, but manageable disease. The study focused on a data mining technique to predict future living status of HIV/AIDS patients at the time of drug regimen change when the patients become toxic to the currently taking ART drug combination. The data is taken from University of Gondar Hospital ART program database. Hybrid methodology is followed to explore the application of data mining on ART program dataset. Data cleaning, handling missing values and data transformation were used for preprocessing the data. WEKA 3.7.9 data mining tools, classification algorithms, and expertise are utilized as means to address the research problem. By using four different classification algorithms, (i.e., J48 Classifier, PART rule induction, Naïve Bayes and Neural network) and by adjusting their parameters thirty-two models were built on the pre-processed University of Gondar ART program dataset. The performances of the models were evaluated using the standard metrics of accuracy, precision, recall, and F-measure. The most effective model to predict the status of HIV patients with drug regimen substitution is pruned J48 decision tree with a classification accuracy of 98.01%. This study extracts interesting attributes such as Ever taking Cotrim, Ever taking TbRx, CD4 count, Age, Weight, and Gender so as to predict the status of drug regimen substitution. The outcome of this study can be used as an assistant tool for the clinician to help them make more appropriate drug regimen substitution. Future research directions are forwarded to come up with an applicable system in the area of the study.

Keywords: HIV drug regimen, data mining, hybrid methodology, predictive model

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468 Opioid Administration on Patients Hospitalized in the Emergency Department

Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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467 Role of Tyrosine-Phosphorylated STAT3 in Liver Regeneration: Survival, DNA Synthesis, Inflammatory Reaction and Liver Mass Recovery

Authors: JiYoung Park, SueGoo Rhee, HyunAe Woo

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In liver regeneration, quiescent hepatocytes need to be primed to fully respond to growth factors such as hepatocyte growth factor. To understand the priming process, it is necessary to analyze patterns of gene expression that occur during liver regeneration after partial hepatectomy (PHx). Recently, tyrosine phosphorylation of signal transducer and activator of transcription 3 (pYSTAT3) has been shown to play an important role in initiating liver regeneration. In order to evaluate the role of pYSTAT3 on liver regeneration after PHx, we used an intrabody which can selectively inhibit pYSTAT3. In our previous studies, an intrabody had been shown that it bound specifically to the pYSTAT3. Adenovirus-mediated expression of the intrabody in HepG2 cells, as well as mouse liver, blocked both accumulation of pYSTAT3 in the nucleus and downstream target of pYSTAT3. In this study, PHx was performed on intrabody-expressing mice and the expression levels of liver regeneration-related genes were analyzed. We also measured liver/body weight ratios and the related cellular signaling pathways were analyzed. Acute phase response genes were reduced in an intrabody-expressing mice during liver regeneration than in control virus-injected mice. However, the time course of liver mass restoration in intrabody-expressing mice was similar to that observed in control virus-injected mice. We also observed that the expression levels of anti-apoptotic genes, such as Bcl2 and Bcl-xL were decreased in intrabody-expressing mice whereas the expression of cell cycle-related genes such as cyclin D1, and c-myc was increased. Liver regeneration after PHx was partially impaired by the selective inhibition of pYSTAT3 with a phosphorylation site-specific intrabody and these results indicated that pYSTAT3 might have limited role in liver mass recovery.

Keywords: STAT3, pYSTAT3, liver regeneration, intrabody

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466 Comprehensive Evaluation of Oral and Maxillofacial Radiology in "COVID-19"

Authors: Sahar Heidary, Ramin Ghasemi Shayan

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The recent coronavirus disease 2019 (COVID-19) occurrence has carried considerabletrials to the world health system, comprising the training of dental and maxillofacial radiology (DMFR). DMFR will keep avital role in healthcare throughout this disaster. Severe acute breathing disease coronavirus 2 (SARS-CoV-2), the virus producing the current coronavirus disease 2019 (COVID-19) pandemic, is not only extremely contagious but can make solemn consequences in susceptible persons comprising dental patients and dental health care personnel (DHCPs). Reactions to COVID-19 have been available by the Cores for Infection Switch and Inhibition and the American Dental Association, but a more detailed answer is necessary for the harmless preparation of oral and maxillofacial radiology. Our goal is to evaluation the existing information just how the illness threatens patients and DHCPs and how to define which patients are possible to be SARS-CoV-2 infected; study how the usage of private shielding utensils and contamination control measures based on recent top observes, and knowledge can decrease the danger of virus spread in radiologic trials; and scrutinize how intraoral radiography, with its actually superior danger of scattering the infection, might be changed by extraoralradiographic methods for definite diagnostic jobs. In the pandemic, teleradiology has been extensively recycled for diagnostic determinations of COVID-19 patients, for discussions with radiologists in crisis cases, or managing of distance among radiology clinics. Dentists can have the digital radiographic images of their emergency patients through online service area also by electronic message or messaging applications to view in their smart phones, laptops, or other electronic devices.

Keywords: radiology, dental, oral, COVID-19, infection

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465 Effectiveness of Gamified Virtual Physiotherapy Patients with Shoulder Problems

Authors: A. Barratt, M. H. Granat, S. Buttress, B. Roy

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Introduction: Physiotherapy is an essential part of the treatment of patients with shoulder problems. The focus of treatment is usually centred on addressing specific physiotherapy goals, ultimately resulting in the improvement in pain and function. This study investigates if computerised physiotherapy using gamification principles are as effective as standard physiotherapy. Methods: Physiotherapy exergames were created using a combination of commercially available hardware, the Microsoft Kinect, and bespoke software. The exergames used were validated by mapping physiotherapy goals of physiotherapy which included; strength, range of movement, control, speed, and activation of the kinetic chain. A multicenter, randomised prospective controlled trial investigated the use of exergames on patients with Shoulder Impingement Syndrome who had undergone Arthroscopic Subacromial Decompression surgery. The intervention group was provided with the automated sensor-based technology, allowing them to perform exergames and track their rehabilitation progress. The control group was treated with standard physiotherapy protocols. Outcomes from different domains were used to compare the groups. An important metric was the assessment of shoulder range of movement pre- and post-operatively. The range of movement data included abduction, forward flexion and external rotation which were measured by the software, pre-operatively, 6 weeks and 12 weeks post-operatively. Results: Both groups show significant improvement from pre-operative to 12 weeks in elevation in forward flexion and abduction planes. Results for abduction showed an improvement for the interventional group (p < 0.015) as well as the test group (p < 0.003). Forward flexion improvement was interventional group (p < 0.0201) with the control group (p < 0.004). There was however no significant difference between the groups at 12 weeks for abduction (p < 0.118067) , forward flexion (p < 0.189755) or external rotation (p < 0.346967). Conclusion: Exergames may be used as an alternative to standard physiotherapy regimes; however, further analysis is required focusing on patient engagement.

Keywords: shoulder, physiotherapy, exergames, gamification

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464 The Capabilities of New Communication Devices in Development of Informing: Case Study Mobile Functions in Iran

Authors: Mohsen Shakerinejad

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Due to the growing momentum of technology, the present age is called age of communication and information. And With Astounding progress of Communication and information tools, current world Is likened to the "global village". That a message can be sent from one point to another point of the world in a Time scale Less than a minute. However, one of the new sociologists -Alain Touraine- in describing the destructive effects of new changes arising from the development of information appliances refers to the "new fields for undemocratic social control And the incidence of acute and unrest social and political tensions", Yet, in this era That With the advancement of the industry, the life of people has been industrial too, quickly and accurately Data Transfer, Causes Blowing new life in the Body of Society And according to the features of each society and the progress of science and technology, Various tools should be used. One of these communication tools is Mobile. Cellular phone As Communication and telecommunication revolution in recent years, Has had a great influence on the individual and collective life of societies. This powerful communication tool Have had an Undeniable effect, On all aspects of life, including social, economic, cultural, scientific, etc. so that Ignoring It in Design, Implementation and enforcement of any system is not wise. Nowadays knowledge and information are one of the most important aspects of human life. Therefore, in this article, it has been tried to introduce mobile potentials in receive and transmit News and Information. As it follows, among the numerous capabilities of current mobile phones features such as sending text, photography, sound recording, filming, and Internet connectivity could indicate the potential of this medium of communication in the process of sending and receiving information. So that nowadays, mobile journalism as an important component of citizen journalism Has a unique role in information dissemination.

Keywords: mobile, informing, receiving information, mobile journalism, citizen journalism

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