Search results for: behavioral-physical and visual methods

Authors: Tuji Jemal Ahmed

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This paper is to provides a comprehensive review of current research works on foodborne illness and food safety, including the risks associated with foodborne illnesses, the latest research on food safety, and the mitigation strategies used to prevent and control foodborne illnesses. Foodborne illness is a major public health concern that affects millions of people every year. As foodborne illnesses have grown more common and dangerous in recent years, it is vital that we research and build upon methods to ensure food remains safe throughout consumption. Additionally, this paper will discuss future directions for food safety research, including emerging technologies, changes in regulations and standards, and collaborative efforts to improve food safety. The first section of the paper provides an overview of the risks of foodborne illness, including a definition of foodborne illness, the causes of foodborne illness, the types of foodborne illnesses, and high-risk foods for foodborne illness, Health Consequences of Foodborne Illness. The second section of the paper focuses on current research on food safety, including the role of regulatory agencies in food safety, food safety standards and guidelines, emerging food safety concerns, and advances in food safety technology. The third section of the paper explores mitigation strategies for foodborne illness, including preventative measures, hazard analysis and critical control points (HACCP), good manufacturing practices (GMPs), and training and education. Finally, this paper examines future directions for food safety research, including hurdle technologies and their impact on food safety, changes in food safety regulations and standards, collaborative efforts to improve food safety, and research gaps and areas for further exploration. In general, this work provides a comprehensive review of current research and future directions in food safety and understanding the risks associated with foodborne illness. The implications of the assessment for food safety and public health are discussed, as well as recommended for research scholars.

Keywords: food safety, foodborne illness, technologies, mitigation

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Authors: Archana S., Usha Rani G., Anand Balakrishnan, Sanjana R., Solomon F., Vijayalakshmi J.

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Background: There is evidence that male factors contribute to the infertility of up to 50% of couples, who are evaluated and treated for infertility using advanced assisted reproductive technologies. Genetic abnormalities, including sperm chromosome aneuploidy as well as structural aberrations, are one of the major causes of male infertility. Recent advances in technology expedite the evaluation of sperm aneuploidy. The purpose of the study was to de-termine the prevalence of sperm aneuploidy in infertile males and the degree of association between DNA fragmentation and sperm aneuploidy. Methods: In this study, 75 infertile men were included, and they were divided into four abnormal groups (Oligospermia, Terato-spermia, Asthenospermia and Oligoasthenoteratospermia (OAT)). Men with children who were normozoospermia served as the control group. The Fluorescence in situ hybridization (FISH) method was used to test for sperm aneuploidy, and the Sperm Chromatin Dispersion Assay (SCDA) was used to measure the fragmentation of sperm DNA. Spearman's correla-tion coefficient was used to evaluate the relationship between sperm aneuploidy and sperm DNA fragmentation along with age. P < 0.05 was regarded as significant. Results: 75 partic-ipants' ages varied from 28 to 48 years old (35.5±5.1). The percentage of spermatozoa bear-ing X and Y was determined to be statistically significant (p-value < 0.05) and was found to be 48.92% and 51.18% of CEP X X 1 – nucish (CEP XX 1) [100] and CEP Y X 1 – nucish (CEP Y X 1) [100]. When compared to the rate of DNA fragmentation, it was discovered that infertile males had a greater frequency of sperm aneuploidy. Asthenospermia and OAT groups in sex chromosomal aneuploidy were significantly correlated (p<0.05). Conclusion: Sperm FISH and SCDA assay results showed increased sperm aneuploidy frequency, and DNA fragmentation index in infertile men compared with fertile men. There is a significant relationship observed between sperm aneuploidy and DNA fragmentation in OAT patients. When evaluating male variables and idiopathic infertility, the sperm FISH screening method can be used as a valuable diagnostic tool.

Keywords: ale infertility, dfi (dna fragmentation assay) (scd-sperm chromatin dispersion).art (artificial reproductive technology), trisomy, aneuploidy, fish (fluorescence in-situ hybridization), oat (oligoasthoteratospermia)

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Authors: Mehwish Sarfaraz Ahmad

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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

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Authors: Siyabonga Kunene, Calvin Shipley

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Introduction: Despite health benefits that come with running, injuries are common with prevalence ranging between 18.2% and 92.4% worldwide. Differences in gait patterns between barefoot and shod running, can determine traits that could lead to running injuries. The aim was to assess and compare lower limb gait cycle patterns between barefoot and shod running among runners. Methods: An experimental same-subject study design was used. The study population consisted of male and female adult recreational runners who were injury free from a running club in Durban. A convenience sampling method was used and 14 participants were recruited. The study was conducted in the physiotherapy performance laboratory at the University of KwaZulu-Natal. A Woodway Desmo Treadmill and KinePro gait analysis system were used. Descriptive & inferential statistics were analysed using Microsoft Excel and Intercooled Stata. Results: Participants included a greater percentage of females (57.1%, n = 8) than males (42.9%, n = 6). The mean population age was 38.57. A significant difference (p < 0.0009) between barefoot cadence (177.9236steps/min) and shod cadence (171.9445steps/min) was observed. Right (0.261s) and left (0.257s) barefoot stand phase was shorter than right (0.273s) and left (0.270s) shod stand phase. Right barefoot swing phase exhibited less significant (0.420s) results when compared to right shod swing phase (0.427s), whereas left barefoot swing phase was quicker (0.416s) than left shod swing phase (0.432s). Significant differences between barefoot and shod stand (p < 0.009) and swing (p < 0.040) phase symmetry occurred. Conclusion: A considerable difference was found between barefoot and shod running gait cycle patterns among participants. This difference may play a role in prevention of running related injuries.

Keywords: barefoot running, shod running, gait cycle pattern, same-subject study design

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Authors: Roohallah Fallah-Moshkani, Mohammad Ali Mohsenpour, Reza Ghiasvand, Hossein Khosravi-Boroujeni, Seyed Mehdi Ahmadi, Paula Brauer, Amin Salehi-Abargouei

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Purpose: Several investigations have proposed the protective association between dietary approaches to stop hypertension (DASH) style diet and risk of cancers; however, they have led to inconsistent results. The present study aimed to systematically review the prospective cohort studies conducted in this regard and, if possible, to quantify the overall effect of using meta-analysis. Methods: PubMed, EMBASE, Scopus, and Google Scholar were searched for cohort studies published up to December 2017. Relative risks (RRs) which were reported for fully adjusted models and their confidence intervals were extracted for meta-analysis. Random effects model was incorporated to combine the RRs. Results: Sixteen studies were eligible to be included in the systematic review from which 8 reports were conducted on the effect of DASH on the risk of mortality from all cancer types, four on the risk of colorectal cancer, and three on the risk of colon and rectal cancer. Four studies examined the association with other cancers (breast, hepatic, endometrial, and lung cancer). Meta-analysis showed that high concordance with DASH significantly decreases the risk of all cancer types (RR=0.83, 95% confidence interval (95%CI):0.80-0.85); furthermore participants who highly adhered to the DASH had lower risk of developing colorectal (RR=0.79, 95%CI: 0.75-0.83), colon (RR=0.81, 95%CI: 0.74-0.87) and rectal (RR=0.79, 95%CI: 0.63-0.98) cancer compared to those with the lowest adherence. Conclusions: DASH-style diet should be suggested as a healthy approach to protect from cancer in the community. Prospective studies exploring the effect on other cancer types and from regions other than the United States are highly recommended.

Keywords: cancer, DASH-style diet, dietary patterns, meta-analysis, systematic review

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Authors: Vrinda P. S. Borker

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Major water pollutants are dyes from effluents of industries. Different methods have been tried to degrade or treat the effluent before it is left to the environment. In order to understand the degradation process and later apply it to effluents, solar degradation study of methylene blue (MB) and methyl red (MR), the model dyes was carried out in the presence of photo-catalysts, the oxides of cobalt oxide Co₃O₄, and copper doped cobalt oxides (Co₀.₉Cu₀.₁)₃O₄ and (Co₀.₉₅Cu₀.₀₅)₃O₄. They were prepared from oxalate complex and hydrazinated oxalate complex of cobalt as well as mix metals, copper, and cobalt. The complexes were synthesized and characterized by FTIR. Complexes were decomposed to form oxides and were characterized by XRD. They were found to be monophasic. Solar degradation of MR and MB was carried out in presence of these oxides in acidic and basic medium. Degradation was faster in alkaline medium in the presence of Co₃O₄ obtained from hydrazinated oxalate. Doping of nanomaterial oxides modifies their characteristics. Doped cobalt oxides are found to photo-decolourise MR in alkaline media efficiently. In the absence of photocatalyst, solar degradation of alkaline MR does not occur. In acidic medium, MR is minimally decolorized even in the presence of photocatalysts. The industrial textile effluent contains chemicals like NaCl and Na₂CO₃ along with the unabsorbed dye. It is reported that these two chemicals hamper the degradation of dye. The chemicals like K₂S₂O₈ and H₂O₂ are reported to enhance degradation. The solar degradation study of MB in presence of photocatalyst (Co₀.₉Cu₀.₁)₃O₄ and these four chemicals reveals that presence of K₂S₂O₈ and H₂O₂ enhances degradation. It proves that H₂O₂ generates hydroxyl ions required for degradation of dye and the sulphate anion radical being strong oxidant attacks dye molecules leading to its fragmentation rapidly. Thus addition of K₂S₂O₈ and H₂O₂ during solar degradation in presence of (Co₀.₉Cu₀.₁)₃O₄ helps to break the organic moiety efficiently.

Keywords: cobalt oxides, Cu-doped cobalt oxides, H₂O₂ in dye degradation, photo-catalyst, solar dye degradation

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Authors: Rehana Khan

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Background: The study investigates the experiences of Tiger Teams within the Sydney Local Health District during the COVID-19 pandemic. Aim: The aims were to understand the experiences of the Tiger Team members, to evaluate the effectiveness of Tiger Teams, and to elicit any learnings for future implementation of Tiger Teams in a similar context. Methods: Tiger Team members who worked from March 2020 to January 2022 were approached, with 23 members agreeing to participate in the study. Individual interviews were undertaken by a researcher on a virtual platform. Thematic analysis was used to analyse the data. Saturation was deemed to have been reached when no new themes or subthemes arose within the final three interviews. Results: Four themes emerged: diversity worked well in Tiger Teams; fear of the unknown and challenging conversations were the main challenges of Tiger Teams; improved use of resources and more structure around the strategy of the Tiger Team model would help in future implementations; and Sydney Local Health District’s response to the pandemic was uniformly considered effective in keeping the community safe. In relation to Sydney Local Health District’s response in future pandemics, participants suggested having a pool of staff in readiness to undertake Tiger Team duties when required; prioritise staff welfare at all levels of involvement during a pandemic; maintaining transparent communication and relationship building between Executive level, Tiger Team members and clinical floor level in relation to decision making; and improve documentation, including evaluations of the COVID-19 pandemic response. Implications: The study provides constructive insights into the experiences of Tiger Team members, and these findings will help inform future planning for surge and secondment of staff in public health emergencies.

Keywords: Tiger Team, pandemic response, future planning, COVID-19

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: Balakrishna Shetty

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Introduction: Stem Cell Imaging is a challenging field since the advent of Stem Cell treatment in humans. Series of research on tagging and tracking the stem cells has not been very effective. The present study is an effort by the authors to track the stem cells injected into calf muscles by Magnetic Resonance Diffusion Weighted Imaging. Materials and methods: Stem Cell injection deep into the calf muscles of patients with peripheral vascular disease is one of the recent treatment modalities followed in our institution. 5 patients who underwent deep intramuscular injection of stem cells as treatment were included for this study. Pre and two hours Post injection MRI of bilateral calf regions was done using 1.5 T Philips Achieva, 16 channel system using 16 channel torso coils. Axial STIR, Axial Diffusion weighted images with b=0 and b=1000 values with back ground suppression (DWIBS sequence of Philips MR Imaging Systems) were obtained at 5 mm interval covering the entire calf. The invert images were obtained for better visualization. 120ml of autologous bone marrow derived stem cells were processed and enriched under c-GMP conditions and reduced to 40ml solution containing mixture of above stem cells. Approximately 40 to 50 injections, each containing 0.75ml of processed stem cells, was injected with marked grids over the calf region. Around 40 injections, each of 1ml normal saline, is injected into contralateral leg as control. Results: Significant Diffusion hyper intensity is noted at the site of injected stem cells. No hyper intensity noted before the injection and also in the control side where saline was injected conclusion: This is one of the earliest studies in literature showing diffusion hyper intensity in intramuscularly injected stem cells. The advantages and deficiencies in this study will be discussed during the presentation.

Keywords: stem cells, imaging, DWI, peripheral vascular disease

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Authors: Felermino D. M. A. Ali, S. C. Ng

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E-learning is an evolutionary form of distance learning and has become better over time as new technologies emerged. Today, efforts are still being made to embrace E-learning systems with emerging technologies in order to make them better. Among these advancements, Educational Data Mining (EDM) is one that is gaining a huge and increasing popularity due to its wide application for improving the teaching-learning process in online practices. However, even though EDM promises to bring many benefits to educational industry in general and E-learning environments in particular, its principal drawback is the lack of easy to use tools. The current EDM tools usually require users to have some additional technical expertise to effectively perform EDM tasks. Thus, in response to these limitations, this study intends to design and implement an EDM application framework which aims at automating and simplify the development of EDM in E-learning environment. The application framework introduces a Service-Oriented Architecture (SOA) that hides the complexity of technical details and enables users to perform EDM in an automated fashion. The framework was designed based on abstraction, extensibility, and interoperability principles. The framework implementation was made up of three major modules. The first module provides an abstraction for data gathering, which was done by extending Moodle LMS (Learning Management System) source code. The second module provides data mining methods and techniques as services; it was done by converting Weka API into a set of Web services. The third module acts as an intermediary between the first two modules, it contains a user-friendly interface that allows dynamically locating data provider services, and running knowledge discovery tasks on data mining services. An experiment was conducted to evaluate the overhead of the proposed framework through a combination of simulation and implementation. The experiments have shown that the overhead introduced by the SOA mechanism is relatively small, therefore, it has been concluded that a service-oriented architecture can be effectively used to facilitate educational data mining in E-learning environments.

Keywords: educational data mining, e-learning, distributed data mining, moodle, service-oriented architecture, Weka

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Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu

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The coir is one of the by-products of the coconut and the coir industry can be identified as one of the traditional industries in Sri Lanka. Sri Lanka is one of the prominent countries for the coir production. Due to the labour insensitiveness, the labourers are the significant factor in the coir production process. The study has analyzed the determinants and its impact on income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division, Galle, Sri Lanka. Simple random sampling was used to generate the sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were carried out. The findings revealed that the household level coir yarn industry is dominated by the female workers and fewer amounts of workers have engaged this industry as the main occupation. In addition to that, elderly participation of the industry is greater than younger participation and most of them engaged as an extra income source. Level of education, the methods of engagement, satisfaction, labour’s children employment in the coir industry, support from the government, method of government support, working hours per day, employed as a main job, no of completed units per day, suffering any job related diseases and type of the diseases were related with income level of household level coir yarn labourers. The recommendations were formulated in respect to these problems including technological transformation for coir yarn production, strengthening of the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programs, the establishment of the labourers association, the initiation of micro credit schemes, better consideration about the job oriented diseases.

Keywords: coir, coir yarn labourers, income, Galle

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Authors: Mayada Mazher, Ahmed Moustafa, Ahmed Abdellatif

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Background: Autophagy is a eukaryotic, highly conserved catabolic process implicated in many pathophysiologies such as wound healing. Autophagy-associated genes serve as a scaffolding platform for signal transduction of macrophage polarization during the inflammatory phase of wound healing and tissue repair process. In the current study, we report a model for the interplay between autophagy-associated genes and macrophages polarization associated genes. Methods: In silico analysis was performed on 249 autophagy-related genes retrieved from the public autophagy database and gene expression data retrieved from Gene Expression Omnibus (GEO); GSE81922 and GSE69607 microarray data macrophages polarization 199 DEGS. An integrated protein-protein interaction network was constructed for autophagy and macrophage gene sets. The gene sets were then used for GO terms pathway enrichment analysis. Common transcription factors for autophagy and macrophages' polarization were identified. Finally, microRNAs enriched in both autophagy and macrophages were predicated. Results: In silico prediction of common transcription factors in DEGs macrophages and autophagy gene sets revealed a new role for the transcription factors, HOMEZ, GABPA, ELK1 and REL, that commonly regulate macrophages associated genes: IL6,IL1M, IL1B, NOS1, SOC3 and autophagy-related genes: Atg12, Rictor, Rb1cc1, Gaparab1, Atg16l1. Conclusions: Autophagy and macrophages' polarization are interdependent cellular processes, and both autophagy-related proteins and macrophages' polarization related proteins coordinate in tissue remodelling via transcription factors and microRNAs regulatory network. The current work highlights a potential new role for transcription factors HOMEZ, GABPA, ELK1 and REL in wound healing.

Keywords: autophagy related proteins, integrated network analysis, macrophages polarization M1 and M2, tissue remodelling

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Authors: B. Karabuluter, O. Karaduman

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Traffic management and traffic planning are important issues, especially in big cities. Due to the increase of personal vehicles and the physical constraints of urban roads, the problem of transportation especially in crowded cities over time is revealed. This situation reduces the living standards, and it can put human life at risk because the vehicles such as ambulance, fire department are prevented from reaching their targets. Even if the city planners take these problems into account, emergency planning and traffic management are needed to avoid cases such as traffic congestion, intersections, traffic jams caused by traffic accidents or roadworks. In this study, in smart traffic management issues, proposed solutions using intelligent vehicles acting in cooperation with urban roads are examined. Traffic management is becoming more difficult due to factors such as fatigue, carelessness, sleeplessness, social behavior patterns, and lack of education. However, autonomous vehicles, which remove the problems caused by human weaknesses by providing driving control, are increasing the success of practicing the algorithms developed in city traffic management. Such intelligent vehicles have become an important solution in urban life by using 'swarm intelligence' algorithms and cooperative driving methods to provide traffic flow, prevent traffic accidents, and increase living standards. In this study, studies conducted in this area have been dealt with in terms of traffic jam, intersections, regulation of traffic flow, signaling, prevention of traffic accidents, cooperation and communication techniques of vehicles, fleet management, transportation of emergency vehicles. From these concepts, some taxonomies were made out of the way. This work helps to develop new solutions and algorithms for cities where intelligent vehicles that can perform cooperative driving can take place, and at the same time emphasize the trend in this area.

Keywords: intelligent traffic management, cooperative driving, smart driving, urban road, swarm intelligence, connected vehicles

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Authors: Sana Ammad

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The tradition of linguistic analysis in Islam and Christianity has developed independently of each other in lieu of the social developments specific to their historical context. However, recently increasing number of Muslim academics educated in the West have tried to apply the Western tradition of linguistic interpretation to the Qur’anic text while completely disregarding the Islamic linguistic tradition used and developed by the traditional scholars over the centuries. The aim of the paper is to outline the linguistic tools and methods used by the traditional Islamic scholars for the purpose of interpretating the Holy Qur’an and shed light on how they contribute towards a better understanding of the text compared to their Western counterparts. This paper carries out a descriptive-comparative study of the linguistic tools developed and perfected by the traditional scholars in Islam for the purpose of textual analysis of the Qur’an as they have been described in the authentic works of Usul Al Fiqh (Jurisprudence) and the principles of textual analysis employed by the Western hermeneutical tradition for the study of the Bible. First, it briefly outlines the independent historical development of the two traditions emphasizing the final normative shape that they have taken. Then it draws a comparison of the two traditions highlighting the similarities and the differences existing between them. In the end, the paper demonstrates the level of academic excellence achieved by the traditional linguistic scholars in their efforts to develop appropriate tools of textual interpretation and how these tools are more suitable for interpreting the Qur’an compared to the Western principles. Since the aim of interpreters of both the traditions is to try and attain an objective understanding of the Scriptures, the emphasis of the paper shall be to highlight how well the Islamic method of linguistic interpretation contributes to an objective understanding of the Qur’anic text. The paper concludes with the following findings: The Western hermeneutical tradition of linguistic analysis developed within the Western historical context. However, the Islamic method of linguistic analysis is much more highly developed and complex and serves better the purpose of objective understanding of the Holy text.

Keywords: Islamic jurisprudence, linguistic analysis, textual interpretation, western hermeneutics

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Authors: Sifiso Vilakazi, Lerato Mzenzi

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BACKGROUND :- Human mind is a double-edged sword, it is both arduous and obtuse, vague and explicit. The neuroscience of brain has baffled all and left none. In this labyrinth, a novel neurotransmitter has set its foot. D-Aspartic acid, which has been established in rats and animals’ brain as a neurochemical in controlling behaviour, aggression, fertility, cognition and memory is set to formulate a new benchmark as a marker among suicidal and accidental death victims. Without losing sight of the fact, we have endeavoured to dig out the biochemical relation behind suicide in our research. We in our research have exerted to decipher the puzzle among humans for D-Aspartic acid using HPLC. METHODS:- We have taken 30 samples each of pre-frontal cortex of brain from suicide and road traffic accidents victims for our case-control research to establish brain D-Aspartic acid level using HPLC as a marker for suicide. RESULTS:- By using Independent/Unpaired T-Test Analysis:- The two-tailed P value is less than 0.0044. MEAN (mMOL/mL/G) for D-Aspartic acid in control is 24.2737±7.5958 and for cases is 19.5540±4.2647. By conventional criteria, this difference is considered to be extremely statistically significant. CONCLUSION:- (1) Brain D-Aspartic acid has an effect in the act of suicide and its values show a large drop before the act of suicide is commenced as compared to road traffic accidents which correlates with the study where D-AA was studied as a novel endogenous neurotransmitter in case of mental health disorders in humans, though never studied on suicide victims, likely getting it reference from research occurring on rats where it was discovered that D-AA plays a role in cognition, personality development, thought process, aggression. (2)The other study which was related to humans and signified the role of D-AA in reproduction, where low D-AA leads to infertility and depression and hence providing the much needed proof of role of D-AA in mental health disorders and suicide, and subsequently to the act of suicide.

Keywords: green energy, policy, technology, implementation

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Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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Authors: Bahatti̇n Ki̇mençe, Uğur Ki̇mençe

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In this study, the purpose of obtaining the influence functions of the displacement discontinuity in an anisotropic elastic medium is to produce the boundary element equations. A Displacement Discontinuous Method formulation (DDM) is presented with the aim of modeling two-dimensional elastic fracture problems. This formulation is found by analytical integration of the fundamental solution along a straight-line crack. With this purpose, Kelvin's fundamental solutions for anisotropic media on an infinite plane are used to form dipoles from singular loads, and the various combinations of the said dipoles are used to obtain the influence functions of displacement discontinuity. This study introduces a technique for coupling Fictitious Stress Method (FSM) and DDM; the reason for applying this technique to some examples is to demonstrate the effectiveness of the proposed coupling method. In this study, displacement discontinuity equations are obtained by using dipole solutions calculated with known singular force solutions in an anisotropic medium. The displacement discontinuities method obtained from the solutions of these equations and the fictitious stress methods is combined and compared with various examples. In this study, one or more crack problems with various geometries in rectangular plates in finite and infinite regions, under the effect of tensile stress with coupled FSM and DDM in the anisotropic environment, were examined, and the effectiveness of the coupled method was demonstrated. Since crack problems can be modeled more easily with DDM, it has been observed that the use of DDM has increased recently. In obtaining the displacement discontinuity equations, Papkovitch functions were used in Crouch, and harmonic functions were chosen to satisfy various boundary conditions. A comparison is made between two indirect boundary element formulations, DDM, and an extension of FSM, for solving problems involving cracks. Several numerical examples are presented, and the outcomes are contrasted to existing analytical or reference outs.

Keywords: displacement discontinuity method, fictitious stress method, crack problems, anisotropic material

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Authors: Prarabdh Tiwari, M. Vidya Sagar, K. Bhima Raju, Joy Choudhury, Subash Chandra, E. Nagaiah, Shakeel Ahmed

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Passive seismic, a wavefield interferometric imaging, low cost and rapid tool for subsurface investigation is used for various geotechnical purposes such as hydrocarbon exploration, seismic microzonation, etc. With the recent advancement, its application has also been extended to groundwater exploration by means of finding the bedrock depth. Council of Scientific & Industrial Research (CSIR)-National Geophysical Research Institute (NGRI) has experimented passive seismic studies along with electrical resistivity tomography for groundwater in hard rock (Choutuppal, Hyderabad). Passive Seismic with Electrical Resistivity (ERT) can give more clear 2-D subsurface image for Groundwater Exploration in Hard Rock area. Passive seismic data were collected using a Tromino, a three-component broadband seismometer, to measure background ambient noise and processed using GRILLA software. The passive seismic results are found corroborating with ERT (Electrical Resistivity Tomography) results. For data acquisition purpose, Tromino was kept over 30 locations consist recording of 20 minutes at each station. These location shows strong resonance frequency peak, suggesting good impedance contrast between different subsurface layers (ex. Mica rich Laminated layer, Weathered layer, granite, etc.) This paper presents signature of passive seismic for hard rock terrain. It has been found that passive seismic has potential application for formation characterization and can be used as an alternative tool for delineating litho-stratification in an urban condition where electrical and electromagnetic tools cannot be applied due to high cultural noise. In addition to its general application in combination with electrical and electromagnetic methods can improve the interpreted subsurface model.

Keywords: passive seismic, resonant frequency, Tromino, GRILLA

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Authors: Dorna Kargar, Mehrasa Masih

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Due to its special geological and geographical conditions, Iran has always been exposed to various natural hazards. Earthquake is one of the natural hazards with random nature that can cause significant financial damages and casualties. This is a serious threat, especially in areas with active faults. Therefore, considering the population density in some parts of the country, locating and zoning high-risk areas are necessary and significant. In the present study, seismic hazard assessment via probabilistic and deterministic method for Tehran, the capital of Iran, which is located in Alborz-Azerbaijan province, has been done. The seismicity study covers a range of 200 km from the north of Tehran (X=35.74° and Y= 51.37° in LAT-LONG coordinate system) to identify the seismic sources and seismicity parameters of the study region. In order to identify the seismic sources, geological maps at the scale of 1: 250,000 are used. In this study, we used Kijko-Sellevoll's method (1992) to estimate seismicity parameters. The maximum likelihood estimation of earthquake hazard parameters (maximum regional magnitude Mmax, activity rate λ, and the Gutenberg-Richter parameter b) from incomplete data files is extended to the case of uncertain magnitude values. By the combination of seismicity and seismotectonic studies of the site, the acceleration with antiseptic probability may happen during the useful life of the structure is calculated with probabilistic and deterministic methods. Applying the results of performed seismicity and seismotectonic studies in the project and applying proper weights in used attenuation relationship, maximum horizontal and vertical acceleration for return periods of 50, 475, 950 and 2475 years are calculated. Horizontal peak ground acceleration on the seismic bedrock for 50, 475, 950 and 2475 return periods are 0.12g, 0.30g, 0.37g and 0.50, and Vertical peak ground acceleration on the seismic bedrock for 50, 475, 950 and 2475 return periods are 0.08g, 0.21g, 0.27g and 0.36g.

Keywords: peak ground acceleration, probabilistic and deterministic, seismic hazard assessment, seismicity parameters

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Authors: M. Reza Roshandel, Tannaz Aghaei Badr, Batoul Khoundabi, Sara C. Lewis, Soroush Rais-Bahrami, John Sfakianos, Reza Mehrazin, Ash K. Tewari

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Introduction: Prostate biopsy is the most reliable diagnostic method for choosing the appropriate management of prostate cancer. However, discrepancies between Gleason grade groups (GG) of different biopsies remain a significant concern. This study aims to assess the association of the radiological factors with GG discrepancies in patients with index Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, using radical prostatectomy (RP) specimens as the most accurate and informative pathology. Methods: This single-institutional retrospective study was performed on a total of 2289 consecutive prostate cancer patients with combined targeted and systematic prostate biopsy followed by radical prostatectomy (RP). The database was explored for patients with the index PI-RADS 3 lesions version 2 and 2.1. Cancers with PI-RADS 4 or 5 scoring were excluded from the study. Patient characteristics and radiologic features were analyzed by multivariable logistic regression. Number-density of lesions was defined as the number of lesions per prostatic volume. Results: Of the 151 prostate cancer cases with PI-RADS 3 index lesions, 27% and 17% had upgrades and downgrades at RP, respectively. Analysis of grade changes showed no significant associations between discrepancies and the number or the number density of PI-RADS 3 lesions. Moreover, the study showed no significant association of the GG changes with race, age, location of the lesions, or prostate volume. Conclusions: This study demonstrated that in PI-RADS 3 cancerous nodules, the chance of the pathology changes in the final pathology of RP specimens was low. Furthermore, having multiple PI-RADS 3 nodules did not change the conclusion, as the possibility of grade changes in patients with multiple nodules was similar to those with solitary lesions.

Keywords: prostate, adenocarcinoma, multiparametric MRI, Gleason score, robot-assisted surgery

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Authors: Jacinta Musyoka, Wesley Too

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Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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Authors: Remus Pravalie, Georgeta Bandoc

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Forests are crucial for humanity and biodiversity, through the various ecosystem services and functions they provide all over the world. Forest ecosystems are vital in Romania as well, through their various benefits, known as provisioning (food, wood, or fresh water), regulating (water purification, soil protection, carbon sequestration or control of climate change, floods, and other hazards), cultural (aesthetic, spiritual, inspirational, recreational or educational benefits) and supporting (primary production, nutrient cycling, and soil formation processes, with direct or indirect importance for human well-being) ecosystem services. These ecological benefits are of great importance in Romania, especially given the fact that forests cover extensive areas countrywide, i.e. ~6.5 million ha or ~27.5% of the national territory. However, the diversity and functionality of these ecosystem services fundamentally depend on certain key attributes of forests, such as biomass, which has so far not been studied nationally in terms of potential changes due to climate change and other driving forces. This study investigates, for the first time, changes in forest biomass in Romania in recent decades, based on a high volume of satellite data (Landsat images at high spatial resolutions), downloaded from the Google Earth Engine platform and processed (using specialized software and methods) across Romanian forestland boundaries from 1987 to 2018. A complex climate database was also investigated across Romanian forests over the same 32-year period, in order to detect potential similarities and statistical relationships between the dynamics of biomass and climate data. The results obtained indicated considerable changes in forest biomass in Romania in recent decades, largely triggered by the climate change that affected the country after 1987. Findings on the complex pattern of recent forest changes in Romania, which will be presented in detail in this study, can be useful to national policymakers in the fields of forestry, climate, and sustainable development.

Keywords: forests, biomass, climate change, trends, romania

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Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria

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Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.

Keywords: basic life support, paediatric basic life support, web-based learning, blended learning

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Authors: Tesleem Adewale Ibrahim

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Introduction: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has been slowly rising in Nigeria for the past few decades. Therefore, novel classes of antibiotics are indispensable to combat the increased incidence of newly emerging multidrug-resistant bacteria like MRSA. Plants have been commonly used in popular medicine of most cultures for the treatment of disease. The in vitro antibacterial activity of some Nigerian common medicinal plants used in traditional medicine has been reported. The aim of this study was to investigate the antibacterial and anti-biofilm of these native plants (Entada abysinnica (leaves), Croton macrostachyus (leaves), Bridelia speciosa (seeds, bark), and Aframomum melegueta (leaves, seeds, and stem) collected in Southwestern Nigeria against a panel of seven biofilm-forming MRSA. Methods: Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of the plant extracts against MRSA were determined by the broth dilution method, and the anti-biofilm assay of the most potent plant extract was performed. Result: The results revealed that, of the four plants, water extracts of leaves of Entada abysinnica, leaves of Croton macrostachyus, seeds and bark Bridelia speciosa, and seeds of Aframomum melegueta exhibited significant antibacterial activity. Based on the MIC/MBC ratio, the extracts of these plants were determined to be bacteriostatic in nature. Anti-biofilm assay showed that the extract of seeds of Aframomum melegueta and leaves of Croton macrostachyus fairly inhibited the growth of MRSA in the preformed biofilm matrix. Conclusion: These four medicinal plant species may represent a source of alternative drugs derived from plant extracts based on folklore use and ethnobotanical knowledge from southwest Nigeria.

Keywords: extract, MRSA, antibacterial, biofilm, medicinal plants

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Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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Authors: Ph. Fauquet-Alekhine

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Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: bias, expert, high risk industry, stress.

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Authors: Miao Zhang, Limin Liu, Feng Zhi, Panpan Niu, Mengya Yang, Xuemei Zhu, Ying Diao, Jun Wang, Ying Zhao

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Background and Aims: Clinical studies have demonstrated that serum semicarbazide-sensitive amine oxidase (SSAO) activities positively correlate with the progression of atherosclerosis. The aim of the present study is to investigate the effect of SSAO inactivation on the development of atherosclerosis. Methods: Female LDLr knockout (KO) mice were given the Western-type diet for 6 and 9 weeks to induce the formation of early and advanced lesions, and semicarbazide (SCZ, 0.125%) was added into the drinking water to inactivate SSAO in vivo. Results: Despite no impact on plasma total cholesterol levels, abrogation of SSAO by SCZ not only resulted in the enlargement of both early (1.5-fold, p=0.0043) and advanced (1.8-fold, p=0.0013) atherosclerotic lesions, but also led to reduced/increased lesion contents of macrophages/smooth muscle cells (SMCs) (macrophage: ~0.74-fold, p=0.0002(early)/0.0016(advanced); SMC: ~1.55-fold, p=0.0003(early) /0.0001(advanced)), respectively. Moreover, SSAO inactivation inhibited the migration of circulating monocytes into peripheral tissues and reduced the amount of circulating Ly6Chigh monocytes (0.7-fold, p=0.0001), which may account for the reduced macrophage content in lesions. In contrast, the increased number of SMCs in lesions of SCZ-treated mice is attributed to an augmented synthetic vascular SMC phenotype switch as evidenced by the increased proliferation of SMCs and accumulation of collagens in vivo. Conclusion: SSAO inactivation by SCZ promotes the phenotypic switch of SMCs and the development of atherosclerosis. The enzymatic activity of SSAO may thus represent a potential target in the prevention and/or treatment of atherosclerosis.

Keywords: atherosclerosis, phenotype switch of smooth muscle cells, SSAO/VAP-1, semicarbazide

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Authors: Bouhouf Atef, Beloulou Mohamed Lamine

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Introduction: Outpatient surgery is continually developing compared to conventional inpatient surgery; its rate is constantly increasing every year due to global socio-economic pressure. Most hospitals continue to perform proctologic surgery in conventional hospitalization. Purpose: As part of a monocentric prospective descriptive study, we examined the feasibility of proctologic surgery under saddle block on an outpatient basis with the same safety conditions as in traditional hospitalization. Material and methods: This is a monocentric prospective descriptive study spread over a period of 24 months, from December 2018 to December 2020 including 150 patients meeting the medico-surgical and socio-environmental criteria of eligibility for outpatient surgery, operated for proctological pathologies under saddle block in outpatient mode, in the surgery department of the regional military hospital of Constantine Algeria. The data were collected and analyzed by the biomedical statistics software Epi-info and Microsoft Excel, then compared with other related studies. Results: This study involved over a period of two years, 150 male patients with an average age of 32 years (20-64). Most patients (95,33%) were ASA I class, and 4,67% ASA II class. All patients received saddle blocks. The average length of stay of patients was six hours. The quality indicators in outpatient surgery in our study were: zero (0)% of deprogrammings, three (3)% of conversions to full hospitalization, 0,7% of readmissions, an average waiting time before access to the operating room of 83 minutes without delay of discharge, a satisfaction rate of 90,8% and a reduction in the cost compared to conventional inpatient surgery in proportions ranging from – 32,6% and – 48,75%. Conclusions: The outpatient management of proctological surgery under saddle block is very beneficial in terms of safety, efficiency, simplicity, and economy. Our results are in line with those of the literature and our work deserves to be continued to include many patients.

Keywords: outpatient surgery, proctological surgery, saddle block, satisfaction, cost

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Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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