Search results for: acute postoperative pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2204

Search results for: acute postoperative pain

914 A Rare Case of Atypical Guillian-Barre Syndrome Following Antecedent Dengue Infection

Authors: Amlan Datta

Abstract:

Dengue is an arboviral, vector borne infection, quite prevalent in tropical countries such as India. Approximately, 1 to 25% of cases may give rise to neurological complication, such as, seizure, delirium, Guillian-Barre syndrome (GBS), multiple cranial nerve palsies, intracranial thrombosis, stroke-like presentations, to name a few. Dengue fever, as an antecedent to GBS is uncommon, especially in adults.Here, we report a case about a middle aged lady who presented with an acute onset areflexic ascending type of polyradiculoneuropathy along with bilateral lower motor neuron type of facial nerve palsy, as well as abducens and motor component of trigeminal (V3) weakness. Her respiratory and neck muscles were spared. She had an established episode of dengue fever (NS1 and dengue IgM positive) 7 days prior to the weakness. Nerve conduction study revealed a demyelinating polyradiculopathy of both lower limbs and cerebrospinal fluid examination showed albuminocytological dissociation. She was treated with 5 days of intravenous immunoglobulin (IVIg), following which her limb weakness improved considerably. This case highlights GBS as a potential complication following dengue fever.

Keywords: areflexic, demyelinating, dengue, polyradiculoneuropathy

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913 Effects of Vitexin on Scopolamine-Induced Memory Impairment in Rats

Authors: Mehdi Sheikhi, Marjan Nassiri-Asl, Esmail Abbasi, Mahsa Shafiee

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Various synthetic derivatives of natural flavonoids are known to have neuroactive properties. The present study aimed to investigate the effects of vitexin (5, 7, 4-trihydroxyflavone-8-glucoside), a flavonoid found in such plants as tartary buckwheat sprouts, wheat leaves phenolome, Mimosa pudica Linn and Passiflora spp, on scopolamine-induced memory impairment in rats. To achieve this goal, we assessed the effects of vitexin on memory retrieval in the presence or absence of scopolamine using a step-through passive avoidance trial. In the first part of the study, vitexin (25, 50, and 100 μM) was administered intracerebroventricularly (i.c.v.) before acquisition trials. In the second part, vitexin, at the same doses, was administered before scopolamine (10 μg, i.c.v.) and before the acquisition trials. During retention tests, vitexin (100 μM) in the absence of scopolamine significantly increased the stepthrough latencies compared to scopolamine. In addition, vitexin (100 μM) significantly reversed the shorter step-through latencies induced by scopolamine (P < 0.05). These results indicate that vitexin has a potential role in enhancing memory retrieval. A possible mechanism is modulation of cholinergic receptors; however, other mechanisms may be involved in its effects in acute exposure.

Keywords: flavonoid, memory retrieval, passive avoidance, scopolamine, vitexin

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912 Recurrence of Pterygium after Surgery and the Effect of Surgical Technique on the Recurrence of Pterygium in Patients with Pterygium

Authors: Luksanaporn Krungkraipetch

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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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911 Dizziness in the Emergency: A 1 Year Prospective Study

Authors: Nouini Adrâa

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Background: The management of dizziness and vertigo can be challenging in the emergency department (ED). It is important to rapidly diagnose vertebrobasilar stroke (VBS), as therapeutic options such as thrombolysis and anticoagulation require prompt decisions. Objective: This study aims to assess the rate of misdiagnosis in patients with dizziness caused by VBS in the ED. Methods and Results: The cohort was comprised of 82 patients with a mean age of 55 years; 51% were women and 49% were men. Among dizzy patients, 15% had VBS. We used Cohen’s kappa test to quantify the agreement between two raters – namely, emergency physicians and neurologists – regarding the causes of dizziness in the ED. The agreement between emergency physicians and neurologists is low for the final diagnosis of central vertigo disorders and moderate for the final diagnosis of VBS. The sensitivity of ED clinal examination for benign conditions such as BPPV was low at 56%. The positive predictive value of the ED clinical examination for VBS was also low at 50%. Conclusion: There is a substantial rate of misdiagnosis in patients with dizziness caused by VBS in the ED. To reduce the number of missing diagnoses of VBS in the future, there is a need to train emergency physicians in neuro vestibular examinations, including the HINTS examination for acute vestibular syndrome (AVS) and the Dix-Hallpike (DH) maneuver for episodic vestibular syndrome. Using video head impulse tests could help reduce the rate of misdiagnosis of VBS in the ED.

Keywords: dizziness, vertigo, vestibular disease, emergency

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910 Synthesis and Anti-Inflammatory Activity of Pyrazol-3-yl Thiazole 4-Carboxylic Acid Derivatives Targeting Enzyme in the Leukotriene Pathway

Authors: Shweta Sinha, Mukesh Doble, Manju S. L.

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Pyrazole scaffold is an important group of compound in heterocyclic chemistry and is found to possess numerous uses in chemistry. Pyrazole derivatives are also known to possess important biological activities including antitumor, antimicrobial, antiviral, antifungal, anticancer and anti-inflammatory. Inflammation is associated with pain, allergy and asthma. Leukotrienes are mediators of various inflammatory and allergic disorders. 5-Lipoxygenase (5-LOX) is an important enzyme involved in the biosynthesis of leukotrienes and metabolism of arachidonic acid (AA) and thus targeted for anti-inflammation. In vitro inhibitory activity of pyrazol-3-yl thiazole 4-carboxylic acid derivatives is tested against enzyme 5-LOX. Most of these compounds exhibit good inhibitory activity against this enzyme. Binding mode study of these compounds is determined by computational tool. Further experiments are being done to understand the mechanism of action of these compounds in inhibiting this enzyme. To conclude, these compounds appear to be a promising target in drug design against 5-LOX.

Keywords: inflammation, inhibition, 5-lipoxygenase, pyrazole

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909 Appropriate Depth of Needle Insertion during Rhomboid Major Trigger Point Block

Authors: Seongho Jang

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Objective: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. Methods: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean ±standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. Results: The underweight or normal group’s SM, SB, and the safe margin were 1.2±0.2, 2.1±0.4, and 1.4 to 1.7 cm, respectively. The overweight group’s SM and SB were 1.4±0.2 and 2.4±0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group’s SM, SB, and the safe margin were 1.8±0.3, 2.7±0.5, and 2.1 to 2.2 cm, respectively. Conclusion: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.

Keywords: pneumothorax, rhomboid major muscle, trigger point injection, ultrasound

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908 Dose Measurement in Veterinary Radiology Using Thermoluminescent Dosimeter

Authors: E. Saeedian, M. Shakerian, A. Zarif Sanayei, Z. Rakeb, F. N. Alizadeh, S. Sarshough, S. Sina

Abstract:

Radiological protection for plants and animals is an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing a direct measurements technique with a thermoluminescent dosimeter. These measurements allow the determination of the entrance skin dose (ESD) by calculating the amount of radiation absorbed by the skin during exposure. A group of Thirty TLD-100 dosimeters produced by Harshaw Company, each with repeatability greater than 95% and calibration using ¹³⁷Cs gamma source, were utilized to measure doses to ten small pets, including cats and dogs in the radiological department in a veterinary clinic in Shiraz, Iran. Radiological procedures were performed using a portable imaging unit (Philips Super M100, Philips Medical System, Germany) to acquire images of the abdomen; ten exams of abdomen images of different pets were monitored, measuring the thicknesses of the two projections (lateral and ventrodorsal) and the distance of the X-ray source from the surface of each pet during the exams. A group of two dosimeters was used for each pet which has been stacked on their skin on the abdomen region. The outcome of this study involved medical procedures with the same kVp, mAs, and nearly identical positions for different diagnostic X-ray procedures executed over a period of two months. The result showed the mean ESD value was 260.34±50.06 µGy due to the approximate size of pets. Based on the results, the ESD value is associated with animal size, and larger animals have higher values. If a procedure doesn't require repetition, the dose can be optimized. For smaller animals, the main challenge in veterinary radiology is the dose increase caused by repetitions, which is most noticeable in the ventrodorsal position due to the difficulty in immobilizing the animal. Animals are an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing direct measurements.

Keywords: direct dose measuring, dosimetry, radiation protection, veterinary medicine

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907 The Stem Cell Transcription Co-factor Znf521 Sustains Mll-af9 Fusion Protein In Acute Myeloid Leukemias By Altering The Gene Expression Landscape

Authors: Emanuela Chiarella, Annamaria Aloisio, Nisticò Clelia, Maria Mesuraca

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ZNF521 is a stem cell-associated transcription co-factor, that plays a crucial role in the homeostatic regulation of the stem cell compartment in the hematopoietic, osteo-adipogenic, and neural system. In normal hematopoiesis, primary human CD34+ hematopoietic stem cells display typically a high expression of ZNF521, while its mRNA levels rapidly decrease when these progenitors progress towards erythroid, granulocytic, or B-lymphoid differentiation. However, most acute myeloid leukemias (AMLs) and leukemia-initiating cells keep high ZNF521 expression. In particular, AMLs are often characterized by chromosomal translocations involving the Mixed Lineage Leukemia (MLL) gene, which MLL gene includes a variety of fusion oncogenes arisen from genes normally required during hematopoietic development; once they are fused, they promote epigenetic and transcription factor dysregulation. The chromosomal translocation t(9;11)(p21-22;q23), fusing the MLL gene with AF9 gene, results in a monocytic immune phenotype with an aggressive course, frequent relapses, and a short survival time. To better understand the dysfunctional transcriptional networks related to genetic aberrations, AML gene expression profile datasets were queried for ZNF521 expression and its correlations with specific gene rearrangements and mutations. The results showed that ZNF521 mRNA levels are associated with specific genetic aberrations: the highest expression levels were observed in AMLs involving t(11q23) MLL rearrangements in two distinct datasets (MILE and den Boer); elevated ZNF521 mRNA expression levels were also revealed in AMLs with t(7;12) or with internal rearrangements of chromosome 16. On the contrary, relatively low ZNF521 expression levels seemed to be associated with the t(8;21) translocation, that in turn is correlated with the AML1-ETO fusion gene or the t(15;17) translocation and in AMLs with FLT3-ITD, NPM1, or CEBPα double mutations. Invitro, we found that the enforced co-expression of ZNF521 in cord blood-derived CD34+ cells induced a significant proliferative advantage, improving MLL-AF9 effects on the induction of proliferation and the expansion of leukemic progenitor cells. Transcriptome profiling of CD34+ cells transduced with either MLL-AF9, ZNF521, or a combination of the two transgenes highlighted specific sets of up- or down-regulated genes that are involved in the leukemic phenotype, including those encoding transcription factors, epigenetic modulators, and cell cycle regulators as well as those engaged in the transport or uptake of nutrients. These data enhance the functional cooperation between ZNF521 and MA9, resulting in the development, maintenance, and clonal expansion of leukemic cells. Finally, silencing of ZNF521 in MLL-AF9-transformed primary CD34+ cells inhibited their proliferation and led to their extinction, as well as ZNF521 silencing in the MLL-AF9+ THP-1 cell line resulted in an impairment of their growth and clonogenicity. Taken together, our data highlight ZNF521 role in the control of self-renewal and in the immature compartment of malignant hematopoiesis, which, by altering the gene expression landscape, contributes to the development and/or maintenance of AML acting in concert with the MLL-AF9 fusion oncogene.

Keywords: AML, human zinc finger protein 521 (hZNF521), mixed lineage leukemia gene (MLL) AF9 (MLLT3 or LTG9), cord blood-derived hematopoietic stem cells (CB-CD34+)

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906 Parkinson's Disease and Musculoskeletal Problems

Authors: Ozge Yilmaz Kusbeci, Ipek Inci

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Aim: Musculoskeletal problems are very common in Parkinson’s disease (PD). They affect quality of life and cause disabilities. However they are under-evaluated, and under-treated. The aim of this study is to evaluate the prevalence and clinical features of musculoskeletal problems in patients with Parkinson disease (PD) compared to controls. Methods: 50 PD patients and 50 age and sex matched controls were interviewed by physicians about their musculoskeletal problems. Results: The prevalence of musculoskeletal problems was significantly higher in the PD group than in the control group (p < 0.05). Commonly involved body sites were the shoulder, low back, and knee. The shoulder and low back was more frequently involved in the PD group than in the control group. However, the knee was similarly involved in both groups. Among the past diagnoses associated with musculoskeletal problems, frozen shoulder, low back pain and osteoporosis more common in the PD group than in the control group (p < 0.05). Furthermore, musculoskeletal problems in the PD group tended to receive less treatment than that of the control group. Conclusion: Musculoskeletal problems were more common in the PD group than in the controls. Therefore assessment and treatment of musculoskeletal problems could improve quality of life in PD patients.

Keywords: parkinson disease, musculoskeletal problems, quality of life, PD disease

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905 A Prospective Study on the Efficacy of Mesenchymal Stem Cells in Intervertebral Disc Regeneration

Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

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Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

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904 Case Report of Angioedema after Application of Botulinum Toxin

Authors: Sokol Isaraj, Lorela Bendo

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Botulinum toxin is the most commonly used treatment to reduce the appearance of dynamic facial wrinkles. It can smooth out wrinkles and restore a more youthful appearance. Although allergic reactions after botox injection are rare, care should be taken by the physician to diagnose the condition and provide suitable treatment in time. The authors report a case of allergic reaction with angioedema to abobotulinumtoxin A. A 50-year-old woman complaining of dynamic wrinkles was injected in a private clinic with Dysport. After two weeks, she returned to the clinic for the touch-up session. Thirty minutes after the completion of the injections in the crow’s feet area, she described the feeling of mild pain and warmth in the injected area, followed by angioedema. The symptoms couldn’t be controlled by IM corticosteroid, and the patient was referred to a hospital center. After adequate systemic treatment for four days, there was a resolution of the symptoms. Despite the reported safety of abobotulinumtoxin A, this case warns practitioners of unpredictably adverse reactions, which require rapid recognition and intravenous support.

Keywords: botulinum toxin, side effects, angioedema, injections

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903 The Effect of Simultaneous Application of Laser Beam and Magnet in Treatment of Intervertebral Disc Herniation

Authors: Alireza Moghtaderi, Negin Khakpour

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Disc Herniation is a common complication in the society and it is one of the main reasons for referring to physical medicine and rehabilitation clinics. Despite of various methods proposed for treatingthis disease, still there is disagreement on success of these methods especially in non-surgical methods, and thus current study aims at determining effect of laser beam and magnet on treatment of Intervertebral Disc Herniation. During a clinical trial study, 80 patients with Intervertebral Disc Herniation underwent a combined package of treatment including magnet, laser beam, PRP and Prolotherapy during 6 months. Average age of patients was 51.25 ± 10.7 with range of 25 – 71 years. 30 men (37.5%) and 50 women (62.5%) took part in the study. average weight of patients was 64.3 ± 7.2 with range of 49 – 79 kg. highest level of Disc Herniation was L5 – S1 with frequency of 17 cases (21.3%). Disc Herniation was severe in 30 cases before treatment, but it reduced to 3 casesafter treatment. This study indicates effect of combined treatment using non-invasive laser beam and magnet therapy on disco genic diseases and mechanical pains of spine is highly effective.

Keywords: hallux, valgus, botulinum toxin a, pain

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902 Biochemical Changes in the Liver of Mice after Exposure to Different Doses of Diclofenac Sodium

Authors: Deepak Mohan, Sushma Sharma

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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a group of widely used drugs for the treatment of rheumatoid diseases and to relieve pain and inflammation due to their analgesic anti-pyretic and anti-inflammatory properties. The therapeutic and many of the toxic effects of NSAIDs result from reversible inhibition of enzymes in the cyclooxygenase (COX) group. In the present investigation the effect of the drug on the concentration of lipids, and on the activity of the enzymes i.e. acid and alkaline phosphatase, GOT, GPT and lipid peroxidase were studied. There was a significant enhancement in the activities of both acid and alkaline phosphatase after 21 days of treatment. Proportionate increase in the MDA contents was observed after different days of diclofenac treatment. Cellular damage in the liver resulted in decrease in the activity of both GOT (Glutamate oxaloacetate transaminase) and GPT (Glutamate pyruvate transaminase) in both low and high dose groups. Significant decrease in the liver contents was also observed in both dose groups.

Keywords: anti-inflammatory, cyclooxygenase, glutamate oxaloacetate transaminase, malondialdehyde

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901 Assessment the Tsunamis Impact with Tectonic Sources in the Southern Mainland of the Haitian Republic: Using Two Numerical Models

Authors: Delva Richard, Zahibo Narcisse, Yalciner Ahmet

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The Republic of Haiti is one of the poor countries of the world, therefore the authorities must make choices to provide timely solutions to the many difficulties that this Caribbean country is experiencing. There is a very acute lack of scientific research to study natural phenomena in depth. A working group meeting was established under the aegis of the World Bank, UNESCO and the authorities, to study the level of exposure of the Hispaniola. The devastating earthquake of August 2021 killed about 2100 and caused massive material damage; and the 14 12 January 2010 killed more than 250,000 people and caused massive material damage, the evidence of which is still 11 years later. In this paper we want to contribute to the assessment of the risk of tsunami on the southern peninsula of the Republic of Haiti. For the realization of this work we have the bathymetric and topographic data of very good qualities from the private measurement campaigns that we have combined with GEBCO for the inundation grids. We use two numerical models MOST and NAMI DANCE for the calculation of the parameters required in any tsunami risk assessment.

Keywords: modélisation numérique, ondes longues océaniques, bathymetrie, evaluation risque, tsunamis

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900 The BL-5D Model: The Development of a Model of Instructional Design for Blended Learning Activities

Authors: Damian Gordon, Paul Doyle, Anna Becevel, Júlia Vilafranca Molero, Cinta Gascon, Arianna Vitiello, Tina Baloh

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It has long been recognized that the creation of any teaching content can be enhanced if the development process follows a pre-defined approach, which is often referred to as an instructional design methodology. These methodologies typically define a number of stages, or phases, that an educator should undertake to help ensure the quality of the final teaching content that is developed. In this paper, we present an instructional design methodology that is focused specifically on the introduction of blended resources into a heretofore bricks-and-mortar course. To achieve this, research was undertaken concerning a range of models of instructional design, as well as literature covering some of the key challenges and “pain points” of blending. Following this, our model, the BL-5D model, is presented, which incorporates some key questions at each stage of this five-stage methodology to guide the development process. Finally, a discussion of some of the key themes and issues that have been uncovered in this work is presented, as well as a template for a blended learning case study that emerged from this approach.

Keywords: blended learning, challenges of blended learning, design methodologies, instructional design

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899 The Use and Safety of Leave from an Acute Inpatient Psychiatry Unit: A Retrospective Review of Pass Outcomes Over Four Years Abstract

Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill

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Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.

Keywords: passes, inpatient, psychiatry, inpatient leave, outcome

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898 Resilience in Patients with Chronic Kidney Disease in Hemodialysis

Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

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Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: hemodialysis units, renal dialysis, renal insufficiency chronic, resilience psychological

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897 The Use of Hydrocolloid Dressing in the Management of Open Wounds in Big Cats

Authors: Catherine Portelli

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Felines, such as Panthera tigris, Panthera leo and Puma concolor, have become common residents in animal parks and zoos. They often sustain injuries from other felines within the same, or adjacent enclosures and from playing with items of enrichment and structures of the enclosure itself. These open wounds, and their treatments, are often challenging in the veterinary practice, where feline-specific studies are lacking. This study is based on the author’s clinical experience gained while working at local animal parks in the past five years, and current evidence of hydrocolloid dressing applied to other species. Hydrocolloid dressing is used for secondary healing of chronic and acute wounds, where there is a considerable amount of tissue loss. The patients included in this study were sedated using medetomidine and ketamine every three to four days, for wound treatment and bandage change. Comparative studies of different techniques of open wound management will improve the healing process of exotic felines in the future by decreasing the time of recovery and incidence of other complications. Such studies will also aid with treatment of injuries sustained in wild felines, such as trap and bite wounds, found in natural conservation areas and wild animal sanctuaries.

Keywords: felines, hydrocolloid dressing, open wound, secondary healing

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896 Synthesis, Characterization, Computational Study, Antimicrobial Evaluation, in Vivo Toxicity Study of Manganese (II) and Copper (II) Complexes with Derivative Sulfa-drug

Authors: Afaf Bouchoucha, Karima Si Larbi, Mohamed Amine Bourouaia, Salah.Boulanouar, Safia.Djabbar

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The synthesis, characterization and comparative biological study of manganese (II) and copper (II) complexes with an heterocyclic ligand used in pharmaceutical field (Scheme 1), were reported. Two kinds of complexes were obtained with derivative sulfonamide, [M (L)₂ (H₂O)₂].H₂O and [M (L)₂ (Cl)₂]3H₂O. These complexes have been prepared and characterized by elemental analysis, FAB mass, ESR magnetic measurements, FTIR, UV-Visible spectra and conductivity. Their stability constants have been determined by potentiometric methods in a water-ethanol (90:10 v/v) mixture at a 0.2 mol l-1 ionic strength (NaCl) and at 25.0 ± 0.1 ºC using Sirko program. DFT calculations were done using B3LYP/6-31G(d) and B3LYP/LanL2DZ. The antimicrobial activity of ligand and complexes against the species Escherichia coli, P. aeruginosa, Klebsiella pneumoniae, S. aureus, Bacillus subtilisan, Candida albicans, Candida tropicalis, Saccharomyces, Aspergillus fumigatus and Aspergillus terreus has been carried out and compared using agar-diffusion method. Also, the toxicity study was evaluated on synchesis complexes using Mice of NMRI strain.

Keywords: hetterocyclic ligand, complex, stability constant, antimicrobial activity, DFT, acute and genotoxicity study

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895 ANA Negative but FANA Positive Patients with Clinical Symptoms of Rheumatic Disease: The Suggestion for Clinicians

Authors: Abdolreza Esmaeilzadeh, Mehri Mirzaei

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Objective: Rheumatic disease is a chronic disease that causes pain, stiffness, swelling and limited motion and function of many joints. RA is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. Of these, about 75% are women. Materials and Methods: This study was formed due to the misconception about ANA test, which is frequently performed with methods based upon solid phase as ELISA. This experiment was conducted on 430 patients, with clinical symptoms that are likely affected with rheumatic diseases, simultaneously by means of ANA and FANA. Results: 36 cases (8.37%) of patients, despite positive ANA, have demonstrated negative results via Indirect Immunofluorescence Assay (IIFA), (false positive). 116 cases (27%) have demonstrated negative ANA results, by means of the ELISA technique, although they had positive IIFA results. Conclusion: Other advantages of IIFA are antibody titration and specific pattern detection that have the capability of distinguishing positive dsDNA results. According to the restrictions and false negative cases, in patients, IIFA test is highly recommended for these disease's diagnosis.

Keywords: autoimmune disease, IIFA, EIA, rheumatic disease

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894 Amelioration of Arsenic and Mercury Induced Vasoconstriction by Eugenol, Linalool and Carvone

Authors: Swati Kundu, Seemi Farhat Basir, Luqman A. Khan

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Acute and chronic exposure to arsenic and mercury is known to produce vasoconstriction. Pathways involved in this hypercontraction and their relative contribution are not understood. In this study, we measure agonist-induced contraction of isolated rat aorta exposed to arsenic and mercury aorta and delineate pathways mediating this effect. PE-induced hypercontraction of 37% and 32% was obtained with 25 µM As(III) and 6 nM Hg(II), respectively. Isometric contraction measurements in the presence of apocynin, verapamil and sodium nitroprusside indicates that the major cause of increased contraction is reactive oxygen species and depletion of nitric oxide. Calcium influx plays a minor role in both arsenic and mercury caused hypercontraction. In the unexposed aorta, eugenol causes relaxation by inhibiting ROS and elevating NO, linalool by blocking voltage dependent calcium channel (VDCC) and elevating NO, and carvone by blocking calcium influx through VDDC. Since arsenic and mercury caused hypercontraction is mediated by increased ROS and depletion of nitric oxide, we hypothesize that molecules which neutralize ROS or elevate NO will be better ameliorators. In line with this argument, we find eugenol to be the best ameliorator of arsenic and mercury hypercontraction followed by linalool and carvone.

Keywords: carvone, eugenol, linalool, mercury

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893 Literature Review and Biomechanical Findings in Patients with Bipartite Medial Cuneiforms

Authors: Aliza Lee, Mark Wilt, John Bonk, Scott Floyd, Bradley Hoffman, Karen Uchmanowicz

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Bipartite medial cuneiforms are relatively rare but may play a significant role in biomechanical and gait abnormalities. It is believed that a bipartite medial cuneiform may alter the available range of motion due to its larger morphological variant, thus limiting the metatarsal plantarflexion needed to achieve adequate hallux dorsiflexion for normal gait. Radiographic and clinical assessments were performed on 2 patients who reported foot pain along the first ray. Both patients had visible bipartite medial cuneiforms on MRI. Using gait plate and Metascan™ analysis, both were noted to have four measurements far beyond the expected range. Medial and lateral heel peak pressure, hallux peak pressure, and 1st metatarsal peak pressure were all noted to be increased. These measurements are believed to be increased due to the hindrance placed on the available ROM of the 1st ray by the increased size of the medial cuneiform. A larger patient population would be needed to fully understand this developmental anomaly.

Keywords: bipartite medial cuneiforms, cuneiform, developmental anomaly, gait abnormality

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892 A Survey on Speech Emotion-Based Music Recommendation System

Authors: Chirag Kothawade, Gourie Jagtap, PreetKaur Relusinghani, Vedang Chavan, Smitha S. Bhosale

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Psychological research has proven that music relieves stress, elevates mood, and is responsible for the release of “feel-good” chemicals like oxytocin, serotonin, and dopamine. It comes as no surprise that music has been a popular tool in rehabilitation centers and therapy for various disorders, thus with the interminably rising numbers of people facing mental health-related issues across the globe, addressing mental health concerns is more crucial than ever. Despite the existing music recommendation systems, there is a dearth of holistically curated algorithms that take care of the needs of users. Given that, an undeniable majority of people turn to music on a regular basis and that music has been proven to increase cognition, memory, and sleep quality while reducing anxiety, pain, and blood pressure, it is the need of the hour to fashion a product that extracts all the benefits of music in the most extensive and deployable method possible. Our project aims to ameliorate our users’ mental state by building a comprehensive mood-based music recommendation system called “Viby”.

Keywords: language, communication, speech recognition, interaction

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891 Subacute Thyroiditis Triggered by Sinovac and Oxford-AstraZeneca Vaccine

Authors: Ratchaneewan Salao, Steven W. Edwards, Kiatichai Faksri, Kanin Salao

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Background: A two-dose regimen of COVID-19 vaccination (inactivated whole virion SARS-CoV-2 and adenoviral vector) has been widely used. Side effects are very low, but several adverse effects have been reported. Methods: A 40-year-old female patient, with a previous history of thyroid goitre, developed severe neck pain, headache, nausea and fatigue 7-days after receiving second vaccination with Vaxzevria® (Oxford-AstraZeneca). Clinical and laboratory findings, including thyroid function tests and ultrasound of thyroid glands, were performed. Results: Her left thyroid gland was multinodular enlarged, and severely tender on palpation. She had difficulty in swallowing and had tachycardia but no signs of hyperthyroidism. Laboratory results supported a diagnosis of subacute thyroiditis. She was prescribed NSAID (Ibuprofen 400 mg) and dexamethasone for 3-days and her symptoms resolved. Conclusions: Although this is an extremely rare event, physicians may encounter more cases of this condition due to the extensive vaccination program using this combination of vaccines.

Keywords: SARS-CoV-2, adenoviral vector vaccines, vaccination, subacute thyroiditis

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890 Design, Molecular Modeling, Synthesize, and Biological Evaluation of Some Dual Inhibitors of Soluble Epoxide Hydrolase (sEH) and Cyclooxygenase 2 (COX-2)

Authors: Elham Rezaee, Sayyed Abbas Tabatabai

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Dual inhibition of COX-2 and sEH enzymes represents one of the distinct pharmaceutical approaches for the treatment of inflammation, pain, cancers, and other diseases. The discovery of these inhibitors for treatment is a great deal of attention because of some advantages such as increased efficacy, a promising safety profile, ease of formulation, and better target engagement. In this research, based on the structure-activity relationship of COX-2 and sEH inhibitors, some amide derivatives with oxadiazole and dihydropyrimidinone rings against sEH and COX-2 enzymes were developed. The designed compounds showed high affinity to the active site of both enzymes in docking studies and were synthesized in good yield and characterized by IR, Mass, 1HNMR, and 13CNMR. All of the novel compounds exhibited considerable in-vitro sEH and COX-2 inhibitory activities in comparison with 12-(3-Adamantan-1-yl-ureido)- dodecanoic acid and celecoxib (a potent urea-based sEH inhibitor and selective nonsteroidal anti-inflammatory drug, respectively). Ethyl 6-methyl-4-(4-(4-(methylsulfonyl)benzamido)phenyl)-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate was found to be the most selective COX-2 inhibitor (COX-2/COX-1 ratio: 683) with IC50 value of 2.1 nM targeting sEH enzyme.

Keywords: COX-2, dual inhibitors, sEH, synthesis

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889 Characterization of Molecular Targets to Mediate Skin Itch and Inflammation

Authors: Anita Jäger, Andrew Salazar, Jörg von Hagen, Harald Kolmar

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In the treatment of individuals with sensitive and psoriatic skin, several inflammation and itch-related molecular and cellular targets have been identified, but many of these have yet to be characterized. In this study, we present two potential targets in the skin that can be linked to the inflammation and itch cycle. 11ßHSD1 is the enzyme responsible for converting inactive cortisone to active cortisol used to transmit signals downstream. The activation of the receptor NK1R correlates with promoting inflammation and the perception of itch and pain in the skin. In this study, both targets have been investigated based on their involvement in inflammation. The role of both identified targets was characterized based on the secretion of inflammation cytokine- IL6, IL-8, and CCL2, as well as phosphorylation and signaling pathways. It was found that treating skin cells with molecules able to inhibit inflammatory pathways results in the reduction of inflammatory signaling molecules secreted by skin cells and increases their proliferative capacity. Therefore, these molecular targets and their associated pathways show therapeutic potential and can be mitigated via small molecules. This research can be used for further studies in inflammation and itch pathways and can help to treat pathological symptoms.

Keywords: inflammation, itch, signaling pathway, skin

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888 Self-Regenerating, Vascularizing Hybrid Scaffold-Hydrogel For Bone Tissue Engineering

Authors: Alisha Gupta

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Osteoarthritis (OA) is the most common form of arthritis which is a degenerative joint disease causing joints to begin to break down and underlying bones to change. This “wear and tear” most frequently affects hands, hips, and knees. This is important because OA pain is considered to be a leading cause of mobility impairment in older adults, with hip and knee OA ranked 11th highest contributors to global disability. Bone tissue engineering utilizing polymer scaffolds and hydrogels is an emerging field for treating osteoarthritis. Polymer scaffolds provide a three-dimensional structure for tissue growth, and hydrogels can be used to deliver drugs and growth factors. The combination of the two materials creates a hybrid structure that can better withstand physiological and mechanical demands while also providing a more controlled environment for drug and nutrient delivery. I think using bone tissue engineering for making scaffold-hydrogel composites that are self-regenerating and vascularizing might be useful in solving this problem. Successful implementation can reconstruct healthy, simulated bone tissue on deficient applicants.

Keywords: tissue engineering, regenerative medicine, scaffold-hydrogel composites, osteoarthritis

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887 Ipsilateral Weakness Caused by Ipsilateral Stroke: A Case Series

Authors: Naim Izet Kajtazi

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Introduction: There are few reported cases of ipsilateral weakness following ischemic or hemorrhagic stroke. In these rare cases, ipsilateral weakness is typically the result of damage to uncrossed components of the corticospinal tract (CST), which were recruited in response to previous CST injury. Patients and Methods: We report a series of six cases of acute ipsilateral weakness or numbness following a hemorrhagic or ischemic stroke from three medical institutions in Saudi Arabia. Results: Three of these patients presented with right-sided weakness caused by an ipsilateral right hemispheric stroke, while two exhibited left-sided symptoms and one had only left-sided numbness. In all six cases, the ipsilateral corona radiata, internal capsule, basal ganglia, insula, and thalamus were involved. No concomitant opposite hemisphere or brainstem lesion in none of the patients was evident. Two patients had previous strokes affecting the brainstem and left corona radiata, respectively. A complete stroke workup to reveal the cause of the stroke was carried out, however, no functional MRI was performed. Conclusion: Ischemic or hemorrhagic stroke may indeed result in ipsilateral weakness or numbness, though in very rare cases. We assume that the most likely mechanism of their ipsilateral weakness subsequent to the ipsilateral stroke was a functional reorganization favoring CST pathways within the ipsilateral hemisphere.

Keywords: stroke, weakness, MRI brain, stroke unit

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886 A phytochemical and Biological Study of Viscum schemperi Engl. Growing in Saudi Arabia

Authors: Manea A. I. Alqrad, Alaa Sirwi, Sabrin R. M. Ibrahim, Hossam M. Abdallah, Gamal A. Mohamed

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Phytochemical study of the methanolic extract of the air dried powdered of the parts of Viscum schemperi Engl. (Family: Viscaceae) using different chromatographic techniques led to the isolation of five compounds: -amyrenone (1), betulinic acid (2), (3β)-olean-12-ene-3,23-diol (3), -oleanolic acid (4), and α-oleanolic acid (5). Their structures were established based on physical, chemical, and spectral data. Anti-inflammatory and anti-apoptotic activities of oleanolic acid in a mouse model of acute hepatorenal damage were assessed. This study showed the efficacy of oleanolic acid to counteract thioacetamide-induced hepatic and kidney injury in mice through the reduction of hepatocyte oxidative damage, suppression of inflammation, and apoptosis. More importantly, oleanolic acid suppressed thioacetamide-induced hepatic and kidney injury by inhibiting NF-κB/TNF-α-mediated inflammation/apoptosis and enhancing SIRT1/Nrf2/Heme-oxygenase signalling pathway. These promising pharmacological activities suggest the potential use of oleanolic acid against hepatorenal damage.

Keywords: oleanolic acid, viscum schimperi, thioacetamide, SIRT1/Nrf2/NF-κB, hepatorenal damage

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885 [Keynote Speech]: Simulation Studies of Pulsed Voltage Effects on Cells

Authors: Jiahui Song

Abstract:

In order to predict or explain a complicated biological process, it is important first to construct mathematical models that can be used to yield analytical solutions. Through numerical simulation, mathematical model results can be used to test scenarios that might not be easily attained in a laboratory experiment, or to predict parameters or phenomena. High-intensity, nanosecond pulse electroporation has been a recent development in bioelectrics. The dynamic pore model can be achieved by including a dynamic aspect and a dependence on the pore population density into pore formation energy equation to analyze and predict such electroporation effects. For greater accuracy, with inclusion of atomistic details, molecular dynamics (MD) simulations were also carried out during this study. Besides inducing pores in cells, external voltages could also be used in principle to modulate action potential generation in nerves. This could have an application in electrically controlled ‘pain management’. Also a simple model-based rate equation treatment of the various cellular bio-chemical processes has been used to predict the pulse number dependent cell survival trends.

Keywords: model, high-intensity, nanosecond, bioelectrics

Procedia PDF Downloads 225