Search results for: aged institution
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2166

Search results for: aged institution

876 Disability and Sexuality: A Human Right Approach to Sexual and Reproductive Health of the Hearing Impaired Adolescents In Developing Countries

Authors: Doctor Akanle Florence Foluso

Abstract:

Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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875 Open Fields' Dosimetric Verification for a Commercially-Used 3D Treatment Planning System

Authors: Nashaat A. Deiab, Aida Radwan, Mohamed Elnagdy, Mohamed S. Yahiya, Rasha Moustafa

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This study is to evaluate and investigate the dosimetric performance of our institution's 3D treatment planning system, Elekta PrecisePLAN, for open 6MV fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields guided by the recommended QA tests prescribed in AAPM TG53, NCS report 15 test packages, IAEA TRS 430 and ESTRO booklet no.7. The study was performed for Elekta Precise linear accelerator designed for clinical range of 4, 6 and 15 MV photon beams with asymmetric jaws and fully integrated multileaf collimator that enables high conformance to target with sharp field edges. Seven different tests were done applied on solid water equivalent phantom along with 2D array dose detection system, the calculated doses using 3D treatment planning system PrecisePLAN, compared with measured doses to make sure that the dose calculations are accurate for open fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields. The QA results showed dosimetric accuracy of the TPS for open fields within the specified tolerance limits. However large square (25cm x 25cm) and rectangular fields (20cm x 5cm) some points were out of tolerance in penumbra region (11.38 % and 10.9 %, respectively). For the test of SSD variation, the large field resulted from SSD 125 cm for 10cm x 10cm filed the results recorded an error of 0.2% at the central axis and 1.01% in penumbra. The results yielded differences within the accepted tolerance level as recommended. Large fields showed variations in penumbra. These differences between dose values predicted by the TPS and the measured values at the same point may result from limitations of the dose calculation, uncertainties in the measurement procedure, or fluctuations in the output of the accelerator.

Keywords: quality assurance, dose calculation, 3D treatment planning system, photon beam

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874 Genetic Polymorphism in the Vitamin D Receptor Gene and 25-Hydroxyvitamin D Serum Levels in East Indian Women with Polycystic Ovary Syndrome

Authors: Dipanshu Sur, Ratnabali Chakravorty

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Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA. Results: Mean serum 25(OH)D in the PCOS and control samples were 19.08±7 and 23.27±6.03 (p=0.048) which were significantly lower in PCOS patients compared with controls. CC genotype of the VDR Apa-I SNP was same frequent in PCOS (25.6%) and controls (25.6%) (OR: 0.9995; 95%CI: 0.528 to 1.8921; p= 0.9987). The CC genotype was also significantly associated with both lower E2 (p=0.031) and Androstenedione levels (p=0.062). We observed a significant association of GC polymorphism with 25(OH)D levels. PCOS women carrying the GG genotype (in GC genes) had significantly higher risk for vitamin D deficiency than women carrying the TT genotype. Conclusions: In conclusion, data from this study indicate that vitamin D levels are lower, and vitamin D deficiency more frequent, in PCOS than in controls. The present findings suggest that the Apa-I, Fok-I polymorphism of the VDR gene is associated with PCOS and seems to modulate ovarian steroid secretion. Further studies are needed to better clarify the biological mechanisms by which the polymorphism influences PCOS risk.

Keywords: vitamin D receptor, polymorphism, vitamin D, polycystic ovary syndrome

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873 Sero-Prevalence of Hepatitis B Surface Antigen and Associated Factors among Pregnant Mothers Attending Antenatal Care Service, Mekelle, Ethiopia: Evidence from Institutional Based Quantitative Cross-Sectional Study

Authors: Semaw A., Awet H., Yohannes M.

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Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

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872 Correlation Between Diastolic Function and Lower GLS in Hypertensive Patients

Authors: A. Kherraf, S. Ouarrak, L. Azzouzi, R. Habbal

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Introduction: Preserved LVEF heart failure is an important cause of mortality and morbidity in hypertensive patients. A strong correlation between impaired diastolic function and longitudinal systolic dysfunction. could have several explanations, first, the diastole is an energy dependent process, especially during its first phase, it also includes active systolic components during the phase of iso volumetric relaxation, in addition, the impairment of the intrinsic myocytic function is part of hypertensive pathology as evidenced by recent studies. METHODS AND MATERIALS: This work consists of performing in a series of 333 hypertensive patients (aged 25 to 75 years) a complete echocardiographic study, including LVEF by Simpson biplane method, the calculation of the indexed left ventricular mass, the analysis of the diastolic function, and finally, the study of the longitudinal deformation of the LV by the technique of speckletracking (calculation of the GLS). Patients with secondary hypertension, leaky or stenosing valve disease, arrhythmia, and a history of coronary insufficiency were excluded from this study. RESULTS: Of the 333 hypertensive patients, 225 patients (67.5%) had impaired diastolic function, of which 60 patients (18%) had high filling pressures. 49.39% had echocardigraphic HVG, Almost all of these patients (60 patients) had low GLS. There is a statistically very significant relationship between lower GLS and increased left ventricular filling pressures in hypertensive patients. These results suggest that increased filling pressures are closely associated with atrioventricular interaction in patients with hypertension, with a strong correlation with impairment of longitudinal systolic function and diastolic function CONCLUSION: Overall, a linear relationship is established between increased left ventricular mass, diastolic dysfunction, and longitudinal LV systolic dysfunction

Keywords: hypertension, diastolic function, left ventricle, heart failure

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871 The Effects of Traditional Thai Massage Technique Delivered by Parents on Stereotypical Behaviors in Children with Autism: A Pilot Study

Authors: Chanada Aonsri, Wichai Eungpinichpong

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Stereotypical behavior is one of the learning and social skills development problems that affect children with autism. Previous studies found that traditional Thai massage (TTM) could reduce stereotypical behaviors in autistic children. However, the effects of TTM delivered by the parents of autistic children have not been explored. This pilot study investigated the effects of TTM by parents on stereotypical behaviors in children with autism. A one-group pretest-posttest design was applied for 15 children, aged 4-16 years, with their parents' permissions. They participated in the study at the Special Education program of the Special Education Center of Khon Kaen University, Thailand. After being trained in a specialized TTM for children, the parents delivered 50-minute TTM to children once a day, twice a week for eight weeks. The severity of autism and autistic behaviors were measured using the Childhood Autism Rating Scale (CARS), and the Autism Treatment Evaluation Checklist (ATEC), respectively. The functions of autonomic nervous systems were measured using Heart Rate Variability (HRV) to indicated physical and mental disorders such as stress. The data at baseline and the 8th week were analyzed using either an independent t-test or Wilcoxon signed-rank test. The study found that 16 sessions of TTM significantly improved measured data for autism in all children including the CARS (p<0.001), ATEC, speech/language/communication (p<0.001), sociability (p<0.001), sensory/cognitive awareness (p<0.001), health/physical/behavior (p < 0.001), and HRV (p<0.001). The results indicated that TTM performed by parents could be useful as an adjunct therapy for autistic children as it can reduce stereotypical behaviors and stress.

Keywords: traditional Thai massage, stereotypical behaviors, Autistic children, parent

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870 The Effects of Parents’ Personality Traits and Family Variables on Aggressive Behavior in Children from the State of Kuwait

Authors: Eisa Al-Balhan

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This study explores the effects of parents’ personality and family variables on aggressive behavior in children from the State of Kuwait. The sample of 117children aged between 6 and 10 years (M=7.79 years, SD =1.4 years),117 fathers, and 117mothers from Kuwait. The following tools were used: a) the Aggressive Behavior Scale for Children (ABSC), b) the Personality Scales Inventory (PSI), and c) the Family Climate Scale (FCS). The results show that there were significant differences between children with highly aggressive behavior and those with low aggressive behavior for most of the personality traits of the father and mother, as well as most of the family climate and its different dimensions according to the father’s knowledge and the mother’s knowledge. Furthermore, there was a significant difference between males and females in the total score of aggressive behavior, verbal aggression, physical aggression, self-aggression, and aggression toward others, with higher scores occurring among males. Most of the correlations of the children’s aggressive behavior were with the personality traits of the father. The personality traits of the mother, family climate, and most of its different dimensions according to the father's and mother's knowledge had significant negative correlations with the child's aggression. There was no effect of the mother's and father's education levels on their child’s aggressive behavior. There was a significant difference between normal families and separated families in the total score of aggressive behavior, verbal aggression, and self-aggression, with a higher score occurring among separated families, and there was no significant difference between the two groups in physical aggression and aggression towards others.

Keywords: aggressive behavior, personality traits of parents, family variables, parents

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869 Legume and Nuts Consumption in Relation to Depression and Anxiety in Iranian Adults

Authors: Ahmad Esmaillzadeh, Javad Anjom-Shoae, Omid Sadeghi,

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Background: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nuts consumption in relation to psychological disorders. Objective: The current study aimed to examine the association of legume and nuts consumption with depression, anxiety and psychological distress in Iranian adults. Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nuts consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected through the use of General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. Results: Mean age of participants was 36.5±7.9 years. Compared with the lowest quintile, men in the highest quintile of legume and nuts consumption had lower odds of anxiety; such that after adjusting for potential confounding variables, men in the top quintile of legume and nuts consumption were 66% less likely to be anxious than those in the bottom quintile (OR: 0.34; 95% CI: 0.14-0.82). Such relationship was not observed among women. We failed to find any significant association between legume plus nuts consumption and depression or psychological distress after adjustment for potential confounders. Conclusion: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No significant association was seen between consumption of legume and nuts and odds of depression or psychological disorder. Further prospective studies are required to confirm these findings.

Keywords: anxiety, depression, legumes, nuts, psychological distress

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868 The Colorectal Cancer in Patients of Eastern Algeria

Authors: S. Tebibel, C. Mechati, S. Messaoudi

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Algeria is currently experiencing the same rate of cancer progression as that registered these last years in the western countries. Colorectal cancer, constituting increasingly a major public health problem, is the most common form of cancer after breast and Neck-womb cancer at the woman and prostate cancer at the man. Our work is based on a retrospective study to determine the cases of colorectal cancer through eastern Algeria. Our goal is to carry out an epidemiological, histological and immune- histochemical study to investigate different techniques for the diagnosis of colorectal cancer and their interests and specific in detecting the disease. The study includes 110 patients (aged between 20 to 87 years) with colorectal cancer where the inclusions and exclusions criteria were established. In our study, colorectal cancer, expresses a male predominance, with a sex ratio of 1, 99 and the most affected age group is between 50 and 59 years. We noted that the colon cancer rate is higher than rectal cancer rate, whose frequencies are respectively 60,91 % and 39,09 %. In the series of colon cancer, the ADK lieberkunien is histological the most represented type, or 85,07 % of all cases. In contrast, the proportion of ADK mucinous (colloid mucous) is only 1,49% only. Well-differentiated ADKS, are very significant in our series, they represent 83,58 % of cases. Adenocarcinoma moderately and poorly differentiated, whose proportions are respectively 2,99 % and 0.05 %. For histological varieties of rectal ADK, we see in our workforce that ADK lieberkunien represent the most common histological form, or 76,74%, while the mucosal colloid is 13,95 %. Research of the mutation on the gene encoding K-ras, a major step in the targeted therapy of colorectal cancers, is underway in our study. Colorectal cancer is the subject of much promising research concern: the evaluation of new therapies (antiangiogenic monoclonal antibodies), the search for predictors of sensitivity to chemotherapy and new prognostic markers using techniques of molecular biology and proteomics.

Keywords: adenocarcinoma, age, colorectal cancer, epidemiology, histological section, sex

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867 The Impact of Continuous Exercise on Depression Levels Among Young Female Athletes in Hamadan Province, Iran

Authors: Mahboubeh Varmaziar

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Depression is a significant public health concern affecting people of all ages and genders. Physical activity has been shown to have a positive effect on mental health, particularly in alleviating symptoms of depression. This study aims to explore the impact of continuous exercise on depression levels among young female athletes in Hamadan Province, Iran. In this randomized controlled trial, 72 women aged 20 to 35 years attending sports centers in Hamadan Province were selected through convenient sampling and randomly assigned to either the control or experimental group. The experimental group participated in a continuous exercise program consisting of 20 sessions over six weeks, with each session lasting 30 minutes. In contrast, the control group maintained their usual daily activities at the sports center. Both groups completed demographic and Beck Depression Inventory questionnaires. Data were analyzed using descriptive and inferential statistics, including two-way ANOVA. The results of the two-way ANOVA, after controlling for the pre-test effect, revealed a significant difference in the mean depression scores between the control and experimental groups (p < 0.001). This suggests that the continuous exercise program significantly reduced depression levels in the young female athletes. The findings suggest that continuous exercise is an effective non-pharmacological intervention for reducing depression in young female athletes. Incorporating regular physical activity into treatment plans may serve as a complementary therapy alongside conventional treatments, offering a low-risk and beneficial approach to managing depression.

Keywords: depression, exercise, female athletes, yong women

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866 A Cephalometric Superimposition of a Skeletal Class III Orthognathic Patient on Nasion-Sella Line

Authors: Albert Suryaprawira

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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.

Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement

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865 Suicide Prevention among Young People: Findings from the Evaluation of Youth Aware of Mental Health in Australian Secondary Schools

Authors: Lauren McGillivray, Michelle Torok, Alison Calear

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Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

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864 The Use of the Mediated Learning Experience in Response of Special Needs Education

Authors: Maria Luisa Boninelli

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This study wants to explore the effects of a mediated intervention program in a primary school. The participants where 120 students aged 8-9, half of them Italian and half immigrants of first or second generation. The activities consisted on the cognitive enhancement of the participants through Feuerstein’s Instrumental Enrichment, (IE) and on an activity centred on body awareness and mediated learning experience. Given that there are limited studied on learners in remedial schools, the current study intented to hypothesized that participants exposed to mediation would yiel a significant improvement in cognitive functioning. Hypothesis One proposed that, following the intervention, improved Q1vata scores of the participants would occur in each of the groups. Hypothesis two postulated that participants within the Mediated Learning Experience would perform significantly better than those group of control. For the intervention a group of 60 participants constituted a group of Mediation sample and were exposed to Mediated Learning Experience through Enrichment Programm. Similiary the other 60 were control group. Both the groups have students with special needs and were exposed to the same learning goals. A pre-experimental research design, in particular a one-group pretest-posttest approach was adopted. All the participants in this study underwent pretest and post test phases whereby they completed measures according to the standard instructions. During the pretest phase, all the participants were simultaneously exposed to Q1vata test for logical and linguistic evaluation skill. During the mediation intervention, significant improvement was demonstrated with the group of mediation. This supports Feuerstein's Theory that initial poor performance was a result of a lack of mediated learning experience rather than inherent difference or deficiencies. Furthermore the use of an appropriate mediated learning enabled the participants to function adequately.

Keywords: cognitive structural modifiability, learning to learn, mediated learning experience, Reuven Feuerstein, special needs

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863 Retrofitting Adaptive Reuse into Palaces of Northern India

Authors: Shefali Nayak

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The architectural appeal, familiarity, and idiom of culturally significant structures are due to societal attachment to various movements, historical association or deviation. Generally, the urge to preserve a building in the northern part of India is driven either by emotional dogma or rational thinking, but, it is also influenced by traditional affinity. The northern region of India has an assortment of palaces and Havelis belonging to various time periods and families with vernacular yet signature style of architecture. Many of them are either successfully conserved by being put into adaptive reuse and some of them have been midst controversies and continued to remain in ruins. The research focuses on comparing successful examples of adaptive reuse such as Neemrana, Mehrangargh Fort palace with a few other merchant havelis converted into heritage hotels. Furthermore, evaluates the architectural aspects of structure, materials, plumbing and electrical installations, as well as specific challenges faced by heritage professionals practicing sustainability, while respecting traditional feelings of various stakeholders. This paper concludes through the analysis of the case study that, its highly unlikely for sustainable design cannot be used as a stand-alone application for heritage structures or cities, it needs the support of architecture conservation to be put into practice. However, it is often demanding to fit a new use of a building into an aged structure. This paper records modern-day generic requirements that reflect challenges faced by different architects, while conserving a heritage structure and retrofitting it into today's requisites. The research objective is to establish how conservation, restoration, and urban regeneration are closely related to sustainable architecture in historical cities.

Keywords: architecture conservation, architecture heritage, adaptive reuse, retrofitting, sustainability, urban regeneration

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862 Physical Planning Trajectories for Disaster Mitigation and Preparedness in Costal and Seismic Regions: Capital Region of Andhra Pradesh, Vijayawada in India

Authors: Timma Reddy, Srikonda Ramesh

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India has been traditionally vulnerable to natural disasters such as Floods, droughts, cyclones, earthquakes and landslides. It has become a recurrent phenomenon as observed in last five decades. The survey indicates that about 60% of the landmass is prone to earthquakes of various intensities; over 40 million hectares is prone to floods; about 8% of the total area is prone to cyclones and 68% of the area is susceptible to drought. Climate change is likely to be perceived through experience of extreme weather events. There is growing societal concern about climate change, given the potential impacts of associated natural hazards such as cyclones, flooding, earthquakes, landslides etc, hence it is essential and crucial to strengthening our settlements to respond to such calamities. So, the research paper focus is to analyze the effective planning strategy/mechanism to integrate disaster mitigation measures in coastal regions in general and Capital Region of Andhra Pradesh in particular. The basic hypothesis is to govern the appropriate special planning considerations would facilitate to have organized way of protective life and properties from natural disasters. And further to integrate the infrastructure planning with conscious direction would provide an effective mitigations measures. It has been planned and analyzed to Vijayawada city with conscious land use planning with reference to space syntax trajectory in accordance to required social infrastructure such as health facilities, institution areas and recreational and other open spaces. It has been identified that the geographically ideal location with reference to the population densities based on GIS tools the properness strategies can be effectively integrated to protect the life and to save the properties by means of reducing the damage/impact of natural disasters in general earth quake/cyclones or floods in particularly.

Keywords: modular, trajectories, social infrastructure, evidence based syntax, drills and equipments, GIS, geographical micro zoning, high resolution satellite image

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861 Mutation Profiling of Paediatric Solid Tumours in a Cohort of South African Patients

Authors: L. Lamola, E. Manolas, A. Krause

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Background: The incidence of childhood cancer incidence is increasing gradually in low-middle income countries, such as South Africa. Globally, there is an extensive range of familial- and hereditary-cancer syndromes, where underlying germline variants increase the likelihood of developing cancer in childhood. Next-Generation Sequencing (NGS) technologies have been key in determining the occurrence and genetic contribution of germline variants to paediatric cancer development. We aimed to design and evaluate a candidate gene panel specific to inherited cancer-predisposing genes to provide a comprehensive insight into the contribution of germline variants to childhood cancer. Methods: 32 paediatric patients (aged 0-18 years) diagnosed with a malignant tumour were recruited, and biological samples were obtained. After quality control, DNA was sequenced using an ion Ampliseq 50 candidate gene panel design and Ion Torrent S5 technologies. Sequencing variants were called using Ion Torrent Suite software and were subsequently annotated using Ion Reporter and Ensembl's VEP. High priority variants were manually analysed using tools such as MutationTaster, SIFT-INDEL and VarSome. Putative identified candidates were validated via Sanger Sequencing. Results: The patients studied had a variety of cancers, the most common being nephroblastoma (13), followed by osteosarcoma (4) and astrocytoma (3). We identified 10 pathogenic / likely pathogenic variants in 10 patients, most of which were novel. Conclusions: According to the literature, we expected ~10% of our patient population to harbour pathogenic or likely pathogenic germline variants, however, we reported about 3 times (~30%) more than we expected. Majority of the identified variants are novel; this may be because this is the first study of its kind in an understudied South African population.

Keywords: Africa, genetics, germline-variants, paediatric-cancer

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860 Body Composition Response to Lower Body Positive Pressure Training in Obese Children

Authors: Basant H. El-Refay, Nabeel T. Faiad

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Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: children, hypocaloric diet, lower body positive pressure supported treadmill, obesity

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859 Predictors of Social Participation of Children with Cerebral Palsy in Primary Schools in Czech Republic

Authors: Marija Zulić, Vanda Hájková, Nina Brkić-Jovanović, Linda Rathousová, Sanja Tomić

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Cerebral palsy is primarily reflected in the disorder of the development of movement and posture, which may be accompanied by sensory disturbances, disturbances of perception, cognition and communication, behavioural disorders and epilepsy. According to current inclusive attitudes towards people with disabilities implies that full social participation of children with cerebral palsy means inclusion in all activities in family, peer, school and leisure environments in the same scope and to the same extent as is the case with the children of proper development and without physical difficulties. Due to the fact that it has been established that the quality of children's participation in primary school is directly related to their social inclusion in future life, the aim of the paper is to identify predictors of social participation, respectively, and in particular, factors that could to improve the quality of social participation of children with cerebral palsy, in the primary school environment in Czech Republic. The study includes children with cerebral palsy (n = 75) in the Czech Republic, aged between six and 12 years who attend mainstream or special primary schools to the sixth grade. The main instrument used was the first and third part of the School function assessment questionnaire. It will also take into account the type of damage assessed according to a scale the Gross motor function classification system, five–level classification system for cerebral palsy. The research results will provide detailed insight into the degree of social participation of children with cerebral palsy and the factors that would be a potential cause of their levels of participation, in regular and special primary schools, in different socioeconomic environments in Czech Republic.

Keywords: cerebral palsy, Czech republic, social participation, the school function assessment

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858 Association of Calcium Intake Adequacy with Wealth Indices among Selected Female Adults Living in Depressed and Non-Depressed Area in Metro Manila, Philippines

Authors: Maria Viktoria Melgo

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This study aimed to determine the possible association between calcium intake and wealth indices of selected female adults. Specifically, it aimed to: a) determine the calcium intake adequacy of the respondents. b) determine the relationship, if any, between calcium intake adequacy, area and wealth indices. The study used the survey design and employed convenience sampling in selecting participants. Two hundred females aged 20 – 64 years old were covered in the study from depressed and non-depressed areas. Data collected were calcium intake taken from two 24-hour food recall and Food Frequency Questionnaire (FFQ) and wealth indices using housing characteristics, household assets and access to utilities and infrastructure. Descriptive statistics and Chi-square test were used to determine the frequency distribution and association between the given variables, respectively, using Statistical Package for Social Sciences (SPSS) and OpenEpi software. The results showed that there were 86% of respondents in the depressed area with an inadequate calcium intake while there were 78% of respondents in the non-depressed area with an adequate calcium intake. No significant relationship was obtained in most wealth indices with calcium intake adequacy and area but appliance and ownership of main material of the house showed a significant relationship to calcium intake adequacy by area. The study recommends that the Local Government Unit (LGU) should provide seminars or nutrition education that will further enhance the knowledge of the people in the community. The study also recommends to conduct a similar study but with different, larger sample size, different location nonetheless if it is in urban or rural and include the anthropometry measurement of the respondents.

Keywords: association, calcium intake adequacy, metro Manila, Philippines, wealth indices

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857 Setswana Speech Rhythm Development in High-Socioeconomic Status Setswana-English Bilingual Children

Authors: Boikanyego Sebina

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The present study investigates the effects of socioeconomic status (SES) and bilingualism on the Setswana speech rhythm of Batswana (citizens) children aged 6-7 years with typical development born and residing in Botswana. Botswana is a country in which there is a diglossic Setswana/English language setting, where English is the dominant high-status language in educational and public contexts. Generally, children from low SES have lower linguistic and cognitive profiles than their age-matched peers from high SES. A greater understanding of these variables would allow educators to distinguish between underdeveloped language skills in children due to impairment and environmental issues for them to successfully enroll children in language development enhancement programs specific to the child’s needs. There are 20 participants: 10 high SES private English-medium educated early sequential Setswana-English bilingual children, taught full-time in English (L2) from the age of 3 years, and for whom English has become dominant; and 10 low SES children who are educated in public schools for whom English is considered a learner language, i.e., L1 Setswana is dominant. The aim is to see whether SES and bilingualism, have had an effect on the Setswana speech rhythm of children in either group. The study primarily uses semi-spontaneous speech based on the telling of the wordless picture storybook. A questionnaire is used to elicit the language use pattern of the children and that of their parents, as well as the education level of the parents and the school the children attend. A comparison of the rhythm shows that children from high SES have a lower durational variability than those from low SES. The findings of the study are that the low durational variability by children from high SES may suggest an underdeveloped rhythm. In conclusion, the results of the present study are against the notion that children from high SES outperform those from low SES in linguistic development.

Keywords: bilingualism, Setswana English, socio-economic status, speech-rhythm

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856 Factors Affecting Access to Education: The Experiences of Parents of Children Who Are Deaf or Hard of Hearing

Authors: Hanh Thi My Nguyen

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The purpose of this research is to examine the experiences of parents of children who are deaf or hard of hearing in supporting their children to access education in Vietnam. Parents play a crucial role in supporting their children to gain full access to education. It was widely reported that parents of those children confronted a range of problems to support their children to access education. To author’s best knowledge, there has been a lack of research exploring the experiences of those parents in literature. This research examines factors affecting those parents in supporting their children to access education. To conduct the study, qualitative approach using a phenomenological research design was chosen to explore the central phenomena. Ten parents of children who were diagnosed as deaf or hard of hearing and aged 6-9 years were recruited through the support of the Association of Parents of Children with Hearing Impairment. Participants were interviewed via telephone with a mix of open and closed questions; interviews were audio recorded, transcribed and thematically analysed. The research results show that there are nine main factors that affected the parents in this study in making decisions relating to education for their children including: lack of information resources, perspectives of those parents on communication approaches, the families’ financial capacity, the psychological impact on the participants after their children’ diagnosis, the attitude of family members, attitude of school administrators, lack of local schools and qualified teachers, and current education system for the deaf in Vietnam. Apart from those factors, the lack of knowledge of the participants’ partners about deaf education and the partners’ employment are barriers to educational access and successful communication with their child.

Keywords: access to education, deaf, hard of hearing, parents experience

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855 Smoking, Bullying, and Being Bullied among Secondary School Students: Their Associations with Attachment Styles

Authors: Ruziana Masiran, Hamidin Awang, Cheah Y. T. Jun, Nor Fauziah Hashim, Archana Premkumar, Mohd. Feizel Aisiddiq, Mohd. Fakharuddin

Abstract:

Risk behaviours among secondary school students are common and show an increasing trend over the years. Existing attachment styles between the students and their parents influence the psychosocial development of this group of population hence contributing to the adoption of risk behaviours. The aim of this study was to determine the associations between three risk behaviours; smoking, bullying and being bullied among secondary school students and their styles of attachment to parents in a district in Malaysia. Using multistage simple random sampling, a cross-sectional study was designed with the level of significance, α set at 0.05. The validated self-administered Inventory of Parent and Peer Attachment (IPPA) and Youth Risk Behaviours Surveillance Questionnaire focusing on smoking and bullying were utilized. Secondary school students aged 13 to 17 years old from ten schools in the district of Hulu Langat, Malaysia were sampled. Prevalence of smoking was 15.8%, bullying 8.5% and being bully victims 19.0%. It was found that male gender was a significant risk factor for smoking (p < 0.001), while being Chinese (OR=0.156, 95%CI=0.029-0.837, p=0.030) and having married parents (OR=0.490, 95%CI=0.302-0.796, p=0.490) are protective against smoking. Students with insecure attachment to mothers (OR=1.650, 95%CI=1.018-2.675, p=0.042) and fathers (OR=2.039, 95%CI=1.285-3.234, p=0.002) are at 1.6 and 2 times risk respectively to smoke compared to those with secure attachment. The odds of male students bullying is almost twice than that for female students (OR=2.017, 95%CI=1.416-2.873, p < 0.001), and the odds of being bullied is 1.5 times higher for male students (OR=1.519, 95%CI=1.183-1.950, p=0.001). Those who are insecurely attached to fathers are at 1.8 times higher risk to be bullies (OR=1.867, 95%CI=1.272-2.740, p < 0.001) and 1.5 times higher risk to be bullied (OR=1.546, 95%CI=1.026-2.329, p=0.037). In conclusion, insecure attachment shows a strong association with smoking, bullying and being bullied among secondary school students in Malaysia.

Keywords: attachment styles, bullied, bullying, insecure attachment, risk behaviours, smoking and attachment

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854 A Study of Language Choice and Use among Young Thai in Malaysia

Authors: Din Eak Arathai

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The purpose of this research report is to investigate the language choice and use among the young generation of Malaysian Thais community. Besides that, it aims to investigate if there is a difference in language choice across the different domains. It will also examine if there has been a language shift from Thai to other languages by the young generation of Thai community in Malaysia. First the study focuses on the proficiency of Thai and other languages used by hundred (100) respondents belonging to young generation of Malaysian Thais aged range from 18-35. Next, language use and choice will be presented with a focus on the domains of family, friendship, entertainment and social. Finally, based on the findings and data collected, we will be able to see if language shift from Thai to other languages has occurred among the young Thai generation in Malaysia. The instrument used in this study was a 30-item questionnaire and the findings of the data analysis were presented in the form of frequency counts and percentages. The findings found that Thai language remains the most preferred language of choice among young Malaysian Thais but usage of other languages, such as Malay, English and Mandarin has increased and begun to influence the language choice of young Malaysian Thais and their proficiency of their mother tongue.In all the domains studied, Thai is almost exclusively the preferred language used when communicating with family. Malay is the most preferred language in communicating with friends while English is the most preferred language when communicating with colleagues. With regards to social and entertainment activities, young Malaysian Thais show great affinity for entertainment in the Thai language. In conclusion, the result of the study showed the beginning of young Malaysian Thais shifting to other languages, especially English and Malay through their daily choices when communicating with friends and family and especially through their language preferences in entertainment.

Keywords: language choice, language use, language shift, language maintenance, young Malaysian Thais, code switching, code mixing

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853 The Fracture Resistance of Zirconia Based Dental Crowns from Cyclic Loading: A Function of Relative Wear Depth

Authors: T. Qasim, B. El Masoud, D. Ailabouni

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This in vitro study focused on investigating the fatigue resistance of veneered zirconia molar crowns with different veneering ceramic thicknesses, simulating the relative wear depths under simulated cyclic loading. A mandibular first molar was prepared and then scanned using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate 32 zirconia copings of uniform 0.5 mm thickness. The manufactured copings then veneered with 1.5 mm, 1.0 mm, 0.5 mm, and 0.0 mm representing 0%, 33%, 66%, and 100% relative wear of a normal ceramic thickness of 1.5 mm. All samples were thermally aged to 6000 thermo-cycles for 2 minutes with distilled water between 5 ˚C and 55 ˚C. The samples subjected to cyclic fatigue and fracture testing using SD Mechatronik chewing simulator. These samples are loaded up to 1.25x10⁶ cycles or until they fail. During fatigue, testing, extensive cracks were observed in samples with 0.5 mm veneering layer thickness. Veneering layer thickness 1.5-mm group and 1.0-mm group were not different in terms of resisting loads necessary to cause an initial crack or final failure. All ceramic zirconia-based crown restorations with varying occlusal veneering layer thicknesses appeared to be fatigue resistant. Fracture load measurement for all tested groups before and after fatigue loading exceeded the clinical chewing forces in the posterior region. In general, the fracture loads increased after fatigue loading and with the increase in the thickness of the occlusal layering ceramic.

Keywords: all ceramic, cyclic loading, chewing simulator, dental crowns, relative wear, thermally ageing

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852 Impact of School-Based Gymnastic Program on Skill-Related Fitness in Early Adolescent Students

Authors: Dinko Vuleta, Dejan Madić, Goran Sporiš, Nebojša Trajković

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The aim of this study was to determine the effects of gymnastics program in school on skill-related fitness in early adolescent students. The study involved 58 adolescent students (12.82±0.54 years; Height 156.81±8.16 cm; 53.46±12.31 kg) from primary school divided into two groups, following the randomization. The gymnastic group was involved in a 12 week of gymnastics classes, while the control group only participated in usual PE classes which consisted of multi-sport activities. The variables were selected within the several fitness batteries, measuring coordination (polygon backwards), upper and lower body strength standing long jump and medicine ball throw), speed (20 m sprint) and agility (4x10 test). Pre-test to post-test values showed significant improvements in all tested variables (p<0.05), except for the 4x10m test, where there were no significant improvements in neither of the groups (p>0.05). Significant interactions of time by group were observed for coordination, sprint speed, standing long jump and medicine ball throw (p<0.05). The results showed significant increase in skill-related fitness of the participants in the gymnastic group compared to the control group. Therefore, participation in gymnastics must be recommended as a positive foundational activity for school-aged children, from early childhood to adulthood. Additionally, the results can provide useful information in optimizing the training loads of pupils involved in gymnastic training throughout PE classes.

Keywords: effects, PE classes, physical fitness, training

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851 Cognitive Behavioral Training to Enhance Performance and Well-Being in Collegiate Athletes

Authors: Angelina Tarabokija

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This study looks into how cognitive behavioral training (CBT) techniques affect collegiate track and field athletes' anxiety related to performance, with a focus on distance runners. The goal of the research is to discover whether consistent use of cognitive behavioral therapy (CBT) methods, such as progressive muscle relaxation, yoga (Y-CBT), visualization, relaxed breathing, and meditation, can reduce performance anxiety and improve sports performance. Six runners from the Rider Track & Field team, aged eighteen to twenty-three, participated in the quantitative research design used in the technique. Prior to employing CBT techniques every day for two weeks, including before competitions or on race day, participants conducted baseline assessments using the Sport Anxiety Scale-2 (SAS-2). The SAS-2 was used in post-competition evaluations to track alterations in performance anxiety. The findings show that participants' total trait anxiety levels significantly decreased after utilizing CBT techniques for one week. However, after two weeks, a few participants' anxiety levels slightly increased, pointing to the need for more research and regular practice. The study indicates that CBT approaches can effectively reduce performance anxiety and increase athletic performance in collegiate track and field athletes, despite constraints related to participant motivation and potential confounding variables. Future areas for research could entail examining the precise impacts of worry, interruption of attention, and bodily anxiety on performance, as well as adding more controls. Overall, by providing insights into evidence-based strategies to maximize mental states and athletic performance in collegiate athletes, this study advances the area of sports psychology.

Keywords: cognitive behavioral training, performance, athletes, anxiety, well-being, SAS-2, Sport, trait anxiety, somatic anxiety

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850 Bioactive Secondary Metabolites from Culturable Unusual Actinomycetes from Solomon Islands Marine Sediments: Isolation and Characterisation of Bioactive Compounds

Authors: Ahilya Singh, Brad Carte, Ramesh Subramani, William Aalbersberg

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A total of 37 actinomycete strains were purified from 25 Solomon Islands marine sediments using four different types of isolation media. Among them, 54% of the strains had obligate requirement of seawater for growth. The ethyl acetate extract of 100 ml fermentation product of each strain was screened for antimicrobial activity against multidrug resistant human pathogens and cytotoxic activity against brine shrimps. A total of 67% of the ethyl acetate extracts showed antimicrobial and/or cytotoxic activities. A strain F-1915 was selected for isolation and evaluation of bioactive compound(s) based on its bioactive properties and chemical profile analysis using the LC-MS. The strain F-1915 was identified to have 96% sequence similarity to Streptomyces violaceusniger on the basis of 16S rDNA sequences using BLAST analysis. The 16S rDNA revealed that the strain F-1915 is a new member of MAR4 clade of actinomycetes. The MAR4 clade is an interesting clade of actinomycetes known for the production of pharmaceutically important hybrid isoprenoid compounds. The ethyl acetate extract of the fermentation product of this strain was purified by silica gel column chromatography and afforded the isolation of one bioactive pure compound. Based on the 1D and 2D NMR spectral data of compound 1 it was identified as a new mono-brominated phenazinone, Marinophenazimycin A, a structure which has already been studied by external collaborators at Scripps Institution of Oceanography but is yet to be published. Compound 1 displayed significant antimicrobial activity against drug resistant human pathogens. The minimum inhibitory concentration (MIC) of compound 1 was against Methicillin Resistant Staphylococcus aureus (MRSA) was about 1.9 μg/ml and MIC recorded against Amphotericin Resistant Candida albicans (ARCA) was about 0.24 μg/ml. The bioactivity of compound 1 against ARCA was found to be better than the standard antifungal agent amphotericin B. Compound 1 however did not show any cytotoxic activity against brine shrimps.

Keywords: actinomycetes, antimicrobial activity, brominated phenazine, MAR4 clade, marine natural products, multidrug resistent, 1D and 2D NMR

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849 Parental Involvement and Students' Outcomes: A Study in a Special Education School in Singapore

Authors: E. Er, Y. S. Cheng

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The role of parents and caregivers in their children’s education is pivotal. Parental involvement (PI) is often associated with a range of student outcomes. This includes academic achievements, socioemotional development, adaptive skills, physical fitness and school attendance. This study is the first in Singapore to (1) explore the relationship between parental involvement and student outcomes; (2) determine the effects of family structure and socioeconomic status (SES) on parental involvement and (3) investigate factors that inform involvement in parents of children with specific developmental disabilities. Approval for the study was obtained from Nanyang Technological University’s Institutional Review Board in Singapore. The revised version of a comprehensive theoretical model on parental involvement was used as the theoretical framework in this study. Parents were recruited from a SPED school in Singapore which caters to school-aged children (7 to 21 years old). Pearson’s product moment correlation, analysis of variance and multiple regression analyses were used as statistical techniques in this study. Results indicate that there are significant associations between parental involvement and educational outcomes in students with developmental disabilities. Next, SES has a significant impact on levels of parental involvement. In addition, parents in the current study reported being more involved at home, in school activities and the community, when teachers specifically requested their involvement. Home-based involvement was also predicted by parents’ perceptions of their time and energy, efficacy and beliefs in supporting their child’s education, as well as their children’s invitations to be more involved. An interesting and counterintuitive inverse relationship was found between general school invitations and parental involvement at home. Research findings are further discussed, and suggestions are put forth to increase involvement for this specific group of parents.

Keywords: autism, developmental disabilities, intellectual disabilities, parental involvement, Singapore

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848 The Effect of Eight-Week Medium Intensity Interval Training and Curcumin Intake on ICMA-1 and VCAM-1 Levels in Menopausal Fat Rats

Authors: Abdolrasoul Daneshjoo, Fatemeh Akbari Ghara

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Background and Purpose: Obesity is an increasing factor in cardiovascular disease and serum levels of cellular adhesion molecule. It plays an important role in predicting risk for coronary artery disease. The purpose of this research was to study the effect of eight weeks moderate intensity interval training and curcumin intake on ICAM-1 & VCAM-1 levels of menopausal fat rats. Materials and methods: in this study, 28 Wistar Menopausal fat rats aged 6-8 weeks with an average weight of 250-300 (gr) were randomly divided into four groups: control, curcumin supplement, moderate intensity interval training and moderate intensity interval training + curcumin supplement. (7 rats each group). The training program was planned as 8 weeks and 3 sessions per week. Each session consisted of 10 one-min sets with 50 percent intensity and the 2-minutes interval between sets in the first week. Subjects started with 14 meters per minute, and 2 (m/min) was added to increase their speed weekly until the speed of 28 (m/min) in the 8th week. Blood samples were taken 48 hours after the last training session, and ICAM-1 A and VCAM-1 levels were measured. SPSS software, one-way analysis of variance (ANOVA) and Pearson correlation coefficient were used to assess the results. Results: The results showed that eight weeks of training and taking curcumin had significant effects on ICAM-1 levels of the rats (p ≤ 0.05). However, it had no significant effect on VCAM-1 levels in menopausal obese rates (p ≥ 0.05). There was no significant correlation between the levels of ICAM-1 and VCAM-1 in eight weeks training and taking curcumin. Conclusion: Implementation of moderate intensity interval training and the use of curcumin decreased ICAM-1 significantly.

Keywords: curcumin, interval training , ICMA, VCAM

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847 Relevance of Brain Stem Evoked Potential in Diagnosis of Central Demyelination in Guillain Barre’ Syndrome

Authors: Geetanjali Sharma

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Guillain Barre’ syndrome (GBS) is an auto-immune mediated demyelination poly-radiculo-neuropathy. Clinical features include progressive symmetrical ascending muscle weakness of more than two limbs, areflexia with or without sensory, autonomic and brainstem abnormalities, the purpose of this study was to determine subclinical neurological changes of CNS with GBS and to establish the presence of central demyelination in GBS. The study was prospective and conducted in the Department of Physiology, Pt. B. D. Sharma Post-graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India to find out early central demyelination in clinically diagnosed patients of GBS. These patients were referred from the department of Medicine of our Institute to our department for electro-diagnostic evaluation. The study group comprised of 40 subjects (20 clinically diagnosed GBS patients and 20 healthy individuals as controls) aged between 6-65 years. Brain Stem evoked Potential (BAEP) were done in both groups using RMS EMG EP mark II machine. BAEP parameters included the latencies of waves I to IV, inter peak latencies I-III, III-IV & I-V. Statistically significant increase in absolute peak and inter peak latencies in the GBS group as compared with control group was noted. Results of evoked potential reflect impairment of auditory pathways probably due to focal demyelination in Schwann cell derived myelin sheaths that cover the extramedullary portion of auditory nerves. Early detection of the sub-clinical abnormalities is important as timely intervention reduces morbidity.

Keywords: brainstem, demyelination, evoked potential, Guillain Barre’

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