Search results for: endoscopic vacuum therapy

Authors: Alireza Moghtaderi, Negin Khakpour

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Hallux Valgus is a kind of Toes aberration where the Metatarsophalangeal joint that connects the big toe to the foot, leading to the inner side and a protrusion on the inner surface of toe arise. This study aimed to determine the effect of botulinum toxin A injection to reduce pain and deviation angle of the thumb in Hallux Valgus and to increase outcomes of treatment as an adjuvant therapy. Randomized clinical study was performed on 18 patients at the Clinic of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences. In this study the Halgvs valgus angle (HVA) between the metatarsals (IMA) and cartilage distal metatarsal angle (DMAA) and pain were assessed before and after injection. Average of Hallux Valgus angle before and after Botox injections were 28/89 ± 10/21 and 21/56 ± 8/22 degrees and the angle deviation in the 6 months after treatment was significantly improved (p <0.001). Injection of botulinum toxin A is a suitable and acceptable method to reform the skeleton deformities and also to reduce the pain in patients with Hallux valgus.

Keywords: metatasal, hallux valgus, pain, botulinum toxuin

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Authors: Priyanka Sharma, Rajeshwar Nath Srivastava

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Hydrogen has a high level of efficacy in suppressing tumour growth. The role of hydrogen in cancer treatment is unclear. This groundbreaking research will focus on the most effective therapeutic approach for osteosarcoma. Recent data reveals that hydrogen, a naturally occurring gaseous chemical, can protect cells from death. However, little is known about the signalling pathways that regulate cardiac cell death and individual apoptosis signalling by H2 and its downstream targets. According to certain research, the anti-tumor effect of H2 released by magnesium-based biomaterials is mediated by the P53-mediated lysosome-mitochondria apoptosis signalling pathway, bolstering the biomaterial's therapeutic potential as a localised anti-tumor treatment. The role of the H2 molecule in the signalling of apoptotic, autophagic, necroptotic, and pyroptotic cell death in Osteosarcoma is discussed in this paper. Potential Hydrogen-based therapy techniques will broaden the treatment horizon for Osteosarcoma.

Keywords: osteosarcoma, metastasis, hhydrogen, therapeutic

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Authors: Somnath Bhattachryya, Montree Bunruangses, Somchat Sonasang, Preecha Yupapin

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In this study and research on meditation and insight, the design and experiment with electronic circuits to manipulate the meditators' mental circles that call the chakras to have the same size is proposed. The shape of the circuit is 4-ports, called an add-drop multiplexer, that studies the meditation structure called the four-mindfulness foundation, then uses an AC power signal as an input instead of the meditation time function, where various behaviors with the method of re-filtering the signal (successive filtering), like eight noble paths. Start by inputting a signal at a frequency that causes the velocity of the wave on the perimeter of the circuit to cause particles to have the speed of light in a vacuum. The signal changes from electromagnetic waves and matter waves according to the velocity (frequency) until it reaches the point of the relativistic limit. The electromagnetic waves are transformed into photons with properties of wave-particle overcoming the limits of the speed of light. As for the matter wave, it will travel to the other side and cannot pass through the relativistic limit, called a shadow signal (echo) that can have power from increasing speed but cannot create speed faster than light or insight. In the experiment, the only the side where the velocity is positive, only where the speed above light or the corresponding frequency indicates intelligence. Other side(echo) can be done by changing the input signal to the other side of the circuit to get the same result. But there is no intelligence or speed beyond light. It is also used to study the stretching, contraction of time and wormholes that can be applied for teleporting, Bose-Einstein condensate and teleprinting, quantum telephone. The teleporting can happen throughout the system with wave-particle and echo, which is when the speed of the particle is faster than the stretching or contraction of time, the particle will submerge in the wormhole, when the destination and time are determined, will travel through the wormhole. In a wormhole, time can determine in the future and the past. The experimental results using the microstrip circuit have been found to be by the principle of quantum relativity, which can be further developed for both tools and meditation practitioners for quantum technology.

Keywords: quantu meditation, insight picture, quantum circuit, absolute time, teleportation

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Authors: Praveena Sinha

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Context: Diabetes is a global public health burden, particularly affecting postmenopausal women. Insulin resistance (IR) is prevalent in this population, and it is associated with an increased risk of developing type 2 diabetes. Yoga therapy is gaining attention as a complementary intervention for diabetes due to its potential to address stress psychophysiology. This study focuses on the efficacy of a 12-week yoga practice in attenuating insulin resistance in early postmenopausal women. Research Aim: The aim of this research is to investigate the effect of a 3-month long yoga practice on insulin resistance in early postmenopausal women. Methodology: The study conducted a prospective longitudinal design with 67 women within five years of menopause. Participants were divided into two groups based on their willingness to join yoga. The Yoga group (n = 37) received routine gynecological management along with an integrated yoga module, while the Non-Yoga group (n = 30) received only routine management. Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR) method before and after the intervention. Statistical analysis was performed using GraphPad Prism Version 5 software, with statistical significance set at P < 0.05. Findings: The results indicate a significant decrease in serum fasting insulin levels and HOMA-IR measurements in the Yoga group, although the decrease did not reach statistical significance. In contrast, the Non-Yoga group showed a significant rise in serum fasting insulin levels and HOMA-IR measurements after 3 months, suggesting a detrimental effect on insulin resistance in these postmenopausal women. Theoretical Importance: This study provides evidence that a 12-week yoga practice can attenuate the increase in insulin resistance in early postmenopausal women. It highlights the potential of yoga as a preventive measure against the early onset of insulin resistance and the development of type 2 diabetes mellitus. Regular yoga practice can be a valuable tool in addressing hormonal imbalances associated with early postmenopause, leading to a decrease in morbidity and mortality related to insulin resistance and type 2 diabetes mellitus in this population. Data Collection and Analysis Procedures: Data collection involved measuring serum fasting insulin levels and calculating HOMA-IR. Statistical analysis was performed using GraphPad Prism Version 5 software, and mean values with standard error of the mean were reported. The significance level was set at P < 0.05. Question Addressed: The study aimed to address whether a 3-month long yoga practice could attenuate insulin resistance in early postmenopausal women. Conclusion: The research findings support the efficacy of a 12-week yoga practice in attenuating insulin resistance in early postmenopausal women. Regular yoga practice has the potential to prevent the early onset of insulin resistance and the development of type 2 diabetes mellitus in this population. By addressing the hormonal imbalances associated with early post menopause, yoga could significantly decrease morbidity and mortality related to insulin resistance and type 2 diabetes mellitus in these subjects.

Keywords: post menopause, insulin resistance, HOMA-IR, yoga, type 2 diabetes mellitus

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Authors: Orestis Kasinopoulos, Maria Karekla, Vasilis Vasiliou, Evangelos Karademas

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Acceptance and Commitment Therapy (ACT) is an empirically supported intervention for treating Chronic Pain Patients, yet its effectiveness for some chronic conditions or when adapted to other languages, has not been explored. An ACT group intervention was designed to explore the effectiveness of treating a Greek speaking heterogeneous sample of Chronic Pain patients with the aim of increasing quality of life, acceptance of pain and functionality. Sixty-nine patients were assessed and randomly assigned to an ACT or control group (relaxation techniques) for eight, 90-minute, sessions. Results are currently being analysed and follow-ups (6 and 12 month) are being completed. Low adherence rates and high attrition rates observed in the study, however point to the direction of future modified interventions. Such modifications may include web-based and smartphone interventions and their benefits in being implemented in chronic pain patients.

Keywords: chronic pain, ACT, internet-delivered, digitalised intervention, adherence, attrition

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Authors: Diwei Lin, Amanda Jh. Tan

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We present a very rare case of de novo large cell neuroendocrine carcinoma of the prostate (LCNEC) in an 84-year-old male on a background of high-grade, muscle-invasive transitional cell carcinoma of the bladder. While NE tumours account for 1% to 5% of all cases of prostate cancer and scattered NE cells can be found in 10% to 100% of prostate adenocarcinomas, pure LCNEC of the prostate is extremely rare. Most LCNEC of the prostate is thought to originate by clonal progression under the selection pressure of therapy and refractory to long-term hormonal treatment for adenocarcinoma of the prostate. De novo LCNEC is only described in case reports and is thought to develop via direct malignant transformation. Limited data in the English literature makes it difficult to accurately predict the prognosis of LCNEC of the prostate. However, current evidence suggesting that increasing NE differentiation in prostate adenocarcinoma is associated with a higher stage, high-grade disease, and a worse prognosis.

Keywords: large cell neuroendocrine cancer, prostate cancer, refractory cancer, medical and health sciences

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Authors: Nicole Selvi Hill, Archchana Radhakrishnan

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Introduction: Traumatic brain injury (TBI) is a leading cause of mortality among trauma patients. In the management of TBI, the main principle is avoiding cerebral ischemia, as this is a strong determiner of neurological outcomes. The use of vasoactive drugs, such as vasopressin, has an important role in maintaining cerebral perfusion pressure to prevent secondary brain injury. Current guidelines do not suggest a preferred vasoactive drug to administer in the management of TBI, and there is a paucity of information on the therapeutic potential of vasopressin following TBI. Vasopressin is also an endogenous anti-diuretic hormone (AVP), and pathways mediated by AVP play a large role in the underlying pathological processes of TBI. This creates an overlap of discussion regarding the therapeutic potential of vasopressin following TBI. Currently, its popularity lies in vasodilatory and cardiogenic shock in the intensive care setting, with increasing support for its use in haemorrhagic and septic shock. Methodology: This is a review article based on a literature review. An electronic search was conducted via PubMed, Cochrane, EMBASE, and Google Scholar. The aim was to identify clinical studies looking at the therapeutic administration of vasopressin in severe traumatic brain injury. The primary aim was to look at the neurological outcome of patients. The secondary aim was to look at surrogate markers of cerebral perfusion measurements, such as cerebral perfusion pressure, cerebral oxygenation, and cerebral blood flow. Results: Eight papers were included in the final number. Three were animal studies; five were human studies, comprised of three case reports, one retrospective review of data, and one randomised control trial. All animal studies demonstrated the benefits of vasopressors in TBI management. One animal study showed the superiority of vasopressin in reducing intracranial pressure and increasing cerebral oxygenation over a catecholaminergic vasopressor, phenylephrine. All three human case reports were supportive of vasopressin as a rescue therapy in catecholaminergic-resistant hypotension. The retrospective review found vasopressin did not increase cerebral oedema in TBI patients compared to catecholaminergic vasopressors; and demonstrated a significant reduction in the requirements of hyperosmolar therapy in patients that received vasopressin. The randomised control trial results showed no significant differences in primary and secondary outcomes between TBI patients receiving vasopressin versus those receiving catecholaminergic vasopressors. Apart from the randomised control trial, the studies included are of low-level evidence. Conclusion: Studies favour vasopressin within certain parameters of cerebral function compared to control groups. However, the neurological outcomes of patient groups are not known, and animal study results are difficult to extrapolate to humans. It cannot be said with certainty whether vasopressin’s benefits stand above usage of other vasoactive drugs due to the weaknesses of the evidence. Further randomised control trials, which are larger, standardised, and rigorous, are required to improve knowledge in this field.

Keywords: catecholamines, cerebral perfusion pressure, traumatic brain injury, vasopressin, vasopressors

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Authors: Yousif M. Yousif Abdallah, Mohamed E. Gar-Elnabi, Abdoelrahman H. A. Bakary, Alaa M. H. Eltoum, Abdelazeem K. M. Ali

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The study was established to measure the amount of radiation outside the treatment field in external beam radiation therapy using day method of dose calculation, the data was collected from 89 patients of cervical carcinoma in order to determine if the dose outside side the irradiation treatment field for spleen, liver, both kidneys, small bowel, large colon, skin within the acceptable limit or not. The cervical field included mainly 4 organs which are bladder, rectum part of small bowel and hip joint these organ received mean dose of (4781.987±281.321), (4736.91±331.8), (4647.64±387.1) and (4745.91±321.11) respectively. The mean dose received by outfield organs was (77.69±15.24cGy) to large colon, (93.079±12.31cGy) to right kidney (80.688±12.644cGy) to skin, (155.86±17.69cGy) to small bowel. This was more significant value noted.

Keywords: radiation dose, cervical carcinoma, day’s methods, radiation medicine

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Authors: Gabriela Wyszogrodzka, Przemyslaw Dorozynski, Barbara Gil, Maciej Strzempek, Bartosz Marszalek, Piotr Kulinowski, Wladyslaw Piotr Weglarz, Elzbieta Menaszek

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MOFs (Metal-Organic Frameworks) belong to a new group of porous materials with a hybrid organic-inorganic construction. Their structure is a network consisting of metal cations or clusters (acting as metallic centers, nodes) and the organic linkers between nodes. The interest in MOFs is primarily associated with the use of their well-developed surface and large porous. Possibility to build MOFs of biocompatible components let to use them as potential drug carriers. Furthermore, forming MOFs structure from cations possessing paramagnetic properties (e.g. iron cations) allows to use them as MRI (Magnetic Resonance Imaging) contrast agents. The concept of formation of particles that combine the ability to transfer active substance with imaging properties has been called theranostic (from words combination therapy and diagnostics). By building MOF structure from iron cations it is possible to use them as theranostic agents and monitoring the distribution of the active substance after administration in real time. In the study iron-MOF: Fe-MIL-101-NH2 was chosen, consisting of iron cluster in nodes of the structure and amino-terephthalic acid as a linker. The aim of the study was to investigate the possibility of applying Fe-MIL-101-NH2 as inhalable theranostic particulate system for the first-line anti-tuberculosis antibiotic – isoniazid. The drug content incorporated into Fe-MIL-101-NH2 was evaluated by dissolution study using spectrophotometric method. Results showed isoniazid encapsulation efficiency – ca. 12.5% wt. Possibility of Fe-MIL-101-NH2 application as the MRI contrast agent was demonstrated by magnetic resonance tomography. FeMIL-101-NH2 effectively shortening T1 and T2 relaxation times (increasing R1 and R2 relaxation rates) linearly with the concentrations of suspended material. Images obtained using multi-echo magnetic resonance imaging sequence revealed possibility to use FeMIL-101-NH2 as positive and negative contrasts depending on applied repetition time. MOFs micronization via ultrasound was evaluated by XRD, nitrogen adsorption, FTIR, SEM imaging and did not influence their crystal shape and size. Ultrasonication let to break the aggregates and achieve very homogeneously looking SEM images. MOFs cytotoxicity was evaluated in in vitro test with a highly sensitive resazurin based reagent PrestoBlue™ on L929 fibroblast cell line. After 24h no inhibition of cell proliferation was observed. All results proved potential possibility of application of ironMOFs as an isoniazid carrier and as MRI contrast agent in inhalatory treatment of tuberculosis. Acknowledgments: Authors gratefully acknowledge the National Science Center Poland for providing financial support, grant no 2014/15/B/ST5/04498.

Keywords: imaging agents, metal-organic frameworks, theranostics, tuberculosis

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Authors: Huma Atta, Ishrat Rehman, Muhammad Umair

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Objective: To find out the effectiveness of Dr. Stein behavioural modification strategies among Down syndrome children’s behavioural problems. Material & Methods: We took a group of individuals (aged 8-16) having Down syndrome from national special education complex, Peshawar. They were assessed through the behavioural problem index to give us an idea on their behaviour problems, those with a behavioural problem were kept in therapy for further sessions to help them improve. Results: A treatment plan was made according to the extracted behavioural problems of Down syndrome children. Dr. Stein recommended behavioural modification treatment strategies were used for behavioural modification of Down syndrome children (Routine, reward, choice, redirection and consistency). Pre-intervention (M=69.11, SD=6.27) and post-intervention (M=61.33, SD=6.51) conditions; t (8) =2.70, p=0.027. Conclusion: After the successful completion of 9 sessions with Down syndrome children, their behavioural problems were reassessed. Results indicated that Dr. Stein behavioural modification strategy is an effective treatment plan for the modification of behavioural problems among Down syndrome children.

Keywords: behavior, down syndrome, treatment, strategies

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Authors: Muziwandile Luthuli

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Although numerous factors predicting adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been broadly studied on both regional and global level, up-to-date adherence of patients to ART remains an overarching, dynamic and multifaceted problem that needs to be investigated over time and across various contexts. There is a rarity of empirical data in the literature on interactive mechanisms by which psychosocial factors influence adherence to ART among PLWHA within the South African context. Therefore, this study was designed to investigate the relationship between depression, HIV stigma, and adherence to ART among adult patients living with HIV at a tertiary hospital in Durban, South Africa, and the mediating roles of self-efficacy and social support. The health locus of control theory and the social support theory were the underlying theoretical frameworks for this study. Using a cross-sectional research design, a total of 201 male and female adult patients aged between 18-75 years receiving ART at a tertiary hospital in Durban, KwaZulu-Natal were sampled, using time location sampling (TLS). A self-administered questionnaire was employed to collect the data in this study. Data were analysed through SPSS version 27. Several statistical analyses were conducted in this study, namely univariate statistical analysis, correlational analysis, Pearson’s chi-square analysis, cross-tabulation analysis, binary logistic regression analysis, and mediational analysis. Univariate analysis indicated that the sample mean age was 39.28 years (SD=12.115), while most participants were females 71.0% (n=142), never married 74.2% (n=147), and most were also secondary school educated 48.3% (n=97), as well as unemployed 65.7% (n=132). The prevalence rate of participants who had high adherence to ART was 53.7% (n=108), and 46.3% (n=93) of participants had low adherence to ART. Chi-square analysis revealed that employment status was the only statistically significant socio-demographic influence of adherence to ART in this study (χ2 (3) = 8.745; p < .033). Chi-square analysis showed that there was a statistically significant difference found between depression and adherence to ART (χ2 (4) = 16.140; p < .003), while between HIV stigma and adherence to ART, no statistically significant difference was found (χ2 (1) = .323; p >.570). Binary logistic regression indicated that depression was statistically associated with adherence to ART (OR= .853; 95% CI, .789–.922, P < 001), while the association between self-efficacy and adherence to ART was statistically significant (OR= 1.04; 95% CI, 1.001– 1.078, P < .045) after controlling for the effect of depression. However, the findings showed that the effect of depression on adherence to ART was not significantly mediated by self-efficacy (Sobel test for indirect effect, Z= 1.01, P > 0.31). Binary logistic regression showed that the effect of HIV stigma on adherence to ART was not statistically significant (OR= .980; 95% CI, .937– 1.025, P > .374), but the effect of social support on adherence to ART was statistically significant, only after the effect of HIV stigma was controlled for (OR= 1.017; 95% CI, 1.000– 1.035, P < .046). This study promotes behavioral and social change effected through evidence-based interventions by emphasizing the need for additional research that investigates the interactive mechanisms by which psychosocial factors influence adherence to ART. Depression is a significant predictor of adherence to ART. Thus, to alleviate the psychosocial impact of depression on adherence to ART, effective interventions must be devised, along with special consideration of self-efficacy and social support. Therefore, this study is helpful in informing and effecting change in health policy and healthcare services through its findings

Keywords: ART adherence, depression, HIV/AIDS, PLWHA

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Authors: Joshua Chew, Vesa Cheng, David Thomson

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Background: Hereditary angioedema (HAE) or C1 esterase deficiency is a relatively rare entity that has a potential for significant anesthetic complications. Methods: A literature review was performed of published cases of surgery in patients with HAE. Results were limited to English language only and cases were examined for management strategies and successful prevention of acute attacks. Results: The literature revealed the successful use of C1 esterase inhibitors as the most common agent in surgical prophylaxis therapy. Other therapeutic targets described included kallikrein inhibitors and bradykinin B2 receptor antagonists. Conclusions: Therapeutic targets that exist for the management of acute attacks in HAE have been successfully employed in the setting of surgery. The data is currently limited and could not be used as a firm evidence base, but the limited outcomes seen are positive and reassuring for the prospective anesthetic management of this potentially fatal condition.

Keywords: anesthesia, C1 esterase deficiency, hereditary angioedema, surgical prophylaxis

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Authors: I. Tulay Cagatay

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Blue-green microalgae cyanobacteria, which are important photosynthetic organisms of aquatic ecosystems, are the primary sources of many bioactive compounds such as proteins, carbohydrates, lipids, vitamins and enzymes that can be used as antimicrobial and antiviral agents. Some of these organisms are nowadays used directly in the food, cosmetic and pharmaceutical industry, or in aquaculture and biotechnological approaches like biofuel or drug therapy. Finding the effective, environmental friendly chemotropic and antimicrobial agents to control fish pathogens are crucial in a country like Turkey which has a production capacity of about 240 thousand tons of cultured fish and has 2377 production farms and which is the second biggest producer in Europe. In our study, we tested the antimicrobial activity of cyanobacterium spp. against some fish pathogens Aeromonas hydrophila and Yersinia ruckeri that are important pathogens for rainbow trout farms. Agar disk diffusion test method was used for studying antimicrobial activity on pathogens. Both tested microorganisms have shown antimicrobial activity positively as the inhibition zones were 0.45 mm and 0.40 mm respectively.

Keywords: fish pathogen, cyanobacteria, antimicrobial activity, trout

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Authors: Ivashkina Elizaveta

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Despite significant research on the positive effects of houseplants on human life, we know almost nothing about how people perceive plants and their attitudes toward them. The following study seeks to fill this void by applying para-social relationships (PSRs) theory to analyze individuals’ perceptions of houseplants. We reveal how people form and maintain PSRs with indoor plants using 15 semi-structured in-depth interviews with Russian-speaking university students who had a close bond with their indoor plants when the study was conducted. The findings indicate that the process of forming PSRs is influenced by factors such as exposure and homophily. Students develop a sense of companionship with their indoor plants, which contributes to establishing a PSR. Participants reported engaging in various activities, such as regular care, communication, and interaction with their plants. The insights gained from this research have implications for horticultural therapy, environmental psychology, and indoor gardening practices.

Keywords: para-social relationships, plants, people-plant interaction, indoor plants, qualitative research

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Authors: S. M. Khairul Halim, Mojtaba Ghodsi, Morteza Mohammadzaheri

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Gait analysis is essential for diagnosing musculoskeletal and neurological conditions. However, current methods are often complex and expensive. This paper introduces a methodology for analysing gait parameters using a smart insole with a built-in accelerometer. The system measures stance time, swing time, step count, and cadence and wirelessly transmits data to a user-friendly IoT dashboard for centralized processing. This setup enables remote monitoring and advanced data analytics, making it a versatile tool for medical diagnostics and everyday usage. Integration with IoT enhances the portability and connectivity of the device, allowing for secure, encrypted data access over the Internet. This feature supports telemedicine and enables personalized treatment plans tailored to individual needs. Overall, the approach provides a cost-effective (almost 25 GBP), accurate, and user-friendly solution for gait analysis, facilitating remote tracking and customized therapy.

Keywords: gait analysis, IoT, smart insole, accelerometer sensor

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Authors: F. Murilo T. Luna, Vanessa F. Oliveira, Alysson Rocha, Expedito J. S. Parente, Andre V. Bueno, Matheus C. M. Farias, Celio L. Cavalcante Jr.

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Aviation jetfuel used in aircraft gas-turbine engines is customarily obtained from the kerosene distillation fraction of petroleum (150-275°C). Mineral jetfuel consists of a hydrocarbon mixture containing paraffins, naphthenes and aromatics, with low olefins content. In order to ensure their safety, several stringent requirements must be met by jetfuels, such as: high energy density, low risk of explosion, physicochemical stability and low pour point. In this context, aviation fuels eventually obtained from biofeedstocks (which have been coined as ‘biojetfuel’), must be used as ‘drop in’, since adaptations in aircraft engines are not desirable, to avoid problems with their operation reliability. Thus, potential aviation biofuels must present the same composition and physicochemical properties of conventional jetfuel. Among the potential feedtstocks for aviation biofuel, the babaçu oil, extracted from a palm tree extensively found in some regions of Brazil, contains expressive quantities of short chain saturated fatty acids and may be an interesting choice for biojetfuel production. In this study, biojetfuel was synthesized through homogeneous transesterification of babaçu oil using methanol and its properties were compared with petroleum-based jetfuel through measurements of oxidative stability, physicochemical properties and low temperature properties. The transesterification reactions were carried out using methanol and after decantation/wash procedures, the methyl esters were purified by molecular distillation under high vacuum at different temperatures. The results indicate significant improvement in oxidative stability and pour point of the products when compared to the fresh oil. After optimization of operational conditions, potential biojetfuel samples were obtained, consisting mainly of C8 esters, showing low pour point and high oxidative stability. Jet engine tests are being conducted in an automated test bed equipped with pollutant emissions analysers to study the operational performance of the biojetfuel that was obtained and compare with a mineral commercial jetfuel.

Keywords: biojetfuel, babaçu oil, oxidative stability, engine tests

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Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi

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Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.

Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain

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Authors: M. G. Gopisankar, A. Surendiran, M. Hemachandren

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The dose requirement of warfarin to achieve target INR range varies in patients with prosthetic heart valve. This variation in is affected by both genetic and non-genetic factors. Earlier studies have identified role of CYP2C9 and VKORC1 genetic polymorphisms on warfarin dose requirement. Warfarin being a substrate for drug transporter, P-glycoprotein coded by ABCB1 gene, may also be influenced by its genetic polymorphisms. This study was aimed to study the effect of single nucleotide polymorphism (SNP), ABCB1 2677G > T on warfarin maintenance dose requirement in patients with steady-state International Normalized Ratio (INR). The median dose requirement was significantly different between the genotype groups GG vs. GT (35 ± 20; 42.5 ± 18, p < 0.05), GG vs. TT (35 ± 20; 41.25 ± 25, p<0.05). There was no significant difference between GT vs. TT. In conclusion, patients with variant allele require a higher weekly maintenance dose of warfarin compared to patients without variant allele.

Keywords: warfarin pharamcogenetics, pharmacogenomics of warfarin, ABCB1 and warfarin, pglycoprotein and warfarin

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Authors: Merzak Laribi, Abdelmadjid Kasser

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Thermal spraying processes are widely used to produce coatings on original constructions as well as in repair and maintenance of long standing structures. A lot of efforts forwarding to develop thermal spray coatings technology have been focused on improving mechanical characteristics, minimizing residual stress level and reducing porosity of the coatings. The specific aim of this paper is to determine either residual stresses distribution or wear resistance of stainless steel coating thermally sprayed on a carbon steel substrate. Internal stresses determination was performed using an extensometric method in combination with a simultaneous progressive electrolytic polishing. The procedure consists of measuring micro-deformations using a bi-directional extensometric gauges glued on the substrate side of the materials. Very thin layers of the deposits are removed by electrochemical polishing across the sample surface. Micro-deformations are instantaneously measured, leading to residual stresses calculation after each removal. Wear resistance of the coating has been determined using a ball-on-plate tribometer. Friction coefficient is instantaneously measured during the tribological test. Attention was particularly focused on the influence of a post-annealing at 850 °C for one hour in vacuum either on the residual stresses distribution or on the wear resistance behavior under specific wear and lubrication conditions. The obtained results showed that the microstructure of the obtained arc sprayed stainless steel coating is classical. It is homogeneous and contains un-melted particles, metallic oxides and also pores and micro-cracks. The internal stresses are in compression in the coating. They are more or less scattered between -50 and -270 MPa on the surface and decreased more at the interface. The value at the surface of the substrate is about –700 MPa, partially due to the molten particles impact with the substrate. The post annealing has reduced the residual stresses in both coating and surface of the steel substrate so that the hole material becomes more relaxed. Friction coefficient has an average value of 0.3 and 0.4 respectively for non annealed and annealed specimen. It is rather oil lubrication which is really benefit so that friction coefficient is decreased to about 0.06.

Keywords: residual stresses, wear resistance, stainless steel, coating, thermal spraying, annealing, lubrication

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Authors: Lubna Azmi, Ila Shukla, Shyam Sundar Gupta, Padam Kant, C. V. Rao

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Elvitegravir is the mainstay of anti-HIV combination therapy in most endemic countries presently. However, it cannot be used alone owing to its long onset time of action. 2-(3,4-dihydroxyphenyl)-3,5,7-trihydroxychromen-4-one (Quercetin: QU) is a polyphenolic compound obtained from Argeria speciosa Linn (Family: Convolvulaceae), an anti-HIV candidate. In the present study, a sensitive, simple and rapid high-performance liquid chromatography coupled with positive ion electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) method was developed for the simultaneous determination elvitegravir and Quercetin, in rat plasma. The method was linear over a range of 0.2–500 ng/ml. All validation parameters met the acceptance criteria according to regulatory guidelines. LC–MS/MS method for determination of Elvitegravir and Quercetin was developed and validated. Results show the potential of drug–drug interaction upon co-administration this marketed drugs and plant derived secondary metabolite.

Keywords: anti-HIV resistance, extraction, HPLC-ESI-MS-MS, validation

Procedia PDF Downloads 345

Authors: May Phyo Wai, Tanyawan Suantawee

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The positive correlation between unhealthy diets (high in fats, sugars, carbohydrates, and low fibers) and the risk of non-communicable diseases (NCDs) like obesity, hypertension, diabetes, and heart diseases has led to a growing interest in healthier lifestyles and diets. Consequently, people are opting for foods rich in fiber and phytochemicals. Wolffia globosa, also known as duckweed or watermeal, is the smallest plant with high nutritional value, including protein, fiber, phytochemicals, and antioxidant properties. It offers numerous health benefits, such as improving gut health and lowering blood glucose levels, and it is widely available in Thailand. The purpose of this study was to develop nutritionally enhanced breadsticks utilizing vacuum heat-dried Wolffia globosa power (WP). Various concentrations of WP (0% as control, 5%, 10%, and 15 % w/w/) were added, and then the breadsticks’ physical properties (hardness, fracturability, and color), phytochemicals (total phenolic compounds: TPC and total flavonoid contents: TFC), and antioxidant properties (DPPH radical scavenging activity (DPPH) and ferric reducing antioxidant power (FRAP) assay) were investigated. Experiments were done by triplicates and data was analyzed by one-way ANOVA. The results showed that the hardness, measured by a texture analyzer, increased significantly (p<0.05) with higher WP concentrations, reaching 2,897.01 ± 77.31 g at 15% WP from 1,314.41 ± 32.52 g of the control. In contrast, the lightness (L*), redness (a*), and yellowness (b*) of the breadsticks significantly decreased (p < 0.05) in a dose-dependent manner with added WP. Incorporating WP, rich in phytochemicals and antioxidants, into the flour significantly enhanced the TPC and TFC of the breadsticks (p<0.05), with TPC and TFC increasing dose-dependently rising to 1.8-fold and 3.5-fold at 15% WP, respectively. The antioxidant power, assessed by DPPH and FRAP assays, also showed a similar trend, with significantly higher values at 10% and 15% WP (p<0.05). These results indicate that adding WP significantly boosted the TPC, TFC, DPPH, and FRAP values of the developed breadsticks. Therefore, incorporating WP into breadsticks might be a promising strategy for creating food products enriched with phytochemicals and antioxidants, offering consumers healthier options in the market.

Keywords: antioxidant properties, breadsticks, phytochemicals, Wolffia globosa

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Authors: G. Fomo, O. J. Achadu, T. Nyokong

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Nanoconjugates of graphene quantum dots (GQDs) and 4-(tetrakis-5-(trifluoromethyl)-2-mercaptopyridinephthalocyanine (H₂Pc(OPyF₃)₄) or 4-(tetrakis-5-(trifluoromethyl)-2-mercaptopyridinephthalocyaninato) zinc (II) (ZnPc(OPyF₃)₄) were synthesized via a novel in situ one-step route. The bottom-up approach for the prepared conjugates could ensure the intercalation of the phthalocyanines (Pcs) directly onto the edges or surface of the GQDs and or non-covalent coordination using the π-electron systems of both materials. The as-synthesized GQDs and their Pcs conjugates were characterized using different spectroscopic techniques and their photophysicochemical properties evaluated. The singlet oxygen quantum yields of the Pcs in the presence of GQDs were enhanced due to Förster resonance energy transfer (FRET) occurrence within the conjugated hybrids. Hence, these nanoconjugates are potential materials for photodynamic therapy (PDT) and photocatalysis applications.

Keywords: graphene quantum dots, metal free fluorinated phthalocyanine, zinc fluorinated phthalocyanine, photophysicochemical properties

Procedia PDF Downloads 182

Authors: H. Yousefnia, S. Zolghadri, N. Amraee, Z. Naseri, Ar. Jalilian

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The purpose of this study was to calculate the absorbed dose to each human organ for two new Sm-153 bone-seeking agents in order to evaluate their effectiveness in bone pain palliation therapy. In this work, the absorbed dose of 153Sm-TTHMP and 153Sm-PDTMP to each human organ was evaluated based on biodistribution studies in rats by radiation dose assessment resource (RADAR) method. The highest absorbed dose for 153Sm-TTHMP and 153Sm-PDTMP is observed in trabecular bone with 1.844 and 3.167 mGy/MBq, respectively. Bone/red marrow dose ratio, as the target/critical organ dose ratio, for 153Sm-PDTMP is greater than 153Sm-TTHMP and is compatible with 153Sm-EDTMP. The results showed that these bone-seeking agents, specially 153Sm-PDTMP, have considerable characteristics compared to the most clinically used bone pain palliative radiopharmaceutical, and therefore, can be good candidates for bone pain palliation in patients with bone metastasis; however, further biological studies in other mammals are still needed.

Keywords: internal dosimetry, PDTMP, 153Sm, TTHMP

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Authors: Ghada Esheba, Fatimah Alturkistani, Arwa Obaid, Ahdab Bashehab, Moayad Alturkistani

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Introduction: Craniopharyngiomas (CPs) are rare epithelial tumors located mainly in the sellar/parasellar region. CPs have been classified histopathologically, genetically, clinically and prognostically into two distinctive subtypes: adamantinomatous and papillary variants. Aim: To examine the pattern of expression of both the β-catenin and epidermal growth factor receptor (EGFR) in surgically resected samples of adamantinomatous CP, and to asses for the possibility of using anti-EGFR in the management of ACP patients. Materials and methods: β-catenin and EGFR immunostaining was performed on paraffin-embedded tissue sections of 18 ACP cases. Result: 17 out of 18 cases (94%) of ACP exhibited strong nuclear/cytoplasmic expression of β-catenin, 15 (83%) of APC cases were positive for EGFR. Conclusion: Nuclear accumulation of β-catenin is a diagnostic hallmark of ACP. EGFR positivity in most cases of ACP could qualify the use of anti-EGFR therapy. 

Keywords: craniopharyngioma, adamantinomatous, papillary, epidermal growth factor receptor, B-catenin

Procedia PDF Downloads 226

Authors: Raffaele Danilo Esposito, Domingo Planes Meseguer, Maria Del Pilar Dorado Rodriguez

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As far as we know, it is still unavailable a commercial solution which would allow to manage, openly and configurable up to user needs, the huge amount of data generated in a modern Radiation Oncology Department. Currently, available information management systems are mainly focused on Record & Verify and clinical data, and only to a small extent on physical data. Thus, results in a partial and limited use of the actually available information. In the present work we describe the implementation at our department of a centralized information management system based on a web server. Our system manages both information generated during patient planning and treatment, and information of general interest for the whole department (i.e. treatment protocols, quality assurance protocols etc.). Our objective it to be able to analyze in a simple and efficient way all the available data and thus to obtain quantitative evaluations of our treatments. This would allow us to improve our work flow and protocols. To this end we have implemented a relational data base which would allow us to use in a practical and efficient way all the available information. As always we only use license free software.

Keywords: information management system, radiation oncology, medical physics, free software

Procedia PDF Downloads 242

Authors: Anita Padmanabhanunni

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Trauma-focused cognitive-treatment (CT) models are among the most efficacious in treating PTSD arising from exposure to rape. However, these treatment approaches are severely under-utilised by South African mental health care practitioners owing to concerns around whether treatments developed in Western clinical contexts are transportable and applicable in routine clinical settings. One way of promoting the use of these efficacious treatments in local contexts is by identifying and appraising the evidence from local outcome studies. This paper presents the findings of a systematic review of research evidence from local outcome studies on the effectiveness of CT in the treatment of rape-related PTSD in South Africa. The study found that whilst limited research has been published in South Africa on the outcome of CT in the treatment of rape survivors, the studies that are available afford insights into the effectiveness of CT.

Keywords: cognitive treatment, PTSD, South Africa, transportability

Procedia PDF Downloads 339

Authors: Khalid A. Rabaeh, Belal Moftah, Ahmed A. Basfar, Akram A. Almousa

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Polymer gel dosimeters are tissue equivalent martial that fabricated from radiation sensitive chemicals which, upon irradiation, polymerize as a function of absorbed radiation dose. Polymer gel dosimeters can uniquely record the radiation dose distribution in three-dimensions (3D). A novel composition of normoxic polymer gel dosimeters based on radiation-induced polymerization of N-(Hydroxymethyl)acrylamide (NHMA) is introduced in this study for radiotherapy treatment planning. The dosimeters were irradiated by 10 MV photon beam of a medical linear accelerator at a constant dose rate of 600 cGy/min with doses up to 30 Gy. The polymerization degree is directly proportional to absorbed dose received by the polymer gel. UV/Vis spectrophotometer was used to investigate the degree of white color of irradiated NHMA gel which is associated to the degree of polymerization of polymer gel dosimeters. The absorbance increases with absorbed dose for all gel dosimeters in the dose range between 0 and 30 Gy. Dose rate , energy of radiation and the stability of the polymerization after irradiation were investigated. No appreciable effects of these parameters on the performance of the novel gel dosimeters were observed.

Keywords: dosimeter, gel, spectrophotometer, N-(Hydroxymethyl)acrylamide

Procedia PDF Downloads 469

Authors: Isabela S. Gonçalves, Vitor G. P. Lima, Tiago M. B. Campos, Marcos Jacobovitz, Luana M. R. Vasconcellos, Ivone R. Oliveira

Abstract:

Periodontitis is an infectious disease of multifactorial origin, which originates from a periodontogenic bacterial biofilm that colonizes the surfaces of the teeth, resulting in an inflammatory reaction to microbial aggression. In the absence of adequate treatment, it can lead to the gradual destruction of the periodontal ligaments, cementum and alveolar bone. In guided tissue/bone regeneration therapy (GTR/GBR), a barrier membrane is placed between the fibrous tissues and the bone defect to prevent unwanted incursions of fibrous tissues into the bone defect, thus allowing the regeneration of quality bone. Currently, there are a significant number of biodegradable barrier membranes available on the market. However, a very common problem is that the membranes are not bioactive/osteogenic, that is, they are incapable of inducing a favorable osteogenic response and integration with the host tissue, resulting in many cases in displacement/expulsion of the membrane, requiring a new surgical procedure and replacement of the implant. Aiming to improve the bioactive and osteogenic properties of the membrane, this work evaluated the production of membranes that integrate the biocompatibility of the hydrophilic synthetic polymer (polyvinyl alcohol - PVA) with the osteogenic effects of chlorinated bioactive glasses (BG58S-Cl), using the electrospinning equipment (AeroSpinner L1.0 from Areka) which allows the execution of spinning by high voltage and/or blowing in solution and with a high production rate, enabling development on an industrial scale. In the formulation of bioactive glasses, the replacement of nitrates by chlorinated molecules has shown to be a promising alternative, since the chloride ion is naturally present in the body and, with its presence in the bioactive glass, the biocompatibility of the material increases. Thus, in this work, chlorinated bioactive glasses were synthesized by the sol-gel route using the compounds tetraethyl orthosilicate (TEOS), calcium chloride dihydrate and monobasic ammonium phosphate with pH adjustments with 37% HCl (1.5 or 2.5) and different calcination temperatures (500, 600 and 700 °C) were evaluated. The BG-58S-Cl powders obtained were characterized by pH, conductivity and zeta potential x time curves and by SEM/FEG, FTIR-ATR and Raman tests. The material produced under the selected conditions was evaluated in relation to the milling procedure, obtaining particles suitable for incorporation into PVA polymer solutions to be electrospun (D50 = 22 µm). Membranes were produced and evaluated regarding the influence of the crosslinking agent content as well as the crosslinking treatment temperature (3, 5 and 10 wt% citric acid) and (130 or 175 oC) and were characterized by SEM/FEG, FTIR, TG and DSC. From the optimization of the crosslinking conditions, membranes were prepared by adding BG58S-Cl powder (5 and 10 wt%) to the PVA solutions and were characterized by SEM-FEG, DSC, bioactivity in SBF and behavior in cell culture (cell viability, total protein content, alkaline phosphatase, mineralization nodules). The micrographs showed homogeneity of the distribution of BG58S-Cl particles throughout the sample, favoring cell differentiation.

Keywords: barrier membranes, chlorinated bioactive glasses, polyvinyl alcohol, tissue regeneration.

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Authors: Yazun Jarrar

Abstract:

Smoking has effect on platelet aggregation and the activity of anti-platelet drugs. The chemical 20-hydroxyeicosatetraenoic acid (20-HETE) is a cardiotoxic arachidonic acid metabolite which increases platelet aggregation. In this study, we investigated the influence of cigarette smoking on 20-HETE levels and protein expression of 20-HETE producing enzyme CYP4A11 in isolated platelets from smoker and non-smoker volunteers. The protein expression and 20-HETE levels were analyzed using immunoblot and High-Performance Liquid Chromatography with Mass Spectrometry (HPL-MS) assays. The results showed that 20-HETE level was higher significantly among smokers than non-smokers (t-test, p-value<0.05). The protein expression of CYP4A11 was significantly higher (t-test, p-value<0.05) among the platelets of smokers. We concluded that cigarette smoking increased the level of platelet activator 20-HETE through increasing the protein expression of CYP4A11. These findings may increase the understanding of smoking-drug interaction during antiplatelets therapy.

Keywords: smoking, 20-HETE, CYP4A11, platelet

Procedia PDF Downloads 184

Authors: Amanda C. Q. M. Vieira, Cybelly M. Melo, Camila B. M. Figueirêdo, Giovanna C. R. M. Schver, Salvana P. M. Costa, Magaly A. M. de Lyra, Ping I. Lee, José L. Soares-Sobrinho, Pedro J. Rolim-Neto, Mônica F. R. Soares

Abstract:

Epiisopiloturine (EPI) is a drug candidate that is extracted from Pilocarpus microphyllus and isolated from the waste of Pilocarpine. EPI has demonstrated promising schistosomicidal, leishmanicide, anti-inflammatory and antinociceptive activities, according to in vitro studies that have been carried out since 2009. However, this molecule shows poor aqueous solubility, which represents a problem for the release of the drug candidate and its absorption by the organism. The purpose of the present study is to investigate the extent of enhancement of kinetic solubility of a solid solution (SS) of EPI in hipromellose phthalate HP-55 (HPMCP), an enteric polymer carrier. SS was obtained by the solvent evaporation methodology, using acetone/methanol (60:40) as solvent system. Both EPI and polymer (drug loading 10%) were dissolved in this solvent until a clear solution was obtained, and then dried in oven at 60ºC during 12 hours, followed by drying in a vacuum oven for 4 h. The results show a considerable modification in the crystalline structure of the drug candidate. For instance, X-ray diffraction (XRD) shows a crystalline behavior for the EPI, which becomes amorphous for the SS. Polarized light microscopy, a more sensitive technique than XRD, also shows completely absence of crystals in SS sample. Differential Scanning Calorimetric (DSC) curves show no signal of EPI melting point in SS curve, indicating, once more, no presence of crystal in this system. Interaction between the drug candidate and the polymer were found in Infrared microscopy, which shows a carbonyl 43.3 cm-1 band shift, indicating a moderate-strong interaction between them, probably one of the reasons to the SS formation. Under sink conditions (pH 6.8), EPI SS had its dissolution performance increased in 2.8 times when compared with the isolated drug candidate. EPI SS sample provided a release of more than 95% of the drug candidate in 15 min, whereas only 45% of EPI (alone) could be dissolved in 15 min and 70% in 90 min. Thus, HPMCP demonstrates to have a good potential to enhance the kinetic solubility profile of EPI. Future studies to evaluate the stability of SS are required to conclude the benefits of this system.

Keywords: epiisopiloturine, hipromellose phthalate HP-55, pharmaceuticaltechnology, solubility

Procedia PDF Downloads 607