Search results for: prevention of infection

Authors: Michelle Maurer, Antonia Last, Mark S. Gresnigt, Bernhard Hube, Alexander S. Mosig

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The intestinal epithelium forms an essential barrier to prevent translocation of microorganisms, toxins or other potentially harmful molecules into the bloodstream. In particular, dendritic cells of the intestinal epithelium orchestrate an adapted response of immune tolerance to commensals and immune defense against invading pathogens. Systemic inflammation is typically associated with a dysregulation of this adapted immune response and is accompanied by a disruption of the epithelial and endothelial gut barrier which enables dissemination of pathogens within the human body. To understand the pathophysiological mechanisms underlying the inflammation-associated gut barrier breakdown, it is crucial to elucidate the complex interplay of the host and the intestinal microbiome. A microfluidically perfused three-dimensional intestine-on-chip model was established to emulate these processes in the presence of immune cells, commensal bacteria, and facultative pathogens. Multi-organ tissue flow (MOTiF) biochips made from polystyrene were used for microfluidic perfusion of the intestinal tissue model. The biochips are composed of two chambers separated by a microporous membrane. Each chamber is connected to inlet and outlet channels allowing independent perfusion of the individual channels and application of microfluidic shear stress. Human umbilical vein endothelial cells (HUVECs), monocyte-derived macrophages and intestinal epithelial cells (Caco-2) were assembled on the biochip membrane. Following 7 – 14 days of growth in the presence of physiological flow conditions, the epithelium was colonized with the commensal bacterium Lactobacillus rhamnosus, while the endothelium was perfused with peripheral blood mononuclear cells (PBMCs). Additionally, L. rhamnosus was co-cultivated with the opportunistic fungal pathogen Candida albicans. Within one week of perfusion, the epithelial cells formed self-organized and well-polarized villus- and crypt-like structures that resemble essential morphological characteristics of the human intestine. Dendritic cells were differentiated in the epithelial tissue that specifically responds to bacterial lipopolysaccharide (LPS) challenge. LPS is well-tolerated at the luminal epithelial side of the intestinal model without signs of tissue damage or induction of an inflammatory response, even in the presence of circulating PBMC at the endothelial lining. In contrast, LPS stimulation at the endothelial side of the intestinal model triggered the release of pro-inflammatory cytokines such as TNF, IL-1β, IL-6, and IL-8 via activation of macrophages residing in the endothelium. Perfusion of the endothelium with PBMCs led to an enhanced cytokine release. L. rhamnosus colonization of the model was tolerated in the immune competent tissue model and was demonstrated to reduce damage induced by C. albicans infection. A microfluidic intestine-on-chip model was developed to mimic a systemic infection with a dysregulated immune response under physiological conditions. The model facilitates the colonization of commensal bacteria and co-cultivation with facultative pathogenic microorganisms. Both, commensal bacteria alone and facultative pathogens controlled by commensals, are tolerated by the host and contribute to cell signaling. The human intestine-on-chip model represents a promising tool to mimic microphysiological conditions of the human intestine and paves the way for more detailed in vitro studies of host-microbiota interactions under physiologically relevant conditions.

Keywords: host-microbiota interaction, immune tolerance, microfluidics, organ-on-chip

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Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Md. Baki Billah, Suraiya Parveen, Shuvra Kanti Dey

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Bangladesh is earning a lot of foreign currency by exporting shrimp, but this industry is facing a tremendous problem due to the infection of white spot syndrome virus (WSSV). This study was undermined to develop rapid detection method of WSSV. A total of shrimp samples 240 collected from the 12 shrimp farms of different coastal regions (Satkhira, Khulna, and Bagerhat) were analyzed by conventional PCR using VP28 and VP664 gene-specific primers. In satkhira, Bagerhat and Khulna 39, 41 and 29 samples were found WSSV positive respectively. Real-time PCR using 71-bp amplicon for VP664 gene correlated well with conventional PCR data. The prevalence rates of WSSV among the collected 240 samples were Satkhira 38%, Khulna 47% and Bagerhat 50%. Molecular analysis of the VP28 gene sequences of WSSV revealed that Bangladeshi strains phylogenetically affiliated to the strains belong to India. This work concluded that WSSV infections are widely distributed in the coastal regions cultured shrimp in Bangladesh. Physico-chemical parameters were within the range of fish culture.

Keywords: coastal regions of Bangladesh, PCR, shrimp, white spot syndrome virus

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Authors: Ghoul Rachid Brahim, Trad Khodja Rafik

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Vertebral localization of the hydatid cyst is a severe form of bone hydatidosis, is a parasitic infection caused by the larval forms of the tapeworms Echinococcus granulosus, The disease is slowly remaining silent (a long incubation period) which may explain why this pathology is often discovered at the stage of neurological complications. The objective of this study is to recall the clinical and radiological aspects of this condition and the importance of early diagnosis and appropriate management. We report a study of 5 patients with vertebral hydatidosis, four men and one woman, four (04) patients operated in the emergency setting for spinal cord compression (decompression by wide laminectomy with evacuation of intra and extra canal vesicles).Albendazole-based medical treatment is instituted in all patients. Results: The evolution was favorable for three patients, the other two patients reoperated for a local recurrence. Conclusion: Vertebral hydatidosis is a rare condition with a poor prognosis due to the risk of neurological damage, the infiltrating nature of bone lesions, the frequency of relapses and therapeutic difficulties. The only curative method remains surgery, which must aim for complete and large excision of the lesions as if it were a “malignant tumour”.

Keywords: hydatidosis, Echinococcosis granulosus, hydatid cyst, spinal cord compression, laminectomy

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Authors: Patricia Abigail B. Miranda, Imelda A. Luna

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Introduction: COVID-19 infection is a novel viral illness that began as a local epidemic in December 2019 in Wuhan, China which quickly emerged into a pandemic by February 2020. The virus causes a spectrum of signs and symptoms, ranging from mild upper respiratory symptoms to acute respiratory distress syndrome, which may lead to death. Among children and neonates, those afflicted with the disease may present asymptomatically or with mild symptoms. To date, there has been limited local data that describes the outcomes of the growing number of COVID-19 cases, specifically in neonates. Methods: A cross-sectional study was conducted to determine the outcomes of neonates born to COVID-19 Positive Mothers from March 2020 until June 2022. The prevalence of COVID-19 among these neonates was also determined. Results: COVID-positive prevalence after 24 hours of life is at 8%, while prevalence after 48 hours among those who still underwent testing was at 13.51%. Moreover, among those COVID-19-negative neonates who had symptoms, they mostly presented with tachypnea (5.7%). The prevalence of complications among COVID-19-negative neonates delivered to COVID-19-positive mothers is 22.7%. Conclusion: Neonates born to COVID-19-positive mothers who yielded positive COVID-19 results are generally asymptomatic. Moreover, there are no associated mortalities among those who yielded positive results.

Keywords: COVID-19, neonates, outcomes, clinical profile

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Authors: Le-Quyen Nguyen, Hoang Van Bui, Ngoc Thi Tran, Binh Thanh Le, Linus Olson, Thanh Quang Le

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Objective: We compared of outcomes between infected and non-infected COVID-19 pregnant at the largest obstetrics and gynecology hospital in southern Vietnam. Materials and Methods: A retrospective study was conducted at gestational age (GA) 28-42 weeks, who terminated pregnancy and had a real-time PCR test for SARS-CoV-2 at Tu Du Hospital. Demographic, clinical, laboratory, and epidemiological data were collected from hospital electronic-medical-records. Diagnosis and screening of SARS-CoV-2 used Real-time-PCR. Results: From July to October 2021, 9,246 pregnant with GA of 28-42 weeks were delivered, including 664 infected with COVID-19 and 8,582 non-infected. The cesarean section (CS) rates of pregnant with and without COVID-19 were 47.3% and 46.0%. At GA 32-34 weeks, the rate of CS with COVID-19 was 5.07 times higher than without. The rate of postpartum hemorrhage (PPH) and the Apgar score between these two groups were similar. The mortality rate of infected pregnants was 2.26%. Conclusions: COVID-19 infection increased the CS rate in the group of preterm pregnancies from 32 to less than 34 weeks. COVID-19 did not increase the risk of complications related to adverse pregnancy outcomes such as PPH, Apgar scores, the ratio of stillbirths, deaths due to malformation, and fetal deaths in labor.

Keywords: COVID-19, SARS-CoV-2, pregnancy, outcome, vietnam

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Authors: Surangrat Srisurapanon, Chatchawal Wongjitrat, Navin Horthongkham, Ruengpung Sutthent

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HBV infection causes a potential serious public health problem. The ability to detect the HBV DNA concentration is of the importance and improved continuously. By using quantitative Polymerase Chain Reaction (qPCR), several factors in standardized; source of material, calibration standard curve and PCR efficiency are inconsistent. Digital PCR (dPCR) is an alternative PCR-based technique for absolute quantification using Poisson's statistics without requiring a standard curve. Therefore, the aim of this study is to compare the data set of HBV DNA generated between dPCR and qPCR methods. All samples were quantified by Abbott’s real time PCR and 54 samples with 2 -6 log10 HBV DNA were selected for comparison with dPCR. Of these 54 samples, there were two outlier samples defined as negative by dPCR. Of these two, samples were defined as negative by dPCR, whereas 52 samples were positive by both the tests. The difference between the two assays was less than 0.25 log IU/mL in 24/52 samples (46%) of paired samples; less than 0.5 log IU/mL in 46/52 samples (88%) and less than 1 log in 50/52 samples (96%). The correlation coefficient was r=0.788 and P-value <0.0001. Comparison to qPCR, data generated by dPCR tend to be the overestimation in the sample with low HBV DNA concentration and underestimated in the sample with high viral load. The variation in DNA by dPCR measurement might be due to the pre-amplification bias, template. Moreover, a minor drawback of dPCR is the large quantity of DNA had to be used when compare to the qPCR. Since the technology is relatively new, the limitations of this assay will be improved.

Keywords: hepatitis B virus, real time PCR, digital PCR, DNA quantification

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Authors: Mohsen Salesi, Seyyed Zoheir Rabei

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Exercise has been considered a cornerstone of diabetes prevention and treatment for decades, but the benefits of resistance training are less clear. The purpose of this study was to determine the impact of resistance training on blood profile and inflammatory marker (CRP) of type 2 diabetes mellitus people. Thirty diabetic male were recruited (age: 50.34±10.28 years) and randomly assigned to 8 weeks resistance exercise training (n=15) and control groups (n=15). Before and after training blood pressure, weight, lipid profile (TC, TG, LDL-c, and HDL-c) and hs-CRP were measured. The resistance exercise training group took part in supervised 50–80 minutes resistance training sessions, three days a week on non-consecutive days for 8 weeks. Each exercise session included approximately 10 min of warm-up and cool-down periods. Results showed that TG significantly decreased (pre 210.19±9.31 vs. 101.12±7.25, p=0.03) and HDL-c significantly increased (pre 42.37±3.15 vs. 47.50±2.19, p=0.01) after exercise training. However, there was no difference between groups in TC, LDL-c, BMI and weight. In addition, a decrease in fasting blood glucose levels showed significant difference between groups (pre 144.65±5.73 vs. 124.21±6.48 p=0.04). Regular resistance exercise training can improve the lipid profile and reducing the cardiovascular risk factors in T2DM patients.

Keywords: lipid profile, resistance exercise, type 2 diabetes mellitus, men

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Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

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Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

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Authors: Jian-Xiu Wan, Yao Yin

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In complex terrain and poor geological conditions areas, Railway, highway and other transportation constructions are still strongly developing. However, various geological disasters happened such as landslide, rock heap and so on. According to the results of geological investigation, the form of skirt (trapezoidal), semicircle and triangle rock heaps are mainly due to complex internal force and external force, in a certain extent, which is related to the terrain, the nature of the rock mass, the supply area and the surface shape of rock heap. Combined with the above factors, discrete element numerical simulation of rock mass is established under different terrain conditions based on 3DEC, and accelerated formation process of rock heap under seismic action is simulated. The fragmentation structure supply area is calculated, in which the most dangerous area is located. At the same time, the formation mechanism and development process are studied in different terrain conditions, and the structure of rock heap is judged by section, which can provide a strong theoretical and technical support for the prevention and control of geological disasters.

Keywords: 3DEC, fragmentation structure, rock heap, slope, seismic action

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Authors: Moise A. E., State G., Tudorache M., Custură I., Enea D. N., Osman (Defta) A., Drăgotoiu D.

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This scientific paper explores risk management strategies in the food supply chain, with a focus on chicken raw materials, in the context of a company sourcing from the EU and non-EU. The aim of the paper is to adapt the requirements of international standards (IFS, BRC, QS, ITW, FSSC, ISO), proposing efficient methods to identify and remediate non-conformities and corrective and preventive actions. Defining the supply flow and acceptance steps promotes collaboration with suppliers to ensure the quality and safety of raw materials. To assess the risks of suppliers and raw materials, objective criteria are developed and vulnerabilities in the supply chain are analyzed, including the risk of fraud. Active monitoring of international alerts through RASFF helps to identify emerging risks quickly, and regular analysis of international trends and company performance enables continuous adaptation of risk management strategies. Implementing these measures strengthens food safety and consumer confidence in the final products supplied.

Keywords: food supply chain, international standards, quality and safety of raw materials, RASFF

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Authors: Eka Sari

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Potential degradation of cellulose and hemicellulose during the fungal pretreatment of lignocellulose has led to fermentable sugar yield will be low. This potential is even greater if the pretreatment of lignocellulosic that have low lignin such as water hyacinth. In order to prepare lignocellulose that have low lignin content, especially water hyacinth efforts are needed to prevent the degradation of cellulose and cellulose. One attempt to prevent the degradation of cellulose and hemicellulose is to replace the substrate needed by the addition of a simple carbon compounds such as glucose. Glucose sources used in this study is molasses. The purpose of this research to get the right of concentration of molasses to reduce the degradation of cellulose and hemicellulose during the pretreatment process and obtain fermentable sugar yields on high. The results showed that the addition of molasses with a concentration of 2% is able to reduce the degradation of cellulose from 25.53% to 10% and hemicellulose degradation of 20.12% to 10.89%. Fermentable sugar yields produced only reached 43.91%. To improve the yield of glucose is then performed additional combonation of molasses of 2% molasses and co-factor Mn2+ 0.5%. Fermentable sugar yield increased to 67.66% and the degradation of cellulose and hemicellulose decreased to 2.44% and 2.71%, respectively.

Keywords: water hyacinth, cellulose, hemicelulose, degradation, pretreatment, fungus

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Authors: Balasaheb Bansode

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Diabetes is a very important component in non-communicable diseases. Diabetes ailment is a route of the multi-morbidities ailments. The South Indian states are almost completing the demographic transition in India. The study objectives present the prevalence of diabetes and its association with co-morbidities among the south Indian women. The study based on National Family Health Survey fourth round (NFHS) 4 conducted in 2015-16. The univariate, bivariate and multivariate analyses techniques have been used to find the association of risk factors and comorbidities with diabetics. The result reveals that the prevalence of diabetes is high among South Indian women. The study shows the women with diabetics have more chances to diagnose with hypertension and anemia comorbidities. The factors responsible for co-morbidities are changing the demographic situation, socioeconomic status, overweight and addict with substance use in South India. The awareness about diabetes prevention and management should be increased through health education, disease management programmes, trained peers and community health workers and community-based programmes.

Keywords: diabetes, risk factors, comorbidities, women

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Authors: Jennis Delina Giles, Nimesha Liyanage, Damindi Senadheera, Dilan Randima, Kushnara Suriyawansa

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Mental health is essential during childhood, adolescence, and adulthood. Mental health issues can influence one's thoughts, disposition, and conduct. A record number of mental health problems are caused by a global pandemic. Prevention of mental disease is vital for both children and adults. We desired to develop a web application for those with mental health difficulties. This web application will provide group chat, discussion, a community feed, and counseling services. The community feed function provides information regarding scheduled conversation space meetings, and the counselor uploads uplifting thoughts and tales of patients who received proper care and overcame mental health issues. Community feed can filter content based on user preferences. The mental health system for adults and adolescents will be updated. The community feed delivers relevant and instructive postings, links, and images so that service recipients can benefit from other platform features and receive encouraging words to assist them in overcoming mental health difficulties.

Keywords: bio medical, mental helath care, empower youths & adults, counselling

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Fardis Teifoori, Mehdi Dehghani, Idoia Postigo, Jorge Martinez

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Introduction: Many skin disorders, such as atopic dermatitis (AD), is characterized by inflammation, infection, and hyperplasia. In this work, keratinocytes from AD patients are used to study the pomegranate seed oil properties for skin care. Material and methods: Isolated keratinocytes from patients with AD were cultured and stimulated by IL-9 (20 ng/ml) and TNF-α (50ng/ml) for 48h to induce vascular endothelial growth factor (VEGF) and Regulated upon activation, normal T cell expressed and secreted (RANTES) production, respectively, in the presence of different concentrations of pomegranate seed oil (20, 50, 100, and 200 µM). Finally, the concentrations of RANTES and VEGF in the cell culture supernatant were quantified according to the standard protocol of commercial ELISA kits. Results: The results indicated that pomegranate seed oil concentrations of 50, 100, and 200 µM could significantly inhibit the production of VEGF and RANTES by stimulating keratinocytes with IL-9 (20 ng/ml) and TNF-α (50ng/ml), respectively. The decrease in VEGF and RANTES concentration in the presence of the pomegranate seed oil concentrations of 20 and 50 uM was not significant. Conclusion: It was concluded that pomegranate seed oil (PSO) counteracts atopic dermatitis conditions dose-dependently: with the highest effect at the concentration of 200 µM. We suggest that the inexpensive and easily available pomegranate seed oil is a good candidate for cosmetics and clinical utilization for skin care.

Keywords: atopic dermatitis, pomegranate, Punica granatum, RANTES, VEGF

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Authors: M. Malekian, M. E. Heydari, M. Irani Estyar

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Human papillomavirus (HPV) is one of the most common sexually transmitted infection, which may lead to cervical cancer as the main cause of it. With early diagnosis and treatment in health care services, cervical cancer and its complications are considered to be preventable. This study was aimed to compare the efficiency, sensitivity, and specificity of Pap smear and polymerase chain reaction (PCR) in detecting HPV. A literature search was performed in Google Scholar, PubMed and SID databases using the keywords 'human papillomavirus', 'pap smear' and 'polymerase change reaction' to identify studies comparing Pap smear and PCR methods for the detection. No restrictions were considered.10 studies were included in this review. All samples that were positive by pop smear were also positive by PCR. However, there were positive samples detected by PCR which was negative by pop smear and in all studies, many positive samples were missed by pop smear technique. Although The Pap smear had high specificity, PCR based HPV detection was more sensitive method and had the highest sensitivity. In order to promote the quality of detection and high achievement of the maximum results, PCR diagnostic methods in addition to the Pap smear are needed and Pap smear method should be combined with PCR techniques according to the high error rate of Pap smear in detection.

Keywords: human papillomavirus, cervical cancer, pap smear, polymerase chain reaction

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Authors: Naveed Ghani, Samreen Javed

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In today’s heterogeneous network environment, there is a growing demand for distrust clients to jointly execute secure network to prevent from malicious attacks as the defining task of propagating malicious code is to locate new targets to attack. Residual risk is always there no matter what solutions are implemented or whet so ever security methodology or standards being adapted. Security is the first and crucial phase in the field of Computer Science. The main aim of the Computer Security is gathering of information with secure network. No one need wonder what all that malware is trying to do: It's trying to steal money through data theft, bank transfers, stolen passwords, or swiped identities. From there, with the help of our survey we learn about the importance of white listing, antimalware programs, security patches, log files, honey pots, and more used in banks for financial data protection but there’s also a need of implementing the IPV6 tunneling with Crypto data transformation according to the requirements of new technology to prevent the organization from new Malware attacks and crafting of its own messages and sending them to the target. In this paper the writer has given the idea of implementing IPV6 Tunneling Secessions on private data transmission from financial organizations whose secrecy needed to be safeguarded.

Keywords: network worms, malware infection propagating malicious code, virus, security, VPN

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Authors: Chun-Lang Chang, Chun-Kai Liu

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In this study, the patients that have undergone total knee replacement surgery from the 2010 National Health Insurance database were adopted as the study participants. The important factors were screened and selected through literature collection and interviews with physicians. Through the Cross Entropy Method (CE), Genetic Algorithm Logistic Regression (GALR), and Particle Swarm Optimization (PSO), the weights of the factors were obtained. In addition, the weights of the respective algorithms, coupled with the Excel VBA were adopted to construct the Case Based Reasoning (CBR) system. The results through statistical tests show that the GALR and PSO produced no significant differences, and the accuracy of both models were above 97%. Moreover, the area under the curve of ROC for these two models also exceeded 0.87. This study shall serve as a reference for medical staff as an assistance for clinical assessment of infections in order to effectively enhance medical service quality and efficiency, avoid unnecessary medical waste, and substantially contribute to resource allocations in medical institutions.

Keywords: Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization, Total Knee Replacement Surgery

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Authors: Sagarjyoti Roy

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Dengue is an arboviral infection, belonging to family flaviviridae, comprising of four serotypes; DENV1, DENV2, DENV3 and DENV4. All four serotypes are capable of causing full-spectrum of clinical features, ranging from self-limiting fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Complications may affect any organ system, including those involving gastrointestinal system and serositis. We report a case, of a 28 years, non-alcoholic male, presenting with a 7 day history of fever and malaise followed by abdominal pain and distension, from 4th day of fever. He was admitted in medicine department of RG KAR medical college hospital. Dengue fever was confirmed by NS1 and dengue IgM positivity. Platelet count was 30,000/cc (1.5- 4 lac/cc) and haematocrit was 52% (38- 50% for men). Clinicoradiological findings revealed bilateral pleural effusion, ascites and splenomegaly. Ascitic fluid was hemorrhagic in nature, with a high protein and RBC content. Liver function tests revealed mild transaminitis with normal coagulation profile. Patient was managed conservatively. A diagnosis of dengue fever complicated by serositis and spontaneous haemoperitoneum was made. The symptoms subsided after a hospital stay of 10 days. The case highlights haemorrhage into peritoneal cavity as a possible complication of dengue fever. Although a definite explanation requires more detailed studies, platelet or endothelial cell dysfunction might be contributory.

Keywords: ascites, dengue, haemoperitoneum, serositis

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Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

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Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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Authors: Brandtner-Hafner Martin

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Adhesives are increasingly being used in the construction sector. On the one hand, this concerns dowel reinforcements using chemical anchors. On the other hand, the sealing and repair of cracks in structural concrete components are still on the rise. In the field of bonding, the interface between the joined materials is the most critical area. Therefore, it is of immense importance to characterize and investigate this section sufficiently by fracture analysis. Since standardized mechanical test methods are not sufficiently capable of doing this, recourse is made to an innovative concept based on fracture energy. Therefore, a series of experimental tests were performed using the so-called GF-principle to study the interface bonding safety of adhesively bonded concrete joints. Several different structural adhesive systems based on epoxy, CA/A hybrid, PUR, MS polymer, dispersion, and acrylate were selected for bonding concrete substrates. The results show that stable crack propagation and prevention of uncontrolled failure in bonded concrete joints depend very much on the adhesive system used, and only fracture analytical evaluation methods can provide empirical information on this.

Keywords: interface bonding safety, adhesively bonded concrete joints, GF-principle, fracture analysis

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Authors: Mabruka S. Elashheb, Adullah Ali Bakush

Abstract:

Schizophrenia is referred to as a disorder, not a disease, because there has not been any clear, reliable, and specific etiological factor. Even if schizophrenia is not a very frequent disease, it is among the most burdensome and costly illnesses worldwide. Prevention of relapse is a major goal of maintenance treatment in patients with psychotic disorders. We performed a comparison of a newer, atypical antipsychotic drug, Risperidone, and an older, conventional neuroleptic drug, Haloperidol, in terms of the effect on the usual kidney and liver functions and negative and positive symptoms in patients with schizophrenia and schizoaffective disorder after three and five weeks of their treatments. It is apparent from the comparative data of Haloperidol and Risperidone treatments in schizophrenic patients that Resperidone had superior improvement of negative and positive symptoms of patients, no harmful effect on liver and kidney functions and greater efficacy and faster recovery from schizophrenic symptoms in patients. On the basis of our findings of the present study, we concluded that treatment with Risperidone is superior to Haloperidol in reducing the risk of relapse among outpatients with schizophrenic disorders.

Keywords: schizophrenia, Haloperidol, Risperidone, positive and negative symptom

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Authors: Abdolreza Esmaeilzadeh, Maryam Erfanmanesh, Sousan Ghasemi, Farzaneh Mohammadi

Abstract:

Background: Hepatitis C Virus (HCV), a public health problem, is an enveloped, single-stranded RNA virus and a member of the Hepacivirus genus of the Flaviviridae family. Liver cancer, cirrhosis, and end-stage liver are the outcomes of chronic infection with HCV. HCV isolates show significant heterogeneity in genetics around the world. Therefore, determining HCV genotypes is a vital step in determining prognosis and planning therapeutic strategies. Materials and Methods: Serum samples of 136 patients were collected and analyzed for anti-HCV antibodies using ELISA (The enzyme-linked immunosorbent assay) method. Then, positive samples were exposed to RT-PCR, which was performed under standard condition. Afterwards, they investigated for genotyping using allele-specific PCR (AS-PCR), and HCV genotype 2.0 line probe assay (LiPA). Results: Samples indicated 216 bp bands on 2% agarose gel. Analyses of the results demonstrated that the most dominant subtype was 3a with frequency of 38.26% in Zanjan Province followed by subtypes of 1b, 1a, 2, and 4 with frequencies of 25.73%, 22.05%, 5.14%, and 4.41%, respectively. The frequency of unknown HCV genotypes was 4.41%. Conclusions: According to the results, it was found that HCV high prevalent genotype in Zanjan is subtype 3a. Analysis of the results provides identification of certain HCV genotypes, and these valuable findings could affect the type and duration of the treatment.

Keywords: anti-HCV antibody, Hepatitis C Virus (HCV), genotype, RT-PCR, AS-PCR

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Authors: Seyyed Hossein Alavi, Soudabeh Mehri Talarposhti

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Quick development of urban population need for housing on the one hand and prevention of irregular urban extension for optimum usage of urban land, resolving problems of urban physiognomy, land using, and environmental issues and urban transport, on the other hand, proposed tall building as urban area extension requirement in developing and advanced countries. Beside the tall building, protection, and creation of green architecture is one the most important issues of today's architecture world. This research is about attending tall building with green architecture in Babolsar city 2015. For this, the issues that can make favorite conditions for green architecture has been discussed. The purpose of this discussion is skeleton extension and accessing interactions between architecture and related technologies. This discussion with using of qualitative research methods (Analytical Description) tried to studying designed performance models and also studying and analyzing the inside and foreign articles and books. Hope this research is useful in solving the existing problems in this issue.

Keywords: tall building, green architecture, skeleton extension, Babolsar city

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Authors: Muhammad Farooq Baig

Abstract:

Objective: The purpose of this study was to compare results obtained using a single fecal specimen for O&P examination, direct immunofluorescence assay (DFA), and two conventional staining methods. Design: Hundred and fifty children fecal specimens were collected and examined by each method. The O&P and the DFA were used as the reference method. Setting: The study was performed at the laboratory in the Basic Medical Science Institute JPMC Karachi. Patients or Other Participants: The fecal specimens were collected from children with a suspected Giardia lamblia infection. Main Outcome Measures: The amount of agreement and disagreement between methods.1) Presence of giardiasis in our population. 2) The sensitivity and specificity of each method. Results: There was 45(30%) positive 105 (70%) negative on DFA, 41 (27.4%) positive 109 (72.6%) negative on iodine and 34 (22.6%) positive 116(77.4%) on saline method. The sensitivity and specificity of DFA in comparision to iodine were 92.2%, 92.7% respectively. The sensitivity and specificity of DFA in comparisoin to saline method were 91.2%, 87.9% respectively. The sensitivity of iodine method and saline method in compariosn to DFA were 82.2%, 68.8% respectively. There is mark diffrence in sensitivity of DFA to conventional method. Conclusion: The study supported findings of other investigators who concluded that DFA method have the greater sensitivity. The immunologic methods were more efficient and quicker than the conventional O&P method.

Keywords: direct immunofluorescence assay (DFA), ova and parasite (O&P), Giardia lamblia, children, medical science

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Authors: Bankole Do, Omodara T. R., Awyinka O. A.

Abstract:

Probiotic supplementation has been known to be associated with a lower prevalence of hypertension. Against these backdrop, activities of the gut microbiota from hypertensive induced pregnant and non-pregnant rats as mediated by the soluble and indigestible fraction of carbohydrates derived from Otiliand fermentedIru were studied in this present work. Microbiota from hypertensive induced non- pregnant rats fed with Otili and Iruhad Proteus vulgaris + Staphylococcus aureus. However, hypertensive induced pregnant rats fed with Otilipredominantly contained Proteus vulgaris + Bacillus lichniformiswhile the group fed with Iruhad Staphylococcus aureus + Bacillus lichniformis. Thus, showingdysbiosis in hypertensive induced rats is influenced by pregnancy. Further In-vitro study showed Proteus vulgaris playing a key role in the fermentative process of the indigestible fraction of carbohydrates while Esherichia coli played the key role in the fermentative process of the soluble fraction of carbohydrates in all the bean samples. This dysbiosis of the gut microbiota, as seen in hypertension in rats in this present study, might be part of the strategies for the prevention and treatment of this Non-Communicable Disease.

Keywords: probiotic, microbiota, dysbiosis, hypertension

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Authors: Clifford Otieno Ochieng, Nsenda Lukumwena

Abstract:

Cities worldwide and most notably those in the global south, including Nairobi City are experiencing accelerated population growth and urban sprawl, accompanied with multiple socioeconomic challenges’ which in turn increase the pressure on already limited infrastructure such as public lighting and on limited financial resources. Based on this premise, through reimaging the value of street lighting infrastructure, the study attempts to highlight the affordance and affordability of streetlights and suggests them as a tool to optimally address limited financial resources that characterize cities in the global south. As a methodology, the paper reviews and analyzes literature available online including Nairobi city budgets; reports from Kenya Power, World Health Organization and United Nations; and articles on enterprise level Internet of Things (IoT) solutions. In conclusion, this study illustrates that streetlights can go well beyond their traditional roles of illuminating cities at night. They can be as suggested in this paper charging stations, communication network terminals and disease prevention nodes.

Keywords: affordance, Nairobi, developing economies, IoT, smart street lights, smart cities

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Authors: Farzaneh Ziaee, Mohammad Ziaee

Abstract:

N-acetyl-L-cysteine (NAC) is a well-known mucolytic agent, and recently its efficacy has been examined for the prevention and remediation of several diseases such as lung infections caused by Coronavirus. Also, it is administrated as the main antidote in paracetamol overdose and is effective for the treatment of idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD). This medicine is used as an antioxidant to prevent diabetic kidney disease (nephropathy). In this study, a method for the acylation of amino acids is employed to manufacture this drug in a height yield. Regarding this patented path, NAC can be made in a single batch step at ambient pressure and temperature. Moreover, this study offers a technique to make peptide bonds which is of interest for pharmaceutical and medicinal industries. The separation process was undertaken using appropriate solvents to achieve an excellent purification level. The synthesized drug was characterized via proton nuclear magnetic resonance (1H NMR), high-performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FT-IR), elemental analysis, and melting point.

Keywords: N-acetylcysteine, synthesis, mucolytic medication, lung anti-inflammatory, COVID-19, antioxidant, pharmaceutical supplement, characterization

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Authors: Islah Ud Din, Amna Bibi

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The current study was carried out to examine the perceived social support, resilience and relapse risk in recovered addicts. A purposive sampling technique was used to collect data from recovered addicts. A multidimensional scale of perceived social support by was used to measure the perceived social support. The brief Resilience Scale (BRS) was used to assess resilience. The Stimulant Relapse Risk Scale (SRRS) was used to examine the relapse risk. Resilience and Perceived social support have substantial positive correlations, whereas relapse risk and perceived social support have significant negative associations. Relapse risk and resilience have a strong inverse connection. Regression analysis was used to check the mediating effect of resilience between perceived social support and relapse risk. The findings revealed that perceived social support negatively predicted relapse risk. Results showed that Resilience plays a role as partial mediation between perceived social support and relapse risk. This Research will allow us to explore and understand the relapse risk factor and the role of perceived social support and resilience in recovered addicts. The study's findings have immediate consequences in the prevention of relapse. The study will play a significant part in drug rehabilitation centers, clinical settings and further research.

Keywords: perceived social support, resilience, relapse risk, recovered addicts, drugs addiction

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