Search results for: myofascial pain syndrome

Authors: Angelis P. Barlampas, Ghita Bianca-Andreea

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A case of a prostatic midline cyst is presented, which was found during a routine general ultrasound examination in an otherwise healthy young man. The incidence of prostatic cysts discovered in suprapubic ultrasound examination has constantly been rising over the previous decades. Despite the fact that the majority of them are benign, a significant amount is related to symptoms, such as pain, dysuria, infertility, and even cancer. The wide use of ultrasound examination and the increasing availability of high-resolution ultrasound systems have rendered new diagnostic challenges. Once upon a time a suprapubic ultrasound was only useful for measuring only the size and the dimensions of the prostatic gland. It did not have the ability to analyze and resolve structures such as cystic or solid nodules. The current machine equipment has managed to depict the imaging characteristics of lesions with high acuity that compares of an intrarectal ultrasound. But the last one is a specialized examination, which demands expertise and good knowledge. Maybe the time has come for the general radiologist and, especially the one who uses suprapubic ultrasound, to pay more attention to the examination of the prostate gland and to take advantage of the superb abilities and the high resolution of the new ultrasound systems. That is exactly, what this case is emphasizing. The incidental discovery of prostatic cysts, and the relatively little available literature about managing them turns them into an interesting theme for exploring and studying. The prostatic cysts are further divided into midline and paramidline cysts, with the first being usually utricle cysts. A more precise categorization is as follows: A midline cystic lesion usually regards a Mullerian duct cyst, a prostatic utricle cyst, an ejaculatory duct cyst, a prostatic cystadenoma, a ductus deferens cyst, and a TURP. On the other hand, a lateral cystic lesion usually refers to a cystic degeneration of benign prostatic hyperplasia, a prostatic retention cyst, a seminal vesicle cyst, diverticular prostatitis, a prostatic abscess, cavitatory prostatitis from chronic prostatitis, a parasitic prostatic cyst, a cystic prostatic carcinoma, e.t.c.

Keywords: prostatic cyst, radiology, benign prostatic lesions, prostatic cancer, suprapubic prostatic ultrasound

Procedia PDF Downloads 58

Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: decision support system, event-sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine

Procedia PDF Downloads 127

Authors: Manuela Caciula, Luis Torres, Simion Tomoiaga

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Introduction: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), more commonly referred to as COVID-19, has wreaked havoc on all facets of higher education since its inception in late 2019. College students, in particular, significantly reduced their daily energy expenditure and increased the time spent sitting to listen to online classes and complete their studies from home. This change, in combination with the associated COVID-19 lockdown, presumably decreased physical activity levels, increased mental health symptoms, and led to the promotion of unhealthy eating habits. Objectives: The main objective of this study was to determine the current self-reported physical activity levels, mental health symptoms, and body composition of college students after the COVID-19 lockdown in order to develop future interventions for the overall improvement of health. Methods: All participants completed pre-existing, well-validated surveys for both physical activity (International Physical Activity Questionnaire - long form) and mental health (Hospital Anxiety and Depression Scale). Body composition was assessed in person with the use of an Inbody 570 device. Results: Of the 90 American college students (M age = 22.52 ± 4.54, 50 females) who participated in this study, depressive and anxious symptom scores consistent with 58% (N = 52) heightened symptomatology, 17% (N = 15) moderate borderline symptomatology, and 25% (N = 23) asymptomatology were reported. In regard to physical activity, 79% (N = 71) of the students were highly physically active, 18% (N = 16) were moderately active, and 3% (N = 3) reported low levels of physical activity. Additionally, 46% (N = 41) of the students maintained an unhealthy body fat percentage based on World Health Organization recommendations. Strong, significant relationships were found between anxiety and depression symptomatology and body fat percentage (P = .003) and skeletal muscle mass (P = .015), with said symptomatology increasing with added body fat and decreasing with added skeletal muscle mass. Conclusions: Future health interventions for American college students should be focused on strategies to reduce stress, anxiety, and depressive characteristics, as well as nutritional information on healthy eating, regardless of self-reported physical activity levels.

Keywords: physical activity, mental health, body composition, COVID-19

Procedia PDF Downloads 98

Authors: Atlal El-Assaad

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Viruses change with time through mutations and result in new variants that may persist or disappear. A Mutation refers to an actual change in the virus genetic sequence, and a variant is a viral genome that may contain one or more mutations. Critical mutations may cause the virus to be more transmissible, with high disease severity, and more vulnerable to diagnostics, therapeutics, and vaccines. Thus, variants carrying such mutations may increase the risk to human health and are considered variants of concern (VOC). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - the contagious in humans, positive-sense single-stranded RNA virus that caused coronavirus disease 2019 (COVID-19) - has been studied thoroughly, and several variants were revealed across the world with their corresponding mutations. SARS-CoV-2 has four structural proteins, known as the S (spike), E (envelope), M (membrane), and N (nucleocapsid) proteins, but prior study and vaccines development focused on genetic mutations in the S protein due to its vital role in allowing the virus to attach and fuse with the membrane of a host cell. Specifically, subunit S1 catalyzes attachment, whereas subunit S2 mediates fusion. In this perspective, we studied all charged amino acid mutations of the SARS-CoV-2 viral spike protein S1 when bound to Antibody CC12.1 in a crystal structure and assessed the effect of different mutations. We generated all missense mutants of SARS-CoV-2 protein amino acids (AAs) within the SARS-CoV-2:CC12.1 complex model. To generate the family of mutants in each complex, we mutated every charged amino acid with all other charged amino acids (Lysine (K), Arginine (R), Glutamic Acid (E), and Aspartic Acid (D)) and studied the new binding of the complex after each mutation. We applied Poisson-Boltzmann electrostatic calculations feeding into free energy calculations to determine the effect of each mutation on binding. After analyzing our data, we identified charged amino acids keys for binding. Furthermore, we validated those findings against published experimental genetic data. Our results are the first to propose in silico potential life-threatening mutations of SARS-CoV-2 beyond the present mutations found in the five common variants found worldwide.

Keywords: SARS-CoV-2, variant, ionic amino acid, protein-protein interactions, missense mutation, AESOP

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Authors: S. Padma, D. H. Tejavathi

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Somatic embryogenesis is a remarkable illustration of the dictum of plant totipotency where developmental reconstruction of somatic cells takes place towards the embryogenic pathway. It recapitulates the morphological and developmental process that occurs in zygotic embryogenesis. S. androgynous commonly called as multivitamin plant. The leaves are consumed as green leafy vegetable by the Southeast Asian communities due to their rich nutritional profile. Despite being a good nutritional vegetable with proteins, vitamins, minerals, amino acids, it is warned for excessive intake due to the presence of alkoloid called papaverine. Papaverine at higher concentrations is toxic and leads to a syndrome called Bronchiolitis Obliterans. In the present study, morphogenetic potential of shoot tip, leaf and nodal explants of Sauropus androgynous was investigated to develop and enhance the reliable plant regeneration protocol via somatic embryogenesis. Somatic embryos were derived directly from the embryogenic callus derived from shoot tip, node and leaf cultures on Phillips and Collins (L2) medium supplemented with NAA at various concentrations ranging from 5.3 µM/l to 26.85 µM/l within two months of inoculation. Thus obtained embryos were sub cultured to modified L2 media supplemented with increased vitamin level for the further growth. Somatic embryos with well-developed cotyledons were transferred to normal and modified L2 basal medium for conversion. The plantlets thus obtained were subjected to brief acclimatization before transferring them to land. About 95% of survival rate was recorded. The augmentation process of culturing various explants through somatic embryogenesis using synthetic medium with various plant growth regulators under controlled conditions have aggrandized the commercial production of Sauropus making it easily available over the conventional propagation methods. In addition, regeneration process through somatic embryogenesis has ameliorated the development of desired character in Sauropus with low papaverine content thereby providing a valuable resource to the food and pharmaceutical industry. Based on this research, plant tissue culture techniques have shown promise for economical and convenient application in Sauropus androgynous breeding.

Keywords: L2 medium, multivitamin plant, NAA, papaverine

Procedia PDF Downloads 207

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

Procedia PDF Downloads 76

Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

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Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

Procedia PDF Downloads 266

Authors: Mohd Zubairy Bin Shamsudin

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Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

Procedia PDF Downloads 469

Authors: Sajewicz-Krukowska Joanna, Domańska-Blicharz Katarzyna, Tarasiuk Karolina, Marzec-Kotarska Barbara

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Astroviral infections pose a significant problem in the poultry industry, leading to multiple adverse effects such as decreased egg production, breeding disorders, poor weight gain, and even increased mortality. Commonly observed chicken astrovirus (CAstV) was recently reported to be responsible for "white chicks syndrome" associated with increased embryo/chick mortality. The CAstV-mediated pathogenesis in chicken occurs due to complex interactions between the infectious pathogen and the immune system. Many aspects of CAstV-chicken interactions remain unclear, and there is no information available regarding gene expression changes in the chicken's spleen in response to CAstV infection. We aimed to investigate the molecular background triggered by CAstV infection. Ten 21-day-old SPF White Leghorn chickens were divided into two groups of 5 birds each. One group was inoculated with CAstV, and the other was used as the negative control. On 4th dpi, spleen samples were collected and immediately frozen at -70°C for RNA isolation. We analysed transcriptional profiles of the chickens' spleens at the 4th day following infection using RNA-seq to establish differentially expressed genes (DEGs). The RNA-seq findings were verified by quantitative real-time PCR (qRT-PCR). A total of 31959 transcripts were identified in response to CAstV infection. Eventually 45 DEGs (p-value<0.05; Log2Foldchange>1)were recognized in the spleen after CAstV infection (26 upregulated DEGs and 19 downregulated DEGs). qRT-PCR performed on 4 genes (IFIT5, OASL, RASD1, DDX60) confirmed RNAseq results. Top differentially expressed genes belonged to novel putative IFN-induced CAstV restriction factors. Most of the DEGs were associated with RIG-I–like signalling pathway or, more generally, with an innate antiviral response(upregulated: BLEC3, CMPK2, IFIT5, OASL, DDX60, IFI6, and downregulated: SPIK5, SELENOP, HSPA2, TMEM158, RASD1, YWHAB). The study provided a global analysis of host transcriptional changes that occur during CAstV infection in vivo and proved the cell cycle in the spleen and immune signalling in chickens were predominantly affected upon CAstV infection.

Keywords: chicken astrovirus, CastV, RNA-seq, transcriptome, spleen

Procedia PDF Downloads 154

Authors: E. Xavier, B. Nandita

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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.

Keywords: embodiment, liminal, refugee, Rohingya

Procedia PDF Downloads 132

Authors: Fathimath Warda, Mariyam Nihaadh

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Students with Special Education Needs (SEN) are increasing in the Maldives, like anywhere else in the world, due to the changes in lifestyle of the people and ease of being diagnosed with advancements in medical health. With the growth in the population of these students, the demand for professionals in various fields is unmet. Thus, with the introduction of the Inclusive Education Policy in 2013, all students are educated in the same classroom by the regular teacher. This poses problems as the teachers are not well trained and qualified to meet the varying needs of the students, given the limited time and the large number of students in the classroom. This is a major concern for all stakeholders in the education sector and research has been conducted by various local scholars in this area. However, studies on the role of parents of such students is an area that remains yet to be explored in the Maldives, which makes a study of this nature crucial. The main aim of this study is to determine the ways in which the education provided to Special Needs Students can be maximized for a better outcome. Therefore, the study intends to understand the involvement of parents in providing education to special needs students from the teachers' perspectives. The basis for this study is the Parent Development Theory developed by Mowder, which was initially known as Parent Role Development Theory. A qualitative research has thus been utilised for the purpose of the study as it requires to find the beliefs and attitudes of teachers, along with relevant justifications regarding the role of parents in educating students with special needs. Data was gathered using one-to-one interviews, as it is one of the most reliable ways of getting meaningful and in-depth data. The study employs a total of 8 participants who are teachers teaching in inclusive classes where students with special needs are included. Emphasis was paid to select teachers who have the experience of teaching students with different disorders commonly found in the Maldives, namely in the four areas, Autism Spectrum Disorder, Down Syndrome, Attention Deficit Hyperactive Disorder and speech impairment. Hence, purposive sampling will be used to select the participants. Data analysis has been done using thematic coding. The findings revealed that teachers highlighted that parents' involvement was a key factor in ensuring success of education in children with special needs. Thus, the study concludes that the role of parents as a necessary input for the proper development of children and in educating children with special needs, suggesting that extra measures have to be taken develop a positive relationship between teachers and parents in order to strengthen this aspect.

Keywords: involvement, parents' role, special education needs, teachers' voice

Procedia PDF Downloads 137

Authors: Sara Javanmardi, Sepehr Aziziz, Baharak Divband, Masoumeh Firouzamandi

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Post-operative adhesions are the most common cause of intestinal obstruction, female infertility and chronic abdominal pain. We developed a novel approach for preventing post-operative peritoneal adhesions using a biodegradable and thermosensitive curcumin hydrogel in rats. Thirteen male Sprague-Dawley rats were assigned randomly into five groups of six animals each: In SHAM group, the cecum was exteriorized, gently manipulated and sent back into the abdomen. In CONTROL group, the surgical abrasion was performed with no further treatment. In Hydrogel group, surgical abrasion was performed with local application of blank hydrogel (1 mL). In Curcumin group, surgical abrasion was performed with local application of curcumin (1 mL). In CUR/HGEL group, surgical abrasion was performed with local application of curcumin hydrogel (1 mL). On day 10, adhesions were assessed using a standardized scale (Evans model), and samples were collected for the Real-time PCR. Real-time PCR was performed to determine mRNA levels of VCAM-1, ICAM-1 and GAPDH. The macroscopic adhesion intensity showed statistically significant differences between the CUR/HGEL and other groups (P=0.0005). The findings of the present study revealed there were statistically significant differences between the groups regarding adhesion band length and numbers (P<0.0001). The protein and mRNA expression of VCAM-1 and ICAM-1 in secal tissues were significantly down regulated due to curcumin-hydrogel application in CUR/HGEL compared to other groups (p<0.05). The thermosensitive hydrogel could reduce the severity and even prevent formation of intra-abdominal adhesion. Curcumin hydrogel could serve as a potential barrier agent to prevent post-operative peritoneal adhesion in rats.

Keywords: peritoneal adhesion, hydrogel, curcumijn, ICAM-1, VCAM-1

Procedia PDF Downloads 89

Authors: Naqoosh Haidry

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Objective & Goal: Enucleation of the maxillomandibular cysts will lead to the creation of post-surgical bone defects which may take more than a year for complete bone healing. The use of bone grafts is common to aid bone regeneration in large defects. The study aimed to evaluate the healing and bone formation capabilities of polymer of injectable platelet fibrin (i-PRF) and hydroxyapatite (HA) as bone graft substitute in maxilla-mandibular postsurgical defects compared to hydroxyapatite alone. The primary objective was to find out the clinical and radiological assessment of healing postoperatively and compare the outcome of both groups. Material and Methods: After surgical enucleation of 19 maxillomandibular cysts/tumors, either HA or HA+ i-PRF graft was adapted to the defect. Clinical outcome variables such as pain (VAS score), edema, and mucosal color were evaluated on postoperative days 01, 03, and 07 while radiological outcome variables such as volume of defect (cc), density of new bone (HU) on computed tomography were evaluated at 2nd and 4th month. The results obtained were tabulated and compared with the inferential analysis. Results: Clinical parameters seem to be better in the HA + i-PRF group, but the result was non-significant. Radiologically, the mean healing ratios were significantly greater in the HA + i-PRF group (63.5 ± 2.34 at 2nd month, 90.3 ± 7.32 at 4th month) compared to the HA group (57.2 ± 5.21at 2nd month, 80.8 ± 5.33 at 4th month). When comparing the mean density of new bone, there was a statistically significant difference with a mean difference of 95.2 HU more in the HA + i-PRF (623 HU ± 42.9) compared to the HA group (528 HU ± 96.5) in 2nd month. Conclusion: The polymer of i-PRF and HA prepared as the sticky bone yields faster and better bone healing in post-enucleation maxillomandibular bony defects as compared to hydroxyapatite alone based on radiological findings till four months.

Keywords: bone defect, density of new bone, hydroxyapatite, injectable platelet rich fibrin, maxillomandibular cysts, surgical defect

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Authors: Aysegul Alyamac, Sukru Gulec

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Ankaferd Blood Stopper (ABS) is a plant extract used to stop bleeding caused by injuries and surgical interventions. ABS also involved in wound healing of intestinal mucosal damage due to oxidative stress and inflammation. Inflammatory Bowel Disease (IBD) is a common chronic disorder of the gastrointestinal tract that causes abdominal pain, diarrhea, and gastrointestinal bleeding, and increases the risk of colon cancer. Inflammation is an essential factor in the development of IBD. The various studies have been performed about the physiological effects of ABS; however, ABS dependent mechanism on colonic inflammation has not been elucidated. Thus, the protective effect of ABS on colonic inflammation was investigated in this study. The Caco-2 and RAW 264.7 murine macrophage cells were used as a model of in vitro colonic inflammation. RAW 264.7 cells were treated with lipopolysaccharide (LPS) for 12 hours to induce the inflammation, and a conditional medium was obtained. Caco-2 cells were treated with 15 µl/ml ABS for 4 hours, then incubated with conditional medium and the cells also were incubated with 15 µl/ml ABS and conditional medium together for 4 hours. Tumor necrosis factor alpha (TNF-α) protein levels were targeted in testing inflammatory condition and its level was significantly increased (25 fold, p<0.001) compared to the control group by using Enzyme-Linked Immunosorbent Assay (ELISA) method. The COX-2 mRNA level was used as a marker gene to show the possible anti-inflammatory effect of ABS in Caco-2 cells. RAW cells-derived conditional medium significantly (3.3 fold, p<0.001) induced cyclooxygenase-2 (COX-2) mRNA levels in Caco-2 cells. The pretreatment of Caco-2 cells caused a significant decrease (3.3 fold, p<0.001) in COX-2 mRNA levels relative to conditional medium given group. Furthermore, COX-2 mRNA level was significantly reduced (4,7 fold, p<0.001) in ABS and conditional medium treated group. These results suggest that ABS might have an anti-inflammatory effect in vitro.

Keywords: Ankaferd blood stopper, CaCo-2, colonic inflammation, RAW 264.7

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Authors: M. G. Nasuruddin, S. Ishak

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In anthropological medicine (traditional therapeutic healing) symbolic interface are used to connect with the cognitive and metacognitive mechanisms to activate conscious and unconscious response of patients or other recipients. At the same time they are used to communicate with the inhabitants of the nether world to whom are ascribed almost all cases of psychosomatic illness. The symbols, which are cultural specific, are divided into verbal and non-verbal forms of communication. The verbal forms are chanting of mantra and doa and the invocation to invoke the spirits while the non-verbal ones are the physical materials such as the offerings, props and decorative elements, music, movements, olfactory sensation and the performance space. The process of communication through these symbols is affected by the Shaman who is a link or intermediary between the healer (Shaman) and the patients and between the healer and the spirits of the nether world. The paper also examines the scientific perspective of the traditional healing through the use of these symbols. The response to these symbols as external stimuli is embedded in the genes that are linked to the hereditary factor in the person’s DNA. When the patients are tuned in to external stimuli such as music, chanting and singing (sonic orders), it can triggers a response from the brain, which may activate its inner pharmacy by releasing drugs such as dopamine and/or opiodsto ameliorate pain and counter depression, anxiety and create a feel good feeling. These symbols act like placebo, evoking the power of the mind over the body and triggering the innate self-healing energy. At the same time they could also be used as nocebo, for example black magic, which has the opposite effect of placebo. In whatever capacity they operate these symbols, which are either visual or auditory, is an integral part of anthropological medicine. For they communicate and conjure emotional responses that are conducive to healing by activating the internal brain pharmacy.

Keywords: communication, healing, placebo, nacebo, symbol

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Authors: Sonto Maputle

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Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

Procedia PDF Downloads 152

Authors: Beatriz Lafuente Alcázar, Yash Wani, Amit J. Nimunkar

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Cardiovascular Diseases (CVDs) are the leading cause of death globally, and around 80% of sudden cardiac deaths are due to arrhythmias or irregular heartbeats. The majority of these pathologies are revealed by either short-term or long-term alterations in the electrocardiogram (ECG) morphology. The ECG is the main diagnostic tool in cardiology. It is a non-invasive, pain free procedure that measures the heart’s electrical activity and that allows the detecting of abnormal rhythms and underlying conditions. A cardiologist can diagnose a wide range of pathologies based on ECG’s form alterations, but the human interpretation is subjective and it is contingent to error. Moreover, ECG records can be quite prolonged in time, which can further complicate visual diagnosis, and deeply retard disease detection. In this context, deep learning methods have risen as a promising strategy to extract relevant features and eliminate individual subjectivity in ECG analysis. They facilitate the computation of large sets of data and can provide early and precise diagnoses. Therefore, the cardiology field is one of the areas that can most benefit from the implementation of deep learning algorithms. In the present study, a deep learning algorithm is trained following a novel approach, using a combination of different databases as the training set. The goal of the algorithm is to achieve the detection of R-peaks in ECG signals. Its performance is further evaluated in ECG signals with different origins and features to test the model’s ability to generalize its outcomes. Performance of the model for detection of R-peaks for clean and noisy ECGs is presented. The model is able to detect R-peaks in the presence of various types of noise, and when presented with data, it has not been trained. It is expected that this approach will increase the effectiveness and capacity of cardiologists to detect divergences in the normal cardiac activity of their patients.

Keywords: arrhythmia, deep learning, electrocardiogram, machine learning, R-peaks

Procedia PDF Downloads 186

Authors: Mohammed Ghazwani, Shyma Ali Alshahrani, Zahra Abdu Yousef, Taif Torki Asiri, Ghofran Abdur Rahman, Asma Ali Alshahrani, Umme Hani

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Background and introduction: Piroxicam is a nonsteroidal anti-inflammatory drug characterized by low solubility-high permeability used to reduce pain, swelling, and joint stiffness from arthritis. Hydrotropes are a class of compounds that normally increase the aqueous solubility of insoluble solutes. Aim: The objective of the present research study was to formulate and optimize Piroxicam hydrotropic starch gel using sodium salicylate, sodium benzoate as hydrotropic salts, and potato starch for topical application. Materials and methods: The prepared Piroxicam hydrotropic starch gel was characterized for various physicochemical parameters like drug content estimation, pH, tube extrudability, and spreadability; all the prepared formulations were subjected to in-vitro diffusion studies for six hours in 100 ml phosphate buffer (pH 7.4) and determined gel strength. Results: All formulations were found to be white opaque in appearance and have good homogeneity. The pH of formulations was found to be between 6.9-7.9. Drug content ranged from 96.8%-99.4.5%. Spreadability plays an important role in patient compliance and helps in the uniform application of gel to the skin as gels should spread easily; F4 showed a spreadability of 2.4cm highest among all other formulations. In in vitro diffusion studies, extrudability and gel strength were good with F4 in comparison with other formulations; hence F4 was selected as the optimized formulation. Conclusion: Isolated potato starch was successfully employed to prepare the gel. Hydrotropic salt sodium salicylate increased the solubility of Piroxicam and resulted in a stable gel, whereas the gel prepared using sodium benzoate changed its color after one week of preparation from white to light yellowish. Hydrotropic potato starch gel proposed a suitable vehicle for the topical delivery of Piroxicam.

Keywords: Piroxicam, potato starch, hydrotropic salts, hydrotropic starch gel

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Authors: J. Nyenhuis, J. Drelich

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This research study was designed to determine if food crops could be bio-fortified with micro-nutrients by growing sprouts on mineral fortified fiber mats. Diets high in processed foods have been found to lack essential micro-nutrients for optimum human development and overall health. Some micro-nutrients such as copper (Cu) have been found to enhance the inflammatory response through its oxidative functions, thereby having a role in cardiovascular disease (CVD), metabolic syndrome (MetS), diabetes and related complications. Recycled cellulose fibers and clay saturated with micro-nutrient ions can be converted to a novel mineral-metal hybrid material in which the fiber mat becomes a carrier of essential micro-nutrients. The reduction of ionic to metallic copper was accomplished using hydrogen at temperatures ranging from 400o to 600oC. Copper particles with diameters ranging from ~1 to 400-500 nm reside on the recycled fibers that make up the mats. Seeds purchased from a commercial, organic supplier were germinated on the specially engineered cellulose fiber mats that incorporated w10 wt% clay fillers saturated with either copper particles or ionic copper. After the appearance of the first leaves, the sprouts were dehydrated and analyzed for Cu content. Nutrient analysis showed 1.5 to 1.6 increase in Cu of the sprouts grown on the fiber mats with copper particles, and 2.3 to 2.5 increase on mats with ionic copper as compared to the control samples. The antibacterial properties of materials saturated with copper ions at room temperature and at temperatures up to 400°C have been verified with halo method tests against Escherichia Coli in previous studies. E. coli is a known pathogenic risk in sprout production. Copper exhibits excellent antibacterial properties when tested on S. aureus, a pathogenic gram-positive bacterium. This has also been confirmed for the fiber-copper hybrid material in this study. This study illustrates the potential for the use of engineered mats as a viable way to increase the micro-nutrient composition of locally-grown food crops and the need for additional research to determine the uptake, nutritional implications and risks of micro-nutrient bio-fortification.

Keywords: bio-fortification, copper nutrient analysis, micro-nutrient uptake, sprouts and mineral-fortified mats

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Authors: Surender Singh, Yogendra Kumar Gupta

Abstract:

Boerhaavia diffusa (BD) Linn. belonging to family Nyctaginaceae is a herbaceous plant and known as ‘punarnava’ in Hindi, used as herbal medicine for pain relief and various ailments. It is widely used as a green leafy vegetable in many Asian and African countries. The objective of present study was to investigate potential adverse effects, if any, of standardized root extract of Boerhaavia diffusa in rats following subchronic administration. In acute toxicity study, no mortality was found at a dose of 2000mg/kg which indicates that oral LD50 of Boerhaavia diffusa root extract is more than 2000mg/kg. The chronic administration of Boerhaavia diffusa for 28 days at a dose of 1000mg/kg body weight did not produce any significant changes in hematological (RBC, WBC, platelets, hemoglobin, bleeding time, clotting time) and biochemical (triglycerides, blood glucose, high density lipoprotein, serum creatinine, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase) parameters of male and female rats as compared to normal control group. All the animals survived until the scheduled necropsy, and their physical and behavioral examinations did not reveal any treatment-related adverse effects. No pathological changes were observed in histological section of heart, kidney, liver, testis, ovaries and brain of Boerhaavia diffusa treated male and female rats as compared to normal control animals.These observations from oral acute toxicitystudy suggest that the extract is practically non-toxic. Thus, it can be inferred that the Boerhaavia diffusa root extract at levels up to 1000 mg/kg/day was found to be safe and does not cause adverse effects in rats. So, the no-observed effect level (NOAEL) of the extract was found to be 1000mg/kg/day.

Keywords: Boerhaavia diffusa, histology, toxicity, sub-acute

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Authors: Navpreet Kaur, Randhir Singh

Abstract:

Diabetic neuropathy is one of the most common microvascular complications of diabetes mellitus which affects more than 50% of diabetic patients. The present study targeted oxidative stress mediated nerve damage in diabetic rats using a hydro-alcohol extract of Cucurbita pepo L. (Family: Cucurbitaceae) and its potential in treatment of diabetic neuropathy. Diabetes neuropathy was induced in Wistar rats by injection of streptozotocin (65 mg/kg, i.p.) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Hydro-alcohol extract of C. pepo seeds was assessed by oral administration at 100, 200 and 400 mg/kg in STZ-nicotinamide induced diabetic rats. Thermal hyperalgesia (Eddy's hot plate and tail immersion), mechanical hyperalgesia (Randall-Selitto) and tactile allodynia (Von Frey hair tests) were evaluated in all groups of streptozotocin diabetic rats to assess the extent of neuropathy. Tissue (sciatic nerve) antioxidant enzymes (SOD, CAT, GSH and LPO) levels were measured along with the formation of AGEs in serum to assess the effect of hydro-alcohol extract of C. pepo in ameliorating oxidative stress. Diabetic rats exhibited significantly decreased tail-flick latency in the tail-immersion test and decreased paw withdrawal threshold in both Randall-Selitto and von-Frey hair test. A decrease in the nociceptive threshold was accompanied by significantly increased oxidative stress in sciatic nerve of diabetic rats. Treatment with the C. pepo hydro-alcohol extract significantly attenuated all the behavioral and biochemical alterations in a dose-dependent manner. C. pepo attenuated the diabetic condition and also reversed neuropathic pain through modulation of oxidative stress and thus it may find application as a possible therapeutic agent against diabetic neuropathy.

Keywords: advanced glycation end products, antioxidant enzymes, cucurbita pepo, hyperglycemia

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Authors: Shannon Glaspy, Gerald Boon, Jack Lambert

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Studies on AE of highly active antiretroviral therapy (HAART) in children and adolescents are rare. The aim of this study is to observe the frequency of treatment limiting adverse drug reactions against years on ARVs and specific ARV regimen. Methods: A retrospective cohort study was conducted in East London, South Africa. All patient files in the pediatric (0 – 18 years) ARV cohort were examined, selecting only those patients started on HAART. ARV regimen changes explicitly due to AE, age on ARV treatment onset, age of AE onset, and gender were extrapolated. Eligible subjects were obtained from patient folders, anonymized and cross-referenced with data obtained from electronic records. A total of 1120 patients [592 male (52.9%) and 528 female (47.1%)] were charted by incidence and year. Additional information was extrapolated in cases where the patient experienced lipodystrophy and lipoatrophy to include the number of years on ARVs prior to the onset of the AE. Results: Of the 1120 HIV infected children of the hospital cohort, a total of 105 (9.37%) AE (53.3% male) observed were deemed eligible for the study due to completeness of medical history and agreement between electronic records and paper files. The AE cited were as follows: lipoatrophy 62 (5.53% of all subjects), lipodystrophy 27 (2.41%), neuropathy 9 (0.8%), anemia 2 (0.17%), Steven Johnsons Syndrome 1 (0.08%), elevated LFTs 1 (0.8%), breast hypertrophy (0.08%), gastritis 1 (0.08%) and rash 1 (0.08%). The most prevalence ARV regimens associated with the onset of the AE are: D4T/3TC/EFV 72 cases (64.86% of all AE), D4T/3TC/LOPr 24 cases (21.62%). Lipoatrophy and lipodystrophy combined represent 84.76% (89 cases) of all adverse events documented in this cohort. Within the 60 cases of lipoatrophy, the average number of years on ARVs associated with an AE is 3.54, with 14 cases experiencing an AE between 0-2 years of HAART. Within the 29 cases of lipodystrophy, the average number of years on ARVs associated with an AE is 3.89, with 4 cases experiencing an AE between 0-2 years on HAART. The regimen D4T/3TC/EFV is associated with 43 cases (71.66%) of lipoatrophy and 21 cases (72.41%) of lipodystrophy. D4T/3TC/LOPr is associated with 15 cases (25%) of lipoatrophy and 7 cases (24.14%) of lipodystrophy. The frequency of AE associated with ARV regimens could be misrepresented due to prevalence of different 1st line regimens which were not captured in this study, particularly with the systematic change of 1st line drugs from D4T to ABC in 2010. Conclusion: In this descriptive study we found a 9.37% prevalence of AE were significant enough to be treatment limiting among our cohort. Lipoatrophy accounted for 59.04% of all documented AE. Overall, D4T/3TC/EFV was associated with 64.86% of all AE, 71.66% of lipoatrophy cases and 72.41% of lipodystrophy cases.

Keywords: ARV, adverse events, HAART, pediatric

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Authors: Shwu-Ling Peng, Chiung-Man Tsai, Chia-Jui Weng

Abstract:

Chronic micro-inflammation is a hallmark of many aging-related neurodegenerative and metabolic syndrome-driven diseases. In high glucose (HG) environment, reactive oxygen species (ROS) is generated and the ROS induced inflammation, cytokines secretion, DNA damage, and cell cycle arrest to lead to cellular senescence. Water chestnut shell (WCS) is a plant hull which containing polyphenolic compounds and showed antioxidant and anticancer activities. Orchid, which containing a natural polysaccharide compound, possesses many physiological activities including anti-inflammatory and neuroprotective effects. These agricultural plants might be able to reduce oxidative stress and inflammation. This study was used HG-induced human normal dermal fibroblasts (HG-HNDFs) as an in vitro model to disclose the effects of water extract of Phalaenopsis orchid flower (WEPF) and ethanol extract of water chestnut shell (EEWCS) on the anti-aging and their underlying molecular mechanisms. The toxicity of extracts on human normal dermal fibroblasts (HNDFs) was determined by MTT method. The senescence of cells was assayed by β-galactosidase (SA-β-gal) kit. ROS and nitrate production was analyzed by Intracellular ROS contents and ELISA, respectively. Western blotting was used to detect the proteins in cells. The results showed that the exposure of HNDFs to HG (30 mM) for 72 h were caused cellular senescence and arrested cells at G0/G1 phase. Indeed, the treatment of HG-HNDFs with WEPF (200 μg/ml) and EEWCS (10 μg/ml) significantly released cell cycle arrest and promoted cell proliferation. The G1/S phase transition regulatory proteins such as protein retinoblastoma (pRb), p53, and p16ᴵᴺᴷ⁴ᵃ depressed by WEPF and EEWCS were also observed. Additionally, the treatment of WEPF and EEWCS increased the activity of HO-1 through upregulating Nrf2 as well as decreased the ROS and NO of HG-HNDFs. Therefore, the senescence marker protein-30 (SMP30) in cells was diminished. In conclusion, the WEPF and EEWCS might inhibit HG-induced aging of HNDFs by reducing oxidative stress and free radicals.

Keywords: agricultural plant extract, anti-aging, high glucose, Phalaenopsis orchid flower, water chestnut shell

Procedia PDF Downloads 154

Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore

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Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.

Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod

Procedia PDF Downloads 195

Authors: Maryam Firouzmandi, Moosa Miri

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Smile is considered to be one of the most effective methods of influencing people. Increasing numbers of patients are requesting cosmetic dental procedures to achieve the perfect smile. Based on the patient’s age, oral and facial characteristics, and the dentist’s expertise, different concepts of treatment would be available. Orthodontics is the most conservative and the ideal treatment alternative for crowded anterior teeth; however, it may be rejected by patients due to occupational limitations of time, physical discomfort including pain and functional limitations, psychological discomfort, and appearance during treatment. In addition, orthodontic treatment will not resolve deficits of contour and color of the anterior teeth. In consequence, patients may demand restorative techniques to resolve their anterior mal-alignment instead, often called "instant orthodontics". Following its introduction, however, adhesive dentistry has suffered at times from overuse. Creating short-term attractive smiles at the expense of long-term dental health and optimal tooth biomechanics by using cosmetic techniques should not be considered an ethical approach. The objective of this narrative review was to investigate the literature for guidelines with regard to decision making and treatment planning for anterior tooth mal-alignment. In this regard, indications of orthodontic, restorative, combination of both treatments, and adjunctive periodontal surgery were discussed in clinical cases to achieve a proportional smile. Restorative modalities would include disking, cosmetic contouring, veneers, and crowns and were compared with limited or comprehensive orthodontic options. A rapid review was also presented on pros and cons of snap on smile to mask malalignments. Diagnostic tools such as mock up, wax up, and digital smile design were also considered to achieve more conservative and functional treatments with respect to biologic factors.

Keywords: crowding, misalignment, veneer, crown, orthodontics

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Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

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Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

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Authors: Mualla McManus, Jenna Luche Thaye

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World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

Procedia PDF Downloads 193

Authors: Abhishek Pandey

Abstract:

Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis and rheumatoid arthritis. Acetaminophen is used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression and top spray granulation technique. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimized formulation, nine different formulations were generated among them batch F7, F8, F9 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of dissolution study. Furtherly, directly compressible granules of both drugs were prepared by using top spray granulation technique in fluidized bed processor equipment and compressed .In order to obtain best product process optimization was carried out by performing four trials in which various parameters like inlet air temperature, spray rate, peristaltic pump rpm, % LOD, properties of granules, blending time and hardness were optimized. Batch T3 coined as optimized batch on the basis physical & chemical evaluation. Finally formulations prepared by both techniques were compared.

Keywords: direct compression, top spray granulation, process optimization, blending time

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Authors: Taku Numao, Kazu Amimoto, Tomoko Shimada, Kyohei Ichikawa

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Background: Unilateral spatial neglect (USN) is a common syndrome following damage to one hemisphere of the brain (usually the right side), in which a patient fails to report or respond to stimulation from the contralesional side. These symptoms are not due to primary sensory or motor deficits, but instead, reflect an inability to process input from that side of their environment. Prism adaptation (PA) is a therapeutic treatment for USN, wherein a patient’s visual field is artificially shifted laterally, resulting in a sensory-motor adaptation. However, patients with USN also tend to perceive a left-leaning subjective vertical in the frontal plane. The traditional PA cannot be used to correct a tilt in the subjective vertical, because a prism can only polarize, not twist, the surroundings. However, this can be accomplished using a head mounted display (HMD) and a web-camera. Therefore, this study investigated whether an HMD system could be used to correct the spatial perception of USN patients in the frontal as well as the horizontal plane. We recruited healthy subjects in order to collect data for the refinement of USN patient therapy. Methods: Eight healthy subjects sat on a chair wearing a HMD (Oculus rift DK2), with a web-camera (Ovrvision) displaying a 10 degree leftward rotation and a 10 degree counter-clockwise rotation along the frontal plane. Subjects attempted to point a finger at one of four targets, assigned randomly, a total of 48 times. Before and after the intervention, each subject’s body-centre judgment (BCJ) was tested by asking them to point a finger at a touch panel straight in front of their xiphisternum, 10 times sight unseen. Results: Intervention caused the location pointed to during the BCJ to shift 35 ± 17 mm (Ave ± SD) leftward in the horizontal plane, and 46 ± 29 mm downward in the frontal plane. The results in both planes were significant by paired-t-test (p<.01). Conclusions: The results in the horizontal plane are consistent with those observed following PA. Furthermore, the HMD and web-camera were able to elicit 3D effects, including in both the horizontal and frontal planes. Future work will focus on applying this method to patients with and without USN, and investigating whether subject posture is also affected by the HMD system.

Keywords: head mounted display, posture, prism adaptation, unilateral spatial neglect

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Authors: Hushyar Azari

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Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.

Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus

Procedia PDF Downloads 179