Search results for: aspiration pneumonia

Authors: Yi-De Liu

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The aim of this paper is to discuss how the construct of networking and social capital can be used to understand the effect events can have on the cultural sector. Based on case study, this research sought the views of those working in the cultural sector on Liverpool’s year as the European Capital of Culture (ECOC). Methodologically, this study involves literature review to prompt theoretical sensitivity, the collection of primary data via online survey (n= 42) and follow-up telephone interviews (n= 8) to explore the emerging findings in more detail. The findings point to a number of ways in which the ECOC constitutes a boost for networking and its effects on city’s cultural sector, including organisational learning, aspiration and leadership. The contributions of this study are two-fold: (1) Evaluating the long-term effects on network formation in the cultural sector following major event; (2) conceptualising the impact assessment of organisational social capital for future ECOC or similar events.

Keywords: network, social capital, cultural impact, european capital of culture

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Authors: Khaled Khleifat

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This study detects the bacterial species that responsible for UTI in both diabetic patients and non-diabetic patients, Jordan. 116 urine samples were investigated in order to determine UTI-causing bacteria. These samples distributed unequally between diabetic male (12) and diabetic female (25) and also non-diabetic male (13) and non-diabetic female (66). The results represent that E.coli is responsible for UTI in both diabetic and non-diabetic patients (15.5% and 29.3% respectively) with large proportion (44.8%). This study showed that not all bacterial species that isolated from the non-diabetic sample could be isolated from diabetic samples. E. coli (15.5%), P. aeruginosa (4.3%), K. pneumonia (1.7%), P. mirabilis (2.6%), S. marcescens (0.9%), S. aureus (1.7%), S. pyogenes (1.7%), E. faecalis (0.9%), S. epidermidis (1.7%) and S. saprophyticus (0.9%). But E. aerogenes, E. cloacae, C. freundii, A. baumannii and B. subtilis are five bacterial species that can’t isolate from all diabetic samples. This study shows that for the treatment of UTI in both diabetic and non-diabetic patients, Chloramphenicol (30 μg), Ciprofloxacin (5 μg) and Vancomycin (30 μg) are more favorable than other antibiotics. In the same time, Cephalothin (30μg) is not recommended.

Keywords: urinary tract infections, diabetes mellitus, bacterial species, infections

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Authors: Victor Onomza Waziri, John K. Alhassan, Idris Ismaila, Noel Dogonyara

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This paper describes the problem of building secure computational services for encrypted information in the Cloud. Computing without decrypting the encrypted data; therefore, it meets the yearning of computational encryption algorithmic aspiration model that could enhance the security of big data for privacy or confidentiality, availability and integrity of the data and user’s security. The cryptographic model applied for the computational process of the encrypted data is the Fully Homomorphic Encryption Scheme. We contribute a theoretical presentations in a high-level computational processes that are based on number theory that is derivable from abstract algebra which can easily be integrated and leveraged in the Cloud computing interface with detail theoretic mathematical concepts to the fully homomorphic encryption models. This contribution enhances the full implementation of big data analytics based on cryptographic security algorithm.

Keywords: big data analytics, security, privacy, bootstrapping, Fully Homomorphic Encryption Scheme

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Authors: Nguyen Thi Huong Nhai

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This paper examines how different motivations to engage in organic farming may impact the farmers’ subjective well-being using a survey database from the French Agence Bio. Three measures representing the subjective well-being of farmers brought by their involvement in organic farming are used in this study: feelings of pride, satisfaction, and feeling of happiness. We focus on the effects of two different types of motivations: intrinsic motivations, such as preservation of human health and public health, concern about the environment, and autonomy in farming decisions; extrinsic motivations, such as fair price, income, and demand incentives. Results show that not all intrinsic motivations can increase farmers’s well-being. The intrinsic motivation relating to environment concern and aspiration seems to have the highest positive impact on the three proxies of SWB in our study. It is interesting to find out that the two extrinsic motivations (profitable price, satisfying the incentive of consumer and cooperative) are proven to have a negative influence. Some comparisons, explanations, and practical implications are also indicated in this research.

Keywords: intrinsic otivation, extrinsic motivation, subjective wellbeing, organic farmers

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Authors: Luciano Batista, Sylvia Saes, Nuno Fouto, Liam Fassam

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This paper introduces the theoretical and methodological basis of an analytical framework conceived with the purpose of bringing industrial ecology perspectives into the core of the underlying disciplines supporting analyses in studies concerned with environmental sustainability aspects beyond the product cycle in a supply chain. Given the pressing challenges faced by the food sector, the framework focuses upon waste minimization through industrial linkages in food supply chains. The combination of industrial ecology practice with basic LCA elements, the waste hierarchy model, and the spatial scale of industrial symbiosis allows the standardization of qualitative analyses and associated outcomes. Such standardization enables comparative analysis not only between different stages of a supply chain, but also between different supply chains. The analytical approach proposed contributes more coherently to the wider circular economy aspiration of optimizing the flow of goods to get the most out of raw materials and cuts wastes to a minimum.

Keywords: by-product synergy, food supply chain, industrial ecology, industrial symbiosis

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Authors: Luke S. Carlos A. Thompson

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The medical model of disability, though beneficial for the medical professional, is often exclusionary, restrictive and dehumanizing when applied to the lived experience of disability. As a result, a critique of this model was constructed called the social model of disability. Much of the language used to articulate the purpose behind the social model of disability can be summed up within the word inclusion. However, this essay asserts that inclusiveness is an incomplete aspiration. The social model, as it currently stands, does not aid in creating a society where those with impairments actually belong. Rather, the social model aids in lessening the visibility, or negative consequence of, difference. Therefore, the social model does not invite society to welcome those with physical and intellectual impairments. It simply aids society in ignoring the existence of impairment by removing explicit forms of exclusion. Rather than simple inclusion, then, this essay uses John Swinton’s concept of friendship and Jean Vanier’s understanding of belonging to better articulate the intended outcome of the social model—a society where everyone can belong.

Keywords: belong, community, differently-able, disability, exclusion, friendship, inclusion, normality

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Authors: Ali Fadhel Ahmed, Tuqa Abdulkareem Hameed

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Moringa oleifera (leaves and seeds) ethanolic and aqueous extracts were tested for antibacterial activity. The effect of plant extracts on three types of bacterial species: Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae, was investigated. Using the agar well diffusion method, ethanolic extracts of Moringa oleifera demonstrated a significant antibacterial effect on the forty tested bacterial strains. Seed-induced inhibition zones (ethanolic extracts)were ranged from16 to 24 mm in diameter against S. aureus, respectively, whileE. coli and K. pneumonia had no effect. Gram-positive and Gram-negative bacteria were not affected by alcoholic and aqueous plant leaf extracts. The purpose of this present study was to look at the cytotoxic effects of M.Oleifera plant (alcoholic extracts).

Keywords: moringa oleifera, escherichia coli, klebsiella pneumoniae, staphylococcus aureus

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Authors: Marwa A. Nasser

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This is an empirical study that provides an investigation of the most significant errors of Egyptian learners in producing English consonants and Arabic consonants, and advice on how these can be remedied. The study adopts a descriptive approach and the analysis is based on audio recordings of two groups of people. The first group includes six volunteers of Egyptian learners belonging to the English Department at Faculty of Women who learn English as a foreign language. The other group includes six Egyptian learners who are studying Tajweed (how to recite Quran correctly). The audio recordings were examined, and sounds were analyzed in an attempt to highlight the most common error done by the learners while reading English or reading (or reciting) Quran. Results show that the two groups of learners have problems with certain phonemic contrasts. Both groups share common errors although both languages are different and not related (e.g. pre-aspiration of fortis stops, incorrect articulation of consonants and velarization of certain sounds).

Keywords: consonant articulations, Egyptian learners of English, Egyptian learners of Quran, empirical study, error analysis, pronunciation problems

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Authors: Lekha Logu

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The coordination behavior of the newly synthesized Schiff base ligands, 4-bromo-2-((p-tolyl imino) methyl) phenol obtained by condensing para-toluidine with 5-bromo salicylaldehyde and N-(3,4-dichloro benzylidene)-4-methylbenzenamine obtained by condensing Para-toluidine with 3,4-dichloro benzaldehyde in ethanolic medium has been explored in this current study. The synthesized Schiff’s base ligands were complexed with lanthanide nitrate salts yielding [LnL(NO3)2(H2O)2]NO3, (Ln=Pr, Sm). Elemental analysis, conductance measurement, and spectral techniques like Nuclear Magnetic Resonance (NMR), Ultraviolet-visible (UV-Vis) and Fourier Transform Infrared (FTIR) have been used to characterize Schiff’s base ligands and their lanthanide metal complexes. An attempt has been made on these complexes for their antimicrobial activity against the gram-positive and gram-negative bacterial species like Escherichia coli, Staphylococcus aureus, Bacillus subtilis, Klebsiella pneumonia and fungal species like Canadida and Aspergillus.

Keywords: lanthanide complexes, Schiff's base, antimicrobial assay, synthesis, characterization

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Authors: Sarah Kinyanjui, Mahnaaz Mohamed

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The child justice system in Kenya is organically departing from a managerial and retributive model to one that espouses restorative justice. Notably, the Children Act 2001, and the most recent, Children Act 2022, signalled an aspiration to facilitate meaningful interventions as opposed to ‘processing’ children through the justice system. In this vein, the Children Act 2022 formally recognises diversion and provides modalities for its implementation. This paper interrogates the diversion promise and reflects on the implementation of diversion as envisaged by the 2022 Act. Using restorative justice, labelling and differential association theories as well as the value of care lenses, the paper discusses diversion as a meaningful response to child offending. It further argues that while diversion presents a strong platform for the realisation of the restorative and rehabilitative ideals, in the absence of a well-planned, coordinated, and resourced framework, diversion may remain a mere alternative ‘conveyor belt’. Strategic multi-agency planning, capacity building and cooperation are highlighted as essential minimums for the realisation of the goals of diversion.

Keywords: diversion for child offenders, restorative justice, responsive criminal justice system, children act 2022 kenya

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Authors: Saima Salehjee, Mike Watts

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In our school-based world, we are commonly confronted by young people for whom the study of science is an unpalatable ‘other world’: they simply do not see themselves as science (sciencey) people. To be clear, we are not interested in all young people becoming career scientists – although some small modicum of that would be quite agreeable. We are, though, keen to form or transform (trans(form)) their appreciations of science and retain open minds on matters scientific to develop the feeling of being ‘sciencey’ with or without the aspiration of becoming scientists. Our discussion in this paper draws upon research undertaken in a co-education primary- and lower-secondary school in Scotland, and our arguments chart the trans(formations) of thirty under-representative and under-researched Scottish South-Asian Muslim students (aged 11-13) over a school term. We use science identity theory as the basis for our analysis: what it means to be ‘sciencey’ and whether (or not) structural forces have impacted their decision of being ‘sciencey’. This work offers new insights into how Scottish, South-Asian, and Muslim students perceive and engage with in and out of school science and highlight some science nudges aimed to support their development of being ‘sciencey’.

Keywords: science identity, science nudges, transformative moments, south-Asian, Muslim, scottish, sciencey

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Authors: Izzatul Ulfana, Angga Pratomo Cahyadi, Rimayanti, Widjiati

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Freezing oocyte could cause temperature stress. Temperature stress triggers cell damage. Insulin Transferrin Selenium (ITS) and Heat Shock Protein 70 (HSP70) had been used to prevent damage to the oocyte after freezing. ITS and HSP70 could cause the difference protective effect. The aim of this research was to obtain an effective cryoprotectant for freezing local goat oocyte in cumulus cells change. The research began by collecting the ovary from a local slaughterhouse in Indonesia, aspiration follicle, in vitro maturation and the freezing had been used vitrification method. Examination of the morphology cells by native staining method. Data on the calculation morphology oocyte analyzed by Kruskall-Wallis Test. After the Kruskall-Wallis Test which indicated significance, followed by Mann-Whitney Test to compare between treatment groups. As a result, cryoprotectant ITS has the best culumus cells after warming

Keywords: Insulin Transferrin Selenium, Heat Shock Protein 70, cryoprotectant, vitrification

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Authors: Suffian Hadi Ayub, Mohammad Rezal Hamzah, Nor Hafizah Abdullah, Sharipah Nur Mursalina Syed Azmy, Hishamuddin Salim

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The liberalisation of the education industry has exposed the institute of higher learning (IHL) in Malaysia to the financial challenges. Without good financial standing, public institution will rely on the government funding. Ostensibly, this contradicts with the government’s aspiration to make universities self-sufficient. With stiff competition from private institutes of higher learning, IHL need to be prepared at the forefront level. The corporate identity itself is the entrance to the world of higher learning and it is in this uniqueness, it will be able to distinguish itself from competitors. This paper examined the perception of the stakeholders at one of the public universities in the east coast region in Malaysia on the perceived reputation and how the university communicate its preparedness for self-sustainability through corporate identity. The findings indicated while the stakeholders embraced the challenges in facing the stiff competition and struggling market conditions, most of them felt the university should put more efforts in mobilising the corporate identity to its constituencies.

Keywords: communication, corporate identity, market conditions, universities

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Authors: Emad M.Abdullat, Hasan A. Ader-Rahman, Rayyan Al Ali, Arwa.A.Hudaib

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This retrospective study aims to determine the epidemiological features of such deaths in one of the general teaching hospitals in Jordan with a focus on weaning practices and its relation to sucking as major factors underlying the mechanism of choking in infants and young children. The study utilized a retrospective design to review the records of forensic cases due to foreign body aspiration examined at the forensic department at the Jordan University Hospital. A total of 27 cases of choking in the pediatric age group were retrieved from the reports of the autopsy cases dissected. All cases of children who died due to chocking by foreign bodies were under 11 years old. Choking by food materials constituted (44.4%) of cases under 3 years of age while choking by non-food material were less prevalent under 3 years of age and comprising 18.5% of the cases. Health care personnel and parents need to be aware that introduction of solid food, unlike exclusive breast or formula-milk feeding, can have serious consequences if occurring in inappropriate timing or consistency during early childhood physical and functional development. Parents need to be educated regarding the appropriate timing and process of weaning.

Keywords: chocking, infants, weaning practices, young children

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Authors: Shweta Jha, Nandita Chaube

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The concept of self has a major role to play in the study of personality which drives the current study in its present form. This is a case of Miss S, a 17-year-old Hindu, currently in eleventh standard, with no family history of mental illness but with a past history of inability to manage relationships, multiple emotional and sexual relationships, repeated self harming behaviour, and sexual abuse over a period of 2 months at the age of 10 years. She comes with a psychiatric history of one episode of dissociative fall followed by a stressful event which left the patient with many psychological disturbances matching the criterion of Cluster B and C traits. Current episode precipitated due to the relationship failure, predisposing factor is her personality traits, and poor social and family support. Considering the patient’s aspiration for positivity and demand of the therapy, ventilation sessions were carried out which made her capable of understanding and dealing with her negative emotions, also strengthened mother child bond, helped her maintain meaningful and healthy relationships, also helped her increase her problem solving ability and adaptive coping skills making her feel more positive and acceptable towards herself, family members and others.

Keywords: cluster B and C traits, personality, therapy, self

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Authors: Seyed Salahedin Naghshbandi, Mahnaz Ahmadikhatir, Siavash Hamidzadeh

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The purpose of this study was to investigate the relationship between organizational political behavior and ethical values with the job enthusiasm of the sport personnel of the National Iranian Gas Company. The population of this research included all personnel of the National Iranian Gas Company's sports personnel (150 people). For collecting information, library resources and three questionnaires, organizational political behavior by Kaspar and Carlsen (1997), Lewall's moral values questionnaire (1986) and job enthusiasm questionnaire Schaufeli & Bekker (2003) have been used. Validity of the questionnaires was confirmed by university professors. Using Cronbach alpha correlation coefficient, the reliability of the organizational political behavior questionnaire was 0.92, the moral values questionnaire was 0.86 and the Schaufeli & Baker job enthusiasm questionnaire was 0.91-0.96. The results of this research show a significant, direct and positive relationship between the components of job aspiration with political behavior and ethical values. Therefore, managers of organizations should, as far as possible, remove political behaviors from the organization and be able to institutionalize ethical values in their organization so that they can increase employee eagerness.

Keywords: political behavior, ethical values, job enthusiasm, staff, national Iranian gas company

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Authors: M. Mehani, N. Salhi, T. Valeria, S. Ladjel

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Red River Gum (Eucalyptus camaldulensis) is a tree of the genus Eucalyptus widely distributed in Algeria and in the world. The value of its aromatic secondary metabolites offers new perspectives in the pharmaceutical industry. This strategy can contribute to the sustainable development of our country. Preliminary tests performed on the essential oil of Eucalyptus camendulensis showed that this oil has antibacterial activity vis-à-vis the bacterial strains (Enterococcus feacalis, Enterobacter cloaceai, Proteus microsilis, Escherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa) and antifungic (Fusarium sporotrichioide and Fusarium graminearum). The culture medium used was nutrient broth Muller Hinton. The interaction between the bacteria and the essential oil is expressed by a zone of inhibition with diameters of MIC indirectly expression of. And we used the PDA medium to determine the fungal activity. The extraction of the aromatic fraction (essentially oil- hydrolat) of the fresh aerian part of the Eucalyptus camendulensis was performed by hydrodistillation. The average essential oil yield is 0.99%. The antimicrobial and fungal study of the essential oil and hydrosol showed a high inhibitory effect on the growth of pathogens.

Keywords: essential oil, Eucalyptus camendulensis, bacteria and fungi, red river gum

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Authors: Odinah Cuartero-Enteria, Kyla Rita Mercado, Jason Salamanes, Aian Pecasales, Sherwin Sabado

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The northern part of Mindanao Island, Philippines has sizable reserve of mineral resources. Years ago, mining activities have been flourishing which resulted to both local economic gain but with environmental concerns. This study investigates the prevalent diseases by mining activities in these areas. The study was done using the secondary data gathered from the Rural Health Units (RHU) of the selected areas. The study further determined the prevalent diseases that existed in the three areas from years 2005, 2010 and 2015 indicating before the mining activities and when mining activities are present. The results show that areas which are far from mining activities have fewer cases of patients suffering from air-borne diseases. The top ten most common diseases such as pneumonia, tuberculosis, influenza, upper respiratory tract infection (URTI) and skin diseases were caused by air-borne due to air pollution. Hence, the places where mining activities are present contribute to the prevalent diseases. Thus, addressing the air pollution caused by mining activities is very important.

Keywords: Philippines, Mindanao Island, mining activities, pollution, prevalent diseases

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Authors: Ya-Hui Lee, Ching-Yi Lu

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Taiwan will become an aging society in 2018. The method to face the challenges related to the aging population has become an important topic. Purpose: This study aims to understand the future preparation of middle-age and older adults, and how they prepared themselves to face the problems of aging, and how they took actions to plan and cope with their future life. Moreover, how did they generate the process of learning action, so that they would be able to live a more active and meaningful life when they entered into their older age? Method: We conducted semi-structure interviews with 10 middle-aged and older adults who had taken actions to prepare for their future. We examined the interviewees’ consciousness and learning actions in their future preparation. Preliminary Results: 1. The triggering factors of the interviewees’ consciousness to prepare for the future included: family events, the desire to maintain active social lives after retirement, the continuation of the interviewees’ professional careers after retirement, and the aspiration for participation in volunteer services. 2. 'Health problems' and 'economic security' were issued of the utmost concern for the interviewees’ future. However, they would transform these worries to learning actions, comprising of active participation in learning, finding relevant information through learning; thus, accumulating more resources to cope with their future needs.

Keywords: middle-age and older adults, preparing for future, older adult learning

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Asaad Alhabsi, Alyaqdan Algafri

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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

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Authors: Babak Rezavand

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Pneumocystis carinii pneumonia (PCP) is one of the main causes of morbidity and mortality among immunocompromised and HIV-positive patients and remained one of the most important common opportunistic infections in these individuals in the world. Pneumocystis infection has been reported in many mammals. The aim of this study was to determine the Pneumocystis infection in wild rats as natural reservoirs of this organism in Tehran city, Iran. Fifty three rats (Rattus rattus) were live trapped in different areas of Tehran city, Iran. After isolation of their lung tissues and homogenization in sterile conditions, DNA was extracted. DNAs from all of the Pneumocystis species were amplified by pAZ102-H and pAZ102-E primers, and Nested PCR was performed using pAZ102-X and pAZ102-W primers from the initial PCR product for all the species of Pneumocystis. Amplification of the genome revealed the presence of Pneumocystis in the lungs of 17 rats (32%) through a PCR product with a bandwidth of 346 bp. In the Nested PCR amplification, from the PCR product of 53 rats, 64.2% of the samples were positive with a bandwidth of 261bp. Pneumocystis SPP infestation is highly prevalent among wild rats in Tehran city, indicating the existence of infection in the natural ecosystem of these rodents. As a host, rat plays an important role in the transmission of the microorganism in the world.

Keywords: pneumocystis SPP, rattus rattus, nested PCR, Tehran

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Authors: Jelena Maletkovic

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Background: Endogenous Cushing’s syndrome is a rare disease, but iatrogenic or drug related Cushing syndrome from glucocorticoid products is commonly seen in clinical practice. With high dose and long term use of glucocorticoids, patients can develop isolated hypothalamic-pituitary-adrenal (HPA) suppression, or HPA axis suppression can be accompanied by overt iatrogenic Cushing’s syndrome. This is a rare case where severe Cushing’s syndrome developed from an unknown medication and was followed by severe and prolonged adrenal insufficiency and multiple potentially fatal complications. Case: This is a 37-year-old woman who is presented to Emergency Room (ER) with shortness of breath and chest pain. Four months prior to this presentation the patient was a generally healthy woman who was looking for improvement in her appearance and visited local Rejuvenation Clinic. After initial consultation with a nurse, she was contacted by a physician over the phone and was advised to start taking multiple injectable medications that will arrive by mail. Medications without any labels on bottles were delivered and the patient started daily intramuscular injections. Over the next two months, she noticed rounding of her face and swelling around her eyes. She gained 20 pounds, mostly abdominal fat and became extremely fatigued. Her muscles on legs were visibly decreasing in size and she felt significant muscle weakness. Unexplained bruising occurred. She started growing hair on face and developed secondary amenorrhea. New severe back pain started. She developed depression and headaches. Finally, over a few days, a number of red-purple stretch marks that were sensitive and painful appeared over her abdomen, upper part of arms and legs. She then became suspicious that these dramatic symptoms are caused by injectable medication and she discontinued injections. Over the next few days she presented to ER with low blood pressure and oxygen saturation of 75%. Studies revealed extensive pneumonia as well as multiple pulmonary emboli. Her white blood count was elevated with 32 000 and she also had acute kidney failure on admission. She was treated for sepsis and was also given stress dose steroids. Steroids were tapered over 48 hours and discontinued. After being discharged to home, on her first visit to endocrinology clinic she had undetectable ACTH of < 2pg/mL and undetectable 8am cortisol of < 0.2mcg/dL. She did not respond to an intramuscular injection of cosyntropin 250mcg and her repeated cortisol after 60 minutes was only 1mcg/dL. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone 20mg+10mg. It took close to 2 years of slow tapering for recovery of this patient’s HPA axis and resolve all the sequelae from Cushing’s syndrome. Conclusion: Misuse and abuse of glucocorticoids have been present almost since these medications were discovered. This is a rare case where not only severe Cushing’s syndrome in full clinical picture developed but also the patient suffered multiple potentially fatal complications and prolonged adrenal insufficiency. Visits to herbal, rejuvenation, esthetic, and similar clinics are becoming more and more popular and physicians need to be aware of possible non-benign nature of medications that their patients may be using.

Keywords: iatrogenic, Cushing's syndrome, adrenal crisis, steroid abuse

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Authors: Yusuf Bala

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The last decades of the 20th Centaury witnessed renewed hope about the birth of democracy and development in Africa the interface between democracy and development in Africa has long engaged the sustained interest of scholars and researchers across Africa. The process was actively supported by all segment of society, labour students market women, rural dweller who saw in it, the prospects of reversing the trend of political despair and in disillusionment that hither to characterized political life in Africa. The political tyranny and dictatorship while having it own clientele and beneficiaries had negative and suffocating effect on the majority of the people. The democratic aspiration of the Africa people is not only confined to the Arena of political Democracy of election and granting of civil and political rights, but it involves the demand for economic empowerment better living standards of the people and adequate social welfare indeed, for the majority of the people democracy is meaningful only when it delivers socio-economic goods. However, democracy and development have generated enormous interest no conclusive evidence seems to be shared in Africa. In the course of this research emphasis shall be made on certain issues, such as issues of corruption in democracy in Africa, ethnic conflict and democracy in Africa contribution of women to democratic practice and women participation in political arena, is still very low, democratization process and industrial relation in Africa as factor that hinder the development of Democracy in Africa, a case study of Nigeria.

Keywords: democracy, development, dictatorship, conflict, ethnicity

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Authors: Raymon P. Española

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Hearing impaired students are admitted to regular high schools in the context of inclusive education. In this setting, several academic difficulties and social struggles are disregarded by many educators. The study aimed to describe the aspirations and lived experiences in mainstream classrooms of hearing impaired students. In the research process, the participants were interviewed using sign language. Thematic analysis of interview responses was done, supplemented by interviews with teachers and classroom observations. The study revealed four patterns of experiences: academic difficulties, coping mechanisms, identification with hearing peers, and impression management. This means that these learners were struggling in inclusive classrooms, where identification with and modeling the positive qualities of hearing peers were done to cope with academic difficulties and alter negative impressions about them. By implication, these learners tended to socially immerse themselves rather than resort to isolation. Along with this tendency was the aspiration for achievement as they were eager to finish post-secondary technical-vocational education. This means aspiring for continuing social immersion into the mainstream. All these findings provide insights to K-12 educators to increase the use of collaborative techniques and experiential learning strategies, as well as to adequately address the special educational needs of these students.

Keywords: descriptive, experiences and aspirations of hearing impaired learners, inclusive classrooms, Surigao City Philippines

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Authors: Lama Ajinah

Abstract:

Luxury brands witnessed continuous growth which followed women’s desire towards individual distinctiveness and social glare. Bags are a woman’s best friend either for aesthetic or functional purposes when she leaves her home for leisure or work. One way of women constant aspiration for being distinguished while reflecting their wealth is through handbags. Subsequently, the demand and attraction by consumers towards the dazzle of luxurious brands for personal pleasure and social status have flourished. According to the literature review, a visual analysis on luxury brands has been explored yet a focus on bags was not discussed in details. Hence, a deep analysis will be dedicated on the two segments by showcasing examples of high-end bag advertising. The research is conducted to understand advertising strategies used in promoting for luxurious products. Furthermore, the paper explores the definition of the term luxury, the condition in which it is used in, and the visual language used along with the term. As luxury is an indicator of superior satisfaction, it is obtained on two levels: a personal and a social level. The examples of luxury brand ads are selected from the last five years to uncover the latest, most common strategies used to promote for luxurious brands. The methods employed in this paper consist of literature review, semiotic analysis, and content analysis. The researcher concludes with revealing the methods used in advertising while categorizing them into various themes.

Keywords: advertising, brands, fashion, graphic design, luxury, semiotic analysis, semiology, visual analysis, visual communication

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Authors: Abdessamad Dali-Ali, Houaria Beldjillali, Fouzia Agag, Asmaa Oukebdane, Ramzi Tidjani, Arslane Bettayeb, Khadidja Meddeber, Radia Dali-Yahia, Nori Midoun

Abstract:

Healthcare-associated infections are a real public health problem, especially in intensive care units. The aim of our study was to describe the epidemiological profile and to estimate the incidence of these infections at the intensive care unit of our teaching hospital. A prospective study was conducted, from June 2012 to December 2013. During this period, 305 patients having a duration of hospitalization equal or more than 48 hours were included in the study. In terms of the incidence of healthcare associated infections, nosocomial pneumonia occupied the first position with a cumulative incidence rate of 20.0%, followed by bacteremia (5.6%), central venous catheter infections (4%), and urinary tract infections (3%). In the case of isolated microorganisms, Gram-negative bacilli not enterobacteriaceae occupied the first place with 48.5%, followed by enterobacteria (32.1%). Acinetobacter baumannii was the most common germ (27.6%). Our study showed that the rate of health-care-associated infections was relatively high in the intensive care unit. A control program to reduce all infections is a priority for the Infection Control Associated Committee.

Keywords: epidemiological profile, healthcare associated infections, intensive care units, teaching hospital of Oran, Algeria

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Authors: Sukhee Park, Gaab Soo Kim

Abstract:

Purpose: We aimed to evaluate the adequacy of second-generation laryngeal mask airway use during prolonged abdominal surgery in respect of ventilation, oxygenation, postoperative pulmonary complications (PPC), and postoperative non-pulmonary complications on living donor kidney transplant (LDKT) surgery. Methods: In total, 257 recipients who underwent LDKT using either laryngeal mask airway-ProSeal (LMA-P) or endotracheal tube (ETT) were retrospectively analyzed. Arterial partial pressure of carbon dioxide (PaCO2 and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between two groups. In addition, PPC including pulmonary aspiration and postoperative non-pulmonary complications including nausea, vomiting, hoarseness, vocal cord palsy, delirium, and atrial fibrillation were also compared. Results: PaCO2 and PFR during surgery were not significantly different between the two groups. PPC was also not significantly different between the two groups. Interestingly, the incidence of delirium was significantly lower in the LMA-P group than the ETT group (3.0% vs. 10.3%, P = 0.029). Conclusions: During prolonged abdominal surgery such as LDKT, second-generation laryngeal mask airway offers adequate ventilation and oxygenation and can be considered a suitable alternative to ETT.

Keywords: laryngeal mask airway, prolonged abdominal surgery, kidney transplantation, postoperative pulmonary complication

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Authors: M. E. Abalaka, S. Y. Daniyan, S. O. Adeyemo, D. Damisa

Abstract:

Gold nanoparticles (AuNPs) have gained increasing interest in recent times. This is greatly due to their special features, which include unusual optical and electronic properties, high stability and biological compatibility, controllable morphology and size dispersion, and easy surface functionalization. In typical synthesis, AuNPs were produced by reduction of gold salt AuCl4 in an appropriate solvent. A stabilizing agent was added to prevent the particles from aggregating. The antibacterial activity of different sizes of gold nanoparticles was investigated against Staphylococcus aureus, Salmonella typhi and Pseudomonas pneumonia using the disk diffusion method in a Müeller–Hinton Agar. The Au-NPs were effective against all bacteria tested. That the Au-NPs were successfully synthesized in suspension and were used to study the antibacterial activity of the two medicinal plants against some bacterial pathogens suggests that Au-NPs can be employed as an effective bacteria inhibitor and may be an effective tool in medical field. The study clearly showed that the Au-NPs exhibiting inhibition towards the tested pathogenic bacteria in vitro could have the same effects in vivo and thus may be useful in the medical field if well researched into.

Keywords: gold nanoparticles, Gomphrena celesioides, Prunus amygdalus, pathogens

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Authors: Issa M. Hweidi, Saba W. Al-Ibraheem

Abstract:

This study aimed to assess the increased hospital length of stay and healthcare costs associated with SSIs among ventriculoperitoneal shunting surgery patients in Jordan. This study adopted a retrospective and nested 1:1 matched case-control design. A non-probability convenient sample of 48 VP shunt patients was recruited for the purpose of the study. The targeted groups of the study basically used to cross-match the variables investigated to minimize the risk of confounding. Information was extracted from the text of patients' electronic health records. As compared to the non-SSI group, the SSI group had an extra mean healthcare cost of $13,696.53 (p=0.001) and longer hospital length of stay (22.64 mean additional days). Furthermore, Acinetobacter baumannii and Klebsiella pneumonia were identified as being the most predominant causative agents of SSIs. The results of this study may provide baseline data for national and regional benchmarking to evaluate the quality of care provided to likewise patients. Adherence to infection control strategies and protocols considering new surveillance methods of SSIs is encouraged.

Keywords: ventriculoperitoneal shunt, health care cost, length of stay, neurosurgery, surgical site infections

Procedia PDF Downloads 75