Search results for: end stage kidney disease

Authors: Syed Dawood M. Taimur

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Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

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Authors: Mahzad Yousefi, Azin Tavakoli

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Periodontal disease is an inflammatory reaction; therefore, it is predicted that changes may occur in some inflammatory parameters that can be detected in routine blood tests. The objective of this study was to evaluate the hematological and biochemistry changes that occur in dogs affected with advanced stages of periodontal disease. 87 dogs were diagnosed with periodontal disease (PD group), and 76 healthy dogs entered the study. The PD dogs had been affected with periodontitis stage 3 or 4 and were candidates for any dental extractions. The healthy dogs were either referred for annual checkups or for issuing health travel certificates that their owners asked for complete lab tests. Neither the diseased nor healthy subjects had a history of infectious, or other general health problems or surgery in the past 3 months. Age, as well as all hematologic including PCV, WBC and RBC count, Hb, MCV, MCH, MCHC, PLT, CBC, NLR, and biochemistry data, including total protein, albumin, glucose, BUN, Creatinine, ALT, AST, and ALP, were recorded and analyzed statistically. Results confirmed that aging has a significant direct relationship with the advanced stages of periodontal disease. Mild leukocytosis occurred in the diseased group; however, it was not significant. Also, the mean total protein of the PD group was lower than that of the healthy dogs, and serum levels of albumin were found to be lower significantly in the diseased group (P<0.05). Mean ±SD amount of Platelet, MCH, and ALT were significantly higher in the diseased group in comparison to the healthy dogs (P<0.05). No significant differences were reported in other evaluated parameters. It is concluded that CBC indices of PD dogs are not systemic inflammatory; however, only a decrease in albumin showed inflammatory responses. Some indices in routine laboratory tests can be changed significantly during advanced stages of the periodontal disease dogs.

Keywords: periodontal disease, dogs, hematological factors, advanced stages, blood tests

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Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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Authors: İbrahi̇m Kara, Seher Arslankaya

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Frequently preferred in the field of engineering in particular, data mining has now begun to be used in the field of health as well since the data in the health sector have reached great dimensions. With data mining, it is aimed to reveal models from the great amounts of raw data in agreement with the purpose and to search for the rules and relationships which will enable one to make predictions about the future from the large amount of data set. It helps the decision-maker to find the relationships among the data which form at the stage of decision-making. In this study, it is aimed to determine the risk of heart attack at the first stage, to control it, and to make its resource planning with the method of data mining. Through the early and correct diagnosis of heart attacks, it is aimed to reveal the factors which affect the diseases, to protect health and choose the right treatment methods, to reduce the costs in health expenditures, and to shorten the durations of patients’ stay at hospitals. In this way, the diagnosis and treatment costs of a heart attack will be scrutinized, which will be useful to determine the risk of the disease at the first stage, to control it, and to make its resource planning.

Keywords: data mining, decision support systems, heart attack, health sector

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Authors: Sidra Naeem, Ayesha Naeem, Sahar Rahim, Nadia Nawaz Qadri

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Citrus greening is a bacterial disease that causes considerable damage to citrus fruits worldwide. Efficient method for this disease detection must be carried out to minimize the production loss. This paper presents a pattern recognition system that comprises three stages for the detection of citrus greening from Orange leaves: segmentation, feature extraction and classification. Image segmentation is accomplished by adaptive thresholding. The feature extraction stage comprises of three visual descriptors i.e. shape, color and texture. From shape feature we have used asymmetry index, from color feature we have used histogram of Cb component from YCbCr domain and from texture feature we have used local binary pattern. Classification was done using support vector machines and k nearest neighbors. The best performances of the system is Accuracy = 88.02% and AUROC = 90.1% was achieved by automatic segmented images. Our experiments validate that: (1). Segmentation is an imperative preprocessing step for computer assisted diagnosis of citrus greening, and (2). The combination of shape, color and texture features form a complementary set towards the identification of citrus greening disease.

Keywords: citrus greening, pattern recognition, feature extraction, classification

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

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

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

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Authors: W. Soufi, F. Boukli Hacene, S. Ghalem

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Alzheimer's disease (AD) is a neurodegenerative disease that leads to a progressive and permanent deterioration of nerve cells. This disease is progressively accompanied by an intellectual deterioration leading to psychological manifestations and behavioral disorders that lead to a loss of autonomy. It is the most frequent of degenerative dementia. Alzheimer's disease (AD), which affects a growing number of people, has become a major public health problem in a few years. In the context of the study of the mechanisms governing the evolution of AD disease, we have found that natural flavonoids are good acetylcholinesterase inhibitors that reduce the rate of ßA secretion in neurons. This work is to study the inhibition of acetylcholinesterase (AChE) which is an enzyme involved in Alzheimer's disease, by methods of molecular modeling. These results will probably help in the development of an effective therapeutic tool in the fight against the development of Alzheimer's disease. Our goal of the research is to study the inhibition of acetylcholinesterase (AChE) by molecular modeling methods.

Keywords: Alzheimer's disease, acetylcholinesterase, flavonoids, molecular modeling

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Authors: Andi Darmawan, Dewi Retno Sari Saputro, Purnami Widyaningsih

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Diabetes mellitus (DM) is a chronic disease in human that occurred if pancreas cannot produce enough of insulin hormone or the body uses ineffectively insulin hormone which causes increasing level of glucose in the blood, or it was called hyperglycemia. In Indonesia, DM is a serious disease on health because it can cause blindness, kidney disease, diabetic feet (gangrene), and stroke. The type of DM criteria can also be divided based on the main causes; they are DM type 1, type 2, and gestational. Diabetes type 1 or previously known as insulin-independent diabetes is due to a lack of production of insulin hormone. Diabetes type 2 or previously known as non-insulin dependent diabetes is due to ineffective use of insulin while gestational diabetes is a hyperglycemia that found during pregnancy. The most one type commonly found in patient is DM type 2. The main factors of this disease are genetic (A) and life style (E). Those disease with 2 factors can be constructed with additive genetic and unique environment (AE) model. In this article was discussed parameter estimation of AE model using Bayesian method and the inheritance character simulation on parent-offspring. On the AE model, there are response variable, predictor variables, and parameters were capable of representing the number of population on research. The population can be measured through a taken random sample. The response and predictor variables can be determined by sample while the parameters are unknown, so it was required to estimate the parameters based on the sample. Estimation of AE model parameters was obtained based on a joint posterior distribution. The simulation was conducted to get the value of genetic variance and life style variance. The results of simulation are 0.3600 for genetic variance and 0.0899 for life style variance. Therefore, the variance of genetic factor in DM type 2 is greater than life style.

Keywords: AE model, Bayesian method, diabetes mellitus type 2, genetic, life style

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Authors: Ognen Kostovski, Svetozar Antovic, Rubens Jovanovic, Irena Kostovska, Nikola Jankulovski

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Introduction:Colorectal carcinoma (CRC) is one of the most common malignancies in the world. The cancer stem cell (CSC) markers are associated with aggressive cancer types and poor prognosis. The aim of study was to determine whether the expression of colorectal cancer stem cell markers CD133 and CD44 could be significant in prediction of clinically aggressive form of CRC. Materials and methods: Our study included ninety patients (n=90) with CRC. Patients were divided into two subgroups: with metatstatic CRC and non-metastatic CRC. Tumor samples were analyzed with standard histopathological methods, than was performed immunohistochemical analysis with monoclonal antibodies against CD133 and CD44 stem cell markers. Results: High coexpression of CD133 and CD44 was observed in 71.4% of patients with metastatic disease, compared to 37.9% in patients without metastases. Discordant expression of both markers was found in 8% of the subgroup with metastatic CRC, and in 13.4% of the subgroup without metastatic CRC. Statistical analyses showed a significant association of increased expression of CD133 and CD44 with the disease stage, T - category and N - nodal status. With multiple regression analysis the stage of disease was designate as a factor with the greatest statistically significant influence on expression of CD133 (p <0.0001) and CD44 (p <0.0001). Conclusion: Our results suggest that the coexpression of CD133 and CD44 have an important role in prediction of clinically aggressive form of CRC. Both stem cell markers can be routinely implemented in standard pathohistological diagnostics and can be useful markers for pre-therapeutic oncology screening.

Keywords: colorectal carcinoma, stem cells, CD133+, CD44+

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Authors: Mohamed Shafi Mahboob Ali

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Male breast cancer (MBC) is a rare entity with overall cases reported less than 1%. However, the incidence of MBC is regularly rising every year. Due to the lack of data on MBC, diagnosis and treatment are tailored to female breast cancer. MBC risk increases with age and is usually diagnosed ten years late as the disease progression is slow compared to female breast cancer (FBC). The most common feature of MBC is an intra-ductal variant, and often, upon diagnosis, the stage of the disease is already advanced. The Prognosis of MBC is often flawed, but new treatment modalities are emerging with the current knowledge and advancement. We presented a series of male breast cancer in our center, highlighting the clinicopathological, radiological and treatment options.

Keywords: male, breast, cancer, clinicopathology, ultrasound, CT scan

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Authors: Itsuo Yokoyama, Rikako Kikuti, Naoko Watabe, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Chronic kidney disease presents significant changes in mineral and bone metabolism, referred to as CKD-MBD. These changes lead to decreased bone mass, heightened bone fragility, fractures, and increased vascular and valvular calcification, ultimately impacting cardiovascular outcomes. Key contributors to these complications in dialysis patients include calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and the vitamin D hormonal system. Methods: In our outpatient dialysis clinic, we monitor the long-term effects of vascular calcifications by calculating the volume of calcified areas in the abdominal aorta based on CT scan data. The results revealed a progressive nature of vascular calcification. To extend our study, we measured the volume of calcification in bones (vertebrae and femur) corresponding to Hounsfield units of 200 and 300. The study aims to investigate changes in osteoporosis during a 5-year follow-up period and its relationship with extraosseous calcification. Results and Considerations: While extraosseous calcification demonstrated a generally progressive nature, often resistant to medical treatment, the degree of osteoporotic change varied among patients. The majority exhibited continuous osteoporotic changes, while some showed improvement or minimal changes in bone calcification. Variations in the distribution and magnitude of osteoporotic changes were observed between groups based on the timing of hemodialysis initiation during the study. The former group tended to display more osteoporotic changes, possibly attributed to differences in medication between the groups. Other contributing factors may include the patient's age, duration of dialysis, or causes of renal disease. In conclusion, we emphasize the importance of carefully monitoring calcium and phosphate levels and maintaining adequate dialysis therapy to prevent osteoporosis in dialysis patients.

Keywords: CKD-MBD, dialysis, calcification, kidney

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Authors: Ekta Jain, Kalpana Dahiya, Vanita Verma

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This paper discusses a priority based imbalanced time minimization assignment problem dealing with the allocation of n jobs to m < n persons in which the project is carried out in two stages, viz. Stage-I and Stage-II. Stage-I consists of n1 ( < m) primary jobs and Stage-II consists of remaining (n-n1) secondary jobs which are commenced only after primary jobs are finished. Each job is to be allocated to exactly one person, and each person has to do at least one job. It is assumed that nature of the Stage-I jobs is such that one person can do exactly one primary job whereas a person can do more than one secondary job in Stage-II. In a particular stage, all persons start doing the jobs simultaneously, but if a person is doing more than one job, he does them one after the other in any order. The aim of the proposed study is to find the feasible assignment which minimizes the total time for the two stage execution of the project. For this, an iterative algorithm is proposed, which at each iteration, solves a constrained imbalanced time minimization assignment problem to generate a pair of Stage-I and Stage-II times. For solving this constrained problem, an algorithm is developed in the current paper. Later, alternate combinations based method to solve the priority based imbalanced problem is also discussed and a comparative study is carried out. Numerical illustrations are provided in support of the theory.

Keywords: assignment, imbalanced, priority, time minimization

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Authors: Surita Maini, Sanjay Dhanka

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Machine learning (ML) involves developing algorithms and statistical models that enable computers to learn and make predictions or decisions based on data without being explicitly programmed. Because of its unlimited abilities ML is gaining popularity in medical sectors; Medical Imaging, Electronic Health Records, Genomic Data Analysis, Wearable Devices, Disease Outbreak Prediction, Disease Diagnosis, etc. In the last few decades, many researchers have tried to diagnose Breast Cancer (BC) using ML, because early detection of any disease can save millions of lives. Working in this direction, the authors have proposed a hybrid ML technique RBF SVM, to predict the BC in earlier the stage. The proposed method is implemented on the Breast Cancer UCI ML dataset with 569 instances and 32 attributes. The authors recorded performance metrics of the proposed model i.e., Accuracy 98.24%, Sensitivity 98.67%, Specificity 97.43%, F1 Score 98.67%, Precision 98.67%, and run time 0.044769 seconds. The proposed method is validated by K-Fold cross-validation.

Keywords: breast cancer, support vector classifier, machine learning, hyper parameter tunning

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Authors: Zakirul Islam, Yugo Kumokawa, Quoc Thinh Tran, Motoki Kubo

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Clubroot is a disease of cruciferous plant caused by soil born pathogen Plasmodiophora brassicae and can significantly limit the production through rapid spreading. The present study was designed to investigate the effect of cultivation practices (chemical and organic soils) on clubroot disease development in Brassica rapa. Disease index and root bacterial composition were investigated for both chemical and organic soils. The bacterial biomass and diversity in organic soil were higher than those in chemical soil. Disease severity was distinct for two different cultivation methods. The number of endophytic bacteria decreased in the infected root for both soils. The increased number of endophytic bacterial number led to reduce the proliferation of pathogen spore inside the root and thus reduced the disease severity in organic plants.

Keywords: clubroot disease, bacterial biomass, root infection, disease index, chemical cultivation, organic cultivation

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Authors: Fathia Ehmouda Zaid, Reim Abudelnbi

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Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Patients and method: Cross-section study (68) patients diagnosed as systemic lupus erythematosus (SLE), who visited the outpatient clinic of rheumatology, these patients were interviewed with a structured questionnaire about their past and current clinically for presence of Cardiovascular disease in systemic lupus and use SLEDAI, specific tests [ECG –ECHO –CXRAY] the data are analyzed statistically by Pearson's correlation coefficient was calculated and statistical significance was defined as P< 0.05,during period (2013-2014). Objective: Estimation Cardiovascular disease manifestation of systemic lupus erythematosus, correlation with disease activity, morbidity, and mortality. Result: (68) Patients diagnosed as systemic lupus erythematosus' age range from (18-48 years), M=(13±29Y), Sex were female 66/68 (97.1%), male 2/68 (2.9%),duration of disease range[1-15year], M =[7±8y], we found Cardiovascular disease manifestation of systemic lupus erythematosus 32/68 (47.1%), correlation with disease activity use SLEDAI,(r= 476** p=0.000),Morbidity,(r= .554**; p=0.000) and mortality (r=.181; p=.139), Cardiovascular disease manifestations of systemic lupus erythematosus are pericarditis 8/68 (11.8%), pericardial effusion 6/68 (8.8%), myocarditis 4/68 (5.9 %), valvular lesions (endocarditis) 1/68 (1.5%), pulmonary hypertension (PAH) 12/68 (17.6%), coronary artery disease 1/68 (1.5%), none of patients have conduction abnormalities involvement. Correlation with disease activity use SLEDAI, pericarditis (r= .210, p=.086), pericardial effusion (r= 0.079, p=.520), myocarditis (r= 272*, p=.027), valvular lesions (endocarditis) (r= .112, p= .362), pulmonary hypertension (PAH) (r= .257*, p=.035) and coronary artery disease (r=.075, p=.544) correlation between cardiovascular disease manifestations of systemic lupus erythematosus and specific organ involvement we found Mucocutaneous (r=.091 p= .459), musculoskeletal (MSK) (r=.110 p=.373), Renal disease (r=.278*, p=.022), neurologic disease (r=.085, p=.489) and Hematologic disease (r=-.264*, p=.030). Conclusion: Cardiovascular manifestation is more frequent symptoms with systemic lupus erythematosus (SLE) is 47 % correlation with disease activity and morbidity but not with mortality. Recommendations: Focus research to evaluation and an adequate assessment of cardiovascular complications on the morbidity and mortality of the patients with SLE are still required.

Keywords: cardiovascular disease, systemic lupus erythematosus, disease activity, mortality

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Authors: Pardis Abolghasemi, Benyamin Hatamsaz

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Background: Diabetic nephropathy is a serious health problem described by specific kidney structure and functional disturbance. Renoprotective effects of the stem cells secretase have been shown in many kidney diseases. The aim is to evaluate the capability of human Wharton’s jelly mesenchymal stem cells conditioned media (hWJMSCs-CM) to alleviate DN in streptozotocin (STZ)-induced diabetes. Methods: Diabetic nephropathy was induced by injection of STZ (60 mg/kg, IP) in twenty rats. Conditioned media was extracted from hWJMSCs at third passages. At week 8, diabetic rats were divided into two groups: treated (hWJMSCs-CM, 500 μl/rat for three weeks, IP) and not treated (DN). In the 11th week, three groups (control, DN and DN+hWJMSCs-CM) were kept in metabolic cages and urine was collected for 24h. Blood pressure (BP) and heart rate (HR) were continuously recorded. The serum samples were maintained for measuring BUN, Cr and angiotensin-converting enzyme (ACE) activity. The left kidney was kept at -80°C for ACE activity assessment. The right kidney and pancreas were used for histopathologic evaluation. Result: Diabetic nephropathy was detected by microalbuminuria and increased albumin/creatinine ratio, as well as the pancreas and renal structural disturbance. Glomerular filtration rate, BP and HR increased in the DN group. The ACE activity was elevated in the serum and kidneys of the DN group. Administration of hWJMSCs-CM modulated the renal functional and structural disturbance and decreased the ACE activity. Conclusion: Conditioned media was extracted from hWJMSCs may have a Renoprotective effect in diabetic nephropathy. This may happen through regulation of ACE activity and renin-angiotensin system inhibition.

Keywords: diabetic nephropathy, mesenchymal stem cells, immunomodulation, anti-inflammation

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Authors: Berrin Şentürk

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In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

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Authors: Lai Tzu-Hsuan, Lai Jung-Nien, Lin Jaung-Geng, Kao Shung-Te, Hsuan-Kuang Jung

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Background: Whether acupuncture therapy contributes to preserving residual renal function (RRF) remains largely unknown. This case series evidenced the potential beneficial effects of acupuncture for preserving RRF in five patients with the end-stage renal disease under hemodialysis (HD) treatment. Participants: Five patients on HD receiving eight sessions of weekly 30-min interdialytic acupuncture (Inter-A) with residual urine volume (rUV) and residual glomerular filtration rate (rGFR) recorded once every two weeks were included for analysis. Outcomes: Changes in rUV and rGFR calculated using 24-hour urine collection data were analyzed to assess RRF. Variations in hemoglobin, urea Kt/V and serum albumin levels measured monthly were analyzed to evaluate HD adequacy. Results: After eight Inter-A sessions, mean (standard deviation (SD)) rUV and rGFR increased from 612 (184) ml/day and 1.48 (.94) ml/min/1.73 m2 at baseline to 803(289) ml/day and 2.04(1.17) ml/min/1.73m2 at 2- and 4-week follow-up, respectively. The mean percentage difference increased by 31% in rUV and 38% in rGFR. Routine measurements on HD adequacy also showed improvement. Conclusions: Acupuncture might be an optional add-on treatment for HD population with poor control of water; however, further well-designed controlled trials are warranted.

Keywords: end-stage renal disease, hemodialysis, acupuncture, residual renal function, residual urine volume

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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Authors: Yasuyuki Takahashi, Genta Hoshi, Kyoko Saito

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Objectives: The objective of this study was to evaluate the reproducibility of I-123-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4- iodophenyl) nortropane (I-123 FP-CIT) SPECT by using specific binding ratio (SBR) in phantom studies and Parkinson’s Disease (PD) patients. Methods: We made striatum phantom originally and confirmed reproducibility. The phantom studies changed head position and accumulation of FP-CIT, each. And image processing confirms influence on SBR by 30 cases. 30 PD received a SPECT for 3 hours post injection of I-123 FP-CIT 167MBq. Results: SBR decreased in rotatory direction by the patient position by the phantom studies. And, SBR improved the influence after the attenuation and the scatter correction in the cases (y=0.99x+0.57 r2=0.83). However, Stage II recognized dispersion in SBR by low accumulation. Conclusion: Than the phantom studies that assumed the normal cases, the SPECT image after the attenuation and scatter correction had better reproducibility.

Keywords: 123I-FP-CIT, specific binding ratio, Parkinson’s disease

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Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

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Authors: Ahmed Abdallatif

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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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Authors: H. Parameshwar Naik, Shripad Kulkarni

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Powdery mildew is a serious disease among the fungal in high humid areas with varied temperature conditions. In recent days disease becomes very severe due to uncertain weather conditions and unique character of the disease is, it produces white mycelia growth on upper and lower leaf surfaces and in severe conditions it leads to defoliation. Results of the experiment revealed that sowing of crop in the I fortnight (FN) of July recorded the minimum mean disease severity (7.96 %) followed by crop sown in II FN of July (13.19 %) as against the crop sown in II FN of August (41.44 %) and I FN of September (33.78 %) and the I fortnight of October (33.77 %). In the first date of sowing infection started at 45 DAS and progressed till 73 DAS and it was up to 14.66 Percent and in second date of sowing disease progressed up to 22.66 percent and in the third date of sowing, it was up to 59.35 percent. Afterward, the disease started earlier and progressed up to 66.15 percent and in sixth and seventh date of sowing disease progressed up to 43.15 percent and 59.85 percent respectively. Disease progress is very fast after 45 days after sowing and highest disease incidence was noticed at 73 DAS irrespective of dates of sowing. From the results of the present study, it is very clear that disease development will be very high if crop sown in between 1st fortnight of August and the 1st fortnight of September.

Keywords: cucumber, India, Karnataka, powdery mildew

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Authors: Hanen Bouaziz, Moez Rafrafi, Ghada Ben Salah, Kamel Jamoussi, Tahia Boudawara, Najiba Zeghal

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The present study investigated the protective role of Hyparrhenia hirta against sodium nitrate (NaNO3)-induced nephrotoxicity. A high-performance liquid chromatography coupled with a mass spectrometer (HPLC-MS) method was developed to separate and identify flavonoids in Hyparrhenia hirta. Seven flavonoids were identified as 3-O-methylquercetin, luteolin-7-O-glucoside, luteolin, apigenin-7-O-glucoside, apigenin-8-C-glucoside, luteolin-8-C-glucoside and luteolin-6-C-glucoside. Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered either alone in drinking water or co-administered with Hyparrhenia hirta. NaNO3 treatment induced a significant increase in plasma levels of creatinine, urea and uric while urinary level decreased significantly. Nephrotoxicity induced by NaNO3 was characterized by significant increase in creatinine clearance. In parallel, a significant increase in malondialdehyde level along with a concomitant decrease in total glutathione content and superoxide dismutase, catalase and glutathione peroxidase activities were observed in the kidney after NaNO3 treatment. The histopathological changes in kidney after NaNO3 administration were shrunken. There were renal tubule cell degeneration and infiltration of mononuclear cells. Most glomeruli revealed shrinkage, a wide capsular space and a peri-glomerular mononuclear cells infiltration. Hyparrhenia hirta supplementation showed a remarkable amelioration of the abnormalities cited above. The results concluded that the treatment with Hyparrhenia hirta had a significant role in protecting the animals from nitrate-induced kidney dysfunction.

Keywords: flavonoids, hyparrhenia hirta, kidney, nitrate toxicity, oxidative stress, rat

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Authors: Agi Sunday

Abstract:

A descriptive analysis of reported cases of sickle cell disease and the level of awareness about genetic counselling in 30 hospitals were carried out. Additionally, 150 individuals between ages 16-45 were randomly selected for evaluation of genetic counselling awareness. The main tools for this study were questionnaires which were taken to hospitals, and individuals completed the others. The numbers of reported cases of sickle cell disease recorded in private, public and teaching hospitals were 14 and 57; 143 and 89; 272 and 57 for the periods of 1995-2000 and 2001-2005, respectively. A general informal genetic counselling took place mostly in the hospitals visited. 122 (86%) individuals had the knowledge of genetic disease and only 43 (30.3%) individuals have been exposed to genetic counselling. 64% of individuals agreed that genetic counselling would help in the prevention of genetic disease.

Keywords: sickle disease, genetic counseling, genetic testing, advocacy

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Authors: Achitphol Chookaew, Paramee Thongsukhsai, Patamarerk Engsontia, Narongwit Nakwan, Pritsana Raugrut

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Lung cancer is one of the most common malignancies and primary cause of death due to cancer worldwide. Non-small cell lung cancer (NSCLC) is the main subtype in which majority of patients present with advanced-stage disease. Herein, we analyzed differentially expressed genes to find potential biomarkers for lung cancer diagnosis as well as prognostic markers. We used transcriptome data from our 2 NSCLC patients and public data (GSE81089) composing of 8 NSCLC and 10 normal lung tissues. Differentially expressed genes (DEGs) between NSCLC and normal tissue and between early-stage and late-stage NSCLC were analyzed by the DESeq2. Pairwise correlation was used to find the DEGs with false discovery rate (FDR) adjusted p-value £ 0.05 and |log2 fold change| ³ 4 for NSCLC versus normal and FDR adjusted p-value £ 0.05 with |log2 fold change| ³ 2 for early versus late-stage NSCLC. Bioinformatic tools were used for functional and pathway analysis. Moreover, the top ten genes in each comparison group were verified the expression and survival analysis via GEPIA. We found 150 up-regulated and 45 down-regulated genes in NSCLC compared to normal tissues. Many immnunoglobulin-related genes e.g., IGHV4-4, IGHV5-10-1, IGHV4-31, IGHV4-61, and IGHV1-69D were significantly up-regulated. 22 genes were up-regulated, and five genes were down-regulated in late-stage compared to early-stage NSCLC. The top five DEGs genes were KRT6B, SPRR1A, KRT13, KRT6A and KRT5. Keratin 6B (KRT6B) was the most significantly increased gene in the late-stage NSCLC. From GEPIA analysis, we concluded that IGHV4-31 and IGKV1-9 might be used as diagnostic biomarkers, while KRT6B and KRT6A might be used as prognostic biomarkers. However, further clinical validation is needed.

Keywords: differentially expressed genes, early and late-stages, gene ontology, non-small cell lung cancer transcriptomics

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Authors: Yash Jain

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The US Center for Disease Control has recommended wearing masks to slow the spread of the virus. The research uses a video feed from a camera to conduct real-time classifications of whether or not a human is correctly wearing a mask, incorrectly wearing a mask, or not wearing a mask at all. Utilizing two distinct datasets from the open-source website Kaggle, a mask detection network had been trained. The first dataset that was used to train the model was titled 'Face Mask Detection' on Kaggle, where the dataset was retrieved from and the second dataset was titled 'Face Mask Dataset, which provided the data in a (YOLO Format)' so that the TinyYoloV3 model could be trained. Based on the data from Kaggle, two machine learning models were implemented and trained: a Tiny YoloV3 Real-time model and a two-stage neural network classifier. The two-stage neural network classifier had a first step of identifying distinct faces within the image, and the second step was a classifier to detect the state of the mask on the face and whether it was worn correctly, incorrectly, or no mask at all. The TinyYoloV3 was used for the live feed as well as for a comparison standpoint against the previous two-stage classifier and was trained using the darknet neural network framework. The two-stage classifier attained a mean average precision (MAP) of 80%, while the model trained using TinyYoloV3 real-time detection had a mean average precision (MAP) of 59%. Overall, both models were able to correctly classify stages/scenarios of no mask, mask, and incorrectly worn masks.

Keywords: datasets, classifier, mask-detection, real-time, TinyYoloV3, two-stage neural network classifier

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Authors: Chariya Laohavich

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At the current, the trends in the lung disease at a university hospital are the treat and diagnosis by bronchoscopy. Bronchoscopic cryotherapy is a long time procedure 1-4 hours. The cryo probe is sensitive and easy to be damaged and expensive. We have this study management for protection the cryo probe, user satisfaction and qualities work. This study conducted in 4 stages: stage 1 for a survey of problems and assessment of user’s needs; stage 2 for designing and developing the Rama-chest cryo arm for a bronchoscopy process; stage 3 for test-implementing the Rama-chest cryo arm in real situations, studying its problems and obstacles, and evaluating the user satisfaction; and stage 4 for an overall assessment and improvement. The sample used in this study consisted of a total of 15 Ramathipbodi Hospital’s Bronchoscopist and bronchoscopist’s nurse who had used the Rama-chest cryo arm for bronchoscopic cryotherapy from January to June 2016. Objective: To study efficacy and user satisfaction on the Rama-chest cryo arm innovation for bronchoscopic cryotherapy. Data were collected using a Rama-chest cryo arm satisfaction assessment form and analysed based on mean and standard deviation. Result is the Rama-chest cryo arm was an innovation that accommodated during bronchoscopic cryotherapy. The subjects rated this the cryo arm as being most satisfactory (M = 4.86 ± , SD 0.48. Therefore we have developed a cryo arm that uses local material, practical and economic. Our innovation is not only flexible and sustainable development but also lean and seamless. This produced device can be used as effectively as the imported one, and thus can be eventually substituted.

Keywords: efficacy, satisfaction, Rama-chest cryo arm, innovation, bronchoscopic cryotherapy

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Authors: Farzaneh Ziaee, Mohammad Ziaee

Abstract:

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

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

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Authors: Shraddha Gopal, Jayam Lazarus

Abstract:

Aims: To study the referral practice and impact of DAT-scan in the diagnosis or exclusion of Parkinson’s disease. Settings and Designs: A retrospective study Materials and methods: A retrospective study of the results of 60 patients who were referred for a DAT scan over a period of 2 years from the Department of Neurology at Northern Lincolnshire and Goole NHS trust. The reason for DAT scan referral was noted under 5 categories against Parkinson’s disease; drug-induced Parkinson’s, essential tremors, diagnostic dilemma, not responding to Parkinson’s treatment, and others. We assessed the number of patients who were diagnosed with Parkinson’s disease against the number of patients in whom Parkinson’s disease was excluded or an alternative diagnosis was made. Statistical methods: Microsoft Excel was used for data collection and statistical analysis, Results: 30 of the 60 scans were performed to confirm the diagnosis of early Parkinson’s disease, 13 were done to differentiate essential tremors from Parkinsonism, 6 were performed to exclude drug-induced Parkinsonism, 5 were done to look for alternative diagnosis as the patients were not responding to anti-Parkinson medication and 6 indications were outside the recommended guidelines. 55% of cases were confirmed with a diagnosis of Parkinson’s disease. 43.33% had Parkinson’s disease excluded. 33 of the 60 scans showed bilateral abnormalities and confirmed the clinical diagnosis of Parkinson’s disease. Conclusion: DAT scan provides valuable information in confirming Parkinson’s disease in 55% of patients along with excluding the diagnosis in 43.33% of patients aiding an alternative diagnosis.

Keywords: DATSCAN, Parkinson's disease, diagnosis, essential tremors

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