Search results for: chronic pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2182

Search results for: chronic pain

682 Genetics of Atopic Dermatitis: Role of Cytokines Genes Polymorphisms

Authors: Ghaleb Bin Huraib, Fahad Al Harthi, Misbahul Arfin, Abdulrahman Al-Asmari

Abstract:

Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin disease characterized by severe itching and recurrent relapsing eczema-like skin lesions, affecting up to 20% of children and 10% of adults in industrialized countries. AD is a complex multifactorial disease, and its exact etiology and pathogenesis have not been fully elucidated. The aim of this study was to investigate the impact of gene polymorphisms of T helper cell subtype Th1 and Th2 cytokines, interferon-gamma (IFN-γ), interleukin-6 (IL-6) and transforming growth factor (TGF)-β1on AD susceptibility in a Saudi cohort. One hundred four unrelated patients with AD and 195 healthy controls were genotyped for IFN-γ (874A/T), IL-6 (174G/C) and TGF-β1 (509C/T) polymorphisms using ARMS-PCR and PCR-RFLP technique. The frequency of genotypes AA and AT of IFN-γ (874A/T) differed significantly among patients and controls (P 0.001). The genotype AT was increased while genotype AA was decreased in AD patients as compared to controls. AD patients also had higher frequency of T containing genotypes (AT+TT) than controls (P = 0.001). The frequencies of allele T and A were statistically different in patients and controls (P = 0.04). The frequencies of genotype GG and allele G of IL-6 (174G/C) were significantly higher while genotype GC and allele C were lower in AD patients than controls. There was no significant difference in the frequencies of alleles and genotypes of TGF-β1 (509C/T) polymorphism between patient and control groups. These results showed that susceptibility to AD is influenced by presence or absence of genotypes of IFN-γ (874A/T) and IL-6 (174G/C) polymorphisms. It is concluded that T-allele and T-containing genotypes (AT+TT) of IFN-γ (874A/T) and G-allele and GG genotype ofIL-6 (174G/C) polymorphisms are susceptible to AD in Saudis.On the other hand, the TGF-β1 (509C/T) polymorphism may not be associated with AD risk in Saudi population however further studies with large sample size are required to confirm these findings.

Keywords: atopic dermatitis, interferon-γ, interleukin-6, transforming growth factor-β1, polymorphism

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681 Lucilia Sericata Netrin-A: Secreted by Salivary Gland Larvae as a Potential to Neuroregeneration

Authors: Hamzeh Alipour, Masoumeh Bagheri, Tahereh Karamzadeh, Abbasali Raz, Kourosh Azizi

Abstract:

Netrin-A, a protein identified for conducting commissural axons, has a similar role in angiogenesis. In addition, studies have shown that one of the netrin-A receptors is expressed in the growing cells of small capillaries. It will be interesting to study this new group of molecules because their role in wound healing will become clearer in the future due to angiogenesis. The greenbottle blowfly Luciliasericata (L. sericata) larvae are increasingly used in maggot therapy of chronic wounds. This aim of this was the identification of moleculareatures of Netrin-A in L. sericata larvae. Larvae were reared under standard maggotarium conditions. The nucleic acid sequence of L. sericataNetrin-A (LSN-A) was then identified using Rapid Amplification of cDNA Ends (RACE) and Rapid Amplification of Genomic Ends (RAGE). Parts of the Netrin-A gene, including the middle, 3′-, and 5′-ends were identified, TA cloned in pTG19 plasmid, and transferred into DH5ɑ Escherichia coli. Each part was sequenced and assembled using SeqMan software. This gene structure was further subjected to in silico analysis. The DNA of LSN-A was identified to be 2407 bp, while its mRNA sequence was recognized as 2115 bp by Oligo0.7 software. It translated the Netrin-A protein with 704 amino acid residues. Its molecular weight is estimated to be 78.6 kDa. The 3-D structure ofNetrin-A drawn by SWISS-MODEL revealed its similarity to the Netrin-1 of humans with 66.8% identity. The LSN-A protein conduces to repair the myelin membrane in neuronal cells. Ultimately, it can be an effective candidate in neural regeneration and wound healing. Furthermore, our next attempt is to deplore recombinant proteins for use in medical sciences.

Keywords: maggot therapy, netrin-A, RACE, RAGE, lucilia sericata

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680 Policy and System Research for Health of Ageing Population

Authors: Sehrish Ather

Abstract:

Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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679 Nursing System Development in Patients Undergoing Operation in 3C Ward: Early Ambulation in Patients with Head and Neck Cancer

Authors: Artitaya Sabangbal, Darawan Augsornwan, Palakorn Surakunprapha, Lalida Petphai

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Background: Srinagarind Hospital Ward 3C has about 180 cases of patients with head and neck cancer per year. Almost all of these patients suffer with pain, fatigue, low self image, swallowing problem and when the tumor is larger they will have breathing problem. Many of them have complication after operation such as pressure sore, pneumonia, deep vein thrombosis. Nursing activity is very important to prevent the complication especially promoting patients early ambulation. The objective of this study was to develop early ambulation protocol for patients with head and neck cancer undergoing operation. Method: this study is one part of nursing system development in patients undergoing operation in Ward 3C. It is a participation action research divided into 3 phases Phase 1 Situation review: In this phase we review the clinical outcomes, process of care, from document such as nurses note and interview nurses, patients and family about early ambulation. Phase 2 Searching nursing intervention about early ambulation from previous study then establish protocol . This phase we have picture package of early ambulation. Phase 3 implementation and evaluation. Result: Patients with head and neck cancer after operation can follow early ambulation protocol 100%, 85 % of patients can follow protocol within 2 days after operation and 100% can follow protocol within 3 days. No complications occur. Patients satisfaction in very good level is 58% and in good level is 42% Length of hospital stay is 6 days in patients with wide excision and 16 day in patients with flap coverage. Conclusion: The early ambulation protocol is appropriate for patients with head and neck cancer who undergo operation. This can restore physical health, reduce complication and increase patients satisfaction.

Keywords: nursing system, early ambulation, head and neck cancer, operation

Procedia PDF Downloads 206
678 ADCOR © Muscle Damage Rapid Detection Test Based on Skeletal Troponin I Immunochromatography Reaction

Authors: Muhammad Solikhudin Nafi, Wahyu Afif Mufida, Mita Erna Wati, Fitri Setyani Rokim, M. Al-Rizqi Dharma Fauzi

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High dose activity without any pre-exercise will impact Delayed Onset Muscle Soreness (DOMS). DOMS known as delayed pain post-exercise and induce skeletal injury which will decrease athletes’ performances. From now on, post-exercise muscle damage can be detected by measuring skeletal troponin I (sTnI) concentration in serum using ELISA but this method needs more time and cost. To prevent decreased athletes performances, screening need to be done rapidly. We want to introduce our new prototype to detect DOMS acutely. Rapid detection tests are based on immunological reaction between skeletal troponin I antibodies and sTnI in human serum or whole blood. Chemical methods that are used in the manufacture of diagnostic test is lateral flow immunoassay. The material used is rat monoclonal antibody sTnI, colloidal gold, anti-mouse IgG, nitrocellulose membrane, conjugate pad, sample pad, wick and backing card. The procedure are made conjugate (colloidal gold and mAb sTnI) and insert into the conjugate pad, gives spray sTnI mAb and anti-mouse IgG into nitrocellulose membrane, and assemble RDT. RDT had been evaluated by measuring the sensitivity of positive human serum (n = 30) and negative human serum (n = 30). Overall sensitivity value was 93% and specificity value was 90%. ADCOR as the first rapid detection test qualitatively showed antigen-antibody reaction and showed good overall performances for screening of muscle damage. Furthermore, these finding still need more improvements to get best results.

Keywords: DOMS, sTnI, rapid detection test, ELISA

Procedia PDF Downloads 492
677 The Consumption of Sodium and Fat from Processed Foods

Authors: Pil Kyoo Jo, Jee Young Kim, Yu Jin Oh, Sohyun Park, Young Ha Joo, Hye Suk Kim, Semi Kang

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When convenience drives daily food choices, the increased consumption of processed foods may be associated with the increased intakes of sodium and fat and further with the onset of chronic diseases. The purpose of this study was to investigate the levels of sodium, saturated fat, and calories intakes through processed foods and the dietary patterns among adult populations in South Korea. We used the nationally representative data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES, 2010-2012) and a cross-sectional survey on the eating behaviors among university students(N=893, 380 men, 513 women) aged from 20 to 24 years. Results showed that South Koreans consumed 43.5% of their total food consumption from processed foods. The 24-hour recalls data showed that 77% of sodium, 60% of fats, 59% of saturated fat, and 44% of calories were consumed from processed food. The intake of processed foods increased by 1.7% in average since 2008 annually. Only 33% of processed food that respondents consumed had nutrition labeling. The data from university students showed that students selected processed foods in convenience store when eating alone compared to eating with someone else. Given the convenience and lack of time, more people will consume processed foods and it may impact their overall dietary intake and further their health. In order to help people to make healthier food choices, regulations and policies to reduce the potentially unhealthy nutrients of processed foods should be strengthened. This research was supported by the National Research Foundation of Korea for 2011 Korea-Japan Basic Scientific Cooperation Program. This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B6037369).

Keywords: sodium, fat, processed foods, diet trends

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676 Melatonin Rescue Fungicide Induced Behavioral and Reproductive Abnormalities through Changes of Dopaminergic Activity in the Brain of Catfish, Mystus cavasisu

Authors: Muhammad Badruzzaman, Alif Hasan, Md. Shahjahan

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Propiconazole is a triazole fungicide extensively used in agriculture which can harm to non-target organisms in aquatic environment through runoff. Chronic exposure to environmental pesticides turn to behavioral impairment in vertebrates including teleosts. However, the potential effect of this fungicide on neurobehavioral impairment and release from it in vertebrates has not been fully explored. In this work, we examined the role of melatonin to rescue fungicide induced neurobehavioral and reproductive alternation and its connection with changes in dopaminergic activity in the brain of Mystus cavasius. After fish were exposed to water containing propiconazole at 0, 0.1, 5, and 250 µg/L for 3 days, significant increases of DA, 3,4-dihydroxyphenylacetic acid (DOPAC; a DA metabolite), and their ratio (DOPAC/DA) were observed in whole brain at 250 µg/L concentration. When fish were treated with propiconazole at 250 µg/L for 3 days, there was a significant elevation of DA, DOPAC and DOPAC/DA in diencephalon and pituitary, and only DA in the telencephalon, compared with control fish. Besides, it induced a reduction in extracellular serotonin and had an anxiolytic-like effect, supported by a decrease in cortisol production. Increased locomotor activity, anxiety and aggressiveness, decreased gonadosomatic index with few vitellogenic oocytes in ovaries after propiconazole treatment. When fish were treated with melatonin, D1 (SCH-23390) or D2 (Haloperidol) dopamine receptor antagonists and combined of melatonin and D1/D2 receptor antagonist and was observed melatonin + D2 receptor antagonist rescued fungicide induced all behavioral changes in fish. These results indicate that propiconazole increases locomotor activity, anxiety and aggressiveness and decreases reproductive activity, which was rescued by combined treatment of melatonin and dopamine receptor antagonist.

Keywords: behavior, catfish, dopamine, fungicide, melatonin

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675 Psychometric Properties of the Eq-5d-3l and Eq-5d-5l Instruments for Health Related Quality of Life Measurement in Indonesian Population

Authors: Dwi Endarti, Susi a Kristina, Rizki Noorizzati, Akbar E Nugraha, Fera Maharani, Kika a Putri, Asninda H Azizah, Sausanzahra Angganisaputri, Yunisa Yustikarini

Abstract:

Cost utility analysis is the most recommended pharmacoeconomic method since it allows widely comparison of cost-effectiveness results from different interventions. The method uses outcome of quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Measurement of QALY requires the data of utility dan life years gained. Utility is measured with the instrument for quality of life measurement such as EQ-5D. Recently, the EQ-5D is available in two versions which are EQ-5D-3L and EQ-5D-5L. This study aimed to compare the EQ-5D-3L and EQ-5D-5L to examine the most suitable version for Indonesian population. This study was an observational study employing cross sectional approach. Data of quality of life measured with EQ-5D-3L and EQ-5D-5L were collected from several groups of population which were respondent with chronic diseases, respondent with acute diseases, and respondent from general population (without illness) in Yogyakarta Municipality, Indonesia. Convenience samples of hypertension patients (83), diabetes mellitus patients (80), and osteoarthritis patients (47), acute respiratory tract infection (81), cephalgia (43), dyspepsia (42), and respondent from general population (293) were recruited in this study. Responses on the 3L and 5L versions of EQ-5D were compared by examining the psychometric properties including agreement, internal consistency, ceiling effect, and convergent validity. Based on psychometric properties tests of EQ-5D-3L dan EQ-5D-5L, EQ-5D-5L tended to have better psychometric properties compared to EQ-5D-3L. Future studies for health related quality of life (HRQOL) measurements for pharmacoeconomic studies in Indonesia should apply EQ-5D-5L.

Keywords: EQ-5D, Health Related Quality of Life, Indonesian Population, Psychometric Properties

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674 Comparative Study in Treatment of Distal Humerus Fracture with Lateral Column Plate Percutaneous Medial Screw and Intercondylar Screw

Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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673 The Nutritional Status and the Kidney Function in Older Patients

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Background: Obesity, particularly abdominal type, lead to accelerated progress of atherosclerosis and thus affects the functioning of various human organs. Non-HDL cholesterol includes residual risk of the cardiovascular diseases which persists in patients after achieved recommended level of LDL cholesterol. The maintenance of normal body mass index plays a particularly important role in both the prevention and treatment of chronic diseases. Materials and Methods: The study covered 96 patients (55 females, 42 males, age 66,9 +/-10,2 years). The nutritional status was determined with the Waist to Height Ratio (WHtR) and the Waist to Hip Ratio (WHR). A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using the MDRD formula. Non-high-density lipoprotein cholesterol (non-HDL) is simply the difference between the total cholesterol concentration and the HDL cholesterol concentration. Results: The higher was level of non-HDL cholesterol, the lower eGFR had studied subjects (p<0.001). Significant correlation was found between higher WHtR and lower the eGFR (p=0.002). Also underweight (30% of patient) led to obtaining lower values of eGFR in subjects over 65 years old. The poorer nutrition the lower was glomerular filtration rate. Conclusions: Nutritional statuses of patients have a significant impact on the level of kidney function. Not only accumulated excess fat in the abdominal area, but also its deficiency affects the deterioration in renal filtration. Higher level of non-HDL not only raises the residual risk of the heart disease but also influences on kidney by worsening eGFR. Proper diet in connection with physical activity should lead to achieving good nutrition in these patients and protect their kidney function.

Keywords: nutrition, non-HDL cholesterol, glomerular filtration rate, lifestyle

Procedia PDF Downloads 248
672 Effect of a Polyherbal Gut Therapy Protocol in Changes of Gut and Behavioral Symptoms of Antibiotic Induced Dysbiosis of Autistic Babies

Authors: Dinesh K. S., D. R. C. V. Jayadevan

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Autism is the most prevalent of a subset of the disorders organized under the umbrella of pervasive developmental disorders. After the publication of Andrew Wakefield's paper in lancet, many critiques deny this connection even without looking in to the matter. The British Medical Journal even put an editorial regarding this issue. BMJ 2010; 340:c1807. But ayurveda has ample of evidences to believe this connectivity. Dysbiosis, yeast growth of the gut, nutritional deficiencies, enzyme deficiencies, essential fatty acid deficiencies, Gastro esophageal reflux disease, indigestion, inflammatory bowel, chronic constipation & its cascade are few of them to note. The purpose of this paper is to present the observed changes in the behavioural symptoms of autistic babies after a gut management protocol which is a usual programme of our autism treatment plan especially after dysbiotic changes after antibiotic administration. Is there any correlation between changes (if significant) in gut symptoms and behavioral problems of autistic babies especially after a dysbiosis induced by antibiotics. Retrospective analysis of the case sheets of autistic patients admitted in Vaidyaratnam P.S.Varier Ayurveda College hospital, kottakkal,kerala, india from September 2010 are taken for the data processing. Autistic patients are used to come to this hospital as a part of their usual course of treatment. We investigated 40 cases diagnosed as autistic by clinical psychologists from different institutions who had dysbiosis induced by antibiotics. Significant change in gut symptoms before and after treatment p<0.05 in most of its components Significant change in behavioral symptoms before and after treatments p<0.05 in most of the components Correlation between gut symptoms change and behavioral symptoms changes after treatment is + 0.86. Conclusion : Selected Polyherbal Ayurveda treatment has significant role to play to make changes abnormal behaviors in autistic babies and has a positive correlation with changes in gut symptoms induced by dysbiosis of antibiotic intake.

Keywords: ayurveda, autism, dysbiosis, antibiotic

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671 Effectively Improving Cognition, Behavior, and Attitude of Diabetes Inpatients through Nutritional Education

Authors: Han Chih Feng, Yi-Cheng Hou, Jing-Huei Wu

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Diabetes is a chronic disease. Nutrition knowledge and skills enable individuals with type 2 diabetes to optimize metabolic self-management and quality of life. This research studies the effect of nutritional education on diabetes inpatients in terms of their cognition, behavior, and attitude. The participants are inpatients diagnosed with diabetes at Taipei Tzu Chi Hospital. A total of 103 participants, 58 male, and 45 females, enrolled in the research between January 2018 and July 2018. The research evaluates cognition, behavior, and attitude level before and after nutritional education conducted by dietitians. The result shows significant improvement in actual consumption (2.5 ± 1.4 vs 3.8 ± 0.7; p<.001), diet control motivation (2.7 ± 0.8 vs 3.4 ± 0.6; p<.001), correct nutrition concept (1.2± 0.4 vs 2.4 ± 0.5; p<.001), learning willingness (2.7± 0.9 vs 3.4 ± 0.6; p<.001), cognitive behaviors (1.4 ± 0.5 vs 2.9 ± 0.7; p<.001). AC sugar (278.5 ± 321.5 vs 152.2 ± 49.1; p<.001) and HbA1C (10.3 ± 2.6 vs 8.6 ± 1.9; p<.001) are significant improvement after nutritional education. After nutritional education, participants oral hypoglycemic agents increased from 16 (9.2%) to 33 (19.0%), insulin decreased from 75 (43.1%) to 68 (39.1%), and hypoglycemic drugs combined with insulin decreased from 83 (47.7%) to 73 (42.0%).Further analysis shows that female inpatients have significant improvement in diet control motivation (3.91 ± 0.85 vs 4.44 ± 0.59; p<0.000), correct nutrition concept (3.24± 0.48 vs 4.47± 0.51; p<0.000), learning willingness (3.89 ± 0.86 vs 4.44 ± 0.59; p<0.000) and cognitive behaviors (2.42 ± 0.58 vs 4.02 ± 0.69; p<0.000); male inpatients have significant improvement in actual food intake (4.41± 0.92 vs 3.97 ± 0.42; p<0.000), diet control motivation (3.62 ± 0.86 vs 4.29 ± 0.62; p<0.000), correct nutrition concept (3.26 ± 0.44 vs 4.36 ± 0.49; p<0.000), learning willingness (3.72± 0.93 vs 4.33± 0.63; p<0.000) and cognitive behaviors (2.45± 0.54 vs 4.03± 0.77; p<0.000). In conclusion, nutritional education proves effective, regardless of gender, in improving an inpatient’s cognition, behavior, and attitude toward diabetes self-management.

Keywords: diabetes, nutrition education, actual consumption, diet control motivation, nutrition concept, learning willingness, cognitive behaviors

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670 Association of Maternal Age, Ethnicity and BMI with Gestational Diabetes Prevalence in Multi-Racial Singapore

Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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669 A Histopathological Study on Leech (Hirudo medicinalis) Application in the Management of Vicarcikā (Eczema)

Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

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Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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668 Anticancer Lantadene Derivatives: Synthesis, Cytotoxic and Docking Studies

Authors: A. Monika, Manu Sharma, Hong Boo Lee, Richa Dhingra, Neelima Dhingra

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Nuclear factor-κappa B serve as a molecular lynchpin that links persistent infections and chronic inflammation to increased cancer risk. Inflammation has been recognized as a hallmark and cause of cancer. Natural products present a privileged source of inspiration for chemical probe and drug design. Herbal remedies were the first medicines used by humans due to the many pharmacologically active secondary metabolites produced by plants. Some of the metabolites like Lantadene (pentacyclic triterpenoids) from the weed Lantana camara has been known to inhibit cell division and showed anti-antitumor potential. The C-3 aromatic esters of lantadenes were synthesized, characterized and evaluated for cytotoxicity and inhibitory potential against Tumor necrosis factor alpha-induced activation of Nuclear factor-κappa B in lung cancer cell line A549. The 3-methoxybenzoyloxy substituted lead analogue inhibited kinase activity of the inhibitor of nuclear factor-kappa B kinase in a single-digit micromolar concentration. At the same time, the lead compound showed promising cytotoxicity against A549 lung cancer cells with IC50 ( half maximal inhibitory concentration) of 0.98l µM. Further, molecular docking of 3-methoxybenzoyloxy substituted analogue against Inhibitor of nuclear factor-kappa B kinase (Protein data bank ID: 3QA8) showed hydrogen bonding interaction involving oxygen atom of 3-methoxybenzoyloxy with the Arginine-31 and Glutamine-110. Encouraging results indicate the Lantadene’s potential to be developed as anticancer agents.

Keywords: anticancer, lantadenes, pentacyclic triterpenoids, weed

Procedia PDF Downloads 139
667 Association between Substance Use Disorder, PTSD and the Effectiveness of Collaborative Care for Depression in Primary Care: A Systematic Literature Search and Narrative Review

Authors: J. Raub, H. Schillok, L. Kaupe, C. Jung-Sievers, G. Pitschel-Walz, M. Bühner, J. Gensichen, F. D. Pokal-Gruppe

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Introduction: In Germany, depression ranks among the top ten diseases with the highest disease burden and often occurs with comorbidities. Collaborative Care (CC), a concept developed in the United States for the primary care management of chronic diseases, has been identified as an efficient model for the treatment of depression in general medicine. A recent meta-analysis highlights research gaps regarding CC in patients with psychiatric multimorbidity. The highest prevalence of psychiatric comorbidities in depression is observed in anxiety disorders, post-traumatic stress disorder (PTSD), and substance use disorders. Methods: We conducted a literature search following the PRISMA guidelines with three components: Collaborative Care, Depression and randomized controlled trial on the common databases. We focused on the examination of psychiatric comorbidities in depression, specifically Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD). Results: During the screening process, we identified nine relevant articles related to PTSD, the number of articles related to Substance Use Disorder (SUD) was ten. We examined a total of 8,634 individuals. Our literature review did not reveal any overall significant superiority of the Collaborative Care model compared to Usual Care in patients with depression with comorbid Substance Use Disorder (SUD) or Posttraumatic Stress Disorder (PTSD). Discussion: Five studies demonstrate a faster and statistically significant improvement in depression outcomes among patients with Substance Use Disorder (SUD) and Posttraumatic Stress Disorder (PTSD). Currently, several randomized controlled trials on the topic of Collaborative Care in depression with psychiatric comorbidity are ongoing, such as miCare, Claro and COMET.

Keywords: Depression, primary care, collaborative care, PTSD, Substance use Disorder

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666 Retrospective Study on the Prognosis of Patients with New-Onset Atrial Fibrillation to Evaluate the Risk of Developing Occult Cancer in Absence of Concurrent Chronic Inflammatory Disease

Authors: Helen Huang, Francisco Javier Quesada Ocet, Blanca Quesada Oce, Javier Jimenez Bello, Victor Palanca Gil, Alba Cervero Rubio, Ana Paya Chaume, Alejandro Herreros-Pomares, Fernando Vidal-Vanaclocha, Rafael Paya Serrano, Aurelio Quesada Dorador, Monica Soliman

Abstract:

Background: Cancer favors both the pro-inflammatory state and autonomic dysfunction, two important mechanisms in the genesis of AF. Atrial remodeling might be caused as a result of paraneoplastic conditions or the result of direct expression of neoplasia. Here, we hypothesize that cancer, through inflammatory mediators, may favor the appearance of AF and patients with the first episode of AF could have a higher risk of developing cancer. Method: Data was collected from patients who attended the emergency department of our hospital for the first episode of AF, diagnosed electrocardiographically, between 2010-2015 (n = 712). The minimum follow-up was 2 years, recording the appearance of cancer, total mortality, recurrences of AF and other events. Patients who developed cancer and those who did not during the 2 years after the onset of AF were compared, as well as with the incidence of cancer in Spain in 2012. Results: After 2 years, 35 patients (4.91%) were diagnosed with cancer, with an annual incidence of 2.45%. Hematological neoplasms were the most frequent (34.28%). The cancer group was older (76.68 +/-12.75 years vs 74.16 +/-12.71; p <0.05) and had fewer typical symptoms (palpitations) (33.38% vs 14.28% , p <0.05). The incidence of cancer in Spain during 2012 was 0.46%, much lower than our sample. When comparing the incidence by age, these differences were maintained both in those over 65 years of age and in those under 65 years of age (2.17% vs. 0.28%; 0.28% vs. 0.18% respectively). Discussion: Therefore, a high incidence of cancer in patients with the first episode of AF was observed (the annual incidence of 2.45% after the onset of AF is 6.1 times that of the general population). After the evaluation of patients with AF in their first detected episode, surveillance of the appearance of cancer should be considered in clinical practice.

Keywords: cancer, cardiovascular outcomes, atrial fibrillation, inflammation

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665 Time-Dependent Modulation on Depressive Responses and Circadian Rhythms of Corticosterone in Models of Melatonin Deficit

Authors: Jana Tchekalarova, Milena Atanasova, Katerina Georgieva

Abstract:

Melatonin deficit can cause a disturbance in emotional status and circadian rhythms of the endocrine system in the body. Both pharmacological and alternative approaches are applied for correction of dysfunctions driven by changes in circadian dynamics of many physiological indicators. In the present study, we tested and compare the beneficial effect of agomelatine (40 mg/kg, i.p. for 3 weeks) and endurance training on depressive behavior in two models of melatonin deficit in rat. The role of disturbed circadian rhythms of plasma melatonin and corticosterone secretion in the mechanism of these treatments was also explored. The continuous exercise program attenuated depressive responses associated with disrupted diurnal rhythm of home-cage motor activity, anhedonia in the sucrose preference test, and despair-like behavior in the forced swimming test were attenuated by agomelatine exposed to chronic constant light (CCL) and long-term exercise in pinealectomized rats. Parallel to the observed positive effect on the emotional status, agomelatine restored CCL-induced impairment of circadian patterns of plasma melatonin but not that of corticosterone. In opposite, exercise training diminished total plasma corticosterone levels and corrected its flattened pattern while it was unable to correct melatonin deficit in pinealectomy. These results suggest that the antidepressant-like effect of pharmacological and alternative approach might be mediated via two different mechanism, correction of the disturbed circadian rhythm of melatonin and corticosterone, respectively. Therefore, these treatment approaches might have a potential therapeutic application in different subpopulations of people characterized by a melatonin deficiency. This work was supported by the National Science Fund of Bulgaria (research grant # № DN 03/10; DN# 12/6).

Keywords: agomelatine, exercise training, melatonin deficit, corticosterone

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664 Night Shift Work as an Oxidative Stressor: A Systematic Review

Authors: Madeline Gibson

Abstract:

Night shift workers make up an essential part of the modern workforce. However, night shift workers have higher incidences of late in life diseases and earlier mortality. Night shift workers are exposed to constant light and experience circadian rhythm disruption. Sleep disruption is thought to increase oxidative stress, defined as an imbalance of excess pro-oxidative factors and reactive oxygen species over anti-oxidative activity. Oxidative stress can damage cells, proteins and DNA and can eventually lead to varied chronic diseases such as cancer, diabetes, cardiovascular disease, Alzheimer’s and dementia. This review aimed to understand whether night shift workers were at greater risk of oxidative stress and to contribute to a consensus on this relationship. Twelve studies published in 2001-2019 examining 2,081 workers were included in the review. Studies compared both the impact of working a single shift and in comparisons between those who regularly work night shifts and only day shifts. All studies had evidence to support this relationship across a range of oxidative stress indicators, including increased DNA damage, reduced DNA repair capacity, increased lipid peroxidation, higher levels of reactive oxygen species, and to a lesser extent, a reduction in antioxidant defense. This research supports the theory that melatonin and the sleep-wake cycle mediate the relationship between shift work and oxidative stress. It is concluded that night shift work increases the risk for oxidative stress and, therefore, future disease. Recommendations are made to promote the long-term health of shift workers considering these findings.

Keywords: night shift work, coxidative stress, circadian rhythm, melatonin, disease, circadian rhythm disruption

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663 Effect of Physical and Breathing Exercises on Quality of Life and Psychophysical Status among Haemodialysis Patients: A Scoping Review

Authors: Noof Eid Al Shammari

Abstract:

Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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662 Combined Cervical Headache Snag with Cervical Snag Half Rotation Techniques on Cervicogenic Headache Patients

Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

Abstract:

Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

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661 Spontaneous Reformation of Dehiscent Frontal Sinus Wall after Endoscopic Removal of Mucocele

Authors: Tan Dexian Arthur, James Wei Ming Kwek, Ian Loh, Lee Tee Sin

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Statement of the Problem: Mucoceles most commonly affect the frontal sinus, which results from chronic obstruction of the sinus ostium or cystic dilatation of mucous glands with ductal obstruction. They are known to cause bony erosion of the sinus walls, which can lead to large defects. These defects were typically managed by obliteration or cranialization of the frontal sinus. Although short term outcomes of conservative management of significant posterior table defects from fractures are promising, there have been no studies on the long-term outcomes of large dehiscences in the posterior wall of the frontal sinus. Methodology & Findings : Computed Tomography (CT) Paranasal Sinuses images were analyzed and found complete spontaneous osteogenesis of a large dehiscent frontal sinus posterior wall, secondary to a large mucocele, 9 years from functional endoscopic sinus surgery with the defect managed conservatively. Conclusion & Significance: The dura is well known for its osteogenic properties. Prior studies have showed that dura could induce osteogenesis in cutaneous tissue in the absence of other central nervous system structures. It was also demonstrated that osteogenesis and chondrogenesis were possible in zygomatic fractures by transplanting neonatal dura grafts to the bony defects in rats. Extrapolating from these studies, the authors postulate that the presence of dura beneath the bony deformity of the posterior frontal sinus wall had likely initiated the osteogenesis and restored the bony defect in the patient. In our literature review, we did not find any reports of spontaneous osteogenesis of large frontal sinus defects. While our experience is incidental, it reinforces the osteogenetic potential of an intact dura and further highlights that selected large defects of the posterior wall of the frontal sinus can be conservatively managed.

Keywords: paranasal sinus mucocele, mucocele, osteogenesis, dehiscence

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660 High Phosphate-Containing Foods and Beverages: Perceptions of the Future Healthcare Providers on Their Harmful Effect in Excessive Consumption

Authors: ATM Emdadul Haque

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Phosphorus is an essential nutrient which is regularly consumed with food and exists in the body as phosphate. Phosphate is an important component of cellular structures and needed for bone mineralization. Excessive accumulation of phosphate is an important driving factor of mortality in chronic renal failure patients; of relevance, these patients are usually provided health care by doctors, nurses, and pharmacists. Hence, this study was planned to determine the level of awareness of the future healthcare providers about the phosphate-containing foods and beverages and to access their knowledge on the harmful effects of excess phosphate consumption. A questionnaire was developed and distributed among the year-1 medical, nursing and pharmacy students. 432 medical, nursing and pharmacy students responded with age ranging from 18-24 years. About 70% of the respondents were female with a majority (90.7%) from Malay ethnicity. Among the respondents, 29.9% were medical, 35.4% were the pharmacy and 34.7% were nursing students. 79.2% students knew that phosphate was an important component of the body, but only 61.8% knew that consuming too much phosphate could be harmful to the body. Despite 97% of the students knew that carbonated soda contained high sugar, surprisingly 77% of them did not know the presence of high phosphate in the same soda drinks; in the similar line of observation, 67% did not know the presence of it in the fast food. However, it was encouraging that 94% of the students wanted to know more about the effects of phosphate consumption, 74.3% were willing to give up drinking soda and eating fast food, and 52% considered taking green coconut water instead of soda drinks. It is, therefore, central to take an educational initiative to increase the awareness of the future healthcare providers about phosphate-containing food and its harmful effects in excessive consumptions.

Keywords: high phosphate containing foods and beverages, excessive consumption, future health care providers, phosphorus

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659 Development, Testing, and Application of a Low-Cost Technology Sulphur Dioxide Monitor as a Tool for use in a Volcanic Emissions Monitoring Network

Authors: Viveka Jackson, Erouscilla Joseph, Denise Beckles, Thomas Christopher

Abstract:

Sulphur Dioxide (SO2) has been defined as a non-flammable, non-explosive, colourless gas, having a pungent, irritating odour, and is one of the main gases emitted from volcanoes. Sulphur dioxide has been recorded in concentrations hazardous to humans (0.25 – 0.5 ppm (~650 – 1300 μg/m3), downwind of many volcanoes and hence warrants constant air-quality monitoring around these sites. It has been linked to an increase in chronic respiratory disease attributed to long-term exposures and alteration in lung and other physiological functions attributed to short-term exposures. Sulphur Springs in Saint Lucia is a highly active geothermal area, located within the Soufrière Volcanic Centre, and is a park widely visited by tourists and locals. It is also a current source of continuous volcanic emissions via its many fumaroles and bubbling pools, warranting concern by residents and visitors to the park regarding the effects of exposure to these gases. In this study, we introduce a novel SO2 measurement system for the monitoring and quantification of ambient levels of airborne volcanic SO2 using low-cost technology. This work involves the extensive production of low-cost SO2 monitors/samplers, as well as field examination in tandem with standard commercial samplers (SO2 diffusion tubes). It also incorporates community involvement in the volcanic monitoring process as non-professional users of the instrument. We intend to present the preliminary monitoring results obtained from the low-cost samplers, to identify the areas in the Park exposed to high concentrations of ambient SO2, and to assess the feasibility of the instrument for non-professional use and application in volcanic settings

Keywords: ambient SO2, community-based monitoring, risk-reduction, sulphur springs, low-cost

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658 Comparative Study Between Two Different Techniques for Postoperative Analgesia in Cesarean Section Delivery

Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

Abstract:

Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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657 Socio-Economic Setting and Implications to Climate Change Impacts in Eastern Cape Province, South Africa

Authors: Kenneth Nhundu, Leocadia Zhou, Farhad Aghdasi, Voster Muchenje

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Climate change poses increased risks to rural communities that rely on natural resources, such as forests, cropland and rangeland, waterways, and open spaces Because of their connection to the land and the potential for climate change to impact natural resources and disrupt ecosystems and seasons, rural livelihoods and well-being are disproportionately vulnerable to climate change. Climate change has the potential to affect the environment in a number of ways that place increased stress on everyone, but disproportionately on the most vulnerable populations, including the young, the old, those with chronic illness, and the poor. The communities in the study area are predominantly rural, resource-based and are generally surrounded by public or private lands that are dominated by natural resources, including forests, rangelands, and agriculture. The livelihoods of these communities are tied to natural resources. Therefore, targeted strategies to cope will be required. This paper assessed the household socio-economic characteristics and their implications to household vulnerability to climate change impacts in the rural Eastern Cape Province, South Africa. The results indicate that the rural communities are climate-vulnerable populations as they have a large proportion of people who are less economically or physically capable of adapting to climate change. The study therefore recommends that at each level, the needs, knowledge, and voices of vulnerable populations, including indigenous peoples and resource-based communities, deserve consideration and incorporation so that climate change policy (1) ensures that all people are supported and able to act, (2) provides as robust a strategy as possible to address a rapidly changing environment, and (3) enhances equity and justice.

Keywords: climate change, vulnerable, socio-economic, livelihoods

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656 MicroRNA-211 Regulates Oxidative Phosphorylation and Energy Metabolism in Human Vitiligoa

Authors: Anupama Sahoo, Bongyong Lee, Katia Boniface, Julien Seneschal, Sanjaya K. Sahoo, Tatsuya Seki, Chunyan Wang, Soumen Das, Xianlin Han, Michael Steppie, Sudipta Seal, Alain Taieb, Ranjan J. Perera

Abstract:

Vitiligo is a common, chronic skin disorder characterized by loss of epidermal melanocytes and progressive depigmentation. Vitiligo has a complex immune, genetic, environmental, and biochemical etiology, but the exact molecular mechanisms of vitiligo development and progression, particularly those related to metabolic control, are poorly understood. Here we characterized the human vitiligo cell line PIG3V and the normal human melanocytes, HEM-l by RNA-sequencing, targeted metabolomics, and shotgun lipidomics. Melanocyte-enriched miR-211, a known metabolic switch in non-pigmented melanoma cells, was severely downregulated in vitiligo cell line PIG3V and skin biopsies from vitiligo patients, while its novel predicted targets transcriptional co-activator PGC1-α (PPARGC1A), ribonucleotide reductase regulatory subunit M2 (RRM2), and serine-threonine protein kinase TAO1 (TAOK1) were reciprocally upregulated. miR-211 binds to PGC1-α 3’UTR locus and represses it. Although mitochondrial numbers were constant, mitochondrial complexes I, II, and IV and respiratory responses were defective in vitiligo cells. Nanoparticle-coated miR-211 partially augmented the oxygen consumption rate in PIG3V cells. The lower oxygen consumption rate, changes in lipid and metabolite profiles, and increased reactive oxygen species production observed in vitiligo cells appear to be partly due to abnormal regulation of miR-211 and its target genes. These genes represent potential biomarkers and therapeutic targets in human vitiligo.

Keywords: metabolism, microRNA, mitochondria, vitiligo

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655 Physical, Psychological, and Sexual Implications of Living with Rheumatoid Arthritis among Women in Re

Authors: Anwaar Anwar Tayel

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Background: Rheumatic arthritis (RA) affect all aspects of patients' life, lead to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient's life. Aim of the study: Identify physical, psychological, and sexual implications of rheumatoid arthritis among women in reproductive age. In addition to investigating the correlations between physical functional disability, psychological problems, and sexual dysfunction.Settings: The study was conducted at Rheumatology Clinic at the Main University Hospital of Alexandria. Subjects: Purposive sample was chosen from women patients with rheumatoid arthritis to be subjects of this study (n=250). Tools: Four tools were used to collect data. Tool I: Socio-demographic questionnaire. Tool II: Stanford Health Assessment Questionnaire Disability Index (HAQ- DI). Tool III: Depression Anxiety Stress Scale (DASS). Tool IV: The Sexual Dysfunction Questionnaire (SDQ) Results: The majority of the studied women suffer from severe physical disability, extreme level of depression, anxiety, and about half of them had an extreme level of stress. Also, the majority of the studied women had a severe level of sexual dysfunction. Also, statistically significant correlations between women's physical disability index, psychological problems, and sexual dysfunction were detected. Conclusion: The findings from this study confirm that women patients with RA suffer from multiple negative implications on the physical, psychological and sexual functions. Recommendations: Provide ongoing support to the patients from the time of diagnosis throughout their care and management. To help them to manage their pain and disabilities, improve their sexual function, promote their mental health, and optimize psychosocial functioning

Keywords: pysical, spycholgical, sexual, implication, rheumatic arthritis

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654 Assessment of Hepatosteatosis Among Diabetic and Nondiabetic Patients Using Biochemical Parameters and Noninvasive Imaging Techniques

Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

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Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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653 Sexually Dimorphic Effects of Chronic Exercise and Myocytic Androgen Receptor Overexpression on Body Composition in Sprague dawley Rats

Authors: Sabrina Barsky, Ashley Monks

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In humans, exercise improves symptoms of various pathological states, although exercise adaptations seem to differ in response to sex. Skeletal muscle anabolism is thought to be regulated by androgen receptor (AR) through poorly specified mechanisms. Interactions of AR and exercise on muscle phenotype remain inconclusive in males, and undetermined in females. We hypothesized that sex differences in exercise adaptations are regulated by the androgenic system and the type of exercise performed. Here we examined interactions between a muscle-specific AR overexpression transgene (HSA-AR) and forced aerobic exercise paradigm on muscle and adipose exercise adaptation in male and female rats. We used dual-energy X-ray absorptiometry (DXA) to examine body composition adaptations post 9-week exercise protocol. We replicated the effects of HSA-AR on body composition, with males only having increased % lean mass and reduced % fat mass (P<0.05). Aerobic exercise improved lean body phenotype significantly, with lesser indices of total and % fat mass (P<0.01) in both sexes. Sex-specific effects of exercise included decreased total body mass (P<0.01) in males and increased lean mass % (P<0.001) in females. Surprisingly, neither AR manipulation nor exercise affected bone parameters in either sex. This varied response in total mass and lean mass according to exercise presents a sexually dimorphic response to exercise. Neither sex showed an interaction between HSA-AR and forced aerobic exercise on body composition. Future work is proposed to examine the effects of exercise type (aerobic versus resistance) and the role of gonadal androgens in sexually dimorphic exercise-mediated mitochondrial adaptations. This work implicates the development of sex-specific exercise therapies.

Keywords: androgen receptor, forced exercise, muscle physiology, sexual dimorphism

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