Search results for: cardiovascular department
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2291

Search results for: cardiovascular department

731 Reliability of Social Support Measurement Modification of the BC-SSAS among Women with Breast Cancer Who Undergone Chemotherapy in Selected Hospital, Central Java, Indonesia

Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

Abstract:

There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

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730 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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729 Prevalence of Cutaneous Leishmaniasis in Human Population of District Kurram, Khyber Pakhtunkhwa, Pakistan

Authors: Shah Abid

Abstract:

Leishmaniasis is a collection of zoonotic infections that affect the viscera, skin, and mucous membrane and are spread by several species of female sandflies in the subfamily phlebotominae. The study's goal was to assess the prevalence of Cutaneous Leishmaniasis in District Kurram using descriptive and cross-sectional methods. From December 2022 to May 2023, the study was carried out at Tehsil Head Quarter (THQ) Hospital, Sadda, District Kurram in the Dermatology Department. The disease was identified using a laboratory method based on clinical manifestations of leishmaniasis. A clean slide's surface was applied to the scraped-off portion of the lesions and rubbed over the blood to make a smear on the slide. The slides were methanol-fixed, stained with traditional Giemsa, and meticulously examined at high magnification to search for LD bodies. The necessary information, such as residence area, lesion kind and location, age, sex, and the total number of lesions, was meticulously acquired. During the time of the investigation, 393 instances of cutaneous leishmaniasis were observed. 1 year to 70 years old was the age range (mean age: 35.45). The age group that was most severely impacted, 16 years and older, had 23 (11.67%) children with this condition. Male to female ratio was 9.7:10. Most of the cases (n=52, 26.29%), were reported in the month of May. Majority of the patients 102 (51.77%) had lesion on face. 42 (16.73) patients had multiple lesions on their body. Face was the most common site followed by lower limbs 93 (37.05). Weekly intralesional injections of sodium stibogluconate (glucantime) were administered to all patients. Without any noticeable adverse effects, all patients had positive responses to the treatment. The condition affects adults more commonly than children, according to analysis of the combined results, and it is more common in women than in men.

Keywords: District Kurram, cutaneous leishmaniasis, zoonosis, glucantime

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728 A Multicriteria Framework for Assessing Energy Audit Software for Low-Income Households

Authors: Charles Amoo, Joshua New, Bill Eckman

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Buildings in the United States account for a significant proportion of energy consumption and greenhouse gas (GHG) emissions, and this trend is expected to continue as well as rise in the near future. Low-income households, in particular, bear a disproportionate burden of high building energy consumption and spending due to high energy costs. Energy efficiency improvements need to reach an average of 4% per year in this decade in order to meet global net zero emissions target by 2050, but less than 1 % of U.S. buildings are improved each year. The government has recognized the importance of technology in addressing this issue, and energy efficiency programs have been developed to tackle the problem. The Weatherization Assistance Program (WAP), the largest residential whole-house energy efficiency program in the U.S., is specifically designed to reduce energy costs for low-income households. Under the WAP, energy auditors must follow specific audit procedures and use Department of Energy (DOE) approved energy audit tools or software. This article proposes an expanded framework of factors that should be considered in energy audit software that is approved for use in energy efficiency programs, particularly for low-income households. The framework includes more than 50 factors organized under 14 assessment criteria and can be used to qualitatively and quantitatively score different energy audit software to determine their suitability for specific energy efficiency programs. While the tool can be useful for developers to build new tools and improve existing software, as well as for energy efficiency program administrators to approve or certify tools for use, there are limitations to the model, such as the lack of flexibility that allows continuous scoring to accommodate variability and subjectivity. These limitations can be addressed by using aggregate scores of each criterion as weights that could be combined with value function and direct rating scores in a multicriteria decision analysis for a more flexible scoring.

Keywords: buildings, energy efficiency, energy audit, software

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727 Effect of Different Planting Times and Mulching Materials on Seed Quality and Yield of China Aster Cultivars

Authors: A. A. Bajad, B. P. Sharma, Y. C. Gupta, B. S. Dilt, R. K. Gupta

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The present investigations were carried out at the experimental farm of Department of Floriculture and Landscape Architecture, Dr. Y. S. Parmar University of Horticulture and Forestry, Nauni, Solan, H.P. during 2015 and 2016. The experiment was laid out in a Randomized Block Design (factorial) consisting of 48 treatment combinations of four planting dates viz., D1- mid March, D2-mid April, D3-mid May and D4- mid June and two cultivars namely V1- Kamini and V2 -Poornima with six mulching materials M¬0¬- without mulch, M1- Black plastic mulch (100 µ), M2- Silver plastic mulch (100 µ), M3¬- Transparent plastic mulch (100 µ), M3-Transparent plastic mulch (100 µ), M4¬- Pine needle (100 µ) and M5- Grass (1 inch layer). Among different planting times, D4 i.e. mid June planting obtained best results for number of seed per flower (179.38), germination percent (83.92 %), electrical conductivity (0.97 ds/m), seedling length (7.93 cm), seedling dry weight (7.09 mg), seedling vigour index I (763.79), moisture content (7.83 %) and 1000 seed weight (1.94 g). However, seed yield per plant (14.30 g) was recorded to be maximum in mid of March. Among the cultivars, cv. ‘Poornima’ gave best results for number of seed per plant (187.30). However, cv. ‘Kamini’ recorded the best result for seed yield per plant (12.55), electrical conductivity (1.11 ds/m), germination percent (80.47 %), seedling length (6.39 cm), seedling dry weight (5.11 mg), seedling vigour index I (649.49), moisture content (9.28 %) and 1000 seed weight (1.70 g). Silver plastic obtained best results for number of seed per flower (170.10), seed yield per plant (15.66 g), germination percent (80.17 %), electrical conductivity (1.26 ds/m), seedling length (5.88 cm), seedling dry weight (4.46 mg), seedling vigour index I (616.78), Moisture content (9.35 %) and 100 seed weight (1.97 g).

Keywords: cultivars, mulch materials, planting times, flowers

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726 Investigating the Antibacterial Properties and Omega-3 Levels of Evening Primrose Plant Against Multi-Drug Resistant Bacteria

Authors: A. H. Taghdisi, M. Mirmohammadi, S. Kamali

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Evening primrose (Oenothera biennis L.) is a biennial and herbaceous and one of the most important species of medicinal plants in the world. due to the production of unsaturated fatty acids such as linoleic acid, alpha-linolenic acid, etc. in its seeds and roots, and compounds such as kaempferol in its leaves, Evening primrose has important medicinal efficiency such as reducing premenstrual problems, acceleration of wound healing, inhibiting platelet aggregation, sedation of cardiovascular diseases, and treatment of viral infections. The sap of the plant is used to treat warts, and the plant itself is used as a charm against mental and spiritual diseases and poisonous animals. Its leaves have significant antibacterial activity against yellow staphylococci. It is also used in the treatment of poisoning, especially the toxication caused by the consumption of alcoholic beverages, in the treatment of arteriosclerosis and diseases caused by liver cell insufficiency. Low germination and production speed are the problems of evening primrose growth and propagation. In the present study, extracts were obtained from four components (flowers, stems, seeds, leaves) of the evening primrose plant using the Soxhlet apparatus. To measure the antibacterial properties against MDR bacteria, microbial methods, including dilution, cultivation on a plate containing nutrient agar culture medium, and disc diffusion in agar, were performed using Staphylococcus aureus and Escherichia coli bacteria on all four extracts. The maximum antibacterial activity related to the dilution method was obtained in all extracts. In the plate culture method, antibacterial activity was obtained for all extracts in the nutrient agar medium. The maximum diameter of the non-growth halo was obtained in the disc diffusion method in agar in the leaf extract. The statistical analysis of the microbial part was done by one-way ANOVA test (SPSS). By comparing the amount of omega-3 in extracts of Iranian and foreign oils available in the market and the extracts extracted from evening primrose plant samples with gas chromatography, it is shown that the stem extract had the most omega-3 (oleic acid) and compared to the extract of the mentioned oils, it had the highest amount of omega-3 overall. Also, the amount of omega-3 in the extract of Iranian oils was much higher than in the extract of foreign oils. It should be noted that the extract of foreign oils had a more complete composition of omega-3 than the extract of Iranian oils.

Keywords: antibacterial activity, MDR bacteria, evening primrose, omega-3

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725 Protective Role of Autophagy Challenging the Stresses of Type 2 Diabetes and Dyslipidemia

Authors: Tanima Chatterjee, Maitree Bhattacharyya

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The global challenge of type 2 diabetes mellitus is a major health concern in this millennium, and researchers are continuously exploring new targets to develop a novel therapeutic strategy. Type 2 diabetes mellitus (T2DM) is often coupled with dyslipidemia increasing the risks for cardiovascular (CVD) complications. Enhanced oxidative and nitrosative stresses appear to be the major risk factors underlying insulin resistance, dyslipidemia, β-cell dysfunction, and T2DM pathogenesis. Autophagy emerges to be a promising defense mechanism against stress-mediated cell damage regulating tissue homeostasis, cellular quality control, and energy production, promoting cell survival. In this study, we have attempted to explore the pivotal role of autophagy in T2DM subjects with or without dyslipidemia in peripheral blood mononuclear cells and insulin-resistant HepG2 cells utilizing flow cytometric platform, confocal microscopy, and molecular biology techniques like western blotting, immunofluorescence, and real-time polymerase chain reaction. In the case of T2DM with dyslipidemia higher population of autophagy, positive cells were detected compared to patients with the only T2DM, which might have resulted due to higher stress. Autophagy was observed to be triggered both by oxidative and nitrosative stress revealing a novel finding of our research. LC3 puncta was observed in peripheral blood mononuclear cells and periphery of HepG2 cells in the case of the diabetic and diabetic-dyslipidemic conditions. Increased expression of ATG5, LC3B, and Beclin supports the autophagic pathway in both PBMC and insulin-resistant Hep G2 cells. Upon blocking autophagy by 3-methyl adenine (3MA), the apoptotic cell population increased significantly, as observed by caspase‐3 cleavage and reduced expression of Bcl2. Autophagy has also been evidenced to control oxidative stress-mediated up-regulation of inflammatory markers like IL-6 and TNF-α. To conclude, this study elucidates autophagy to play a protective role in the case of diabetes mellitus with dyslipidemia. In the present scenario, this study demands to have a significant impact on developing a new therapeutic strategy for diabetic dyslipidemic subjects by enhancing autophagic activity.

Keywords: autophagy, apoptosis, dyslipidemia, reactive oxygen species, reactive nitrogen species, Type 2 diabetes

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724 Assessment of Land Use Land Cover Change-Induced Climatic Effects

Authors: Mahesh K. Jat, Ankan Jana, Mahender Choudhary

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Rapid population and economic growth resulted in changes in large-scale land use land cover (LULC) changes. Changes in the biophysical properties of the Earth's surface and its impact on climate are of primary concern nowadays. Different approaches, ranging from location-based relationships or modelling earth surface - atmospheric interaction through modelling techniques like surface energy balance (SEB) are used in the recent past to examine the relationship between changes in Earth surface land cover and climatic characteristics like temperature and precipitation. A remote sensing-based model i.e., Surface Energy Balance Algorithm for Land (SEBAL), has been used to estimate the surface heat fluxes over Mahi Bajaj Sagar catchment (India) from 2001 to 2020. Landsat ETM and OLI satellite data are used to model the SEB of the area. Changes in observed precipitation and temperature, obtained from India Meteorological Department (IMD) have been correlated with changes in surface heat fluxes to understand the relative contributions of LULC change in changing these climatic variables. Results indicate a noticeable impact of LULC changes on climatic variables, which are aligned with respective changes in SEB components. Results suggest that precipitation increases at a rate of 20 mm/year. The maximum and minimum temperature decreases and increases at 0.007 ℃ /year and 0.02 ℃ /year, respectively. The average temperature increases at 0.009 ℃ /year. Changes in latent heat flux and sensible heat flux positively correlate with precipitation and temperature, respectively. Variation in surface heat fluxes influences the climate parameters and is an adequate reason for climate change. So, SEB modelling is helpful to understand the LULC change and its impact on climate.

Keywords: LULC, sensible heat flux, latent heat flux, SEBAL, landsat, precipitation, temperature

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723 Dietary Patterns and Hearing Loss in Older People

Authors: N. E. Gallagher, C. E. Neville, N. Lyner, J. Yarnell, C. C. Patterson, J. E. Gallacher, Y. Ben-Shlomo, A. Fehily, J. V. Woodside

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Hearing loss is highly prevalent in older people and can reduce quality of life substantially. Emerging research suggests that potentially modifiable risk factors, including risk factors previously related to cardiovascular disease risk, may be associated with a decreased or increased incidence of hearing loss. This has prompted investigation into the possibility that certain nutrients, foods or dietary patterns may also be associated with incidence of hearing loss. The aim of this study was to determine any associations between dietary patterns and hearing loss in men enrolled in the Caerphilly study. The Caerphilly prospective cohort study began in 1979-1983 with recruitment of 2512 men aged 45-59 years. Dietary data was collected using a self-administered, semi-quantitative, 56-item food frequency questionnaire (FFQ) at baseline (1979-1983), and 7-day weighed food intake (WI) in a 30% sub-sample, while pure-tone unaided audiometric threshold was assessed at 0.5, 1, 2 and 4 kHz, between 1984 and 1988. Principal components analysis (PCA) was carried out to determine a posteriori dietary patterns and multivariate linear and logistic regression models were used to examine associations with hearing level (pure tone average (PTA) of frequencies 0.5, 1, 2 and 4 kHz in decibels (dB)) for linear regression and with hearing loss (PTA>25dB) for logistic regression. Three dietary patterns were determined using PCA on the FFQ data- Traditional, Healthy, High sugar/Alcohol avoider. After adjustment for potential confounding factors, both linear and logistic regression analyses showed a significant and inverse association between the Healthy pattern and hearing loss (P<0.001) and linear regression analysis showed a significant association between the High sugar/Alcohol avoider pattern and hearing loss (P=0.04). Three similar dietary patterns were determined using PCA on the WI data- Traditional, Healthy, High sugar/Alcohol avoider. After adjustment for potential confounding factors, logistic regression analyses showed a significant and inverse association between the Healthy pattern and hearing loss (P=0.02) and a significant association between the Traditional pattern and hearing loss (P=0.04). A Healthy dietary pattern was found to be significantly inversely associated with hearing loss in middle-aged men in the Caerphilly study. Furthermore, a High sugar/Alcohol avoider pattern (FFQ) and a Traditional pattern (WI) were associated with poorer hearing levels. Consequently, the role of dietary factors in hearing loss remains to be fully established and warrants further investigation.

Keywords: ageing, diet, dietary patterns, hearing loss

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722 Values-based Physical Education in a Diverse South African Context

Authors: C. F. Jones Couto

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The implementation of quality Physical Education (PE) inspires and instils lasting healthy behavioural patterns, hence have the potential as an educational tool to teach values in today’s society. The goal of PE should be to contribute to the acceptance of the infinite qualities of South Africa’s (RSA) diversity and to claim RSA’s diversity as a source of strength that forms a universal bond of a common set of values. There is a global change in the interaction of children with their environment; their lives are shaped by forces that do not necessarily assist them in learning and applying values. In most countries today, the responsibility for developing values is assigned to schools in formal teaching settings. Values-based education offers an investment in individual and societal improvement through attendance to a values framework. The aim of this qualitative research is to develop a PE programme aligned with the current South African curriculum, enriched with values of Olympism and Ubuntuism, and to present PE teacher training workshops (TTW). Participatory action research will be used as the basis of how data will be collected, analysed, and presented on an ongoing, cyclical basis. PE teachers from different schools in the Tshwane District of RSA will participate as they can best inform the research questions and enhance the understanding of the phenomenon under study. The outcomes of using PE as a tool to teach values can propose recommendations to the Department of Basic Education of RSA to improve and implement a quality PE curriculum that is applicable to practice and that will optimize the chances of meeting the South African National Curriculum Statement standards. A PE programme with the aim of holistic development, based on the values of Olympism and Ubuntuism, can strive to ensure that the values set out in RSA’s constitution are part of PE organization, planning, and teaching at each South African school.

Keywords: olympism, physical education, teacher training, ubuntuism, values-based education

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721 Factors Affecting Entrepreneurial Behavior and Performance of Youth Entrepreneurs in Malaysia

Authors: Mohd Najib Mansor, Nur Syamilah Md. Noor, Abdul Rahim Anuar, Shazida Jan Mohd Khan, Ahmad Zubir Ibrahim, Badariah Hj Din, Abu Sufian Abu Bakar, Kalsom Kayat, Wan Nurmahfuzah Jannah Wan Mansor

Abstract:

This study aimed and focused on the behavior of youth entrepreneurs’ especially entrepreneurial self-efficacy and the performance in micro SMEs in Malaysia. Entrepreneurship development calls for support from various quarters, and mostly the need exists to initiate a youth entrepreneurship culture and drive amongst the youth in the society. Although backed up by the government and non-government organizations, micro-entrepreneurs are still facing challenges which greatly delay their progress, growth and consequently their input towards economic advancement. Micro-entrepreneurs are confronted with unique difficulties such as uncertainty, innovation, and evolution. Reviews on the development of entrepreneurial characteristics such as need for achievement, internal locus of control, risk-taking and innovation and have been recognized as highly associated with entrepreneurial behavior. The data in this study was obtained from the Department of Statistics, Malaysia. A random sampling of 830 respondents was distributed to 14 states that involve of micro-entrepreneurs. The study adopted a quantitative approach whereby a set of questionnaire was used to gather data. Multiple regression analysis was chosen as a method of analysis testing. The result of this study is expected to provide insight into the factor affecting entrepreneurial behavior and performance of youth entrepreneurs in micro SMEs. The finding showed that the Malaysian youth entrepreneurs do not have the entrepreneurial self-efficacy within themselves in order to accomplish greater success in their business venture. The establishment of entrepreneurial schools to allow our youth to be exposed to entrepreneurship from an early age and the development of special training focuses on the creation of business network so that the continuous entrepreneurial culture is crafted.

Keywords: youth entrepreneurs, micro entrepreneurs, entrepreneurial self-efficacy, entrepreneurial performance

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720 Analysis of Gender Budgeting in Healthcare Sector: A Case of Gujarat State of India

Authors: Juhi Pandya, Elekes Zsuzsanna

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Health is related to every aspect of human being. Even a quintal change leads to ill-health of an individual. Gender plays an eminent role in determining an individual health exposure. Political implications on health have implicit effects on the individual, societal and economical. The inclusion of gender perspective into policies have plunged enormous attention globally, nationally and locally to detract inequalities and achieve economic growth. Simultaneously, there is an initiation of policies with gender perspective which are named differently but hold similar meaning or objective. They are named gender mainstreaming policies or gender sensitization policies. Gender budgeting acts as a tool for the application of gender mainstreaming policies. It incorporates gender perspective into the budgetary process by restricting the revenues and expenditures at all level of the budget. The current study takes into account the analysis of Gender Budgeting reports in terms of healthcare from the 2014-16 year of Gujarat State, India. The expenditures and literature under the heading of gender budgeting reports named “Health and Family Welfare Department” are discussed in the paper. The data analytics is done with the help of reports published by the Gujarat government on Gender Budgeting. The results discuss upon the expenditure and initiation of new policies as a roadmap for the promotion of gender equality from the path of gender budgeting. It states with the escalation of the budgetary numbers for the health expenditure. Additionally, the paper raises the questions on the hypothetical loopholes pertaining to the gender budgeting in Gujarat. The budget reports do not show a specify explanation to the expenditure use of budget for the schemes mentioned in healthcare. It also does not clarify that how many beneficiaries are benefited through gender budget. The explanation just provides an overlook of theory for healthcare Schemes/Yojana or Abhiyan.

Keywords: gender, gender budgeting, gender equality, healthcare

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719 Ozone Therapy for Disc Herniation: A Non-surgical Option

Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

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718 Spatio-Temporal Analysis of Drought in Cholistan Region, Pakistan: An Application of Standardized Precipitation Index

Authors: Qurratulain Safdar

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Drought is a temporary aberration in contrast to aridity, as it is a permanent feature of climate. Virtually, it takes place in all types of climatic regions that range from high to low rainfall areas. Due to the wide latitudinal extent of Pakistan, there is seasonal and annual variability in rainfall. The south-central part of the country is arid and hyper-arid. This study focuses on the spatio-temporal analysis of droughts in arid and hyperarid region of Cholistan using the standardized precipitation index (SPI) approach. This study has assessed the extent of recurrences of drought and its temporal vulnerability to drought in Cholistan region. Initially, the paper described the geographic setup of the study area along with a brief description of the drought conditions that prevail in Pakistan. The study also provides a scientific foundation for preparing literature and theoretical framework in-line with the selected parameters and indicators. Data were collected both from primary and secondary data sources. Rainfall and temperature data were obtained from Pakistan Meteorology Department. By applying geostatistical approach, a standardized precipitation index (SPI) was calculated for the study region, and the value of spatio-temporal variability of drought and its severity was explored. As a result, in-depth spatial analysis of drought conditions in Cholistan area was found. Parallel to this, drought-prone areas with seasonal variation were also identified using Kriging spatial interpolation techniques in a GIS environment. The study revealed that there is temporal variation in droughts' occurrences both in time series and SPI values. The paper is finally concluded, and strategic plan was suggested to minimize the impacts of drought.

Keywords: Cholistan desert, climate anomalies, metrological droughts, standardized precipitation index

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717 Exploring Program Directors’ and Faculty’s Perception and Factors Leading to Burnout in Higher Education Institutions in Azerbaijan

Authors: Gunay Imanguliyeva

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Burnout is one of the concerning issues in education. The present paper aimed to explore the concept of burnout among program directors and faculty working in three higher education institutions (HEIs) in Azerbaijan and identify the factors contributing to burnout and the possible consequences of this syndrome on research participants’ professional and personal life. The researcher believed that if the concept of burnout was defined precisely and explored among more faculty, administration, and educational institutions, university leadership may have looked for the ways to support program directors and faculty, which would increase job satisfaction and decrease turnover. An exploratory qualitative research design was chosen for this study. The conceptual framework of this study was based on the Maslach Burnout Inventory. The instruments of the research were semi-structured interviews, observation, and document review. Three EFL (Teaching English as a Foreign Language) instructors and three program directors of the English Language Department working in three higher educational institutions in Azerbaijan participated in this study. The major findings of this study showed that both program directors and faculty suffered from burnout. Though they were aware of the factors that caused burnout, they did not know how to deal with this feeling. While research participants had high feeling of Emotional Exhaustion and Depersonalization, they had a low feeling of Personal Accomplishment. The researcher suggests that further research is important to measure the level of burnout and to enable HEIs to increase the productivity of program directors’ and faculty’s work as well as decrease the rate of retention in future. Also, in order to help program directors and faculty to cope with burnout, the research recommends the university leadership to meet their psycho-social needs, emotional-physical needs, and personal-intellectual needs. Keywords: burnout, emotional exhaustion, factors, well-being, higher education

Keywords: burnout, well-being, higher education, factors

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716 Oral Betahistine Versus Intravenous Diazepam in Acute Peripheral Vertigo: A Randomized, Double-Blind Controlled Trial

Authors: Saeed Abbasi, Davood Farsi, Soudabeh Shafiee Ardestani, Neda Valizadeh

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Objectives: Peripheral vertigo is a common complaint of patients who are visited in emergency departments. In our study, we wanted to evaluate the effect of betahistine as an oral drug vs. intravenous diazepam for the treatment of acute peripheral vertigo. We also wanted to see the possibility of substitution of parenteral drug with an oral one with fewer side effects. Materials and Methods: In this randomized, double-blind study, 101 patients were enrolled in the study. The patients were divided in two groups in a double-blind randomized manner. Group A took oral placebo and 10 mg of intravenous diazepam. Group B received 8mg of oral betahistine and intravenous placebo. Patients’ symptoms and signs (Vertigo severity, Nausea, Vomiting, Nistagmus and Gate) were evaluated after 0, 2, 4, 6 hours by emergency physicians and data were collected by a questionnaire. Results: In both groups, there was significant improvement in vertigo (betahistine group P=0.02 and Diazepam group P=0.03). Analysis showed more improvement in vertigo severity after 4 hours of treatment in betahistine group comparing to diazepam group (P=0.02). Nausea and vomiting were significantly lower in patients receiving diazepam after 2 and 6 hours (P=0.02 & P=0.03).No statistically significant differences were found between the groups in nistagmus, equilibrium & vertigo duration. Conclusion: The results of this randomized trial showed that both drugs had acceptable therapeutic effects in peripheral vertigo, although betahistine was significantly more efficacious after 4 hours of drug intake. As for higher nausea and vomiting in betahistine group, physician should consider these side effects before drug prescription.

Keywords: acute peripheral vertigo, betahistine, diazepam, emergency department

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715 Role of Family in Child Behavior Problems: A General Overview of Dissertations and Thesis at Turkey

Authors: Selen Demirtas Zorbaz, Ozlem Ulas

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Examining the reasons of child behaviour problems has been one of the focus of psychology and related disciplines for so long. It can be said there is a lot of reasons of child behaviour problems and familial factors might be the leading ones. When taking into account the prevalence of the children having behaviour problems in Turkey, it can be said that it is important to carry out studies putting forward the reasons of behaviour problems. From this point of view, the aim of this study is to examine dissertations and thesis putting forward the relationship between problem behaviour of the children (12-year-old and younger) and teenagers (12-18 years old), and familial factors. For that purpose, 46 dissertations that were chosen according to the study criteria out of 141 dissertations scanned by using the keywords of ‘behaviour problems’ and ‘behaviour disorder’ at Higher Education Thesis Centre between the years of 1989 and 2016 have been taken into the scope of the study. ‘Thesis Examination Draft Form’ has been prepared for the purpose of being used for data collecting tool. For the analysis of the data, percentage, and frequency analysis methods have been used. When the results of these studies are evaluated on the whole, it is seen that all the dissertations and thesis done are descriptive study, and it was not encountered any studies designed as experimental. When looked at the distribution of dissertations by years, it is seen that the first thesis was done in 1989 and the most number of dissertations were done in the years of 2014 and 2016. When looked at the department in which the dissertations were done, it can be said that dissertations and thesis were done in many different fields of disciplines ranging from psychology and special education. In addition to this, when investigated the group taken into the scope of dissertations and thesis research, it is seen that the children mostly worked with are below the age of 12 and types of studies are master’s thesis. When the dissertations and thesis are examined by means of topics, it is seen that mostly-studied topics are demographic variables such as gender, whether the family is fragmented or not, education level of the family and the parents’ attitude. Obtained findings have been examined in the light of literature.

Keywords: family, child behaviour problem, dissertations, thesis

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714 Effects of Climate Change on Floods of Pakistan, and Gap Analysis of Existing Policies with Vision 2025

Authors: Saima Akbar, Tahseen Ullah Khan

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The analysis of the climate change impact on flood frequency represents an important issue for water resource management and flood risk mitigation. This research was conducted to address the effects of climate change on flood incidents of Pakistan and find out gaps in existing policies to reducing the environmental aspects on floods and effects of global warming. The main objective of this research was to critically analyses the National Climate Change Policy (NCCP), National Disaster Management Authority (NDMA), Federal Flood Commission (FFC) and Vision 2025, as an effective policy document which is not only hitting the target of a climate resilient Pakistan but provides room for efficient and flexible policy implementation. The methodology integrates projected changes in monsoon patterns (since last 20 years and overall change in rainfall pattern since 1901 to 2015 from Pakistan Metrological Department), glacier melting, decreasing dam capacity and lacks in existing policies by using SWOT (Strength, Weakness, Opportunities, Threats) model in order to explore the relative impacts of global warming on the system performance. Results indicate the impacts of climate change are significant, but probably not large enough to justify a major effort for adapting the physical infrastructure to expected climatic conditions in Vision 2025 which is our shared destination to progress, ultimate aspiration to see Pakistan among the ten largest economies of the world by 2047– the centennial year of our independence. The conclusion of this research was to adapt sustainable measures to reduce flood impacts and make policies as neighboring countries are adapting for their sustainability.

Keywords: climatic factors, monsoon, Pakistan, sustainability

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713 Effect of Non-Surgical Periodontal Therapy According to Periodontal Severity

Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

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Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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712 Significance of Personnel Recruitment in Implementation of Computer Aided Design Curriculum of Architecture Schools

Authors: Kelechi E. Ezeji

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The inclusion of relevant content in curricula of architecture schools is vital for attainment of Computer Aided Design (CAD) proficiency by graduates. Implementing this content involves, among other variables, the presence of competent tutors. Consequently, this study sought to investigate the importance of personnel recruitment for inclusion of content vital to the implementation of CAD in the curriculum for architecture education. This was with a view to developing a framework for appropriate implementation of CAD curriculum. It was focused on departments of architecture in universities in south-east Nigeria which have been accredited by National Universities Commission. Survey research design was employed. Data were obtained from sources within the study area using questionnaires, personal interviews, physical observation/enumeration and examination of institutional documents. A multi-stage stratified random sampling method was adopted. The first stage of stratification involved random sampling by balloting of the departments. The second stage involved obtaining respondents’ population from the number of staff and students of sample population. Chi Square analysis tool for nominal variables and Pearson’s product moment correlation test for interval variables were used for data analysis. With ρ < 0.5, the study found significant correlation between the number of CAD literate academic staff and use of CAD in design studio/assignments; that increase in the overall number of teaching staff significantly affected total CAD credit units in the curriculum of the department. The implications of these findings were that for successful implementation leading to attainment of CAD proficiency to occur, CAD-literacy should be a factor in the recruitment of staff and a policy of in-house training should be pursued.

Keywords: computer-aided design, education, personnel recruitment, curriculum

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711 Base Deficit Profiling in Patients with Isolated Blunt Traumatic Brain Injury – Correlation with Severity and Outcomes

Authors: Shahan Waheed, Muhammad Waqas, Asher Feroz

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Objectives: To determine the utility of base deficit in traumatic brain injury in assessing the severity and to correlate with the conventional computed tomography scales in grading the severity of head injury. Methodology: Observational cross-sectional study conducted in a tertiary care facility from 1st January 2010 to 31st December 2012. All patients with isolated traumatic brain injury presenting within 24 hours of the injury to the emergency department were included in the study. Initial Glasgow Coma Scale and base deficit values were taken at presentation, the patients were followed during their hospital stay and CT scan brain findings were recorded and graded as per the Rotterdam scale, the findings were cross-checked by a radiologist, Glasgow Outcome Scale was taken on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Continuous variables with normal and non-normal distributions are reported as mean ± SD. Categorical variables are presented as frequencies and percentages. Relationship of the base deficit with GCS, GOS, CT scan brain and length of stay was calculated using Spearman`s correlation. Results: 154 patients were enrolled in the study. Mean age of the patients were 30 years and 137 were males. The severity of brain injuries as per the GCS was 34 moderate and 109 severe respectively. 34 percent of the total has an unfavorable outcome with a mean of 18±14. The correlation was significant at the 0.01 level with GCS on presentation and the base deficit 0.004. The correlation was not significant between the Rotterdam CT scan brain findings, length of stay and the base deficit. Conclusion: The base deficit was found to be a good predictor of severity of brain injury. There was no association of the severity of injuries on the CT scan brain as per the Rotterdam scale and the base deficit. Further studies with large sample size are needed to further evaluate the associations.

Keywords: base deficit, traumatic brain injury, Rotterdam, GCS

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710 Osteoarticular Ultrasound for Diagnostic Purposes in the Practice of the Rheumatologist

Authors: A. Ibovi Mouondayi, S. Zaher, K. Nassar, S. Janani

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Introduction: Osteoarticular ultrasound has become an essential tool for the investigation and monitoring of osteoarticular pathologies for rheumatologists. It is performed in the clinic, cheap to access than other imaging technics. Important anatomical sites of inflammation in inflammatory diseases such as synovium, tendon sheath, and enthesis are easily identifiable on ultrasound. Objective: The objective of this study was to evaluate the importance of ultrasound for rheumatologists in the development of diagnoses of inflammatory rheumatism in cases of uncertain clinical presentation. Material and Methods: This is a retrospective study conducted in our department and carried out over a period of 30 months from January 2020 to June 2022. We included all patients with inflammatory arthralgia without clinical arthritis. Patients' data were collected through a patient operating system. Results: A total of 35 patients were identified, made up of 4 men and 31 women, with a sex ratio M/F of 0.12. The average age of the patients was 48.8 years, with extremes ranging from 17 years to 83 years. All patients had inflammatory polyarthralgia for an average of 9.3 years. Only two patients had suspicious synovitis on clinical examination. 91.43% of patients had a positive inflammatory assessment with an average CRP of 22.2 mg/L. Rheumatoid factor (RF) was present in 45.7% of patients and anti-CCP in 48.57%, with respective averages of 294.43 and 314.63 international units/mL. Radiographic lesions were found in 54% of patients. Osteoarticular ultrasound was performed in all these patients. Subclinical synovitis was found in 60% of patients, including 23% Doppler positive. Tenosynovitis was found in 11% of patients. Enthesitis was objectified in 3% of patients. Rheumatoid arthritis (RA) was retained in 40% of patients; psoriatic arthritis in 6% of patients, hydroxyapatite arthritis, and osteoarthritis in 3% each. Conclusion: Osteoarticular ultrasound has been an essential tool in the practice of rheumatology in recent years. It is for diagnostic purposes in chronic inflammatory rheumatism as well as in degenerative rheumatism and crystal induced arthropathies, but also essential in the follow-up of patients in rheumatology.

Keywords: ultrasound, skeletal, rheumatoid arthritis, arthralgia

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709 A Cloud-Based Mobile Auditing Tools for Muslim-Friendly Hospitality Services

Authors: Mohd Iskandar Illyas Tan, Zuhra Junaida Mohamad Husny, Farawahida Mohd Yusof

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The potentials of Muslim-friendly hospitality services bring huge opportunities to operators (hoteliers, tourist guides, and travel agents), especially among the Muslim countries. In order to provide guidelines that facilitate the operations among these operators, standards and manuals have been developing by the authorities. Among the challenges is the applicability and complexity of the standard to be adopted in the real world. Mobile digital technology can be implemented to overcome those challenges. A prototype has been developed to help operators and authorities to assess their readiness in complying with MS2610:2015. This study analyzes the of mobile digital technology characteristics that are suitable for the user in conducting sharia’ compliant hospitality audit. A focus group study was conducted in the state of Penang, Malaysia that involves operators (hoteliers, tourist guide, and travel agents) as well as agencies (Islamic Tourism Center, Penang Islamic Affairs Department, Malaysian Standard) that involved directly in the implementation of the certification. Both groups were given the 3 weeks to test and provide feedback on the usability of the mobile applications in order to conduct an audit on their readiness towards the Muslim-friendly hospitality services standard developed by the Malaysian Standard. The feedbacks were analyzed and the overall results show that three criteria (ease of use, completeness and fast to complete) show the highest responses among both groups for the mobile application. This study provides the evidence that the mobile application development has huge potentials to be implemented by the Muslim-friendly hospitality services operator and agencies.

Keywords: hospitality, innovation, audit, compliance, mobile application

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708 Accuracy of Peak Demand Estimates for Office Buildings Using Quick Energy Simulation Tool

Authors: Mahdiyeh Zafaranchi, Ethan S. Cantor, William T. Riddell, Jess W. Everett

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The New Jersey Department of Military and Veteran’s Affairs (NJ DMAVA) operates over 50 facilities throughout the state of New Jersey, U.S. NJDMAVA is under a mandate to move toward decarbonization, which will eventually include eliminating the use of natural gas and other fossil fuels for heating. At the same time, the organization requires increased resiliency regarding electric grid disruption. These competing goals necessitate adopting the use of on-site renewables such as photovoltaic and geothermal power, as well as implementing power control strategies through microgrids. Planning for these changes requires a detailed understanding of current and future electricity use on yearly, monthly, and shorter time scales, as well as a breakdown of consumption by heating, ventilation, and air conditioning (HVAC) equipment. This paper discusses case studies of two buildings that were simulated using the QUick Energy Simulation Tool (eQUEST). Both buildings use electricity from the grid and photovoltaics. One building also uses natural gas. While electricity use data are available in hourly intervals and natural gas data are available in monthly intervals, the simulations were developed using monthly and yearly totals. This approach was chosen to reflect the information available for most NJ DMAVA facilities. Once completed, simulation results are compared to metrics recommended by several organizations to validate energy use simulations. In addition to yearly and monthly totals, the simulated peak demands are compared to actual monthly peak demand values. The simulations resulted in monthly peak demand values that were within 30% of the measured values. These benchmarks will help to assess future energy planning efforts for NJ DMAVA.

Keywords: building energy modeling, eQUEST, peak demand, smart meters

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707 An Analysis of Prefabricated Construction Waste: A Case Study Approach

Authors: H. Hakim, C. Kibert, C. Fabre, S. Monadizadeh

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Construction industry is an industry saddled with chronic problems of high waste generation. Waste management that is to ensure materials are utilized in an efficient manner would make a major contribution to mitigating the negative environmental impacts of construction waste including finite resources depletion and growing occupied landfill areas to name a few. Furthermore, ‘material resource efficiency’ has been found an economically smart approach specially when considered during the design phase. One effective strategy is to utilizing off-site construction process which includes a series of prefabricated systems such as mobile, modular, and HUD construction (Department of Housing and Urban Development manufactured buildings). These types of buildings are by nature material and resource-efficient. Despite conventional construction that is exposed to adverse weather conditions, manufactured construction production line is capable of creating repetitive units in a factory controlled environment. A factory can have several parallel projects underway with a high speed and in a timely manner which simplifies the storage of excess materials and re-allocating to the next projects. The literature reports that prefabricated construction significantly helps reduce errors, site theft, rework, and delayed problems and can ultimately lead to a considerable waste reduction. However, there is not sufficient data to quantify this reduction when it comes to a regular modular house in the U.S. Therefore, this manuscript aims to provide an analysis of waste originated from a manufactured factory trend. The analysis was made possible with several visits and data collection of Homes of Merits, a Florida Manufactured and Modular Homebuilder. The results quantify and verify a noticeable construction waste reduction.

Keywords: construction waste, modular construction, prefabricated buildings, waste management

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706 Demographic Characteristics and Factors Affecting Mortality in Pediatric Trauma Patients Who Are Admitted to Emergency Service

Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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705 The Effect of a New Reimbursement Policy for Discharge Planning Service

Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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704 Improving Home and School Collaboration: Analysis of Parent and Teacher Involvement Practices in Public Elementary Schools in Benguet, Philippines

Authors: Sherry Junette Tagle

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Extensive research continues to prove the positive effects of home and school collaborations in education. Although parent involvement programs in Benguet, Philippines are in place, the impact has yet to affect the current aggregate performance of elementary pupils. This study describes the involvement of public elementary teachers and parents along Epstein’s types of involvement using the sequential explanatory design. Survey and interview results show that teachers place greater value on activities that cater to communicating, volunteering, learning at home and decision making. On the other hand, parents are actively involved in all six types and value the importance of their involvement in school to their child’s schooling. Parents of grades 1-4 pupils significantly give importance to communicating activities to offset difficulties encountered by young pupils while parents of grades 5-6 pupils, have declining interest in volunteering and learning at home activities citing older children as being more independent to do teacher-assigned tasks. Teachers, compared to the other respondent groups, significantly place higher value on the importance of parent leaders as their partners in implementing school activities. In general, involvement of parents and teachers in home-school activities is intensive in the lower grade levels and decreases as their child progresses through school. A recommended program for future collaborations of the Philippine’s Department of Education has been formulated to diversify existing activities and elicit greater participation among the school’s stakeholders to achieve holistic development of the pupils and ultimately improve pupils’ school aggregate performance.

Keywords: Epstein's types of involvement, community collaborations, home and school partnerships, parent involvement

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703 Oral Lichen Planus a Manifestation of Grinspan's Syndrome or a Lichenoid Reaction to Medication

Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor

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Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.

Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus

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702 Associations of Vitamin D Receptor Polymorphisms with Coronary Artery Diseases

Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

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Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

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