Search results for: blood platelets

Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

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Authors: Shima Mahmoudi, Babak Pourakbari, Setareh Mamishi, Mostafa Teymuri, Majid Marjani

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Although cytokine analysis has greatly contributed to the understanding of tuberculosis (TB) pathogenesis, data on cytokine profiles that might distinguish progression from latency of TB infection are scarce. Since PE/PPE proteins are known to induce strong humoral and cellular immune responses, the aim of this study was to evaluate the diagnostic potential of interleukin-2 (IL-2) as biomarker after specific antigen stimulation with PE35 and PPE68 for the discrimination of active and latent tuberculosis infection (LTBI). The production of IL-2 was measured in the antigen-stimulated whole-blood supernatants following stimulation with recombinant PE35 and PPE68. All the patients with active TB and LTBI had positive QuantiFERON-TB Gold in Tube test. The level of IL-2 following stimulation with recombinant PE35 and PPE68 were significantly higher in LTBI group than in patients with active TB infection or control group. The discrimination performance (assessed by the area under ROC curve) for IL-2 following stimulation with recombinant PE35 and PPE68 between LTBI and patients with active TB were 0.837 (95%CI: 0.72-0.97) and 0.75 (95%CI: 0.63-0.89), respectively. Applying the 12.4 pg/mL cut-off for IL-2 induced by PE35 in the present study population resulted in sensitivity of 78%, specificity of 78%, PPV of 78% and NPV of 100%. In addition, a sensitivity of 81%, specificity of 70%, PPV of 67% and 87% of NPV was reported based on the 4.4 pg/mL cut-off for IL-2 induced by PPE68. In conclusion, peptides of the antigen PE35 and PPE68, absent from commonly used BCG strains, stimulated strong IL-2- positive T cell responses in patients with LTBI. This study confirms IL-2 induced by PE35 and PPE68 as a sensitive and specific biomarker and highlights IL-2 as new promising adjunct markers for discriminating of LTBI and Active TB infection.

Keywords: IL-2, PE35, PPE68, tuberculosis

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Authors: Afzan Mahmad, Santibuana Abd Rahman, Gouri Kumar Dash, Mohd. Syafiq Bin Abdullah

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Antibacterial activity of the methanol extract of fruit peel of Punica granatum Linn (Family: Punicaceae) was evaluated against two Gram positive and two Gram negative bacteria. The Gram positive bacteria included Staphylococcus aureus, Streptococcus pneumoniae and the Gram negative organisms included Escherichia coli and Pseudomonas aeruginosa respectively. The culture media used for antibacterial assay was Mueller Hinton agar for the growth of S. aureus, E. coli, and P. aeruginosa. The media used for the growth of S. pneumoniae was Mueller Hinton blood agar. The antibacterial assay was performed through Disc diffusion technique. The methanol extract was tested at three different concentrations (50, 100 and 200 mg/ml). Standard antibiotic discs containing vancomycin (30 μg) for S. pneumoniae, penicillin (10 units) for S. aureus, ceftriaxone (30 μg) for E. coli and ciprofloxacin (5 μg) for P. aeruginosa were used for the activity comparison. The results of the study revealed that the extract possesses antibacterial activity against S. aureus, S. pneumoniae and P. aeruginosa at all tested concentrations. The maximum zone of inhibition of 19 mm of the extract at 200 mg/ml was observed against S. pneumoniae. However, no zone of inhibition was observed against E. coli at the tested concentrations of the extract. Based on the results obtained in this study, it may be concluded that the fruit peel of P. granatum possess broad spectrum of antibacterial activity against a number bacteria.

Keywords: Punica granatum Linn., methanol extract, antibacterial, zone of inhibition

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Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Despite improvements in stroke management, it remains the leading cause of disability worldwide. It has been suggested that enhancing brain angiogenesis after stroke will improve stroke outcome. Promoting post stroke angiogenesis requires the upregulation of angiogenic factors with a simultaneous reduction of anti-angiogenic factors. Thrombospondin-1 is the main anti-angiogenic protein in the living cells. Counterintuitively, it has been shown that animals with Thrombospondin-1 knockdown will have better stroke outcome. Data about the clinical significance of Thrombspondin-1 levels at the time of admission is still lacking. The objective of this work is to assess the association between serum Thrombospondin-1 levels measured at the time of admission and baseline neurologic severity after stroke. Patients and Methods: Blood samples were collected from patients admitted to the King Abdullah University Hospital (KAUH) with ischemic stroke at the time of admission and serum Thrombopsondin-1 levels were measured using ELISA. Patients neurologic severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). Results: Samples from 50 patients admitted between January 2016 and December 2016 were collected. The median age of participants was 68 years and the median NIHSS was 3. Multinomial regression identified serum Thrombospondin-1 as an independent predictor of stroke outcome (p=0.003). Baseline serum Thrombsopondin-1 was negatively associated with NIHSS at the time of admission (spearman rho correlation coefficient=0.272, p=0.032). Conclusion: Serum Thrombospondin-1 at the time of admission may be a useful marker of stroke severity that predicts more severe neurologic severity.

Keywords: thrombospondin, stroke, neuroprotection, biomarkers

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Authors: Karthika Durairaj, Buvaneswari G., Gowdham M., Gilles M., Velmurugan G.

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Background: Hyperglycaemia is the primary cause of metabolic illness. Recently, researchers focused on the possibility that chemical exposure could promote metabolic disease. Hyperglycaemia causes a variety of metabolic diseases dependent on its etiologic conditions. According to animal and population-based research, individual chemical exposure causes health problems through alteration of endocrine function with the influence of microbial influence. We were intrigued by the function of gut microbiota variation in high fat and chemically induced hyperglycaemia. Methodology: C57/Bl6 mice were subjected to two different treatments to generate the etiologic-based diabetes model: I – a high-fat diet with a 45 kcal diet, and II - endocrine disrupting chemicals (EDCs) cocktail. The mice were monitored periodically for changes in body weight and fasting glucose. After 120 days of the experiment, blood anthropometry, faecal metagenomics and metabolomics were performed and analyzed through statistical analysis using one-way ANOVA and student’s t-test. Results: After 120 days of exposure, we found hyperglycaemic changes in both experimental models. The treatment groups also differed in terms of plasma lipid levels, creatinine, and hepatic markers. To determine the influence on glucose metabolism, microbial profiling and metabolite levels were significantly different between groups. The gene expression studies associated with glucose metabolism vary between hosts and their treatments. Conclusion: This research will result in the identification of biomarkers and molecular targets for better diabetes control and treatment.

Keywords: hyperglycaemia, endocrine-disrupting chemicals, gut microbiota, host metabolism

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Authors: Ali Golestani, Vahid Naseri, Hossein Taheri

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Recently, some of studies examined the effect of exercise on neurotrophic factors influencing the growth, protection, plasticity and function in central and peripheral nerve cells. The aim of this study was to investigate the effects of continuous and interval aerobic exercises with moderate intensity on serum levels of glial cell line-derived neurotrophic factor (GDNF) and aerobic capacity in obese children. 21 obese students with an average age of 13.6 ± 0.5 height 171 ± 5 and BMI 32 ± 1.2 were divided randomly to control, continuous aerobic and interval aerobic groups. Training protocol included continuous or interval aerobic exercises with moderate intensity 50-65%MHR, three times per week for 10 weeks. 48 hours before and after executing of protocol, blood samples were taken from the participants and their GDNF serum levels were measured by ELISA. Aerobic power was estimated using Shuttle-run test. T-test results indicated a small increase in their GDNF serum levels, which was not statistically significant (p =0.11). In addition, the results of ANOVA did not show any significant difference between continuous and interval aerobic training on the serum levels of their GDNF but their aerobic capacity significantly increased (p =0.012). Although continuous and interval aerobic exercise improves aerobic power in obese children, they had no significant effect on their serum levels of GDNF.

Keywords: aerobic power, continuous aerobic training, glial cell line-derived neurotrophic factor (GDNF), interval aerobic training, obese children

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Authors: Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O Saleh, Manal Badawi

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Background: Diabetes is a metabolic disease that affects a wide range of people worldwide and results in serious complications. Streptozotocin (STZ) causes selective cytotoxicity in the pancreatic β-cell, and it has been extensively used to induce diabetes mellitus in rats. The present study investigated the effects of diosmin and chrysin alone or in combination with each other on glucose level and on liver in STZ diabetic rats. Methods: In this study, rats were divided into six experimental groups (normal, untreated STZ-diabetic (60 mg/kg B.W., IP), treated STZ-diabetic with glycazide (10 mg/kg B.W, oral), treated STZ-diabetic with diosmin (100 mg/kg B. W., oral), treated STZ-diabetic with chrysin (80 mg/kg B.W., oral), treated STZ-diabetic with diosmin (50 mg/kg B.W, oral) + chrysin (40 mg/kg B.W., oral). After 2 weeks blood samples were withdrawn and glucose was measured. Animals were anaesthetized with an intraperitoneal injection of sodium pentobarbital (60 mg/kg), and sacrificed for dissecting liver. Results: Throughout the experimental period, all treatments significantly (P<0.05) lowered serum glucose, AST, ALT, triglyceride, cholesterol, IL-6, TNF-α and IL-1β. Moreover, the treated diabetic rats showed higher levels of reduced glutathione (P<0.05) in the liver compared to the diabetic control rats and inhibited diabetes-induced elevation in the levels of malondialdehyde in liver. The results of this study clearly demonstrated that diosmin and chrysin possess several treatment-oriented properties, including the control of hyperglycemia, antioxidant effects and anti-inflammatory effects. Conclusion: Considering these observations, it appears that diosmin and chrysin may be a useful supplement to delay the developmentof diabetes and its complications.

Keywords: diabetes, streptozocin, chrysin, rat, diosmin, cytokines

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Authors: Emily Schlebes, Christian Hundhausen, Jens W. Fischer

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The glycosaminoglycan hyaluronan (HA) is a major component of the extracellular matrix, typically produced by fibroblasts of the connective tissue but also by immune cells. Here, we investigated the capacity of human peripheral blood CD8 T cells from healthy donors to produce HA and to express HA receptors as well as HA degrading enzymes. Further, we evaluated the effect of pharmacological HA inhibition on CD8 T cell function. Using immunocytochemistry together with quantitative PCR analysis, we found that HA synthesis is rapidly induced upon antibody-induced T cell receptor (TCR) activation and almost exclusively mediated by HA synthase 3 (HAS3). TCR activation also resulted in the upregulation of HA receptors CD44, hyaluronan-mediated motility receptor (HMMR), and layilin (LAYN), although kinetics and strength of expression varied greatly between subjects. The HA-degrading enzymes HYAL1 and HYAL2 were detected at low levels and induced by cell activation in some individuals. Interestingly, expression of HAS3, HA receptors, and hyaluronidases were modulated by the proinflammatory cytokines IL-6 and IL-1bβ in most subjects. To assess the functional role of HA in CD8 T cells, we performed carboxyfluorescein succinimidyl ester (CFSE) based proliferation assays and cytokine analysis in the presence of the HA inhibitor 4- Methylumbelliferone (4-MU). Despite significant inter-individual variation with regard to the effective dose, 4-MU resulted in the inhibition of CD8 T cell proliferation and reduced release of TNF-α and IFN-γ. Collectively, these data demonstrate that human CD8 T cells respond to TCR stimulation with a synthesis of HA and expression of HA-related genes. They further suggest that HA inhibition may be helpful in interfering with pathogenic T cell activation in human disease.

Keywords: CD8 T cells, extracellular matrix, hyaluronan, hyaluronan synthase 3

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Authors: Hasibe Caballero-Gomez, Richard Pepino

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Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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Authors: Cecilia Amponsem-Boateng, Timothy Bonney Oppongx, Weidong Zhang, Jonathan Boakye Yiadom, Lianke Wang, Kwabena Acheampong, Godfrey Opolot

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In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12–22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.

Keywords: hypertension, second-cycle schools, Ghana, youth

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Authors: Mohammad Naeem Lakanwall, Jamshid Abdul-Ghafar

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Background: Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland; however, there is a lack of scientific literature from Afghanistan, a country with very limited health care facilities and resources. To our best knowledge, this is the first study aimed to describe the frequency of occurrence and factors associated with thyroid dysfunction in the Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Methods: A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) hypothyroidism, 2) hyperthyroidism, 3) normal. Results: A total of 127 individuals were included in the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction. 74% of the participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels, and (12%) higher TSH levels, classified as hyper and hypothyroid, respectively. Conclusions: The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large-scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.

Keywords: Afghanistan, factors, frequency, hypothyroid, hyperthyroid, thyroid, thyroid stimulating hormone

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Authors: Somaye Sabetnia

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This paper is accomplished to probe Susanna Kaysen’s memoir Girl, Interrupted in the light of Michel Foucault’s theory of madness comprehensively set forth in his History of Madness (1961). It is an endeavor to analysis this novel based on Foucault’s idea of madness. In his archeological study of madness, Foucault introduces a way to perceive madness and its association with dominant discourses. He argues that the concept of madness is constructed within the social context, and different institutions affect its definition. Furthermore, he takes into consideration how each era treats madness, and affirms that in modern times, people considered mad are exiled out of cities, confined in madhouses, and later in clinics where they are treated with drugs. Set after World War II, the novel under observation highlights women’s conditions in which they were becoming a housewife or following their own desires; in fact, choosing the second one results in labeling mad. The protagonist of novel is labeled 'mad,' and is hence impelled to go to asylums where so-called patients are under the vigilant surveillance of the authorities to go through the process of 'normalization.' To discern how she is considered 'mad,' this article probes the dominant discourse of the time when the stories take place to provide a better understanding of madness under the impact of social, cultural, and political conditions. It examines how a so-called mad considered 'Other' and treated after being confined by the disciplinary system of the asylum in a panoptic world. In addition to, it describes the aim of treatment is to punish and control a patient not to cure. This article aims to indicate that Susanna Kaysen tries to picture what is defined as women’s madness is the result of the patriarchal society of the post-war America as well as the mental illness has nothing to do with blood; it is rather the result of the social inequality of the age.

Keywords: clinical treatment, disciplining and punishment, dominant discourse, normalization, other, panoptic world, reason vs. unreason

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Authors: Belaynesh Tsegay, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigray. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigray, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigray. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood were collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using ELISA (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the SPSS version 20, and p<0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18–25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15–13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17–7.74, p=0.022) were significantly associated with HBV infections. Conclusion: The seroprevalence of HBV among prisoners was nearly high or borderline, with a very low HCV prevalence. HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, tigray

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Authors: Veronika Lesáková, Silvia Slezáková, František Štěpánek

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Drug dosage forms consisting of multi-unit particle systems (MUPS) for modified drug release provide a promising route for overcoming the limitation of conventional tablets. Despite the conventional use of pellets as units for MUP systems, 3D printed polymers loaded with a drug seem like an interesting candidate due to the control over dosing that 3D printing mechanisms offer. Further, 3D printing offers high flexibility and control over the spatial structuring of a printed object. The final MUPS tablets include PVP and HPC as granulate with other excipients, enabling the compaction process of this mixture with 3D printed inclusions, also termed minitablets. In this study, we have developed the multi-step production process for MUPS tablets, including the 3D printing technology. The MUPS tablets with incorporated 3D printed minitablets are a complex system for drug delivery, providing modified drug release. Such structured tablets promise to reduce drug fluctuations in blood, risk of local toxicity, and increase bioavailability, resulting in an improved therapeutic effect due to the fast transfer into the small intestine, where particles are evenly distributed. Drug loaded 3D printed minitablets were compacted into the excipient mixture, influencing drug release through varying parameters, such as minitablets size, matrix composition, and compaction parameters. Further, the mechanical properties and morphology of the final MUPS tablets were analyzed as many properties, such as plasticity and elasticity, can significantly influence the dissolution profile of the drug.

Keywords: 3D printing, dissolution kinetics, drug delivery, hot-melt extrusion

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Authors: Farshad Ghazalian, Seyed Hossein Alavi

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Background: Use of whole body vibration (WBV) as an exercise method has rapidly increased over the last decade. The aim of this study was to evaluate effects of five week whole-body vibration training with different amplitudes and progressive frequencies on fibrinolytic and coagulative factors. Methods: Twenty five healthy male students were divided randomly in three groups: high amplitude vibration group (n=10), low amplitude vibration group (n=10), and control group (n=5). The vibration training consisted of 5 week whole-body vibration 3 times a week with amplitudes 4 and 2 mm and progressive frequencies from 25Hz with increments of 5Hz weekly. Concentrations of fibrinogen, plasminogen, tPA, and PAI-1 before and after 5 weeks of training were measured in plasma samples. Statistical analysis was done using one way analysis of variance. In order to compare pre-test with post test we used Wilcoxon signed ranked test .P<0.05 was considered statistically significant. Results: The 5 week high amplitude vibration training caused a significant improvement in tissue plasminogen activator (tPA) (p=0.028), and PAI-1 (p=0.033), fibrinogen showed decrease albeit not significantly (p=0.052). Plasminogen showed decrease not significantly (p=0.508). Low-amplitude vibration training caused a significant improvement in tissue plasminogen activator (tPA) (p=0.006) and and PAI-1 showed decrease not significantly (p=0.907). Fibrinogen showed decrease albeit not significantly (p=0.19). Plasminogen showed decrease not significantly (p=0.095). However, between groups there was no significant effect on tissue plasminogen activator (tPA) (p = 0.50), PAI-1 (p=0.249), Plasminogen (p=0.742), and fibrinogen (p=0.299). Conclusion: Amplitude of vibrations training is a important variable that effect on fibrino lytic factors.

Keywords: vibration, fibrinolysis, blood coagulation, plasminogen

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Roshan Kamal Topno, Maneesh Kumar, Manas Ranjan Dikhit, Krishna Pandey, Major Madhukar, Vidhya Nand Rabidas, Vahab Ali, Ganesh Chandra Sahoo, Bhawana, Devendra Prasad Yadav, Rishikesh Kumar, Pradeep Das

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A diagnostic marker for asymptomatic subject becomes a crucial need for advocating early prophylactic majors to control protozoal infection. The main issue in epidemiological affected regions is the presence of an asymptomatic individual that might potentially convert to a symptomatic visceral leishmaniasis (VL). The epidemiological study has been conducted at highly VL endemic Moriyama village in Patna district, Bihar, India that covers total population of 1540 individuals. Here, 1104(74.02%) people had been randomly screened and only 46 (4.17%) asymptomatic individuals were found sero-positive by the rK39 test. After taking signed informed consent form, blood samples were collected from 46 asymptomatic subjects for further hematological and immunological tests. Total leukocyte count, hemoglobin (gm%), neutrophil, lymphocyte, platelet count and interleukin-10 (IL-10) had been included as diagnostic markers. Interestingly only 5 (10.86%) individuals showed their asymptomatic conversion into symptomatic VL patients during quarterly surveillance. In overall analysis only two markers are suggestive for disease conversion that is hemoglobin (gm%) and IL-10. In all the infected patients, both the mean decrease in hemoglobin and mean increase of IL-10 was 19.23% from its normal value. The results might suggest that hematological and immunological changes would become helpful for early diagnosis of asymptomatic to symptomatic VL conversion.

Keywords: asymptomatic, epidemiological, symptomatic visceral leishmaniasis, hemoglobin (gm%), interleukin-10, diagnosis

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Authors: Moussa Majed, Omar Yaser

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The main objective of this experiment was to study the impact of Probiotic compound on the specific immunity as the case study of infectious bursal disease. Total of 8000 one-day old Ross 108 broiler were randomly divided into two experimental groups; control group (4500 birds) and experimental group (3500 birds). Birds in two groups were reared under similar environmental conditions. Birds in control group received basal diets without probiotic whereas the birds in experimental one were fed basal diets supplemented with a commercial probiotic mixture) probiotic lacting k, which contains bacteria cells beyond to lactobacillus, Streptococcus and bifidobacterium genus that are isolated from gut microflora in healthy chickens(. The commercial probiotic were used according to the manufacturer instruction. 400 blood samples for each group were collected from wing vein every 5-7 days as interval period till 42 days old. Indirect Enzyme-Linked Immunosorbent Assay (ELISA) test was performed to detect the level of infectious bursal disease virus (IBDV) antibodies. The results clearly showed that the mean of immune titers was significantly (p= 0.03) higher in trail group than control one. The coefficient of variance percentages were 55% and 39% for control and trial groups respectively, this illustrates that homogeneity of immunity titers in the trail group was much better comparing with control group. The values of geometric means of titers in the control group and trial group were reported 3820 and 8133, respectively. The crude mortality rate in the experimental group was two times lower comparing with control group (14% and 28% respectively, p = 0.005

Keywords: probiotic, broiler chicken, infectious bursal disease, immunity, ELISA test

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Authors: Yagahira E. Castro-Sesquen, Robert H. Gilman, Carolina Mejia, Daniel E. Clark, Jeong Choi, Melissa J. Reimer-Mcatee, Rocio Castro, Jorge Flores, Edward Valencia-Ayala, Faustino Torrico, Ricardo Castillo-Neyra, Lance Liotta, Caryn Bern, Alessandra Luchini

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Early diagnosis of reactivation of Chagas disease in HIV patients could be lifesaving; however, in Latin American the diagnosis is performed by detection of parasitemia by microscopy which lacks sensitivity. To evaluate if levels of T. cruzi antigens in urine determined by Chunap (Chagas urine nanoparticle test) are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. T. cruzi antigens in urine of HIV patients (N=55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. The percentage of Chagas positive patients determined by Chunap compared to blood microscopy, qPCR, and ELISA was 100% (6/6), 95% (18/19) and 74% (23/31), respectively. Chunap specificity was 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels (determined by qPCR) and urine T. cruzi antigen concentrations (p<0.001). A cut-off of > 105 pg was chosen to determine patients with reactivation of Chagas disease (6/6). Urine antigen concentration was significantly higher among patients with CD4+ lymphocyte counts below 200/mL (p=0.045). Chunap shows potential for early detection of reactivation and with appropriate adaptation can be used for monitoring Chagas disease status in T. cruzi/HIV co-infected patients.

Keywords: antigenuria, Chagas disease, Chunap, nanoparticles, parasitemia, poly N-isopropylacrylamide (NIPAm)/trypan blue particles (polyNIPAm/TB), reactivation of Chagas disease.

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: hypertension, north of Iran, dietary intake, weight

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Authors: Barari Alireza, Seyed Hossein Alavi, Ghasemi Mohamad

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Objectives: VEGF and PDGF play central role in the processes of angiogenesis and vascular changes in most body tissues. The aim of the present study to determine effect of endurance training with ginseng on VEGF and PDGF levels is untrained female. Methods: Statistic society of this study was untraining male students of Azad University of Sari Branch in year of 2012-2013. Forty young untrained female (age 21.3 ± 0.90 year, height162.08±8.07cm , body weight 65.45± 7.6 kg and body mass index [BMI] 23.23 ± 2.64 kg/m2) were randomly divided into four groups: control(C), endurance(E), ginseng (G), endurance and ginseng (EG). Participants in training groups performed endurance training for 6 weeks and three sessions per week with 60-80% HRmax. Subjects perform endurance training and consumed ginseng for six weeks. Blood samples from the subjects before and after the test was performed. One wey ANOVA were used to test for differences between group and pair T-test were used for differences within groups. In all cases, P<0.05 was considered to be statistically significant. Results: A higher and significant Vo2 max was found in E and EG groups, while no change in other groups. BMI and Fat% were significantly decreased in EG group. No significant difference was found between and within groups in VEGF level. A higher and significant PDGF was only in endurance group, while there was significant reduction observed in G and EG groups. One-way ANOVA for PDGF showed significant difference between groups. Conclusion: The finding of the current study indicated that ginseng likely could through reducing of angiogenesis factors Such as VEGF and PDGF and reduced activity of tumor necrosis factor and inhibited inflammatory process.

Keywords: endurance, ginseng, VEGF, PDGF, untrained female

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Authors: Muhammad Imran Nisar, Fyezah Jehan, Tauseef Akhund, Sadia Shakoor, Kanwal Nayani, Furqan Kabir, Asad Ali, Anita Zaidi

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Pneumococcal Vaccine -10 (PCV 10) was included in the Expanded Program of immunization (EPI) in Sindh, Pakistan in February 2013. This study was carried out immediately before the introduction of PCV 10 to establish baseline pneumococcal carriage and prevalent serotypes in naso-pharynx of children 3-11 months of age in an urban and rural community in Sindh, Pakistan. An additional sample of children aged 12 to 59 months was drawn from the urban community. Nasopharyngeal specimens were collected from a random sample of children. Samples were processed in a central laboratory in Karachi. Pneumococci were cultured on 5% Sheep Blood Agar and serotyping was performed using CDC standardized sequential multiplex PCR assay on bacterial colonies. Serotypes were then categorized into vaccine (PCV-10 and PCV-13) type and non-vaccine types. A total of 670 children were enrolled. Carriage rate for pneumococcus based on culture positivity was 74% and 79.5 % in the infant group in Karachi and Matiari respectively. Carriage rate was 78.2% for children aged 12 to 59 months in Karachi. Proportion of PCV 10 serotypes in infants was 38.8% and 33.5% in Karachi and Matiari respectively. In the older age group in Karachi, the proportion was 30.6%. Most common serotypes were 6A, 6B, 23F, 19A and 18C. This survey establishes vaccine and non-vaccine serotype carriage rate in a vaccine-naïve pediatric population among rural and urban communities in Sindh province. Annually planned surveys in the same communities will inform change in carriage rate after the introduction and uptake of PCV 10 in these communities.

Keywords: Naso-Pharyngeal carriage, Pakistan, PCV10, Pneumococcus

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Authors: S. Saeed, T. Butt, M. Rehan, S. Khaliq

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Objective: To determine the frequency of pre-analytical errors in samples taken from patients for various lab tests at Fauji Foundation Hospital, Rawalpindi. Material and Methods: All the lab specimens for diagnostic purposes received at the lab from Fauji Foundation hospital, Rawalpindi indoor and outdoor patients were included. Total number of samples received in the lab is recorded in the computerized program made for the hospital. All the errors observed for pre-analytical process including patient identification, sampling techniques, test collection procedures, specimen transport/processing and storage were recorded in the log book kept for the purpose. Results: A total of 476616 specimens were received in the lab during the period of study including 237931 and 238685 from outdoor and indoor patients respectively. Forty-one percent of the samples (n=197976) revealed pre-analytical discrepancies. The discrepancies included Hemolyzed samples (34.8%), Clotted blood (27.8%), Incorrect samples (17.4%), Unlabeled samples (8.9%), Insufficient specimens (3.9%), Request forms without authorized signature (2.9%), Empty containers (3.9%) and tube breakage during centrifugation (0.8%). Most of these pre-analytical discrepancies were observed in samples received from the wards revealing that inappropriate sample collection by the medical staff of the ward, as most of the outdoor samples are collected by the lab staff who are properly trained for sample collection. Conclusion: It is mandatory to educate phlebotomists and paramedical staff particularly performing duties in the wards regarding timing and techniques of sampling/appropriate container to use/early delivery of the samples to the lab to reduce pre-analytical errors.

Keywords: pre analytical lab errors, tertiary care hospital, hemolyzed, paramedical staff

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: K. Shafiei, A. Pirestani, G. Ghalamkari, S. Safavipour

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Use of GnRH or its agonists to increase conception rates should be based on an understanding of GnRH-induced biological effects on the reproductive-endocrine system. This effect may occur through GnRH-stimulated LH surge stimulating production of progesterone by corpus luteum.the aim of this study was to compare the effects on reproductive efficiency of a luteolytic dose of a synthetic prostaglandin Cloprostenol Sodium versus ainjectable progesterone and Luliberin- A on Follicle estrogen and progesterone levels.In this study, we used45 head of holstein dairy heifersin the three treatments, with 15 replicates per treatment were performed in random groups. all the heifers before the projects is began in two steps injection 3 mL CloprostenolSodium with an interval of 11 days been synchronized and 10 days later, second injection of prostaglandin was conducted after that we started below protocol:Control group (daily sodium chloride serum injection 1 cc), Group B: Day Zero, intramuscular injection of 15 mg Luliberin- A + every other day injection of 3 cc progesterone + day 7, injection of Cloprostenol Sodium+ day 9, injection of 15 mg Luliberin- A.Group C: similar to Grop B + daily injection of progesterone after that blood samples was collected and centrifuged.plasma were analysed by ELISA.the analysis of this study uses SPSS data software package and compared between the mean and LS Means LSD test at 5% significance level was used.The results of this study shows that maximum of progesterone plasma levels were in the control gruop (P ≥ 0.05).Therefore, daily injection of progesterone inhibit the growth CL. the most estrogen levels in plasma were in Group C (P ≥ 0.05) thus it can be concluded, rise in endogenous estrogen concentrations normally stimulates the preovulatory LH release in heifers.

Keywords: Luliberin- A, Cloprostenol Sodium, estrogen, progesterone, dairy heifers

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Authors: Wanutchaya Duanginta, Napaporn Apiratmateekul, Tippawan Sangkaew, Sunaree Wekinhirun, Kunchit Kongros, Wanvisa Treebuphachatsakul

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Thailand has a tropical climate with an average outdoor ambient air temperature of over 30°C, which can exceed manufacturer recommendations for the storage of glucose test strips. This study monitored temperature and humidity at actual sites of five sub-district health promoting hospitals (HPH) in Phitsanulok Province for the storage of glucose test strips in refrigerated conditions. Five calibrated data loggers were placed at the actual sites for glucose test strip storage at five HPHs for 8 weeks between April and June. For the stress test, two lot numbers of glucose test strips, each with two glucose meters, were kept in a plastic box with desiccants and placed in a refrigerator with the temperature calibrated to 4°C and at room temperature (RT). Temperature and humidity in the refrigerator and at RT were measured every hour for 30 days. The mean temperature for storing test strips at the five HPHs ranged from 29°C to 33°C, and three of the five HPHs (60%) had a mean temperature above 30°C. The refrigerator temperatures were 3.8 ± 2.0°C (2.0°C to 6.5°C), and relative humidity was 51 ± 2% (42 to 54%). The maximum of blood glucose testing by glucose meters when the test strips were stored in a refrigerator were not significantly different (p > 0.05) from unstressed test strips for both glucose meters using amperometry-GDH-PQQ and amperometry-GDH-FAD principles. Opening the test strip vial daily resulted in higher variation than when refrigerated after a single-use. However, the variations were still within an acceptable range. This study concludes that glucose tested strips can be stored in plastic boxes in a refrigerator if it is well-controlled for temperature and humidity. Storage of glucose-tested strips in the refrigerator during hot and humid weather may be useful for HPHs with limited air conditioners.

Keywords: environmental stressed test, thermal stressed test, quality control, point-of-care testing

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Authors: Fall Abdourahmane, Lazrak Meryem, El Hsaini Houda, El Ammari Laila, Gamih Hasnae, Yahyane Abdelhakim, Benjouad Abdelaziz, Aguenaou Hassan, El Kari Khalid

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Introduction: The double burden of malnutrition (DBM), characterized by the coexistence of undernutrition and overnutrition, is a significant health challenge, particularly in low- and middle-income countries. In Morocco, 61.3% of women of reproductive age (WRA) are overweight or obese, including 30.4% who were obese, while 34.4% were anaemic, and 49.7% have iron deficiency anaemia. Objective: This study aims to determine the prevalence of DBM at the individual level among Moroccan WRA, defined by the coexistence of iron deficiency anaemia and overweight/obesity. Methods: a cross-sectional national survey was conducted among a representative sample of 2090 Moroccan WRA. Data collected included socio-economic parameters, anthropometric measurements, and blood samples. Haemoglobin levels were measured photometrically using Hemocue, while ferritin and CRP were assessed through immunoturbudimetry. Results: The prevalence of overweight/obesity, iron deficiency, anaemia and iron deficiency anaemia among WRA in Morocco were 60.2%, 30.6%, 34.4% and 50.0% respectively. The coexistence of overweight/obesity with anaemia and iron deficiency was observed in 19.2% and 16.3% of women, respectively. Among overweight/obese women, 32.5% were anaemic, 28.4% were iron deficient, and 47.6% had iron deficiency anaemia. the prevalence of DBM was higher in urban areas compared to rural settings. Conclusion: The coexistence of undernutrition and overnutrition among WRA highlights the urgent need for integrated public health interventions addressing both anaemia and obesity simultaneously. Tailored strategies should consider the specific socio-economic and geographical contexts to effectively combat this dual burden.

Keywords: the double burden of malnutrition, iron deficiency anaemia, overweight, obesity

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Authors: Christianah Adebimpe Dare, Nelson Oghenebrorhie Elvis

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This study was aimed at analysing the phytochemicals in Chrysophyllum albidum cotyledon extract and their in vitro antioxidant and anti-inflammatory effects. The star apple fruit was bought at Igbona market Osogbo, Osun State, Nigeria. The seed from the fruit was removed and defatted. The residue was exhaustively extracted with methanol. The Chrysophyllum albidum cotyledon methanol extract (CCME) was phytochemically screened, flavonoids and phenol contents, antioxidant and anti-inflammatory assays were carried out on the extract using standard procedures. Phytochemicals analysis revealed the presence of steroids, tannins, flavonoid, saponin, triterpenes, and xanthoproteins. The phenolic concentration, total flavonoids concentration, and total sugar concentration were found to be 26.72 ± 0.048 µgTAE/mg, 23.12 ± 1.92µg of Rutin equivalent (RTE)/mg (10.49 ± 1.12µg of Quercetin equivalent (QE/mg) and 778.38 ± 12.82 µg of glucose/ml, respectively. The extract demonstrated significant inhibitory effect compared with the standards as potent antioxidant with percentage inhibition of DPPH as 38.10 %-39.51 %, lipid peroxidation as 45.85 %-65.85 %; ferric reducing power showed linear correlation to the standard and the anti-inflammatory potential with 22.06 %-26.37 % protection of the human red blood membrane and the percentage inhibition of denaturation of albumin 3.42 %-7.32 %. The study showed that C. albidum cotyledon methanol extract is a potent antioxidant and anti-inflammatory agent to combat oxidative stress and pathological diseases caused by reactive species.

Keywords: albumin denaturation, free radicals, lipid peroxidation, reactive species

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Authors: Yaya Gao, Bing Zhong, Yafeng Liu, Fei Chen

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Aim: The purpose of this study was to explore the difference between acellular dermal matrix (ADM) combined with anterolateral thigh (ALT) flap and ALT flap alone. Methods: HSCC patients were treated and divided into group A (ALT) and group B (ALT+ADM) between January 2014 and December 2018. We compared and analyzed the intraoperative information and postoperative outcomes of the patients. Results: There were 21 and 17 patients in group A and group B, respectively. The operation time, blood loss, defect size and anastomotic vessel selection showed no significant difference between two groups. The postoperative complications, including wound bleeding (n=0 vs. 1, p=0.459), wound dehiscence (n=0 vs. 1, p=0.459), wound infection (n=5vs.3, p=0.709), pharyngeal fistula (n=5vs.4, p=1.000) and hypoproteinemia (n=11 vs. 12, p=0.326) were comparable between the groups. Dysphagia at 6 months (number of liquid diets=0vs. 0; number of partial tube feedings=1vs. 1; number of total tube feedings=1vs. 0, p=0.655) also showed no significant differences. However, significant differences was observed in dysphagia at 12 months (number of liquid diets=0vs. 0; number of partial tube feedings=3 vs. 1; number of total tube feedings=10vs. 1, p=0.006). Conclusion: For HSCC patients, the use of the ALT flap combined ADM, compared to ALT treatment, showed better swallowing function at 12 months. The ALT flap combined ADM may serve as a safe and feasible alternative for selected HSCC patients.

Keywords: hypopharyngeal squamous cell carcinoma, anterolateral thigh free flap, acellular dermal matrix, reconstruction, dysphagia

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