Search results for: background music

Authors: Abrar Noorain, Zeinab Amara, Sulaf Abdelaziz

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Background: Diabetic foot disease imposes a financial burden on diabetic patients and healthcare services. In Sudan, diabetic foot ulcer prevalence reached 18.1%. This study aims to assess the knowledge, attitudes, and practices and the correlation between the level of foot care knowledge and self-care practices among diabetic patients in Sudan. Methodology: In a cross-sectional study involving 262 patients with type 1 and type 2 diabetes attending diabetic clinics in three primary care centers in Khartoum, Sudan, during September to November 2022, information regarding participants sociodemographic status, foot care knowledge, attitudes, and practices was gathered using a validated, structured questionnaire in a face-to-face interview method. These data were analyzed using the statistical package for the social sciences (SPSS) 22. Results: The patients’ mean age was 54.9 years, with a female predominance (56%). Of the participants, 37% had diabetes mellitus for over ten years. On the topic of foot care, 35.5% of patients showed good knowledge, and 76% were aware of the risk of reduced foot sensation. In relation to nail care, only 19% knew how to cut nails correctly. Conclusion: Knowledge, attitudes, and practices about diabetic foot care are substandard. There is a positive correlation between foot care knowledge and self-care practices. Hence, educating diabetic patients with foot care knowledge through an awareness program and the characteristics of diabetic shoes may improve self-care practices.

Keywords: DM, DFD, DFU, PHC, SPSS

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Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

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Authors: Suvorov Vasyl, Filipchuk Viktor

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Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).

Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy

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Authors: Khwaja Bahman Qaderi, Noorullah Rafiqee

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Background: With today's increasing Internet users, e-commerce has become a viable model for strengthening relationships between sellers, entrepreneurs, and consumers due to its speed, efficiency, and cost reduction. Agriculture is the economic backbone for 80 percent of the Afghan population. According to MCIT statistics, there are currently around 10 million internet users in Afghanistan. With this data, it was expected that Afghan people should have utilized e-commerce in their agricultural aspects, although it appears to be less used. Objective: This study examines the scope of e-commerce in Afghanistan's agriculture enterprises, how they harness the potential of internet users, and what obstacles they face in implementing e-commerce in their businesses. Method: The study distributed a 39-question questionnaire to agribusinesses in five different zones of Afghanistan. After extracting the responses and excluding the incomplete questionnaires, 280 were included in the analysis step to perform a non-parametric sign test. Result: E-commerce in Afghanistan faces four major political, economic, Internet, and technological obstacles, and no company in the country has implemented e-commerce. In addition, e-commerce is still in its infancy among agricultural companies in the country. Internet use is still primarily limited to email and sharing product images on Facebook & Instagram for advertising purposes. There are no companies that conduct international transactions via the Internet. Conclusion: This study contributes to knowing the challenges and barriers that the agriculture e-commerce faces in Afghanistan to find the effective solutions to use the capacity of internet users in the country and increase the sales rate of agricultural products through the Internet.

Keywords: E-commerce, barriers and challenges, agriculture companies, Afghanistan

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Authors: Shima Behzadi

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Background: In many human malignant tumors, microRNA expression is aberrant. This study investigates miR-141 as a prognostic marker in colorectal cancer with K-Ras mutation. Materials and methods: In this case-control study, 100 patients, mostly over the age of 50, who were diagnosed with colorectal cancer were selected. The pathology department of the Mostoufi Pathobiology and Genetics Laboratory in Tehran confirmed the presence of colorectal cancer in samples of paraffin-embedded colon tissue. The case group was composed of patients with codon 12 and 13 mutations in exon 2 of the K-Ras gene, while tumor samples of individuals without these mutations in exon 2 of the K-Ras gene were selected as the control group, with patient consent. The changes in the expression of miR-141 were examined in both groups. Results: The study found that 20% of the patients tested positive for codon 12 mutation, and 10% of patients had codon 13 mutation. As a result, in 30 cases, there was a higher level of miR-141 expression. The miR-141 gene expression level in K-Ras positive tumor samples was 1.5 times higher than its expression level in K-Ras negative samples. This increase in expression was statistically significant, with a p-value of less than 0.001, indicating that the observed results are highly statistically significant. Conclusion: The study revealed that the incidence of typical K-Ras gene mutations among the colorectal cancer patients in the sample matches the national average in Iran. Additionally, the expression of miR-141 can serve as a useful biomarker to aid in the prognosis of colorectal cancer.

Keywords: colorectal cancer, K-Ras gene, miR-141 marker, real time PCR, electrophoresis

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Authors: Zahra Azizi, Ashkan Karbasi, Farzin Firouzian, Sara Soleimani Asl, Akram Ranjbar

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Background: One of the most often used herbicides in agriculture is paraquat (PQ), which is very harmful to both people and animals. Chitosan is a well-known, non-toxic polymer commonly used in preparing particles via ionotropic gelation facilitated by negatively charged agents such as sodium alginate. This study aimed to compare the effects of PQ and nanoparaquat (PQNPs) on liver function in male rats. Materials & Methods: Rats were exposed to PQ & PQNPs (4 mg/kg/day, intraperitoneally) for seven days. Then, rats were anesthetized, and serum and liver samples were collected. Later, enzymatic activities such as alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) in serum and oxidative stress biomarkers such as lipid peroxidation (LPO), total antioxidant capacity (TAC) and total thiol groups (TTG) levels in liver tissue were measured by colorimetric methods. Also, histological changes in the liver were evaluated. Results: PQ altered the levels of ALT, AST, and ALP while inducing oxidative stress in the liver. Additionally, liver homogenates with PQ exposure had challenged LPO, TAC, and TTG levels. The severe liver damage is indicated by a significant increase in the enzyme activity of AST, ALT, and ALP in serum. According to the results of the current study, PQNPs, as compared to PQ and the control group, lowered ALT, AST, ALP, and LPO levels while increasing TAC and TTG levels. Conclusion: According to biochemical and histological investigations, PQ loaded in chitosan-alginate particles is more efficient than free PQ at reducing liver toxicity.

Keywords: paraquat, paraquat nanoparticles, liver, oxidative stress

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Authors: Liesbeth Van Kelst, Jozefiene Jansens

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Background: All care providers within mother and child care are confronted, at some point in their career, with the care for parents who (will) lose or have lost a baby. Obtaining the correct attitude and communicating well during these difficult moments are aspects that many healthcare provides continue to struggle with. Parents still encounter well-intentioned but inappropriate communication from healthcare providers. Aim: To study how communication, both verbal and non-verbal, around the death of a baby during pregnancy, birth, or in the first ten days postnatal was experienced by parents and healthcare providers. Methods: A qualitative study using grounded theory principles was conducted. Data were collected through 22 individual face-to-face in-depth interviews with parents who had lost a baby (n = 12) and intramural caregivers, such as midwives, nurses, gynecologists and neonatologists (n=10). In the first phase, data were analyzed within each group separately (parents and healthcare providers) and in the second phase, findings from both groups were compared and analyzed according to meta-synthesis principles. Results: The themes that emerged from the data demonstrated congruent experiences between the group of the parents and the health care providers. Both strengths and weaknesses in current care were named and suggestions for appropriate communication were formulated. Conclusion: Since most health care providers only occasionally care for parents with a deceased baby, a communication tool can optimize communication between healthcare professionals and parents who lose a baby. This is very important as the words which are said at this difficult period last a lifetime in the heads of parents.

Keywords: communication, death, perinatal loss, stillbirth

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Authors: Rabia Khaliala, Adi Vitman-Schorr

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Background: The increase in longevity of people on one hand, and on the other hand the fact that the social networks in later life become increasingly narrower, highlight the importance of Internet use to enhance quality of life (QoL). However, whether Internet use increases or decreases social networks, loneliness and quality of life is not clear-cut. Purposes: To explore the direct and/or indirect effects of Internet use on QoL, and to examine whether ethnicity and time the elderly spent with family moderate the mediation effect of Internet use on quality of life throughout loneliness. Methods: This descriptive-correlational study was carried out in 2016 by structured interviews with a convenience sample of 502 respondents aged 50 and older, living in northern Israel. Bootstrapping with resampling strategies was used for testing mediation a model. Results: Use of the Internet was found to be positively associated with QoL. However, this relationship was mediated by loneliness, and moderated by the time the elderly spent with family members. In addition, respondents' ethnicity significantly moderated the mediation effect between Internet use and loneliness. Conclusions: Internet use can enhance QoL of older adults directly or indirectly by reducing loneliness. However, these effects are conditional on other variables. The indirect effect moderated by ethnicity, and the direct effect moderated by the time the elderly spend with their families. Researchers and practitioners should be aware of these interactions which can impact loneliness and quality of life of older persons differently.

Keywords: internet use, loneliness, quality of life, social contacts

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Authors: Djeamsly Salomon

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Background: Epidemiological surveillance is a dynamic national system used to observe all aspects of the evolution of priority health problems, through: collection, analysis, systematic interpretation of information, and dissemination of results with necessary recommendations. The study was conducted to assess the mandatory disease surveillance system in the Sud Department. Methods: A study was conducted from March to May 2021 with key players involved in surveillance at the level of health institutions in the department . The CDC's 2021 updated guideline was used to evaluate the system. We collected information about the operation, attributes, and usefulness of the surveillance system using interviewer-administered questionnaires. Epi-Info7.2 and Excel 2016 were used to generate the mean, frequencies and proportions. Results: Of 30 participants, 23 (77%) were women. The average age was 39 years[30-56]. 25 (83%) had training in epidemiological surveillance. (50%) of the forms checked were signed by the supervisor. Collection tools were available at (80%). Knowledge of at least 7 notifiable diseases was high (100%). Among the respondents, 29 declared that the collection tools were simple, 27 had already filled in a notification form. The maximum time taken to fill out a form was 10 minutes. The feedback between the different levels was done at (60%). Conclusion: The surveillance system is useful, simple, acceptable, representative, flexible, stable and responsive. The data generated was of high quality. However, it is threatened by the lack of supervision of sentinel sites, lack of investigation and weak feedback. This evaluation demonstrated the urgent need to improve supervision in the sites and to feedback information. Strengthen epidemiological surveillance.

Keywords: evaluation, notifiable diseases, surveillance, system

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Authors: Rajani S. Pujar, Pandurangarao N. Kulkarni

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Increased temporal masking affects the speech perception in persons with sensorineural hearing impairment especially under adverse listening conditions. This paper presents a cascaded scheme, which employs a noise reduction algorithm as well as temporal splitting of the speech signal. Earlier investigations have shown that by splitting the speech temporally and presenting alternate segments to the two ears help in reducing the effect of temporal masking. In this technique, the speech signal is processed by two fading functions, complementary to each other, and presented to left and right ears for binaural dichotic presentation. In the present study, half cosine signal is used as a fading function with crossover gain of 6 dB for the perceptual balance of loudness. Temporal splitting is combined with noise reduction algorithm to improve speech perception in the background noise. Two noise reduction schemes, namely spectral subtraction and Wiener filter are used. Listening tests were conducted on six normal-hearing subjects, with sensorineural loss simulated by adding broadband noise to the speech signal at different signal-to-noise ratios (∞, 3, 0, and -3 dB). Objective evaluation using PESQ was also carried out. The MOS score for VCV syllable /asha/ for SNR values of ∞, 3, 0, and -3 dB were 5, 4.46, 4.4 and 4.05 respectively, while the corresponding MOS scores for unprocessed speech were 5, 1.2, 0.9 and 0.65, indicating significant improvement in the perceived speech quality for the proposed scheme compared to the unprocessed speech.

Keywords: MOS, PESQ, spectral subtraction, temporal splitting, wiener filter

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Authors: Jun Hong Lee

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Background: Alzheimer`s disease (AD) I: creases with age and is characterized by the premature progressive loss of neuronal cell. In contrast, cancer cells have inappropriate cell proliferation and resistance to cell death. Objective: We evaluated the association between cancer and AD and also examined the specific types of cancer. Patients and Methods/Material and Methods: This retrospective, nationwide, longitudinal study used National Health Insurance Service – Senior cohort (NHIS-Senior) 2002-2013, which was released by the KNHIS in 2016, comprising 550,000 random subjects who were selected from over than 60. The study included a cohort of 4,408 patients who were first diagnoses as AD between 2003 and 2005. To match each dementia patient, 19,150 subjects were selected from the database by Propensity Score Matching. Results: We enrolled 4,790 patients for analysis in this cohort and the prevalence of AD was higher in female (19.29%) than in male (17.71%). A higher prevalence of AD was observed in the 70-84 year age group and in the higher income status group. A total of 540 cancers occurred within the observation interval. Overall cancer was less frequent in those with AD (12.25%) than in the control (18.46%), with HR 0.704 (95% Confidence Intervals (CIs)=0.0.64-0.775, p-Value < 0.0001). Conclusion: Our data showed a decreased incidence of overall cancers in patients with AD similar to previous studies. Patients with AD had a significantly decreased risk of colon & rectum, lung and stomach cancer. This finding lower than but consistent with Western countries. We need further investigation of genetic evidence linking AD to cancer.

Keywords: Alzheimer, cancer, nationwide, longitudinal study

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Authors: Deng Zengming, Wang Mingjiang

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As 3D video is explored as a hot research topic in the last few decades, free-viewpoint TV (FTV) is no doubt a promising field for its better visual experience and incomparable interactivity. View synthesis is obviously a crucial technology for FTV; it enables to render images in unlimited numbers of virtual viewpoints with the information from limited numbers of reference view. In this paper, a novel hybrid synthesis framework is proposed and blending priority is explored. In contrast to the commonly used View Synthesis Reference Software (VSRS), the presented synthesis process is driven in consideration of the temporal correlation of image sequences. The temporal correlations will be exploited to produce fine synthesis results even near the foreground boundaries. As for the blending priority, this scheme proposed that one of the two reference views is selected to be the main reference view based on the distance between the reference views and virtual view, another view is chosen as the auxiliary viewpoint, just assist to fill the hole pixel with the help of background information. Significant improvement of the proposed approach over the state-of –the-art pixel-based virtual view synthesis method is presented, the results of the experiments show that subjective gains can be observed, and objective PSNR average gains range from 0.5 to 1.3 dB, while SSIM average gains range from 0.01 to 0.05.

Keywords: fusion method, Gaussian mixture model, hybrid framework, view synthesis

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Authors: M. Juffrie, Siti Helmyati, Toto Sudargo, B. J. Istiti Kandarina

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Background: Iron fortification is one potential way to overcome anemia but it can cause gut microbiota imbalance. Probiotics addition can increase the growth of good gut bacteria while prebiotics can support the probiotics growth. Tempeh is rich in nutrients required for hemoglobin synthesis, such as protein, vitamin B12, vitamin C, zinc, iron and copper. Objective: To know the efficacy of fermented tempeh extract fortified with iron and synbiotic in maintain gut microbiota balance. Methods: Fermented synbiotic tempeh extract was made using Lactobacillus plantarum Dad13 and Fructo-oligosaccharides. A total of 32 anemic Wistar rats underwent the iron repletion phase then divided into 4 groups, given: 1) Fermented synbiotic tempeh extract with 50 ppm Fe/NaFeEDTA (Na), 2) Fermented synbiotic tempeh extract with 50 ppm Fe/FeSO4 (Fe), 3) Fermented synbiotic tempeh extract (St), and 4) not receive any interventions (Co). Rats were feed AIN-93 free Fe during intervention. Gut microbiota was measured with culture technique using selective media agar while hemoglobin concentration (Hb) was measured with photometric method before and after intervention. Results: There were significant increase in Hb after intervention in Na, Fe, and St, 6.85 to 11.80; 6.41 to 11.48 and 6.47 to 11.03 mg/dL, respectively (p <0.05). Co did not show increase in Hb (6.40 vs. 6.28 mg/dL). Lactobacilli increased in all groups while both of Bifidobacteria increased and E. coli decreased only in Na and St groups. Conclusion: Iron fortification of fermented synbiotic tempeh extract can increase hemoglobin concentrations in anemic animal, increase Lactobacilli and decrease E. coli. It can be an alternative solution to conduct iron fortification without deteriorate the gut microbiota.

Keywords: tempeh, synbiotic, iron, haemoglobin, gut microbiota

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Authors: Mahshid Rezaei, Zahra Tajari, Zahra Esmaeily, Atefeh Eyvazkhani, Shahrzad Daei, Marjan Mansouri Dara, Mohaddesh Rezaei, Abolghassem Djazayeri, Ahmadreza Dorosti Motlagh

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Background: Musculoskeletal pain is one of the most prevalent symptoms in elderly age. Nutrition and diet are considered important underlying factors that could affect chronic musculoskeletal pain. The purpose of this study was to identify the relationship between empirical dietary inflammatory patterns (EDII) and musculoskeletal pain. Method: In this cross-sectional study, 213 elderly individuals were selected from several health centers. The usual dietary intake was evaluated by a valid and reliable 147-items food frequency questionnaire (FFQ). To measure the intensity of pain, Visual Analogue Scale (VAS) was used. Multiple Linear Regression was applied to assess the association between EDII and musculoskeletal pain. Results: The results of multiple linear regression analysis indicate that a higher EDII score was associated with higher musculoskeletal pain (β= 0.21: 95% CI: 0.24-1.87: P= 0.003). These results stayed significant even after adjusting for covariates such as sex, marital status, height, family number, sleep, BMI, physical activity duration, waist circumference, protector, and medication use (β= 0.16: 95% CI: 0.11-1.04: P= 0.02). Conclusion: Study findings indicated that higher inflammation of diet might have a direct association with musculoskeletal pains in elderlies. However, further investigations are required to confirm these findings.

Keywords: musculoskeletal pain, empirical dietary inflammatory pattern, elderlies, dietary pattern

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Authors: Ya-Ching Wang, Yi-Maun Subeq

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Background: There is a lack of evidence to understand differences in risk for developing breast cancer between sexual minority women and heterosexual women in Taiwan. The purpose of this study is to compare differences in risk for developing breast cancer between the two groups of Taiwanese women. Methods: An online cross-sectional survey was used to collect data. A total of 238 Taiwanese women (mean age 30.69 years old, SD=8.231, range 20-60) were recruited between December 2016 and February 2017, including 115 heterosexual women and 123 sexual minority women. Results: There were no significant differences between heterosexual women and sexual minority women in body mass index, history of non-malignant breast disease, age at menarche and menopause, use of hormone replacement therapy, use of hormone replacement therapy, nor the prevalence of breast cancer. The sexual minority women had higher rates of current drinking, smoking and using breast-bindings and also reported exercise more a week; the heterosexual women had higher rates of pregnancy, children, breastfeed, miscarriages, abortion and use of birth control pills. Discussion/Conclusion: There were significant differences between heterosexual women and sexual minority women in reproductive factors and behavioral risk factors for the development of breast cancer. In particular, the finding that the sexual minority women had higher rate of using breast-bindings (56.6%) than the heterosexual women (4.7%) should be further explore, in order to understand whether long-term breast compression is associated with the development of breast cancer.

Keywords: breast cancer, risk, sexual orientation, Taiwan

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Authors: Mary Esere, Mogbekeloluwa Fakokunde, Adetoun Idowu

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Background: Working in a military setting could elicit some amount of stressful doses into ones system because of the attendant peculiar characteristics found in the military environment. Thus, this study was carried out to find out the sources of occupational stress among teachers in various Command Secondary Schools within 2 Division of Nigerian Army. Method: The study employed a survey method. Simple random sampling technique was used to select the schools in the Division. A total of 200 respondents participated in the study. Sources of Teachers’ Occupational Stress Questionnaire (STOSQ) was administered to the respondents to collect relevant data. The t-test and Analysis of Variance (ANOVA) statistics were used to test the hypotheses. Findings: From the study, it was discovered that teachers in this setting do experience occupational stress. Their major sources of stress bother on issues relating to salaries and allowances and staff welfare concerns. The findings also revealed that there were no significant differences in the sources of occupational stress among the teachers in respect to gender and marital status. Discussion: Based on these findings, it was recommended that the Appropriate Superior Authority (ASA) should reconstitute the proscribed Armed Forces Schools Management Board (AFSMB) where issues, such as staff salaries and welfare concerns for teachers working in the schools under the three services (Army, Navy, Airforce) will always be addressed. This will go a long way in enhancing the psychological well-being of the teachers.

Keywords: Nigerian army, occupational stress, sources, teachers

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Authors: Pinyada Santisarun, Yaowaret Tharawoot, Songyut Akkakoson

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This paper reports on a literature review sub-study of a larger research project which has been designed to identify the rhetorical organization of a travel writing genre, together with the use of lexical choices, syntactical structures, and graphological features, based on a randomly-selected corpus of Thailand travel listicles. Conducted as a library-based overview, this study aims to specify theoretical and practical elements for the said larger study. The materials for the review have been retrieved from various Internet sources, covering both public search engines and library databases. Generally, the article focuses on answering questions about the ‘what’ and the ‘how’ of such background elements widely discussed in the literature as the meaning of listicles, how the travel listicles’ patterns and regularities can be categorized to form a new genre, the effect of computer-mediated communication on the travel world, the travel language, and the current situation concerning the importance of travel listicles. The theoretical and practical data derived from this study provide valuable insights into the way in which the genre analysis and lexico-syntactical examination of Thailand travel listicles in the present authors’ larger research project can be properly conducted. The data gained can be added to the expanding body of knowledge in the field of the ESP genre.

Keywords: computer-mediated communication, digital writing, genre-based analysis, online travel writing, tourism language

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Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan

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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.

Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India

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Authors: Maria Magdy Danial Riad

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Background: In the United Kingdom (UK), pharmacists' roles have expanded considerably in recent decades to encompass clinical practice through more direct patient care. However, dispensing and compounding remain core activities for pharmacists. A lack of marketed preparations for species-specific animal use results in veterinary pharmacy practice compounding, retaining its prominence. Current participation by pharmacists to support this sphere of practice would appear to be minimal. Objectives: This study was undertaken to determine the opinions and views toward the practice of veterinary pharmacy by a cross-sectional group of pharmacists. Methods: Research data were collected via a self-administered survey questionnaire distributed at the 2012 annual conference of the Royal Pharmaceutical Society. Sampling was purposive, with a random distribution of the questionnaire to pharmacists during the conference sessions. Key findings: Interaction by pharmacists with veterinary pharmacies is currently minimal, primarily due to a lack of knowledge of veterinary medicines. Respondents revealed a lack of veterinary pharmacy courses during their undergraduate studies. This has led to situations where some veterinary prescriptions are dispensed without adequate checks being performed by the pharmacist. Pharmacists, on occasion, do not dispense veterinary prescriptions presented to them due to insufficient knowledge of veterinary medicines and/or a lack of consultable reference sources. The effect on practice is that pharmacists do not always participate as fully as would seem logical. Conclusions: Pharmacists' participation in veterinary pharmacy is limited by a lack of knowledge of veterinary medicines, mostly resulting from inadequate tuition on veterinary pharmacy during their initial education.

Keywords: veterinary pharmacy, veterinary medicines, pharmacy education, pharmacists continuing professional development

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Authors: Kimton Opiyo, Elliot M. Berry, Patil Karamchand, Barnabas K. Natamba

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Background: Postpartum depression (PPD) is a major psychiatric disorder that affects women soon after birth and in some cases, is a continuation of antenatal depression. Food insecurity (FI) and social support (SS) are known to be associated with major depressive disorder, and vice versa. This study was conducted to examine the interrelationships among FI, SS, and PPD among postpartum women in Gulu, a post-conflict region in Uganda. Methods: Cross-sectional data from postpartum women on depression symptoms, FI and SS were, respectively, obtained using the Center for Epidemiologic Studies-Depression (CES-D) scale, Individually Focused FI Access scale (IFIAS) and Duke-UNC functional social support scale. Standard regression methods were used to assess associations among FI, SS, and PPD. Results: A total of 239 women were studied, and 40% were found to have any PPD, i.e., with depressive symptom scores of ≥ 17. The mean ± standard deviation (SD) for FI score and SS scores were 6.47 ± 5.02 and 19.11 ± 4.23 respectively. In adjusted analyses, PPD symptoms were found to be positively associated with FI (unstandardized beta and standardized beta of 0.703 and 0.432 respectively, standard errors =0.093 and p-value < 0.0001) and negatively associated with SS (unstandardized beta and standardized beta of -0.263 and -0.135 respectively, standard errors = 0.111 and p-value = 0.019). Conclusions: Many women in this post-conflict region reported experiencing PPD. In addition, this data suggest that food security and psychosocial support interventions may help mitigate women’s experience of PPD or its severity.

Keywords: postpartum depression, food insecurity, social support, post-conflict region

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Authors: Zoltan Abram

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Background: In the last time it was hardly increased the prevalence of psychical diseases and disorders which reduce work capacity, life quality and life expectancy. Objectives: The aim of our research is to study the psychical health state of the Romanian adults living in the middle part of the country and the role of some economical, psychological and social factors, especially in relationship with depression. Methods: The study is based on a complex anonymous questionnaire, including Beck depressive scale, which was completed by a representative sample among adult population. The applied method was a combination between stratification and more-steps sampling. Results: After our results depression is the most common psychical illness with 9,1% diagnosis, but the tendency to depression, the existence of depressive symptoms is much higher than the treated illness. The percentage of suicide attempt among the studied population was 2,9%. It is analysed how gender, age, professional and social status, living and working conditions and different social factors are influencing the health state. According to Beck score, it was established a significant difference in the favour of female, elderly people, lower educational level, urban population. Conclusions: In our study it is underlined the importance of health promotion and education. It is concluded that improving living standards, modifying in a proper way the lifestyle of the population, we can positively influence the physical and mental health state of the Romanian adult population.

Keywords: Beck scale, depression, psychological aspects, suicide attempt

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Authors: Hye-Young Shin, Chan Kee Park

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Background: To compare the thinning patterns of the ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) as measured using Cirrus high-definition optical coherence tomography (HD-OCT) in patients with visual field (VF) defects that respect the vertical meridian. Methods: Twenty eyes of eleven patients with VF defects that respect the vertical meridian were enrolled retrospectively. The thicknesses of the macular GCIPL and pRNFL were measured using Cirrus HD-OCT. The 5% and 1% thinning area index (TAI) was calculated as the proportion of abnormally thin sectors at the 5% and 1% probability level within the area corresponding to the affected VF. The 5% and 1% TAI were compared between the GCIPL and pRNFL measurements. Results: The color-coded GCIPL deviation map showed a characteristic vertical thinning pattern of the GCIPL, which is also seen in the VF of patients with brain lesions. The 5% and 1% TAI were significantly higher in the GCIPL measurements than in the pRNFL measurements (all P < 0.01). Conclusions: Macular GCIPL analysis clearly visualized a characteristic topographic pattern of retinal ganglion cell (RGC) loss in patients with VF defects that respect the vertical meridian, unlike pRNFL measurements. Macular GCIPL measurements provide more valuable information than pRNFL measurements for detecting the loss of RGCs in patients with retrograde degeneration of the optic nerve fibers.

Keywords: brain lesion, macular ganglion cell, inner plexiform layer, spectral-domain optical coherence tomography

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Authors: Elif Ates, Naile Bilgili

Abstract:

Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

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Authors: Alok Raghav, Jamal Ahmad

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Background: Serum albumin glycation and advanced glycation end products (AGE) formation correlates in diabetes and its associated complications. Extensive modified human serum albumin is used to study the biochemical, electrochemical and functional properties in hyperglycemic environment with relevance to diabetes. We evaluate Spectroscopic, side chain modifications, amino acid analysis, biochemical and functional group properties in four glucose modified samples. Methods: A series four human serum albumin samples modified with glucose was characterized in terms of amino acid analysis, spectroscopic properties and side chain modifications. The diagnostic technique employed incorporates UV Spectroscopy, Fluorescence Spectroscopy, biochemical assays for side chain modifications, amino acid estimations, electrochemical and optical characterstic of glycated albumin. Conclusion: Glucose modified human serum albumin confers AGEs formation alters biochemical, electrochemical, optical, and functional property that depend on the reactivity of glucose and its concentration used for in-vitro glycation. A biochemical, electrochemical, optical, and functional characterization of modified albumin in-vitro produced AGE product that will be useful to interpret the complications and pathophysiological significance in diabetes.

Keywords: human serum albumin, glycated albumin, adavanced glycation end products, associated pathologies

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Authors: Kelvin Mwaba, Nicole Strickland

Abstract:

Background and Objectives: Overexploitation and illegal fishing have been identified as the primary cause of the global decline in the fish stock. While commercial companies and small-scale fishing sectors are strictly regulated in South Africa, recreational anglers are not. The underlying assumption seems to be that recreational anglers can self-regulate. The aim of the present study was to investigate the relationship that recreational anglers have with nature and how this relationship can predict unlawful fishing practices. Methods: Using a survey design, 99 self-identified recreational anglers were recruited through convenient sampling. The anglers were accessed from fishing tackle shops around False Bay in the Western Cape province of South Africa. Data was collected using a self-administered questionnaire that consisted of pro-environmental behavior survey and the Nature Relatedness Scale. Results: Data analyses indicated that significant differences with regard to nature relatedness on the basis of participants’ age and level of education. Older and more educated anglers scored higher on nature relatedness than younger and less educated anglers. Logistic regression analysis showed that nature relatedness was a significant predictor of pro-environmental behaviors (R²= 0.061). Discussion and Conclusion: The findings of the present study provide support regarding the importance of encouraging healthy and sustainable relationships between humans and nature. Combating harmful fishing practices can achieve through understanding and promoting human care for nature among anglers and others involved in fishing.

Keywords: pro-environmental, behavior, anglers, South Africa

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Authors: Jaime R. Silva, Gabriel E. Reyes, Marianne Krause

Abstract:

Background: The two-polarity model of the depressive personality argues that experience is organized around two axes: interpersonal relatedness and self-definition. Differential emphasis on one of these poles defines three types of depressive experience: Anaclitic, Introjective or Mixed pattern. On the one hand, Anaclitic pattern has been conceptually related with exaggerated biological stress sensitivity. On the other hand, the Introjective pattern was linked with anhedonic symptomatology. The general aim of the study was to find empirical support for this relationship. Methods: 101 non-clinical individuals participated in two experimental sessions. During the first session, the biological stress reactivity (cortisol concentration in saliva) and the subjective stress perceived (self-reported) during the Trier Social Stress Test (TSST), were investigated. In the second session, a visual discrimination task with a specific reward system, to study the reinforcement sensitivity (anhedonia), was performed. Results: Results evidenced that participants with Introjective depressive symptoms showed a higher interpersonal sensitivity and a diminished sensitivity to reinforcement. In addition, results also indicated that such a group has a poor psychological detection of its exacerbated reactivity to stress, which is the opposite pattern evidenced amongst the Anaclitic group. Conclusions: In perspective, these results empirically support the two-polarity of the depressive personality model. Clinical implications are discussed.

Keywords: depression, interpersonal stress, personality, trier social stress test

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Authors: A. Haddick, A. Soltan

Abstract:

Background: During the period of recovery from an operative obstetric procedure, a woman is not only at risk of the life-threatening complications accompanying labour but also those associated with surgery and anaesthesia. It is speculated that women in the recovery area may receive a lower standard of care over a night shift. Thus obstetric recovery room care should be evaluated regularly to ensure all women receive an equally high standard of care 24/7. Aim: The aim of this audit was to undertake an audit in the Liverpool Women’s Hospital on the care in recovery, and to ascertain the extent to which the standards were met. This audit included the full audit cycle. Method: Standards were taken from the AAGBI, RCOA, NICE and CNST guidelines. There were 12 standards including appropriate documentation of vital signs and appropriate length of stay after surgery. Notes from 100 patients were analysed from March 2011-March 2012. There were 52 day notes and 48 night notes; these were accessed to gain the relevant data. In the re audit 35 notes were accessed from March 14-September 14. Results: The Liverpool Women’s Hospital met in total 10 of these standards. 10 were met during the day shift (83%) and 0 met during the night shift. In the re audit, there was a significant improvement in the standards met at night. 9 of the standards were met during the day and 7 of the standards were met at night. Clearly there are still improvements to be made. Conclusions: In the original audit, an audit action plan was formulated. This was following discussion of the results of this audit in an MDT meeting and presentation with a consultant Obstetrician, the head of Midwifery, the head of Obstetrics theatres and a recovery nurse. This audit will be further discussed in the Liverpool Woman's Hospital in July 2015 for further implementation for improvement.

Keywords: care, recovery, room, women

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Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: S. Bilal, S. A. Bhat, I. Hussain, J. D. Parrah, S. P. Ahmad, M. R. Mir

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Background: The wound healing involves a highly coordinated cascade of cellular and immunological response over a period including coagulation, inflammation, granulation tissue formation, epithelialization, collagen synthesis and tissue remodeling. Wounds in aged heal more slowly than those in younger, mainly because of comorbidities that occur as one age. The present study is about the influence of age on wound healing. 1x1cm^2 (100 mm) wounds were created on the back of the animal. The animals were divided into two groups; one group had animals in the age group of 3-9 months while another group had animals in the age group of 15-21 months. Materials and Methods: 24 clinically healthy rabbits in the age group of 3-21 months were used as experimental animals and divided into two groups viz A and B. All experimental parameters, i.e., Excision wound model, Measurement of wound area, Protein extraction and estimation, Protein extraction and estimation and DNA extraction and estimation were done by standard methods. Results: The parameters studied were wound contraction, hydroxyproline, glucosamine, protein, and DNA. A significant increase (p<0.005) in the hydroxyproline, glucosamine, protein and DNA and a significant decrease in wound area (p<0.005) was observed in the age group of 3-9 months when compared to animals of an age group of 15-21 months. Wound contraction together with hydroxyproline, glucosamine, protein and DNA estimations suggest that advanced age results in retarded wound healing. Conclusion: The decrease wound contraction and accumulation of hydroxyproline, glucosamine, protein and DNA in group B animals may be associated with the reduction or delay in growth factors because of the advancing age.

Keywords: age, wound healing, excision wound, hydroxyproline, glucosamine

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Authors: Sara Herrero Jaén, José María Santamaría García, María Lourdes Jiménez Rodríguez, Jorge Luis Gómez González, Adriana Cercas Duque, Alexandra González Aguna

Abstract:

Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.

Keywords: calculator, care, eHealth, health

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