Search results for: cognitive pain modulation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3290

Search results for: cognitive pain modulation

1430 Elevated Systemic Oxidative-Nitrosative Stress and Cerebrovascular Function in Professional Rugby Union Players: The Link to Impaired Cognition

Authors: Tom S. Owens, Tom A. Calverley, Benjamin S. Stacey, Christopher J. Marley, George Rose, Lewis Fall, Gareth L. Jones, Priscilla Williams, John P. R. Williams, Martin Steggall, Damian M. Bailey

Abstract:

Introduction and aims: Sports-related concussion (SRC) represents a significant and growing public health concern in rugby union, yet remains one of the least understood injuries facing the health community today. Alongside increasing SRC incidence rates, there is concern that prior recurrent concussion may contribute to long-term neurologic sequelae in later-life. This may be due to an accelerated decline in cerebral perfusion, a major risk factor for neurocognitive decline and neurodegeneration, though the underlying mechanisms remain to be established. The present study hypothesised that recurrent concussion in current professional rugby union players would result in elevated systemic oxidative-nitrosative stress, reflected by a free radical-mediated reduction in nitric oxide (NO) bioavailability and impaired cerebrovascular and cognitive function. Methodology: A longitudinal study design was adopted across the 2017-2018 rugby union season. Ethical approval was obtained from the University of South Wales Ethics Committee. Data collection is ongoing, and therefore the current report documents result from the pre-season and first half of the in-season data collection. Participants were initially divided into two subgroups; 23 professional rugby union players (aged 26 ± 5 years) and 22 non-concussed controls (27 ± 8 years). Pre-season measurements were performed for cerebrovascular function (Doppler ultrasound of middle cerebral artery velocity (MCAv) in response to hypocapnia/normocapnia/hypercapnia), cephalic venous concentrations of the ascorbate radical (A•-, electron paramagnetic resonance spectroscopy), NO (ozone-based chemiluminescence) and cognition (neuropsychometric tests). Notational analysis was performed to assess contact in the rugby group throughout each competitive game. Results: 1001 tackles and 62 injuries, including three concussions were observed across the first half of the season. However, no associations were apparent between number of tackles and any injury type (P > 0.05). The rugby group expressed greater oxidative stress as indicated by increased A•- (P < 0.05 vs. control) and a subsequent decrease in NO bioavailability (P < 0.05 vs. control). The rugby group performed worse in the Ray Auditory Verbal Learning Test B (RAVLT-B, learning, and memory) and the Grooved Pegboard test using both the dominant and non-dominant hands (visuomotor coordination, P < 0.05 vs. control). There were no between-group differences in cerebral perfusion at baseline (MCAv: 54 ± 13 vs. 59 ± 12, P > 0.05). Likewise, no between-group differences in CVRCO2Hypo (2.58 ± 1.01 vs. 2.58 ± 0.75, P > 0.05) or CVRCO2Hyper (2.69 ± 1.07 vs. 3.35 ± 1.28, P > 0.05) were observed. Conclusion: The present study identified that the rugby union players are characterized by impaired cognitive function subsequent to elevated systemic-oxidative-nitrosative stress. However, this appears to be independent of any functional impairment in cerebrovascular function. Given the potential long-term trajectory towards accelerated cognitive decline in populations exposed to SRC, prophylaxis to increase NO bioavailability warrants consideration.

Keywords: cognition, concussion, mild traumatic brain injury, rugby

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1429 A Conceptual Model of the 'Driver – Highly Automated Vehicle' System

Authors: V. A. Dubovsky, V. V. Savchenko, A. A. Baryskevich

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The current trend in the automotive industry towards automatic vehicles is creating new challenges related to human factors. This occurs due to the fact that the driver is increasingly relieved of the need to be constantly involved in driving the vehicle, which can negatively impact his/her situation awareness when manual control is required, and decrease driving skills and abilities. These new problems need to be studied in order to provide road safety during the transition towards self-driving vehicles. For this purpose, it is important to develop an appropriate conceptual model of the interaction between the driver and the automated vehicle, which could serve as a theoretical basis for the development of mathematical and simulation models to explore different aspects of driver behaviour in different road situations. Well-known driver behaviour models describe the impact of different stages of the driver's cognitive process on driving performance but do not describe how the driver controls and adjusts his actions. A more complete description of the driver's cognitive process, including the evaluation of the results of his/her actions, will make it possible to more accurately model various aspects of the human factor in different road situations. This paper presents a conceptual model of the 'driver – highly automated vehicle' system based on the P.K. Anokhin's theory of functional systems, which is a theoretical framework for describing internal processes in purposeful living systems based on such notions as goal, desired and actual results of the purposeful activity. A central feature of the proposed model is a dynamic coupling mechanism between the decision-making of a driver to perform a particular action and changes of road conditions due to driver’s actions. This mechanism is based on the stage by stage evaluation of the deviations of the actual values of the driver’s action results parameters from the expected values. The overall functional structure of the highly automated vehicle in the proposed model includes a driver/vehicle/environment state analyzer to coordinate the interaction between driver and vehicle. The proposed conceptual model can be used as a framework to investigate different aspects of human factors in transitions between automated and manual driving for future improvements in driving safety, and for understanding how driver-vehicle interface must be designed for comfort and safety. A major finding of this study is the demonstration that the theory of functional systems is promising and has the potential to describe the interaction of the driver with the vehicle and the environment.

Keywords: automated vehicle, driver behavior, human factors, human-machine system

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1428 In vivo Antiplatelet Activity Test of Wet Extract of Mimusops elengi L.'s Leaves on DDY Strain Mice as an Effort to Treat Atherosclerosis

Authors: Dewi Tristantini, Jason Jonathan

Abstract:

Coronary Artery Disease (CAD) is one of the deathliest diseases which is caused by atherosclerosis. Atherosclerosis is a disease that plaque builds up inside the arteries. Plaque is made up of fat, cholesterol, calcium, platelet, and other substances found in blood. The current treatment of atherosclerosis is to provide antiplatelet therapy treatment, but such treatments often cause gastrointestinal irritation, muscle pain and hormonal imbalance. Mimusops elengi L.’s leaves can be utilized as a natural and cheap antiplatelet’s source because it contains flavonoids such as quertecin. Antiplatelet aggregation effect of Mimusops elengi L.’s leaves’ wet extract was measured by bleeding time on DDY strain mice with the test substances were given orally during the period of 8 days. The bleeding time was measured on first day and 9th day. Empirically, the dose which is used for humans is 8.5 g of leaves in 600 ml of water. This dose is equivalent to 2.1 g of leaves in 350 ml of water for mice. The extract was divided into 3 doses for mice: 0.05 ml/day; 0.1 ml/day; 0.2 ml/day. After getting the percentage of the increase in bleeding time, data were analyzed by analysis of variance test (Anova), followed by individual comparison within the groups by LSD test. The test substances above respectively increased bleeding time 21%, 62%, and 128%. As the conclusion, the 0.02 ml/day dose of Mimusops elengi L.’s leaves’ wet extract could increase bleeding time better than clopidogrel as positive controls with 110% increase in bleeding time.

Keywords: antiplatelets, atheroschlerosis, bleeding time, Mimusops elengi

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1427 Campylobacteriosis as a Zoonotic Disease

Authors: A. Jafarzadeh, G. R. Hashemi Tabar

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Campylobacteriosis is caused by Campylobacter organisms. This is most commonly caused by C. jejuni, It is among the most common bacterial infections of humans, often a foodborne illness. It produces an inflammatory, sometimes bloody, diarrhea or dysentery syndrome, mostly including cramps, fever and pain. It is found in cattle, swine, and birds, where it is non-pathogenic. But the illness can also be caused by C. coli (also found in cattle, swine, and birds) C. upsaliensis (found in cats and dogs) and C. lari (present in seabirds in particular). Infection with a Campylobacter species is one of the most common causes of human bacterial gastroenteritis. For instance, an estimated 2 million cases of Campylobacter enteritis occur annually in the U.S., accounting for 5-7% of cases of gastroenteritis. Furthermore, in the United Kingdom during 2000 Campylobacter jejuni was involved in 77.3% in all cases of foodborne illness. 15 out of every 100,000 people are diagnosed with campylobacteriosis every year, and with many cases going unreported, up to 0.5% of the general population may unknowingly harbor Campylobacter in their gut annually. A large animal reservoir is present as well, with up to 100% of poultry, including chickens, turkeys, and waterfowl, having asymptomatic infections in their intestinal tracts. An infected chicken may contain up to 109 bacteria per 25 grams, and due to the installations, the bacteria is rapidly spread to other chicken. This vastly exceeds the infectious dose of 1000-10,000 bacteria for humans. In this article this disease is fully discussed in human and animals.

Keywords: campylobacteriosis, human, animal, zoonosis

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1426 A Comparative Study of Active Release Technique and Myofascial Release Technique in Treatment of Patients with Upper Trapezius Spasm

Authors: Daxa Mishra, R. Harihara, Ankita

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Trapezius muscle pain is the most common musculoskeletal disorder occurring in individuals who work with awkward positions, have repetitive movements and movements with precision demands. Treatment techniques like active release technique (ART) and myofascial release (MFR) can be used to relieve muscle spasm. The aim of the study is to compare the effect of ART and MFR on the upper trapezius muscle spasm. Methodology: A series of 60 patients of both sexes between the age group of 20 and 55 with upper trapezius spasm were divided into two groups by computerized randomization. Subjects in each group received treatment in the form of either ART or MFR for the period of seven days. cervical range of motion (ROM), neck disability index scale (NDI) and visual analog scale (VAS) tools were used to measure the outcome. Results: Paired Sample ‘t’ test was used to compare the Outcome differences within each group, while Independent ‘t’ test was used to compare the differences between the two groups for the same outcome measures. The improvement was found in both the groups at 7th day following intervention, but the group which received ART showed significant improvements as compared to group which received MFR. Conclusion: Although both techniques are effective in alleviation of symptoms and associated disability in upper trapezius muscle spasm, ART gave better results as compared to MRF.

Keywords: goniometer, myofascial release, active release, physiotherapy

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1425 Investigating Role of Novel Molecular Players in Forebrain Roof-Plate Midline Invagination

Authors: Mohd Ali Abbas Zaidi, Meenu Sachdeva, Jonaki Sen

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In the vertebrate embryo, the forebrain anlagen develops from the anterior-most region of the neural tube which is the precursor of the central nervous system (CNS). The roof plate located at the dorsal midline region of the forebrain anlagen, acts as a source of several secreted molecules involved in patterning and morphogenesis of the forebrain. One such key morphogenetic event is the invagination of the forebrain roof plate which results in separation of the single forebrain vesicle into two cerebral hemispheres. Retinoic acid (RA) signaling plays a key role in this process. Blocking RA signaling at the dorsal forebrain midline inhibits dorsal invagination and results in the absence of certain key features of this region, such as thinning of the neuroepithelium and a lowering of cell proliferation. At present we are investigating the possibility of other signaling pathways acting in concert with RA signaling to regulate this process. We have focused on BMP signaling, which we found to be active in a mutually exclusive domain to that of RA signaling within the roof plate. We have also observed that there is a change in BMP signaling activity on modulation of RA signaling indicating an antagonistic relationship between the two. Moreover, constitutive activation of BMP signaling seems to completely inhibit thinning and partially affect invagination, leaving the lowering of cell proliferation in the midline unaffected. We are employing in-silico modeling as well as molecular manipulations to investigate the relative contribution if any, of regional differences in rates of cell proliferation and thinning of the neuroepithelium towards the process of invagination. We have found expression of certain cell adhesion molecules in forebrain roof-plate whose mRNA localization across the thickness of neuroepithelium is influenced by Bmp and RA signaling, giving regional rigidity to roof plate and assisting invagination. We also found expression of certain cytoskeleton modifiers in a localized small domains in invaginating forebrain roof plate suggesting that midline invagination is under control of many factors.

Keywords: bone morphogenetic signaling, cytoskeleton, cell adhesion molecules, forebrain roof plate, retinoic acid signaling

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1424 Direct Compression Formulation of Poorly Compressible Drugs to Minimize the Tablet Defects

Authors: Abhishek Pandey

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Capping and lamination are the most common tablet defects with poorly compressible drugs the common example of that Ibuprofen and Acetaminophen. Generally both these drugs are compressed by wet granulation method which is very time consuming process Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis Acetaminophen used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression technique and their evaluation. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimize formulation nine different formulations were generated among them batch F5, F6, F7 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of evaluation parameters.

Keywords: capping, lamination, tablet defects, direct compression

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1423 Helping Older Users Staying Connected

Authors: Q. Raza

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Getting old is inevitable, tasks which were once simple are now a daily struggle. This paper is a study of how older users interact with web application based upon a series of experiments. The experiments conducted involved 12 participants and the experiments were split into two parts. The first set gives the users a feel of current social networks and the second set take into considerations from the participants and the results of the two are compared. This paper goes in detail on the psychological aspects such as social exclusion, Metacognition memory and Therapeutic memories and how this relates to users becoming isolated from society, social networking can be the roof on a foundation of successful computer interaction. The purpose of this paper is to carry out a study and to propose new ideas to help users to be able to use social networking sites easily and efficiently.

Keywords: cognitive psychology, special memory, social networking and human computer interaction

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1422 Disconnect between Water, Sanitation and Hygiene Related Behaviours of Children in School and Family

Authors: Rehan Mohammad

Abstract:

Background: Improved Water, Sanitation and Hygiene (WASH) practices in schools ensure children’s health, well-being and cognitive performance. In India under various WASH interventions in schools, teachers, and other staff make every possible effort to educate children about personal hygiene, sanitation practices and harms of open defecation. However, once children get back to their families, they see other practicing inappropriate WASH behaviors, and they consequently start following them. This show disconnect between school behavior and family behavior, which needs to be bridged to achieve desired WASH outcomes. Aims and Objectives: The aim of this study is to assess the factors causing disconnect of WASH-related behaviors between school and the family of children. It also suggests behavior change interventions to bridge the gap. Methodology: The present study has chosen a mixed- method approach. Both quantitative and qualitative methods of data collection have been used in the present study. The purposive sampling for data collection has been chosen. The data have been collected from 20% children in each age group of 04-08 years and 09-12 years spread over three primary schools and 20% of households to which they belong to which is spread over three slum communities in south district of Delhi. Results: The present study shows that despite of several behavior change interventions at school level, children still practice inappropriate WASH behaviors due to disconnect between school and family behaviors. These behaviors show variation from one age group to another. The inappropriate WASH behaviors being practiced by children include open defecation, wrong disposal of garbage, not keeping personal hygiene, not practicing hand washing practices during critical junctures and not washing fruits and vegetables before eating. The present study has highlighted that 80% of children in the age group of 04-08 years still practice inappropriate WASH behaviors when they go back to their families after school whereas, this percentage has reduced to 40% in case of children in the age group 09-12 years. Present study uncovers association between school and family teaching which creates a huge gap between WASH-related behavioral practices. The study has established that children learn and de-learn the WASH behaviors due to the evident disconnect between behavior change interventions at schools and household level. The study has also made it clear that children understand the significance of appropriate WASH practices but owing to the disconnect the behaviors remain unsettled. The study proposes several behavior change interventions to sync the behaviors of children at school and family level to ensure children’s health, well-being and cognitive performance.

Keywords: behavioral interventions, child health, family behavior, school behavior, WASH

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1421 Functional Neurocognitive Imaging (fNCI): A Diagnostic Tool for Assessing Concussion Neuromarker Abnormalities and Treating Post-Concussion Syndrome in Mild Traumatic Brain Injury Patients

Authors: Parker Murray, Marci Johnson, Tyson S. Burnham, Alina K. Fong, Mark D. Allen, Bruce McIff

Abstract:

Purpose: Pathological dysregulation of Neurovascular Coupling (NVC) caused by mild traumatic brain injury (mTBI) is the predominant source of chronic post-concussion syndrome (PCS) symptomology. fNCI has the ability to localize dysregulation in NVC by measuring blood-oxygen-level-dependent (BOLD) signaling during the performance of fMRI-adapted neuropsychological evaluations. With fNCI, 57 brain areas consistently affected by concussion were identified as PCS neural markers, which were validated on large samples of concussion patients and healthy controls. These neuromarkers provide the basis for a computation of PCS severity which is referred to as the Severity Index Score (SIS). The SIS has proven valuable in making pre-treatment decisions, monitoring treatment efficiency, and assessing long-term stability of outcomes. Methods and Materials: After being scanned while performing various cognitive tasks, 476 concussed patients received an SIS score based on the neural dysregulation of the 57 previously identified brain regions. These scans provide an objective measurement of attentional, subcortical, visual processing, language processing, and executive functioning abilities, which were used as biomarkers for post-concussive neural dysregulation. Initial SIS scores were used to develop individualized therapy incorporating cognitive, occupational, and neuromuscular modalities. These scores were also used to establish pre-treatment benchmarks and measure post-treatment improvement. Results: Changes in SIS were calculated in percent change from pre- to post-treatment. Patients showed a mean improvement of 76.5 percent (σ= 23.3), and 75.7 percent of patients showed at least 60 percent improvement. Longitudinal reassessment of 24 of the patients, measured an average of 7.6 months post-treatment, shows that SIS improvement is maintained and improved, with an average of 90.6 percent improvement from their original scan. Conclusions: fNCI provides a reliable measurement of NVC allowing for identification of concussion pathology. Additionally, fNCI derived SIS scores direct tailored therapy to restore NVC, subsequently resolving chronic PCS resulting from mTBI.

Keywords: concussion, functional magnetic resonance imaging (fMRI), neurovascular coupling (NVC), post-concussion syndrome (PCS)

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1420 Factor Associated with Uncertainty Undergoing Hematopoietic Stem Cell Transplantation

Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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1419 Physiotherapy Program for Frozen Shoulder on Length of Follow up and Range of Motions

Authors: Orawan Vichiansan, J. Kraipoj, K.Phandech, P. Sirasaporn

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Generally, frozen shoulder will improve over time, although it may take a long time up to year. The symptoms of frozen shoulder present by pain around shoulder and consequently limit range of motions. The effect of frozen shoulder leads to limit activities daily living life and high medical care cost. Physiotherapy is well known treatment for frozen shoulder but there was no data about the treatment of physiotherapy in frozen shoulder and length of follow up. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on range of motion and length of follow up. A retrospective study design was conducted. 469 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of range of motions and length of follow up was recorded. The medical record of 183 males and 286 females with average aged 57.82±12.32 years were reviewed in this study. There was a statistically significant increase in shoulder flexion [mean difference 30.24 with 95%CI were [24.37-36.12], shoulder abduction [mean difference 34.93 with 95%CI were 27.8-42.0], shoulder internal rotation [mean difference 17.25 with 95%CI were 12.55-21.95] and shoulder external rotation [mean difference 17.71 with 95%CI were [13.07-22.36] respectively. In addition, the length of follow up averaged 84 days. In summary, the retrospective study show physiotherapy program likely to be benefit for patients with frozen shoulder in term of range of motion and short length of follow up.

Keywords: frozen shoulder, physiotherapy, range of motions, length of follow up

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1418 Covid Encephalopathy and New-Onset Seizures in the Context of a Prior Brain Abnormality: A Case Report

Authors: Omar Sorour, Michael Leahy, Thomas Irvine, Vladimir Koren

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Introduction: Covid encephalitis is a rare yet dangerous complication, particularly affecting the older and immunocompromised. Symptoms range from confusion to delirium, coma, and seizures. Although neurological manifestations have become more well-characterized in COVID patients, little is known about whether priorneurological abnormalities may predispose patients to COVID encephalopathy. Case Description: A 73 y.o. male with a CT and MRI-confirmed stable, prior 9 mm cavernoma in the right frontal lobe and no past history of seizures was hospitalized with generalized weakness, abdominal pain, nausea, and shortness of breath with subsequent COVID pneumonia. Three days after the initial presentation, the patient developed a spontaneous generalized tonic-clonic seizure consistent with presumed COVID encephalitis, along with somnolence and confusion. A day later, the patient had two other seizure episodes. Follow-up EEG suggested an inter-ictal epileptic focus with sharp waves corresponding to roughly the same location as the patient’s pre-existing cavernoma. The patient’s seizures stopped shortly thereafter, while his encephalopathy continued for days. Conclusion: We illustrate that a pre-existing anatomic cortical abnormality may act as a potential nidus for new-onset seizure activity in the context of suggested COVID encephalopathy. Future studies may further demonstrate that manifestations of COVIDencephalopathy in certain patients may be more predictable than initially assumed.

Keywords: cavernoma, covid, encephalopathy, seizures

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1417 Gender Differences in the Perception of Advertising in Postmodern Era

Authors: J. Zavodny Pospisil, L. S. Zavodna, K. Cerna

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The goal of this paper is to identify the main differences in the way men and women perceive TV ads. This paper is based on a research project conducted partly as a review of relevant papers, which deals with gender influence on the cognitive process and postmodern perception of advertising. In addition to that, qualitative research was conducted by means of interviews and structured questionnaires. Furthermore, data acquired from the research were used to evaluate our objectives and hypotheses. The goal of this paper is to compare women's and men's perception of advertisement. Although women are able to perceive more details than men, men are more susceptible to sexual appeals in advertising. Significant differences were also found in the perception of sexual appeals in the context of gender.

Keywords: advertising, consumer, emotion, gender, psychology of advertising

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1416 Phytochemical and Antimicrobial Studies of Root Bark Extracts from Glossonema boveanum (Decne.)

Authors: Ahmed Jibrin Uttu, Maimuna Waziri

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The root bark of Glossonema boveanum (Decne), a member of Apocynaceae family, is used by traditional medicine practitioner to treat urinary and respiratory tract infections, bacteremia, typhoid fever, bacillary dysentery, diarrhea and stomach pain. This present study aims to validate the medicinal claims ascribed to the root bark of the plant. Preliminary phytochemical study of the root bark extracts (n-hexane, ethyl acetate, chloroform and methanol extracts) showed the presence of alkaloids, carbohydrates, steroids, triterpenes, cardiac glycosides, saponins, tannins and flavonoids. Antimicrobial study of the extracts showed activities against Staphylococus aureus, Bacillus subtilis, Salmonella typhii, Shigella dysenteriae, Escherichia coli, Enterobacter cloacae, Streptococcus agalactiae and Candida albicans while Micrococcus luteus, Pseudomonas aeruginosa and Klebsiella Pneumoniae showed resistance to all the extracts. The inhibitory effect was compared with the standard drug ciprofloxacin and fluconazole. MIC and MBC for both extracts were also determined using the tube dilution method. This study concluded that the root bark of G. boveanum, used traditionally as a medicinal plant, has antimicrobial activities against some causative organisms.

Keywords: Glossonema boveanum (Decne.), phytochemical, antimicrobial, minimum inhibitory concentration, minimum bactericidal concentration

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1415 Synthesis and Solubilization of Flurbiprofen Derivatives and Investigation of Their Biological Activities

Authors: Muhammad Mustaqeem, Musa Kaleem Baloch, Irfan Ullah, Ammarah Luqman, Afshan Ahmad

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Flurbiprofen is one of the most potent nonsteroidal anti-inflammatory drugs. It is widely used for relief of pain in patients suffering from rheumatic diseases, migraine, sore throat and primary dysmenorrhea. However, its aqueous solubility is very low and hinders the skin permeation. Thus, it is imperative to develop such a drug delivery systems which can improve its aqueous solubility and hence improve the skin permeation and therapeutic compliance. Microemulsions have been also proven to increase the cutaneous absorption of lipophilic drugs as compared to conventional vehicles. Micro-emulsion is thermodynamically stable emulsion that has the capacity to ‘hide/solubilize’ water-insoluble molecules within a continuous oil phase. Therefore, flurbiprofen was converted to Easters through chemical reactions with alcohols such as methanol, ethanol, propanol and butanol. The product was further treated with hydrazine to get hydrazide. The solubility of the parent drug Flurbiprofen and the products were solubilized in microemulsions formed using various surfactants like ionic, non-ionic and zwitterions. It has been concluded that the product was more soluble than the parent compound. The biological activities of these were also investigated. The outcome was very promising and the product was more active than the parent compound. It, therefore, concluded that in this way, we can not only enhance the solubility of the drug and increase its bioactivity, but also reduce the risk of stomach cancer.

Keywords: Flurbiprofen, microemulsion, surfactants, hyrazides

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1414 Teaching Speaking Skills to Adult English Language Learners through ALM

Authors: Wichuda Kunnu, Aungkana Sukwises

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Audio-lingual method (ALM) is a teaching approach that is claimed that ineffective for teaching second/foreign languages. Because some linguists and second/foreign language teachers believe that ALM is a rote learning style. However, this study is done on a belief that ALM will be able to solve Thais’ English speaking problem. This paper aims to report the findings on teaching English speaking to adult learners with an “adapted ALM”, one distinction of which is to use Thai as the medium language of instruction. The participants are consisted of 9 adult learners. They were allowed to speak English more freely using both the materials presented in the class and their background knowledge of English. At the end of the course, they spoke English more fluently, more confidently, to the extent that they applied what they learnt both in and outside the class.

Keywords: teaching English, audio lingual method, cognitive science, psychology

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1413 User Experience in Relation to Eye Tracking Behaviour in VR Gallery

Authors: Veslava Osinska, Adam Szalach, Dominik Piotrowski

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Contemporary VR technologies allow users to explore virtual 3D spaces where they can work, socialize, learn, and play. User's interaction with GUI and the pictures displayed implicate perceptual and also cognitive processes which can be monitored due to neuroadaptive technologies. These modalities provide valuable information about the users' intentions, situational interpretations, and emotional states, to adapt an application or interface accordingly. Virtual galleries outfitted by specialized assets have been designed using the Unity engine BITSCOPE project in the frame of CHIST-ERA IV program. Users interaction with gallery objects implies the questions about his/her visual interests in art works and styles. Moreover, an attention, curiosity, and other emotional states are possible to be monitored and analyzed. Natural gaze behavior data and eye position were recorded by built-in eye-tracking module within HTC Vive headset gogle for VR. Eye gaze results are grouped due to various users’ behavior schemes and the appropriate perpetual-cognitive styles are recognized. Parallelly usability tests and surveys were adapted to identify the basic features of a user-centered interface for the virtual environments across most of the timeline of the project. A total of sixty participants were selected from the distinct faculties of University and secondary schools. Users’ primary knowledge about art and was evaluated during pretest and this way the level of art sensitivity was described. Data were collected during two months. Each participant gave written informed consent before participation. In data analysis reducing the high-dimensional data into a relatively low-dimensional subspace ta non linear algorithms were used such as multidimensional scaling and novel technique technique t-Stochastic Neighbor Embedding. This way it can classify digital art objects by multi modal time characteristics of eye tracking measures and reveal signatures describing selected artworks. Current research establishes the optimal place on aesthetic-utility scale because contemporary interfaces of most applications require to be designed in both functional and aesthetical ways. The study concerns also an analysis of visual experience for subsamples of visitors, differentiated, e.g., in terms of frequency of museum visits, cultural interests. Eye tracking data may also show how to better allocate artefacts and paintings or increase their visibility when possible.

Keywords: eye tracking, VR, UX, visual art, virtual gallery, visual communication

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1412 The Sensitization Profile of Children Allergic to IgE-mediated Cow's Milk Proteins

Authors: Gadiri Sabiha

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Introduction : IgE-dependent cow's milk protein allergy (APLV) is one of the most common allergies in children and is one of the three most common allergies observed in children under 6 years of age. Its natural evolution is most often towards healing. The objective is to determine the sensitization profile of patients allergic to cow's milk (VL). Material and method :A retrospective study carried out on a pediatric population (age < 12 years) over a period of four years (2018-2021) in the context of a suspected food allergy to cow's milk proteins carried out on 121 children aged between 8 months -12 years The search for specific IgE was carried out by immunodot (EUROLINE Pediatric; EUROIMMUN) test which allows a semi-quantitative determination of specific IgE. Results 36 patients (29.7%) had a cow's milk protein allergy (ALPV) with a slight female predominance (58.33% girls vs 41.66% boys) The main clinical signs were: acute diarrhoea; vomiting; Intense abdominal pain, and cutaneous signs (pruritus/urticaria) with respective frequencies of 72%; 58%; 44% and 19%. The 3 major and specific VL allergens identified were beta-lactoglobulin 59% caseins 51% and alpha-lactalbumin 29.7%, The profile of sensitization to LV varies according to age, in infants before 1 year of anti-casein, IgE are predominant 83.3%, followed by beta-lactoglobulin 66.66% and alpha-lactolbumin 50% Conclusion CMPA is a frequent pathology which ranks among the three most common food allergies in children. This is the first to appear, most often starting in infants under 6 months old.

Keywords: specific Ige, food allergy, cow 's milk, child

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1411 Effectiveness of Physiotherapy in Hand Dysfunction of Leukemia Patients with Chronic Musculoskeletal Graft versus Host Disease Post Bone Marrow Transplant

Authors: Mohua Chatterjee, Rajib De

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Introduction: Bone Marrow Transplant (BMT) is often performed to treat patients with various types of leukemia. A majority of these patients develop complications like chronic musculoskeletal GVHD post-BMT where patients get scleroderma, pain and restricted range of motion of joints of hand. If not treated early, it may cause permanent deformity of hand. This study was done to find the effectiveness of physiotherapy in hand dysfunction caused due to chronic musculoskeletal GVHD of leukemia patients after BMT. Methodology: 23 patients diagnosed with leukemia and having musculoskeletal GVHD were treated with a set of exercises including active exercises and stretching. The outcome was measured by Cochin Hand Function Scale (CHFS) at baseline and after four weeks of intervention. Results: Two patients were not able to carry out exercises beyond two weeks due to relapse of disease and one patient defaulted. It was found that all the patients who received physiotherapy had significant improvement in hand function. Mean CHFS decreased from 63.67 to 27.43 (P value < 0.001) indicating improvement in hand function after four weeks of physiotherapy. Conclusion: Early intervention of physiotherapy is effective in reducing hand dysfunction of leukemia patients with musculoskeletal GVHD post-BMT.

Keywords: bone marrow transplant, hand dysfunction, leukemia, musculoskeletal graft versus host disease, physiotherapy

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1410 Carbon-Based Electrodes for Parabens Detection

Authors: Aniela Pop, Ianina Birsan, Corina Orha, Rodica Pode, Florica Manea

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Carbon nanofiber-epoxy composite electrode has been investigated through voltammetric and amperometric techniques in order to detect parabens from aqueous solutions. The occurrence into environment as emerging pollutants of these preservative compounds has been extensively studied in the last decades, and consequently, a rapid and reliable method for their quantitative quantification is required. In this study, methylparaben (MP) and propylparaben (PP) were chosen as representatives for paraben class. The individual electrochemical detection of each paraben has been successfully performed. Their electrochemical oxidation occurred at the same potential value. Their simultaneous quantification should be assessed electrochemically only as general index of paraben class as a cumulative signal corresponding to both MP and PP from solution. The influence of pH on the electrochemical signal was studied. pH ranged between 1.3 and 9.0 allowed shifting the detection potential value to smaller value, which is very desired for the electroanalysis. Also, the signal is better-defined and higher sensitivity is achieved. Differential-pulsed voltammetry and square-wave voltammetry were exploited under the optimum pH conditions to improve the electroanalytical performance for the paraben detection. Also, the operation conditions were selected, i.e., the step potential, modulation amplitude and the frequency. Chronomaprometry application as the easiest electrochemical detection method led to worse sensitivity, probably due to a possible fouling effect of the electrode surface. The best electroanalytical performance was achieved by pulsed voltammetric technique but the selection of the electrochemical technique is related to the concrete practical application. A good reproducibility of the voltammetric-based method using carbon nanofiber-epoxy composite electrode was determined and no interference effect was found for the cation and anion species that are common in the water matrix. Besides these characteristics, the long life-time of the electrode give to carbon nanofiber-epoxy composite electrode a great potential for practical applications.

Keywords: carbon nanofiber-epoxy composite electrode, electroanalysis, methylparaben, propylparaben

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1409 Development and Validation of a Carbon Dioxide TDLAS Sensor for Studies on Fermented Dairy Products

Authors: Lorenzo Cocola, Massimo Fedel, Dragiša Savić, Bojana Danilović, Luca Poletto

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An instrument for the detection and evaluation of gaseous carbon dioxide in the headspace of closed containers has been developed in the context of Packsensor Italian-Serbian joint project. The device is based on Tunable Diode Laser Absorption Spectroscopy (TDLAS) with a Wavelength Modulation Spectroscopy (WMS) technique in order to accomplish a non-invasive measurement inside closed containers of fermented dairy products (yogurts and fermented cheese in cups and bottles). The purpose of this instrument is the continuous monitoring of carbon dioxide concentration during incubation and storage of products over a time span of the whole shelf life of the product, in the presence of different microorganisms. The instrument’s optical front end has been designed to be integrated in a thermally stabilized incubator. An embedded computer provides processing of spectral artifacts and storage of an arbitrary set of calibration data allowing a properly calibrated measurement on many samples (cups and bottles) of different shapes and sizes commonly found in the retail distribution. A calibration protocol has been developed in order to be able to calibrate the instrument on the field also on containers which are notoriously difficult to seal properly. This calibration protocol is described and evaluated against reference measurements obtained through an industry standard (sampling) carbon dioxide metering technique. Some sets of validation test measurements on different containers are reported. Two test recordings of carbon dioxide concentration evolution are shown as an example of instrument operation. The first demonstrates the ability to monitor a rapid yeast growth in a contaminated sample through the increase of headspace carbon dioxide. Another experiment shows the dissolution transient with a non-saturated liquid medium in presence of a carbon dioxide rich headspace atmosphere.

Keywords: TDLAS, carbon dioxide, cups, headspace, measurement

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1408 Ethnomedicinal Studies on Pteredophytes of District Bagh Azad Jammu and Kashmir, Pakistan

Authors: Israr Ahmad, Sehrish Sabir

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Present study deals with the taxonomic and ethno medicinal uses of some Pteridophytes species present in District Bagh AJK, Pakistan. The people of District Bagh extensively use Pteridophytes for different purposes. Ethno botanical evidence and Ornamental Potential of the taxa of wild pteridophytes was documented through field trips during 2017-2018, and data was collected through a structured questionnaire, and in-depth interviews were conducted from the natives in the hilly regions. Total of 22 Pteridophytes belonging to 13 genera 9 families were collected. Out of 22 species, one species (Cystoathyriumchinense ) newly record from Pakistan. The most leading family is Pteridaceae, having 9species, followed by Dryopteridaceae, having 4species, and Aspleniaceae having 3species. The remaining families are represented by single species of each. Inhabitants of mountainous and rural zones regularly used these taxa for different remedy, which are not discussed in the previous available literature. The novel remedies reported in this research areCystoathyriumchinense decoction used for irregular menstruation, Cyclosorusopulentus crushed leaves and stem are used for the treatment of stomach disorder.Onychiumlucidumused to treatJaundice, injury, pain dysentery, common cold, and arresting bleeding. Based on these findings, it is further recommended that phytochemical studies should be conducted to explore active chemical constituents for the cure of various diseases. Conservation efforts must be done to conserve many threatened species of the research area.

Keywords: adiantum, cancer, pakistan, pteridophytes

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1407 Bridging the Gap between Obstetric and Colorectal Services after Obstetric Anal Sphincter Injuries

Authors: Shachi Joshi

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Purpose: The primary aim of this study was to determine the prevalence of pelvic dysfunction symptoms following OASI. The secondary aim was to assess the scope of a dedicated perineal trauma clinic in identifying and investigating women that have experienced faecal incontinence after OASI and if a transitional clinic arrangement to colorectal surgeons would be useful. Methods: The clinical database was used to identify and obtain information about 118 women who sustained an OASI (3rd/ 4th degree tear) between August 2016 and July 2017. A questionnaire was designed to assess symptoms of pelvic dysfunction; this was sent via the post in November 2018. Results: The questionnaire was completed by 45 women (38%). Faecal incontinence was experienced by 42% (N=19), flatus incontinence by 47% (N=21), urinary incontinence by 76% (N=34), dyspareunia by 49% (N=22) and pelvic pain by 33% (N=15). Of the questionnaire respondents, only 62% (N=28) had attended a perineal trauma clinic appointment. 46% (N=13) of these women reported having experienced difficulty controlling flatus or faeces in the questionnaire, however, only 23% (N=3) of these reported ongoing symptoms at the time of clinic attendance and underwent an endoanal ultrasound scan. Conclusion: Pelvic dysfunction symptoms are highly prevalent following an OASI. Perineal trauma clinic attendance alone is not sufficient for identification and follow up of symptoms. Transitional care is needed between obstetric and colorectal teams, to recognize and treat women with ongoing faecal incontinence.

Keywords: incontinence, obstetric anal sphincter, injury, repair

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1406 Artificial Intelligence in Disease Diagnosis

Authors: Shalini Tripathi, Pardeep Kumar

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The method of translating observed symptoms into disease names is known as disease diagnosis. The ability to solve clinical problems in a complex manner is critical to a doctor's effectiveness in providing health care. The accuracy of his or her expertise is crucial to the survival and well-being of his or her patients. Artificial Intelligence (AI) has a huge economic influence depending on how well it is applied. In the medical sector, human brain-simulated intellect can help not only with classification accuracy, but also with reducing diagnostic time, cost and pain associated with pathologies tests. In light of AI's present and prospective applications in the biomedical, we will identify them in the paper based on potential benefits and risks, social and ethical consequences and issues that might be contentious but have not been thoroughly discussed in publications and literature. Current apps, personal tracking tools, genetic tests and editing programmes, customizable models, web environments, virtual reality (VR) technologies and surgical robotics will all be investigated in this study. While AI holds a lot of potential in medical diagnostics, it is still a very new method, and many clinicians are uncertain about its reliability, specificity and how it can be integrated into clinical practice without jeopardising clinical expertise. To validate their effectiveness, more systemic refinement of these implementations, as well as training of physicians and healthcare facilities on how to effectively incorporate these strategies into clinical practice, will be needed.

Keywords: Artificial Intelligence, medical diagnosis, virtual reality, healthcare ethical implications 

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1405 Soft Computing Approach for Diagnosis of Lassa Fever

Authors: Roseline Oghogho Osaseri, Osaseri E. I.

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Lassa fever is an epidemic hemorrhagic fever caused by the Lassa virus, an extremely virulent arena virus. This highly fatal disorder kills 10% to 50% of its victims, but those who survive its early stages usually recover and acquire immunity to secondary attacks. One of the major challenges in giving proper treatment is lack of fast and accurate diagnosis of the disease due to multiplicity of symptoms associated with the disease which could be similar to other clinical conditions and makes it difficult to diagnose early. This paper proposed an Adaptive Neuro Fuzzy Inference System (ANFIS) for the prediction of Lass Fever. In the design of the diagnostic system, four main attributes were considered as the input parameters and one output parameter for the system. The input parameters are Temperature on admission (TA), White Blood Count (WBC), Proteinuria (P) and Abdominal Pain (AP). Sixty-one percent of the datasets were used in training the system while fifty-nine used in testing. Experimental results from this study gave a reliable and accurate prediction of Lassa fever when compared with clinically confirmed cases. In this study, we have proposed Lassa fever diagnostic system to aid surgeons and medical healthcare practictionals in health care facilities who do not have ready access to Polymerase Chain Reaction (PCR) diagnosis to predict possible Lassa fever infection.

Keywords: anfis, lassa fever, medical diagnosis, soft computing

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1404 Quantitative Determination of Heavy Metals in Some Commonly Consumed Herbal Medicines in Kano State, Nigeria

Authors: Aliyu Umar, Mohammed Yau, Faruruwa M. Dahiru, Saed Garba

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Evaluation of heavy metals in twelve commonly consumed herbal medicines/preparations in Kano State, Nigeria, was carried out. The samples comprised of five unregistered powdered medicines, namely, Zuwo, (ZW); Rai Dorai, (RD); Miyar Tsanya, (MTS); Bagaruwar Makka, (BM); and Madobiya, (M); five unregistered liquid herbal medicinal concussions for pile (MB), yellow fever (MS), typhoid (MT), stomach pain (MC), sexually transmitted diseases (STDs); and two registered herbal medicines; Alif Powder (AP) and Champion Leaf (CL). The heavy metals evaluation was carried out using Atomic Absorption Spectroscopy (AAS) and the result revealed the concentrations (ppm) ranges of the heavy metals as follows: Cadmium (0.0045 – 0.1601), Chromium (0.0418 – 0.2092), Cobalt (0.0038 – 0.0760), Copper (0.0547 – 0.2465), Iron (0.1197 – 0.3592), Manganese (0.0123 – 1.4462), Nickel (0.0073 – 0.0960), Lead (0.185 – 0.0927) and Zinc (0.0244 – 0.2444). Comparing the results obtained in this work with the standards of the World Health Organization (WHO), the Food and Agricultural Organization (FAO) and permissible limits of other countries, the concentrations of heavy metals in the herbal medicine/preparations are within the allowed permissible limits range in herbal medicines and their use could be safe.

Keywords: Kano state, herbal medicines, registered, unregistered

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1403 The Strategy for Detection of Catecholamines in Body Fluids: Optical Sensor

Authors: Joanna Cabaj, Sylwia Baluta, Karol Malecha, Kamila Drzozga

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Catecholamines are the principal neurotransmitters that mediate a variety of the central nervous system functions, such as motor control, cognition, emotion, memory processing, and endocrine modulation. Dysfunctions in catecholamine neurotransmission are induced in some neurologic and neuropsychiatric diseases. Changeable neurotransmitters level in biological fluids can be a marker of several neurological disorders. Because of its significance in analytical techniques and diagnostics, sensitive and selective detection of neurotransmitters is increasingly attracting a lot of attention in different areas of bio-analysis or biomedical research. Recently, fluorescent techniques for detection of catecholamines have attracted interests due to their reasonable cost, convenient control, as well as maneuverability in biological environments. Nevertheless, with the observed need for a sensitive and selective catecholamines sensor, the development of a convenient method for this neurotransmitter is still at its basic level. The manipulation of nanostructured materials in conjunction with biological molecules has led to the development of a new class of hybrid modified biosensors in which both enhancement of charge transport and biological activity preservation may be obtained. Immobilization of biomaterials on electrode surfaces is the crucial step in fabricating electrochemical as well as optical biosensors and bioelectronic devices. Continuing systematic investigation in the manufacturing of enzyme–conducting sensitive systems, here is presented a convenient fluorescence sensing strategy for catecholamines detection based on FRET (fluorescence resonance energy transfer) phenomena observed for, i.e., complexes of Fe²⁺ and epinephrine. The biosensor was constructed using low temperature co-fired ceramics technology (LTCC). This sensing system used the catalytical oxidation of catecholamines and quench of the strong luminescence of obtained complexes due to FRET. The detection process was based on the oxidation of substrate in the presence of the enzyme–laccase/tyrosinase.

Keywords: biosensor, conducting polymer, enzyme, FRET, LTCC

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1402 A Comparative Analysis of Various Companding Techniques Used to Reduce PAPR in VLC Systems

Authors: Arushi Singh, Anjana Jain, Prakash Vyavahare

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Recently, Li-Fi(light-fiedelity) has been launched based on VLC(visible light communication) technique, 100 times faster than WiFi. Now 5G mobile communication system is proposed to use VLC-OFDM as the transmission technique. The VLC system focused on visible rays, is considered for efficient spectrum use and easy intensity modulation through LEDs. The reason of high speed in VLC is LED, as they flicker incredibly fast(order of MHz). Another advantage of employing LED is-it acts as low pass filter results no out-of-band emission. The VLC system falls under the category of ‘green technology’ for utilizing LEDs. In present scenario, OFDM is used for high data-rates, interference immunity and high spectral efficiency. Inspite of the advantages OFDM suffers from large PAPR, ICI among carriers and frequency offset errors. Since, the data transmission technique used in VLC system is OFDM, the system suffers the drawbacks of OFDM as well as VLC, the non-linearity dues to non-linear characteristics of LED and PAPR of OFDM due to which the high power amplifier enters in non-linear region. The proposed paper focuses on reduction of PAPR in VLC-OFDM systems. Many techniques are applied to reduce PAPR such as-clipping-introduces distortion in the carrier; selective mapping technique-suffers wastage of bandwidth; partial transmit sequence-very complex due to exponentially increased number of sub-blocks. The paper discusses three companding techniques namely- µ-law, A-law and advance A-law companding technique. The analysis shows that the advance A-law companding techniques reduces the PAPR of the signal by adjusting the companding parameter within the range. VLC-OFDM systems are the future of the wireless communication but non-linearity in VLC-OFDM is a severe issue. The proposed paper discusses the techniques to reduce PAPR, one of the non-linearities of the system. The companding techniques mentioned in this paper provides better results without increasing the complexity of the system.

Keywords: non-linear companding techniques, peak to average power ratio (PAPR), visible light communication (VLC), VLC-OFDM

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1401 Epidemiology of Primary Bronchopulmonary Cancer in Tunisia

Authors: Melliti Rihab, Zaeid Sonia, Khechine Wiem, Daldoul Amira

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Introduction: Lung cancer is the leading cause of cancer death. Its incidence is increasing, and its prognosis remains pejorative. We present the clinical, pathological, and therapeutic characteristics of bronchopulmonary cancer (BPC) in Tunisia. Methods: Retrospective study including patients followed in the oncology department of the University Hospital of Monastir between April 2014 and December 2021 suffering from lung cancer. Results: These are 117 patients, including 86.3% men and 13.7% women (sex ratio 6.3). The average age was 64 years ± 9 (37-83), with 95.7% being over 50 years old. Patients were smokers in 82% of cases. The clinical signs were dominated by chest pain (27.5%) and dyspnea in 21.1% of cases. In 6 patients, an episode of COVID-19 infection revealed the diagnosis. Half of the patients had a PS between 0 and 1. Small cell lung cancer was present in 18 patients (15.4%). The majority of non small cell lung cancer was of the adenocarcinoma type (68.7%). The diagnosis was late (stage IV) in 62.4% of cases. BPC was metastatic to bone (52%), contralateral lung (25.9%), and brain (27.3%). Patients were oligometastatic in 26% of cases. Surgery and radiotherapy were performed respectively in 14.5% and 23.1% of cases. Three-quarters of the patients had had nutrition (75.2%). The ROS1 mutation was present in 1 patient. PDL-1 expression was >40% in 2 patients. Survival was mean eight months ± 7.4. Conclusion: Lung cancer is diagnosed at a late stage in Tunisia. The lack of molecular study for non-small cell PBC and the lack of marketing authorization for tyrosine kinase inhibitors in Tunisia make the management incomplete.

Keywords: SCLC, NCSLC, ROS1, PDL1

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