Search results for: hospital inventory
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3000

Search results for: hospital inventory

1140 Periodicity of Solutions to Impulsive Equations

Authors: Jin Liang, James H. Liu, Ti-Jun Xiao

Abstract:

It is known that there exist many physical phenomena where abrupt or impulsive changes occur either in the system dynamics, for example, ad-hoc network, or in the input forces containing impacts, for example, the bombardment of space antenna by micrometeorites. There are many other examples such as ultra high-speed optical signals over communication networks, the collision of particles, inventory control, government decisions, interest changes, changes in stock price, etc. These are impulsive phenomena. Hence, as a combination of the traditional initial value problems and the short-term perturbations whose duration can be negligible in comparison with the duration of the process, the systems with impulsive conditions (i.e., impulsive systems) are more realistic models for describing the impulsive phenomenon. Such a situation is also suitable for the delay systems, which include some of the past states of the system. So far, there have been a lot of research results in the study of impulsive systems with delay both in finite and infinite dimensional spaces. In this paper, we investigate the periodicity of solutions to the nonautonomous impulsive evolution equations with infinite delay in Banach spaces, where the coefficient operators (possibly unbounded) in the linear part depend on the time, which are impulsive systems in infinite dimensional spaces and come from the optimal control theory. It was indicated that the study of periodic solutions for these impulsive evolution equations with infinite delay was challenging because the fixed point theorems requiring some compactness conditions are not applicable to them due to the impulsive condition and the infinite delay. We are happy to report that after detailed analysis, we are able to combine the techniques developed in our previous papers, and some new ideas in this paper, to attack these impulsive evolution equations and derive periodic solutions. More specifically, by virtue of the related transition operator family (evolution family), we present a Poincaré operator given by the nonautonomous impulsive evolution system with infinite delay, and then show that the operator is a condensing operator with respect to Kuratowski's measure of non-compactness in a phase space by using an Amann's lemma. Finally, we derive periodic solutions from bounded solutions in view of the Sadovskii fixed point theorem. We also present a relationship between the boundedness and the periodicity of the solutions of the nonautonomous impulsive evolution system. The new results obtained here extend some earlier results in this area for evolution equations without impulsive conditions or without infinite delay.

Keywords: impulsive, nonautonomous evolution equation, optimal control, periodic solution

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1139 Spatio-Temporal Analysis of Land Use Land Cover Change Using Remote Sensing and Multispectral Satellite Imagery of Islamabad Pakistan

Authors: Basit Aftab, Feng Zhongke

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The land use/land cover change (LULCC) is a significant indicator sensitive to an area's environmental changes. As a rapidly developing capital city near the Himalayas Mountains, the city area of Islamabad, Pakistan, has expanded dramatically over the past 20 years. In order to precisely measure the impact of urbanization on the forest and agricultural lands, the Spatio-temporal analysis of LULCC was utilized, which helped us to know the impacts of urbanization, especially on ecosystem processes, biological cycles, and biodiversity. The Islamabad region's Multispectral Satellite Images (MSI) for 2000, 2010, and 2020 were employed as the remote sensing data source. Local documents of city planning, forest inventory and archives in the agriculture management departments were included to verify the image-derived result. The results showed that from 2000 to 2020, the built-up area increased to 48.3% (505.02 Km2). Meanwhile, the forest, agricultural, and barre land decreased to 28.9% (305.64 Km2), 10.04% (104.87 Km2), and 11.61% (121.30 Km2). The overall percentage change in land area between 2000 – 2020 was recorded maximum for the built-up (227.04%). Results revealed that the increase in the built-up area decreased forestland, barren, and agricultural lands (-0.36, -1.00 & -0.34). The association of built-up with respective years was positively linear (R2 = 0.96), whereas forestland, agricultural, and barren lands association with years were recorded as negatively linear (R2 = -0.29, R2 = -0.02, and R2 = -0.96). Large-scale deforestation leads to multiple negative impacts on the local environment, e.g., water degradation and climate change. It would finally affect the environment of the greater Himalayan region in some way. We further analyzed the driving forces of urbanization. It was determined by economic expansion, climate change, and population growth. We hope our study could be utilized to develop efforts to mitigate the consequences of deforestation and agricultural land damage, reducing greenhouse gas emissions while preserving the area's biodiversity.

Keywords: urbanization, Himalaya mountains, landuse landcover change (LULCC), remote sensing., multi-spectral satellite imagery

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1138 Low Back Pain-Related Absenteeism among Healthcare Workers in Kibuli Muslim Hospital, Kampala Uganda

Authors: Aremu Abdulmujeeb Babatunde

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Background: Low back pain was not only considered to be the most common reason for functional disability worldwide, but also estimated to have affected 90% of the universal population. This study aimed at determining the prevalence, consequences and socio-demographic factors associated with low back pain. Methods; A cross-sectional survey was employed and a total number of 150 self-structured questionnaire was distributed among healthcare workers and this was used to determine the prevalence of low back pain and work related absenteeism. Data was entered using Epi info soft-ware and analyzed using SPSS. Results; An overall response rate of 84% (n = 140) was achieved. The study established that majority (37%) of the respondents were in the age bracket of 20-39 years, 57% female (n=59) and 64% of them were married. the pint prevalence was 84%, 31% of the respondents took leave from work as a result of low back pain. There was high prevalence of sick leave among nursing staff 45.2%, Chi-square test shows that there was a statistically significant association between the respondents occupations and daily time spent during their work (P value 0.011 and 0.042) respectively. Socio-demographic factors like age, marital status and gender were not statistically significant at P<0.05. Conclusions; The medical and socio-professional consequences of low back pain among healthcare workers was as a result of their occupation designations and the daily time spent in carry out this occupations.

Keywords: low back pain, healthcare workers, prevalence, sick leave

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1137 Double Fortified Salt-An Effective Measure to Prevent Micronutrient Deficiencies in Indian Pregnant Women

Authors: Kejal Joshi Reddy, Sirimavo Nair

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Micronutrient malnutrition affects pregnant women and children extremely with reference to growth manifestations in gestation as well as after birth. Early fetal development affected by iodine and iron deficiency leads to poor life quality. Various researchers have found interesting interrelations between iron and iodine. A few studies on impact assessment of DFS supplementation during pregnancy have been reported in India. Aim To provide meaningful contribution by assessing the efficacy of DFS supplementation on iodine and iron status of pregnant women. Design An interventional study. Setting A semi government hospital of urban Vadodara. Subjects Pregnant women (n=150) enrolled during first trimester (< 12 weeks) and followed up till the end of gestation, n=75 were divided in experimental (DFS supplemented) and control (Non supplemented) group. Results Impact on iron and iodine status was assessed by Hb concentration and UIE respectively. Mean Hb improved significantly (p < 0.001) (+0.42 g/dl) in experimental group and reduced non significantly (-0.20 g/dl) in control group at the end, since DFS provided additional 93 mg of iron within 6 months. Median UIE improved non significantly (278.6 to 299.01µg/L) in experimental group and decreased significantly (p < 0.05) (376.59 to 288.66 µg/L) in control group. Conclusion DFS could improve iron and iodine status of experimental group compared to control group. It is an effective measure to control two essential micronutrient deficiencies together.

Keywords: DFS supplementation, anemia, pregnancy, iodine deficiency, iron

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1136 Histochemical Localization of Hepatitis B Surface Antigen in Hepatocellular Carcinoma: An Evaluation of Two Staining Techniques in a Tertiary Hospital in Calabar, Nigeria

Authors: Imeobong Joseph Inyang, Aniekan-Augusta Okon Eyo, Abel William Essien

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Hepatitis B virus (HBV) is one of the known human carcinogens. The presence of HBsAg in liver tissues indicates active viral replication. More than 85% of Hepatocellular Carcinoma (HCC) cases occur in countries with increased rates of chronic HBV infection. An evaluation study to determine the relationship between positivity for HBsAg and development of HCC and its distribution between age and gender of subjects was done. Shikata Orcein and Haematoxylin and Eosin (H&E) staining techniques were performed on liver sections. A total of 50 liver tissue specimens comprising 38 biopsy and 12 post-mortem specimens were processed. Thirty-five of the 50 specimens were positive for HBsAg with Orcein stain whereas only 16 were positive with H&E stain, and these were also positive with Orcein stain, giving an HBsAg prevalence of 70.0% (35/50). The prevalence of HCC in the study was 56.0% (28/50), of which 21 (75.0%) cases were positive for HBsAg, 18 (64.3%) were males while 10 (35.7%) were females distributed within the age range of 20-70 years. The highest number of HBsAg positive HCC cases, 7/21 (33.3%) occurred in the age group 40-49 years. There was no relationship in the pattern of distribution of HCC between age and gender using the Pearson correlation coefficient (r = 0.0474; P < 0.05). HBV infection predisposed to HCC. Orcein technique was more specific and is therefore recommended for screening of liver tissues where facilities for immunohistochemistry are inaccessible.

Keywords: Hepatitis B. surface antigen, hepatocellular carcinoma, orcein, pathology

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1135 SUSTAINEXT–Validating a Zero-Waste: Dynamic, Multivalorization Route Biorefinery for Plant Extracts

Authors: Adriana Diaz Triana, Wolfgang Wimmer, Sebastian Glaser, Rainer Pamminger

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SUSTAINEXT is a pioneer initiative in Extremadura, Spain under the EU Biobased industries. SUSTANEXT will scale-up and validate an industrial facility to produce botanical extracts, based on three key pillars. First, the whole valorization of bio-based feedstocks with a zero-waste and zero-emissions ambition. SUSTAINEXT will be deployed with six feedstocks. Three medicinal and aromatic plants (Rosemary, Chamomile, and Lemon verbena) will be locally sourced from disused tobacco fields with installed agri-voltaics; and three underexploited agro-industrial side streams will be further valorized (Olive, artichoke-cardoon, and pomegranate). Second, a dynamic, analytical biorefinery (DYANA) will isolate polyphenol and tri-terpenes from feedstocks in a disruptive and circular way. SUSTAINEXT explores 12 valorization routes (VRs) to extract and purify 46 functional ingredients, of which 13 are new in the market and 12 are newly produced in Europe. Third, the integrated and versatile value chain engages all actors, from feedstocks suppliers to extract users in the industries of food, animal feed, nutraceuticals, cosmetics, chemical performance, soil enhancers and fertilizers. This paper addresses SUTAINEXT activities towards zero impacts and full regulatory compliance. A comprehensive Life Cycle Thinking approach is proposed, with four complementary assessments running iteratively along the project duration (4,5 years). These are the Life Cycle Cost (LCCA), Life Cycle (LCA), Social Life Cycle (S-LCA) and Circularity (CA) assessments. The LCA will help evaluate the feedstock suitability parameters and intrinsic characteristics that quantify the feedstock´s grade for a determined use, and the feedstock´s suitability index for a specific VR. The LCA will also study the emissions, land use change, energy generation and consumption, and other environmental aspects and impacts of the VRs, to identify the most resource efficient and less impactful distribution of products from the circular biorefinery model used in SUSTAINEXT. Challenges to complete the LCA include the definition of the system boundaries, carrying out a robust inventory, and the proper allocation of impacts to the different VRs.

Keywords: biorefinery, botanical extracts, life cycle assessment, valorization routes.

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1134 Methanolic Extract of the Exudates of Aloe Otallensis and Its Effect on Leishmania Donovani Parasite

Authors: Zerihun Tesfaye Nigusse

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Objective: This study evaluates the antileishmanial activity of the methanolic extract of Aloe otallensis (A. otallensis) on the promastigote stage of Leishmaniadonovani (L. donovani) as compared to standard drugs and to screen its phytochemical constituents. Methods: Phytochemical screening was done by using the method mentioned by Evans and Trease on methanolic extract of the exudates of Aloe otallensis leaves. The extract was also evaluated for in vitro antileishmanial activity against L. donavani, which is found in the Parasitology Unit of Black Lion Hospital. The result was compared to standard drugs of sodium stibogluconate, milfostin and paramomycin. Results: The extract has good antileishmanial activity with an IC50 of 0.123 0 μg/mL on L. donovani (AM 563). The experimental data showed that relatively, it had better activity than paramomycin and milfostin but less activity than sodium stibogluconate. The data analyses were done by GraphPad Prism version 5 software after it was read by an ELISA reader at the wavelength of 650 nm. The phytochemical screening of the exudates of A. otallensis showed the presence of phenol, alkaloid and saponin. Conclusions: The methanol extract of the exudates of A.otallensishas a good anti- leishmaniasis activity and this may be attributed to phenol, alkaloid and saponin present in the plant. But it needs further analysis for the conformation of which constituent presents in high concentration to know which one has the strongest effect.

Keywords: anti leshimaniasis, aloe otallensis, leshimania ethiopica, IC50

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1133 Survey of Neonatologists’ Burnout on a Neonatal Surgical Unit: Audit Study from Cairo University Specialized Pediatric Hospital

Authors: Mahmoud Tarek, Alaa Obeida, Mai Magdy, Khalid Hussein, Aly Shalaby

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Background: More doctors are complaining of burnout than before, Burnout is a state of physical and mental exhaustion caused by the doctor’s lifestyle, unfortunately, Medical errors are also more likely in those suffering from burnout and these may result in malpractice suits. Methodology: It is a retrospective audit of burnout response on all neonatologists over a 9 months period. We gathered data using burnout questionnaire, it was obtained from 23 physicians, the physicians divided into 5 categories according to the final score of the 28 questions in the questionnaire. Category 1 with score from 28-38 with almost no work stress, category 2 with score (38-50) who express a low amount of job related stress, category 3 with score (51-70) with moderate amount of stress, category 4 with score (71-90) those express a high amount of job stress and begun to burnout, category 5 with score (91 and above) who are under a dangerous amount of stress and advanced stage of burnout. Results: 33 neonatologists have received the questionnaire, 23 responses were sent back with a response rate of 69.6%. The results showed that 61% of physicians fall in category 4, 31% of the physician in category 5, while 8% of physicians equally distributed between category 2 and 3 (4% each of them). On the other hand, there is no physician present in category 1. Conclusion: Burnout is prevalent in SNICUs, So interventions to minimize burnout prevalence may be of greater importance as this may be reflected indirectly on medical conditions of the patients and physicians, efforts should be done to decrease this high rate of burnout.

Keywords: Cairo, work overload, exhaustion, surgery, neonatal ICU

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1132 The Mechanism Underlying Empathy-Related Helping Behavior: An Investigation of Empathy-Attitude- Action Model

Authors: Wan-Ting Liao, Angela K. Tzeng

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Empathy has been an important issue in psychology, education, as well as cognitive neuroscience. Empathy has two major components: cognitive and emotional. Cognitive component refers to the ability to understand others’ perspectives, thoughts, and actions, whereas emotional component refers to understand how others feel. Empathy can be induced, attitude can then be changed, and with enough attitude change, helping behavior can occur. This finding leads us to two questions: is attitude change really necessary for prosocial behavior? And, what roles cognitive and affective empathy play? For the second question, participants with different psychopathic personality (PP) traits are critical because high PP people were found to suffer only affective empathy deficit. Their cognitive empathy shows no significant difference from the control group. 132 college students voluntarily participated in the current three-stage study. Stage 1 was to collect basic information including Interpersonal Reactivity Index (IRI), Psychopathic Personality Inventory-Revised (PPI-R), Attitude Scale, Visual Analogue Scale (VAS), and demographic data. Stage two was for empathy induction with three controversial scenarios, namely domestic violence, depression with a suicide attempt, and an ex-offender. Participants read all three stories and then rewrite the stories by one of two perspectives (empathetic vs. objective). They would then complete the VAS and Attitude Scale one more time for their post-attitude and emotional status. Three IVs were introduced for data analysis: PP (High vs. Low), Responsibility (whether or not the character is responsible for what happened), and Perspective-taking (Empathic vs. Objective). Stage 3 was for the action. Participants were instructed to freely use the 17 tokens they received as donations. They were debriefed and interviewed at the end of the experiment. The major findings were people with higher empathy tend to take more action in helping. Attitude change is not necessary for prosocial behavior. The controversy of the scenarios and how familiar participants are towards target groups play very important roles. Finally, people with high PP tend to show more public prosocial behavior due to their affective empathy deficit. Pre-existing value and belief as well as recent dramatic social events seem to have a big impact and possibly reduce the effect of the independent variables (IV) in our paradigm.

Keywords: empathy, cognitive, emotional, psychopathy

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1131 The Effect of Size and Tumor Depth on Histological Clearance Margins of Basal Cell Carcinomas

Authors: Martin Van, Mohammed Javed, Sarah Hemington-Gorse

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Aim: Our aim was to determine the effect of size and tumor depth of basal cell carcinomas (BCCs) on surgical margin clearance. Methods: A retrospective study was conducted at the Welsh Centre for Burns and Plastic Surgery (WCBPS), Morriston Hospital between 1 Jan 2016 – 31 July 2016. Only patients with confirmed BCC on histopathological analysis were included. Patient data including anatomical region treated, lesion size, histopathological clearance margins and histological sub-types were recorded. An independent T-test was performed determine statistical significance. Results: A total of 228 BCCs were excised in 160 patients. Eleven lesions (4.8%) were incompletely excised. The nose area had the highest rate of incomplete excision. The mean diameter of incompletely excised lesions was 11.4mm vs 11.5mm in completely excised lesions (p=0.959) and the mean histological depth of incompletely excised lesions was 4.1mm vs. 2.5mm for completely excised BCCs (p < 0.05). Conclusions: BCC tumor depth of > 4.1 mm was associated with high rate of incomplete margin clearance. Hence, in prospective patients, a BCC tumor depth (>4 mm) on tissue biopsy should alert the surgeon of potentially higher risk of incomplete excision of lesion.

Keywords: basal cell carcinoma, excision margins, plastic surgery, treatment

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1130 Telemedicine for Telerehabilitation in Areas Affected by Social Conflicts in Colombia

Authors: Lilia Edit Aparicio Pico, Paulo Cesar Coronado Sánchez, Roberto Ferro Escobar

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This paper presents the implementation of telemedicine services for physiotherapy, occupational therapy, and speech therapy rehabilitation, utilizing telebroadcasting of audiovisual content to enhance comprehensive patient recovery in rural areas of San Vicente del Caguán municipality, characterized by high levels of social conflict in Colombia. The region faces challenges such as dysfunctional problems, physical rehabilitation needs, and a high prevalence of hearing diseases, leading to neglect and substandard health services. Limited access to healthcare due to communication barriers and transportation difficulties exacerbates these issues. To address these challenges, a research initiative was undertaken to leverage information and communication technologies (ICTs) to improve healthcare quality and accessibility for this vulnerable population. The primary objective was to develop a tele-rehabilitation system to provide asynchronous online therapies and teleconsultation services for patient follow-up during the recovery process. The project comprises two components: Communication systems and human development. A technological component involving the establishment of a wireless network connecting rural centers and the development of a mobile application for video-based therapy delivery. Communications systems will be provided by a radio link that utilizes internet provided by the Colombian government, located in the municipality of San Vicente del Caguán to connect two rural centers (Pozos and Tres Esquinas) and a mobile application for managing videos for asynchronous broadcasting in sidewalks and patients' homes. This component constitutes an operational model integrating information and telecommunications technologies. The second component involves pedagogical and human development. The primary focus is on the patient, where performance indicators and the efficiency of therapy support were evaluated for the assessment and monitoring of telerehabilitation results in physical, occupational, and speech therapy. They wanted to implement a wireless network to ensure audiovisual content transmission for tele-rehabilitation, design audiovisual content for tele-rehabilitation based on services provided by the ESE Hospital San Rafael in physiotherapy, occupational therapy, and speech therapy, develop a software application for fixed and mobile devices enabling access to tele-rehabilitation audiovisual content for healthcare personnel and patients and finally to evaluate the technological solution's contribution to the ESE Hospital San Rafael community. The research comprised four phases: wireless network implementation, audiovisual content design, software application development, and evaluation of the technological solution's impact. Key findings include the successful implementation of virtual teletherapy, both synchronously and asynchronously, and the assessment of technological performance indicators, patient evolution, timeliness, acceptance, and service quality of tele-rehabilitation therapies. The study demonstrated improved service coverage, increased care supply, enhanced access to timely therapies for patients, and positive acceptance of teletherapy modalities. Additionally, the project generated new knowledge for potential replication in other regions and proposed strategies for short- and medium-term improvement of service quality and care indicators

Keywords: e-health, medical informatics, telemedicine, telerehabilitation, virtual therapy

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1129 Life Cycle Assessment of an Onshore Wind Turbine in Kuwait

Authors: Badriya Almutairi, Ashraf El-Hamalawi

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Wind energy technologies are considered to be among the most promising types of renewable energy sources due to the growing concerns over climate change and energy security. Kuwait is amongst the countries that began realising the consequences of climate change and the long-term economic and energy security situation, considering options when oil runs out. Added to this are the fluctuating oil prices, rapid increase in population, high electricity consumption and protection of the environment It began to make efforts in the direction of greener solutions for energy needs by looking for alternative forms of energy and assessing potential renewable energy resources, including wind and solar. The aim of this paper is to examine wind energy as an alternative renewable energy source in Kuwait, due to its availability and low cost, reducing the dependency on fossil fuels compared to other forms of renewable energy. This paper will present a life cycle assessment of onshore wind turbine systems in Kuwait, comprising 4 stages; goal and scope of the analysis, inventory analysis, impact assessment and interpretation of the results. It will also provide an assessment of potential renewable energy resources and technologies applied for power generation and the environmental benefits for Kuwait. An optimum location for a site (Shagaya) will be recommended for reasons such as high wind speeds, land availability and distance to the next grid connection, and be the focus of this study. The potential environmental impacts and resources used throughout the wind turbine system’s life-cycle are then analysed using a Life Cycle Assessment (LCA). The results show the total carbon dioxide (CO₂) emission for a turbine with steel pile foundations is greater than emissions from a turbine with concrete foundations by 18 %. The analysis also shows the average CO₂ emissions from electricity generated using crude oil is 645gCO₂/kWh and the carbon footprint per functional unit for a wind turbine ranges between 6.6 g/kWh to 10 g/kWh, an increase of 98%, thus providing cost and environmental benefits by creating a wind farm in Kuwait. Using a cost-benefit analysis, it was also found that the electricity produced from wind energy in Kuwait would cost 17.6fils/kWh (0.05834 $/kWh), which is less than the cost of electricity currently being produced using conventional methods at 22 fils/kW (0.07$/kWh), i.e., a reduction of 20%.

Keywords: CO₂ emissions, Kuwait, life cycle assessment, renewable energy, wind energy

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1128 Contribution of the Cogeneration Systems to Environment and Sustainability

Authors: Kemal Çomakli, Uğur Çakir, Ayşegül Çokgez Kuş, Erol Şahin

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Kind of energy that buildings need changes in various types, like heating energy, cooling energy, electrical energy and thermal energy for hot top water. Usually the processes or systems produce thermal energy causes emitting pollutant emissions while they produce heat because of fossil fuels they use. A lower consumption of thermal energy will contribute not only to a reduction in the running costs, but also in the reduction of pollutant emissions that contribute to the greenhouse effect and a lesser dependence of the hospital on the external power supply. Cogeneration or CHP (Combined heat and Power) is the system that produces power and usable heat simultaneously. Combined production of mechanical or electrical and thermal energy using a simple energy source, such as oil, coal, natural or liquefied gas, biomass or the sun; affords remarkable energy savings and frequently makes it possible to operate with greater efficiency when compared to a system producing heat and power separately. Because of the life standard of humanity in new age, energy sources must be continually and best qualified. For this reason the installation of a system for the simultaneous generation of electrical, heating and cooling energy would be one of the best solutions if we want to have qualified energy and reduce investment and operating costs and meet ecological requirements. This study aims to bring out the contributions of cogeneration systems to the environment and sustainability by saving the energy and reducing the emissions.

Keywords: sustainability, cogeneration systems, energy economy, energy saving

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1127 Effect of Aerobics Exercise on the Patient with Anxiety Disorder

Authors: Ahmed A. Abd El Rahim, Andrew Anis Fakhrey Mosaad

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Background: An important psychological issue that has an impact on both mental and physical function is anxiety disorders. The general consensus is that aerobic exercise and physical activity are good for lowering anxiety and mood. Purpose: This study's goal was to look into how patients with anxiety disorders responded to aerobic exercise. Subjects: Anxiety disorders were identified in 30 individuals from the psychiatric hospital at Sohag University who were chosen based on inclusive criteria and had ages ranging from 25 to 45. Methods: Patients were split into two equal groups at random: For four weeks, three sessions per week, fifteen patients in group A (the study group), seven men and eight women, underwent medication therapy and aerobic exercise. Age (28.4 ± 2.11 years), weight (72.5 ± 10.06 kg), height (164.8 ± 9.64 cm), and BMI (26.65 ± 2.68 kg/m2) were all mean SD values. And in Group B (Control Group), only medication therapy was administered to 15 patients (9 males and 6 females). Age (29.6 ± 3.68), weight (75 ± 7.07 kg), height (166.9 ± 6.75) cm, and BMI (26.87 ± 1.11) kg/m2 were the mean SD values. Before and after the treatment, the Hamilton Anxiety Scale was used to gauge the patient's degree of anxiety. Results: Within the two groups, there were significant differences both before and after the treatment. Following therapy, there was a significant difference between the two groups; the study group displayed better improvement on the Hamilton Anxiety Scale. Conclusion: Patients with anxiety problems can benefit from aerobic activities and antianxiety drugs as effective treatments for lowering anxiety levels.

Keywords: aerobic exercises, anxiety disorders, antianxiety medications, Hamilton anxiety scale

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1126 Acupuncture Reduces Pain Disability, Stress, and Depression in United States Military Veterans with Chronic Pain

Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

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The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

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1125 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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1124 Nurses’ Perception of Pain and Skin Tearing during Dressing Change

Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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1123 The Effects of Self- and Partner Reported Attachment Orientations and Mate Retention Behaviors: Actor and Partner Effects in Romantic Couples

Authors: Jasna Hudek-Knezevic, Igor Kardum, Nada Krapic, Martina Jurcic

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The aim of this study was to examine the effects of self- and partner reported attachment orientations on self-reported mate retention behaviors in romantic couples using the actor-partner interdependence model. The study was carried out on 187 heterosexual couples aged from 18 to 35 years, with an average relationship length of 4.5 years. Participants were asked to complete the revised scale of adult attachment and short form of mate retention inventory. Actor and partner effects of self- and partner reported anxious and avoidant attachment orientations on mate retention categories (direct guarding, intersexual negative inducements, positive inducements, public signals of possession and intrasexual negative inducements) and domains (cost-inflicting and benefit-provisioning), as well on overall mate retention were examined. Actor effects for women estimate whether their attachment orientations predict their own mate retention behaviors, whereas men’s actor effects estimate whether their attachment orientations predict their own mate retention behaviors. Women’s partner effects estimate whether their attachment orientations predict their partner’s mate retention behaviors, whereas men’s partner effects estimate whether their attachment orientations predict their partner’s mate retention behaviors. The use of two data sources, self- and partner reports, allow the control of the effects of common method variance when exploring actor and partner effects. Positive actor and partner effects of anxious attachment, as well as negative actor and partner effects of avoidant attachment on mate retention, were expected. In other words, it was expected that more anxiously attached individuals themselves, as well as their partners, will use mate retention behaviors more frequently. On the other hand, more avoidantly attached individuals themselves, as well as their partners, will use mate retention behaviors less frequently. These hypotheses were partially confirmed. The results showed that the strongest and most consistent effects across both data sources were men’s actor effects on the cost-inflicting mate retention domain, and especially on two mate retention categories, direct guarding, and intersexual negative inducements. Additionally, a consistent positive partner effect of men’s anxious attachment orientations on direct guarding was also obtained. Avoidant attachment orientation exerted few and inconsistent actor and partner effects on mate retention domains and categories. The results are explained by theoretical propositions addressing the effects of attachment orientations on an interpersonal romantic relationship in early adulthood.

Keywords: actor and partner effects, attachment orientations, dyadic analysis, mate retention behavior

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1122 The Diet Adherence in Cardiovascular Disease Risk Factors Patients in the North of Iran Based on the Mediterranean Diet Adherence

Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahboobeh Gholipour, Moona Naghshbandi

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Background and objectives: Before any nutritional intervention, it is necessary to have the prospect of eating habits of people with cardiovascular risk factors. In this study, we assessed the adherence of healthy diet based on Mediterranean dietary pattern and related factors in adults in the north of Iran. Methods: This study was conducted on 550 men and women with cardiovascular risk factors that referred to Heshmat hospital in Rasht, northern Iran. Information was collected by interview and reading medical history and measuring anthropometric indexes. The Mediterranean Diet Adherence Screener was used for assessing dietary adherence, this screener was modified according to religious beliefs and culture of Iran. Results: The mean age of participants was 58±0.38 years. The mean of body mass index was 27±0.01 kg/m2, and the mean of waist circumference was 98±0.2 cm. The mean of dietary adherence was 5.76±0.07. 45% of participants had low adherence, and just 4% had suitable adherence. The mean of dietary adherence in men was significantly higher than women (p=0. 07). Participants in rural area and high educational participants insignificantly had an unsuitable dietary Adherence. There was no significant association between some cardiovascular disease risk factors and dietary adherence. Conclusion: Education to different group about dietary intake correction and using a Mediterranean dietary pattern that is similar to dietary intake in the north of Iran, for controlling cardiovascular disease is necessary.

Keywords: dietary adherence, Mediterranean dietary pattern, cardiovascular disease, north of Iran

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1121 Assessing Environmental Psychology and Health Awareness in Delhi: A Fundamental Query for Sustainable Urban Living

Authors: Swati Rajput

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Environmental psychology explains that the person is a social agent that seeks to extract meaning from their built and natural environment to behave in a particular manner. It also shows the attachment or detachment of people to their environment. Assessing environmental psychology of people is imperative for planners and policy makers for urban planning. The paper investigates the environmental psychology of people living in nine districts of Delhi by calculating and assessing their Environmental Emotional Quotient (EEQ). Emotional Quotient deals with the ability to sense, understand, attach and respond according to the power of emotions. An Environmental Emotional Quotient has been formulated based upon the inventory administered to them. The respondents were asked questions related to their view and emotions about the green spaces, water resource conservation, air and environmental quality. An effort has been made to assess the feeling of belongingness among the residents. Their views were assessed on green spaces, reuse, and recycling of resources and their participation level. They were also been assessed upon health awareness level by considering both preventive and curative segments of health care. It was found that only 12 percent of the people is emotionally attached to their surroundings in the city. The emotional attachment reduces as we move away from the house to housing complex to neighbouring areas and rest of the city. In fact, the emotional quotient goes lower to lowest from house to other ends of the city. It falls abruptly after the radius of 1 km from the residence. The result also shows that nearly 54% respondents accept that there is environment pollution in their area. Around 47.8% respondents in the survey consider that diseases occur because of green cover depiction in their area. Major diseases are to airborne diseases like asthma and bronchitis. Seasonal disease prevalent, which specially occurred from last 3-4 years are malaria, dengue and chikengunya. Survey also shows that only 31 % of respondents visit government hospitals while 69% respondents visit private hospitals or small clinics for healthcare services. The paper suggests the need for environmental sensitive policies and need for green insurance in mega cities like Delhi.

Keywords: environmental psychology, environmental emotional quotient, preventive health care and curative health care, sustainable living

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1120 Strawberry Productivity of Peri-Urban and Urban Locations across Southeast Michigan, USA

Authors: Maria E. Laconi, Kyla D. Scherr, Mary A. Jamieson

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Human populations in urban environments have rapidly grown in recent decades. Consequently, the intensity of land-use and development has also increased in many urban and peri-urban environments. Some cities, such as Detroit, Michigan, USA, have embraced urban agriculture and local food production. Little is known, however, about how the local and landscape scale environmental factors influence crop productivity on urban farms. Our study aims to evaluate factors influencing the productivity of strawberries on community farms and gardens in the Detroit metropolitan area. Strawberries are one of few fruits that can provide an abundant harvest just after the first season of being planted, which is ideal for urban gardeners in developed areas. In the spring of 2016, we planted six different strawberry cultivars (three everbearing and three June bearing varieties) at five farm sites in Wayne and Oakland County (six replicate plants per cultivar per site). We surveyed flower and fruit phenology and production for everbearing varieties weekly (flowers for June bearing varieties were removed to enhance productivity in the coming growing season). Additionally, we conducted one initial 36hr pollinator survey in mid-September during peak fruit production and characterized local and landscape scale land-cover data. Preliminary results and observations from this first year of our study revealed that strawberry production varied significantly by site. Specifically, productivity at our most northern site appeared to suffer from delayed phenology and early frost damage to ripening strawberries. Bee abundance and diversity also differed among farms, though further surveys are needed to adequately inventory the pollinator community. Finally, strawberry cultivars demonstrated significant differences in the number and size of fruits produced. We plan to continue this study in the coming years, increasing the number of sites surveyed and number of pollinator sampling events. Our study aims to inform strategies for enhancing crop productivity on urban and peri-urban farms.

Keywords: insect pollination, strawberry productivity, sustainable agriculture, urban gardening

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1119 The Hospitals Residents Problem with Bounded Length Preference List under Social Stability

Authors: Ashish Shrivastava, C. Pandu Rangan

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In this paper, we consider The Hospitals Residents problem with Social Stability (HRSS), where hospitals and residents can communicate only through the underlying social network. Those residents and hospitals which don not have any social connection between them can not communicate and hence they cannot be a social blocking pair with respect to a socially stable matching in an instance of hospitals residents problem with social stability. In large scale matching like NRMP or Scottish medical matching scheme etc. where set of agents, as well as length of preference lists, are very large, social stability is a useful notion in which members of a blocking pair could block a matching if and only if they know the existence of each other. Thus the notion of social stability in hospitals residents problem allows us to increase the cardinality of the matching without taking care of those blocking pairs which are not socially connected to each other. We know that finding a maximum cardinality socially stable matching, in an instance, of HRSS is NP-hard. This motivates us to solve this problem with bounded length preference lists on one side. In this paper, we have presented a polynomial time algorithm to compute maximum cardinality socially stable matching in a HRSS instance where residents can give at most two length and hospitals can give unbounded length preference list. Preference lists of residents and hospitals will be strict in nature.

Keywords: matching under preference, socially stable matching, the hospital residents problem, the stable marriage problem

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1118 The Occurrence of Depression with Chronic Liver Disease

Authors: Roop Kiran, Muhammad Shoaib Zafar, Nazish Idrees Chaudhary

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Depression is known to be the second most frequently occurring comorbid mental illness among patients suffering from chronic physical conditions. Around the world, depression is associated with chronic liver diseases as one of the dominant symptoms. This evidence brings attention to the research about various predictors for short life expectancy and poor quality of life in patients suffering from comorbid depression and CLD. Following are the objectives of this study i) measure the occurrence rate of comorbid depression among patients with CLD and ii) find the frequency of risk factors between patients with and without depression comorbid with CLD. This is a quantitative study with a cross-sectional design. The research data was collected through a measure called Hamilton Depression Rating Scale (HDRS) with a demographic Performa from 100 patients who visited the Department of Psychiatry for consultation at Mayo Hospital Lahore with a diagnosed CLD from the last four years. There were (42%) patients with CLD who had comorbid depression. Among depressed and non-depressed patients, significant differences were found (p<0.05) for unemployment in 25 (59.5%) males and 20 (34.5%) female patients, for co-morbidity in 25 (59.5%) males and 18 (31.0%) female patients, for illiteracy in 18 (42.9%) males and 13 (22.4%) female patients, for the history of CLD for more than the last 2years in 41 (97.6%) males and 47 (81.0%) female patients, for severity of CLD in 26 (61.9%) males and 20 (34.5%) female patients. This concludes that depression frequently occurs among patients with CLD. This study recommends considerable attention to plan preventative measures in the future and develop such intervention protocols that consider the management of risk factors that significantly influence comorbid depression with CLD.

Keywords: psychiatry, comorbid, health, quality of life

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1117 Prevalence of Uropathogens in Diabetic Patients with Urinary Tract Infection and Antimicrobial Sensitivity Pattern at Bangladesh

Authors: Mohammad Saifuddin, Shahjada Selim

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Patients with diabetes mellitus (DM) are prone to develop infection, especially urinary tract infection (UTI) in comparison with non-diabetics. Due to the emergence of multidrug resistant (MDR) uropathogenic strains, the choice of antimicrobial agent is sometimes difficult. This study is designed to reveal the distribution of uropathogens in Diabetic patients and corresponding sensitivity patterns and to correlate the microbiological results with various clinical parameters. A nine-month retrospective review of 100 urine culture reports of Diabetic patients from January 2015 to September 2015 from semiurbanmultispeciality hospital of Feni, Bangladesh were analyzed. Only Diabetic patients were included in this study who were clinically diagnosed as UTI patients with a corresponding urine culture showing a bacterial count of ˃105cfu/ml.Out of 100 patients with UTI, 39 (39%) were male, and 61 (61%) were female. Organisms grown in urine culture were Escherichia coli (64) followed by Klebsiella (11), Proteus (7), Staph Aureus (4), Pseudomonas (4), Acinetobacter (3), Sreptococcus(3), Enterococcus (2 ) and one each of Enterobacter and Fungi. Overall sensitivity pattern in decreasing order of various commonly used antibiotics was Meropenem (89%), Nitrofurantoin (86%), Amikacin (81%), Ceftriaxone (68%), Cefuroxime (61%), Cefixime (39%), Quinolones (28%), Amoxicillin (16%). The significance of the study lies in the determination of common pathogens in diabetic patients with UTI and the resistance pattern of antibiotics so that physicians and pharmacists get the proper information rationalizing the rational use of antibiotics.

Keywords: Bangladesh, Diabetes Mellitus, E. coli, urinary tract infection

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1116 Nursing Experience of Providing Nursing Care to a Lung Transplantation Patient by Applying the Self-Efficacy Theory

Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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1115 Intervention Program for Emotional Management in Disruptive Situations Through Self-Compassion and Compassion

Authors: M. Bassas, J. Grané-Morcillo, J. Segura, J. M. Soldevila

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Mental health prevention is key in a society where, according to the World Health Organization, the fourth leading cause of death worldwide is suicide. Compassion is closely linked to personal growth. It shows once again that therapies based on prevention remain an urgent and social need. In this sense, a growing body of research demonstrates how cultivating a compassionate mind can help alleviate and prevent a variety of psychological problems. In the early 21st century, there has been a boom in third-generation compassion-based therapies, although there is a lack of empirical evidence of their efficacy. This study proposes a psychotherapy method (‘Being Method’), whose central axis revolves around emotional management through the cultivation of compassion. Therefore, the objective of this research was to analyze the effectiveness of this method with regard to the emotional changes experienced when we focus on what we are concerned about through the filter of compassion. The Being Method was born from the influence of Buddhist philosophy and contemporary psychology based mainly on Western rationalist currents. A quantitative cross-sectional study has been carried out in a sample of women between 18 and 53 years old (n=47; Mage=36.02; SDage= 11.86) interested in personal growth in which the following 6 measuring instruments were administered: Peace of mind Scale (PoM), Rosenberg Self-Esteem Scale (RSES), Subjective Happiness Scale (SHS), 2 Sacles of the Compassionate Action and Engagement Scales (CAES), Coping Response Inventory for Adults (CRI-A) and Cognitive-Behavioral Strategies Evaluation Scale (MOLDES). Following an experimental method approach, participants were divided into an experimental and control group. Longitudinal analysis was also carried out through a pre-post program comparison. Pre-post comparison outcomes indicated significant differences (p<.05) between before and after the therapy in the variables Peace of Mind, Self-esteem, Happiness, Self-compassion (A-B), Compassion (A-B), in several mental molds, as well as in several coping strategies. Also, between-groups tests proved significantly higher means obtained in the experimental group. Thus, these outcomes highlighted the effectiveness of the therapy, improving all the analyzed dimensions. The social, clinical and research implications are discussed.

Keywords: being method, compassion, effectiveness, emotional management, intervention program, personal growth therapy

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1114 Logistics and Supply Chain Management Using Smart Contracts on Blockchain

Authors: Armen Grigoryan, Milena Arakelyan

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The idea of smart logistics is still quite a complicated one. It can be used to market products to a large number of customers or to acquire raw materials of the highest quality at the lowest cost in geographically dispersed areas. The use of smart contracts in logistics and supply chain management has the potential to revolutionize the way that goods are tracked, transported, and managed. Smart contracts are simply computer programs written in one of the blockchain programming languages (Solidity, Rust, Vyper), which are capable of self-execution once the predetermined conditions are met. They can be used to automate and streamline many of the traditional manual processes that are currently used in logistics and supply chain management, including the tracking and movement of goods, the management of inventory, and the facilitation of payments and settlements between different parties in the supply chain. Currently, logistics is a core area for companies which is concerned with transporting products between parties. Still, the problem of this sector is that its scale may lead to detainments and defaults in the delivery of goods, as well as other issues. Moreover, large distributors require a large number of workers to meet all the needs of their stores. All this may contribute to big detainments in order processing and increases the potentiality of losing orders. In an attempt to break this problem, companies have automated all their procedures, contributing to a significant augmentation in the number of businesses and distributors in the logistics sector. Hence, blockchain technology and smart contracted legal agreements seem to be suitable concepts to redesign and optimize collaborative business processes and supply chains. The main purpose of this paper is to examine the scope of blockchain technology and smart contracts in the field of logistics and supply chain management. This study discusses the research question of how and to which extent smart contracts and blockchain technology can facilitate and improve the implementation of collaborative business structures for sustainable entrepreneurial activities in smart supply chains. The intention is to provide a comprehensive overview of the existing research on the use of smart contracts in logistics and supply chain management and to identify any gaps or limitations in the current knowledge on this topic. This review aims to provide a summary and evaluation of the key findings and themes that emerge from the research, as well as to suggest potential directions for future research on the use of smart contracts in logistics and supply chain management.

Keywords: smart contracts, smart logistics, smart supply chain management, blockchain and smart contracts in logistics, smart contracts for controlling supply chain management

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1113 The Relationship Between Weight Gain, Cyclicality of Diabetologic Education and the Experienced Stress: A Study Involving Pregnant Women

Authors: Agnieszka Rolinska, Marta Makara-Studzinska

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Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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1112 Role of Direct Immunofluorescence in Diagnosing Vesiculobullous Lesions

Authors: Mitakshara Sharma, Sonal Sharma

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Vesiculobullous diseases are heterogeneous group of dermatological disorders with protean manifestations. The most important technique for the patients with vesiculobullous diseases is conventional histopathology and confirmatory tests like direct immunofluorescence (DIF) and indirect immunofluorescence (IIF). DIF has been used for decades to investigate pathophysiology and in the diagnosis. It detects molecules such as immunoglobulins and complement components. It is done on the perilesional skin. Diagnosis of DIF test depends on features like primary site of the immune deposits, class of immunoglobulin, number of immune deposits and deposition at other sites. The aim of the study is to correlate DIF with clinical and histopathological findings and to analyze the utility of DIF in the diagnosis of these disorders. It is a retrospective descriptive study conducted for 2 years from 2015 to 2017 in Department of Pathology, GTB Hospital on perilesional punch biopsies of vesiculobullous lesions. Biopsies were sent in Michael’s medium. The specimens were washed, frozen and incubated with fluorescein isothiocyanate (FITC) tagged antihuman antibodies IgA, IgG, IgM, C3 & F and were viewed under fluorescent microscope. Out of 401 skin biopsies submitted for DIF, 285 were vesiculobullous diseases, in which the most common was Pemphigus vulgaris (34%) followed by Bullous pemphigoid (21.5%), Dermatitis herpetiformis (16%), Pemphigus foliaceus (11.9%), Linear IgA disease (11.9%), Epidermolysisbullosa (2.39%) and Pemphigus herpetiformis (1.7%). We will be presenting the DIF findings in the all these vesiculobullous diseases. DIF in conjugation with histopathology gives the best diagnostic yield in these lesions. It also helps in the diagnosis whenever there is a clinical and histopathological overlap.

Keywords: antibodies, direct immunofluorescence, pemphigus, vesiculobullous

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1111 Detection of Oral Mucosal Lesions in Cutaneous Psoriatic Patients

Authors: Rania A. R. Soudan, Easter Joury

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Introduction: Psoriasis is a common chronic dermatologic disease. It may affect the mucous membranes. The presence of oral mucosal lesions has been a subject of controversy. The aim: To determine possible association between oral mucosal lesions and psoriasis, and to correlate the same with different types of psoriasis and severity of the disease. Materials and Methods: The oral mucosa was clinically examined in 100 randomly selected Syrian psoriatic patients presented to the Dermatological Diseases Hospital in Damascus University, Syria (February 2009 - December 2010), and in 100 matched controls. PASI index was used to evaluate the disease severity. Chi-square and Student t-test were used to compare differences between groups. Results: Oral mucosal lesions were observed in 72% of the psoriasis cases, while 46% of the control group’s subjects had oral lesions. Fissured tongue, geographic tongue, and red lesions were detected in 36%, 25%, and 7% of the examined psoriatics, respectively. These lesions were significantly more frequent in the psoriatics than in the controls. A correlation was found between furred tongue and the age of the psoriasis patients. However, an association was observed for fissured tongue, furred tongue with the severity of the disease, and for fissured tongue, white lesions, cheilitis with nail involvement. However, no correlation with the psoriasis types was recorded. Conclusion: Some oral mucosal lesions were associated with psoriasis, so these lesions may be considered as oral manifestations of this disease, and should be taken into account in new studies as possible predictors or markers of this dermatitis. Further studies are recommended to confirm these oral manifestations.

Keywords: psoriasis, tongue, mucosa, lesions

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