Search results for: surgical history
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3417

Search results for: surgical history

1527 Federalism, a System of Government: Comparative Study of Australia and Canada

Authors: Rana Tajammal Rashid

Abstract:

Federalism is a political system in which government power and responsibility are divided between a federal legislature and units of the state or provincial legislatures. This system provides the structure for the states having large territory and through that can manage the state affairs and administration easily. Many of the largest countries in the world are federations, like; The United States, Canada, India, Pakistan South Africa, Argentina, and Australia. Every large democratic nation has a federal system of government. This study will explore the feature and good governance of two developed countries Canada and Australia. This study will be helpful to the developing countries like Pakistan, India which have a federal form of structure to run the affairs of the state. In the federal system of Pakistan there are lot of issues and conflicts with the provinces with a comparative study of these two developed countries, i.e., Australia and Canada, our policy and decision maker political actors will understand in which way a state will successfully manage the issues related to federalism. This study will also provide the help to the students of comparative politics that how to analysis the different political system of the developed countries of the world.

Keywords: federalism, features of federalism, types of federalism, history of federalism, Australian federalism, Canadian federalism, federalism developments, executives, federal and provincial autonomy legislative, judicial

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1526 Challenges and Opportunities of Intercultural Communication in Afghanistan

Authors: Kefayatullah Wahidi

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This article examines the challenges and opportunities of intercultural communication in Afghanistan. Afghanistan, with its ancient history and location on the Silk Road, connects the great civilizations of the world. This country holds a sensitive strategic and geopolitical position in the Middle East. In Afghanistan, various ethnic groups live, each with distinct linguistic, religious, and racial cultures. In today's world, elements such as identity, religion, and culture form the main components of international political relations. In some cases, these factors can even overshadow the materialistic and self-interest-driven aspects of international relations. Therefore, we used a qualitative case study method (using interviews) for this research. In this context, we attempted to discuss the issues and problems related to the challenges and opportunities of intercultural communication, with the participation of a sample of 12 Afghan people. The findings of this research show that Afghanistan is facing many challenges in the field of intercultural communication. Cultural dissatisfaction, linguistic and religious differences, and cultural sanctions are among the major challenges that can cause tensions and a lack of mutual understanding. At the same time, intercultural communication is an opportunity to increase mutual understanding, cultural exchange, and constructive interactions. Please note that I have made some minor edits for clarity and grammar, but the overall content remains the same.

Keywords: cultural dissatisfactions, language differences, intercultural communication, Afghanistan

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1525 Haemoperitoneum in a Case of Dengue Fever

Authors: Sagarjyoti Roy

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Dengue is an arboviral infection, belonging to family flaviviridae, comprising of four serotypes; DENV1, DENV2, DENV3 and DENV4. All four serotypes are capable of causing full-spectrum of clinical features, ranging from self-limiting fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Complications may affect any organ system, including those involving gastrointestinal system and serositis. We report a case, of a 28 years, non-alcoholic male, presenting with a 7 day history of fever and malaise followed by abdominal pain and distension, from 4th day of fever. He was admitted in medicine department of RG KAR medical college hospital. Dengue fever was confirmed by NS1 and dengue IgM positivity. Platelet count was 30,000/cc (1.5- 4 lac/cc) and haematocrit was 52% (38- 50% for men). Clinicoradiological findings revealed bilateral pleural effusion, ascites and splenomegaly. Ascitic fluid was hemorrhagic in nature, with a high protein and RBC content. Liver function tests revealed mild transaminitis with normal coagulation profile. Patient was managed conservatively. A diagnosis of dengue fever complicated by serositis and spontaneous haemoperitoneum was made. The symptoms subsided after a hospital stay of 10 days. The case highlights haemorrhage into peritoneal cavity as a possible complication of dengue fever. Although a definite explanation requires more detailed studies, platelet or endothelial cell dysfunction might be contributory.

Keywords: ascites, dengue, haemoperitoneum, serositis

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1524 A Clinical Study of Placenta Previa and Its Effect on Fetomaternal Outcome in Scarred and Unscarred Uterus at a Tertiary Care Hospital

Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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1523 Corpus-Based Analysis on the Translatability of Conceptual Vagueness in Traditional Chinese Medicine Classics Huang Di Nei Jing

Authors: Yan Yue

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Huang Di Nei Jing (HDNJ) is one of the significant traditional Chinese medicine (TCM) classics which lays the foundation of TCM theory and practice. It is an important work for the world to study the ancient civilizations and medical history of China. Language in HDNJ is highly concise and vague, and notably challenging to translate. This paper investigates the translatability of one particular vagueness in HDNJ: the conceptual vagueness which carries the Chinese philosophical and cultural connotations. The corpora tool Sketch Engine is used to provide potential online contexts and word behaviors. Selected two English translations of HDNJ by TCM practitioner and non-practitioner are used to examine frequency and distribution of linguistic features of the translation. It was found the hypothesis about the universals of translated language (explicitation, normalisation) is true in one translation, but it is on the sacrifice of some original contextual connotations. Transliteration is purposefully used in the second translation to retain the original flavor, which is argued as a violation of the principle of relevance in communication because it yields little contextual effects and demands more processing effort of the reader. The translatability of conceptual vagueness in HDNJ is constrained by source language context and the reader’s cognitive environment.

Keywords: corpus-based translation, translatability, TCM classics, vague language

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1522 On Driving Forces of Cultural Globalization and its Retroaction: Under the Guidance of Skopos Theory

Authors: Zhai Yujia

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None of the scholars and researchers has ever stepped into this field, though there are quite a few papers worked on various topics relevant to cultural and economic globalization separately. Economic globalization is earlier than cultural globalization. Since the invention of currency, people have had the sense of making money for the purpose of living, supporting their families, or other personal reasons. Their strong desire for earning a living is one of the incentives to propel the trade, tourism and other related economic activities that provide the service within the homeland at first and expand into the whole world later, as the global markets grow and mature. The need for operation impels international communication or interaction. To achieve this, it is vital to realize or recognize other cultures to some degree, concluding language, customs, social etiquette and history of different nations. All this drives the cultural globalization process. In contrast, it is clear that the development of cultural globalization does accelerate the process of economic globalization in return. Under the guidance of Skopos theory (first proposed by Hans Vermeer, and its core principle is that the translation process is determined by the purpose), this paper aims to demonstrate that cultural globalization is not a process in isolation by analyzing its driving forces and retroaction thoroughly with an approach of overview. It intertwines with economic globalization. The two push each other to proper gradually during their development, serving as the indispensable parts of the globalization process.

Keywords: cultural globalization, driving forces, retroaction, Skopos theory

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1521 Repeated Reuse of Insulin Injection Syringes and Incidence of Bacterial Contamination among Diabetic Patients in Jimma University Specialized Hospital, Jimma, Ethiopia

Authors: Muluneh Ademe, Zeleke Mekonnen

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Objective: to determine the level of bacterial contamination of reused insulin syringes among diabetic patients. Method: A facility based cross-sectional study was conducted among diabetic patients. Data on socio-demographic variables, history of injection syringe reuse, and frequency of reuse of syringes were collected using predesigned questionnaire. Finally, the samples from the syringes were cultured according to standard microbiological techniques. Result: Eighteen diabetic patients at Jimma University Hospital participated. A total of 83.3% of participants reused a single injection syringe for >30 consecutive injections, while 16.7% reused for >30 injections. Our results showed 22.2% of syringes were contaminated with methicillin-resistant Staphylococcus aures. Conclusion: We conclude reuse of syringe is associated with microbial contamination. The findings that 4/18 syringes being contaminated with bacteria is an alarming situation. A mechanism should be designed for patients to get injection syringes with affordable price. If reusing is not avoidable, reducing number of injections per a single syringe and avoiding needle touching with hand or other non-sterile material may be an alternative to reduce the risk of contamination.

Keywords: diabetes mellitus, Ethiopia, subcutaneous insulin injection, syringe reuse

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1520 WILCKO-PERIO, Periodontally Accelerated Orthodontics

Authors: Kruttika Bhuse

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Aim: Synergism between periodontists and orthodontists (periodontal accelerated osteogenic orthodontics- PAOO) creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines and has made adult orthodontics a reality. Thus, understanding the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. Wilckodontics can be an attractive treatment option and be a “win-win” situation for both the dental surgeon and patient by reducing the orthodontic treatment time in adults. Materials and methods: In this review, data related to the clinical aspects, steps of procedure, biomechanics of bone, indications and contraindications and final outcome of wilckodontic shall be discussed. 50 supporting articles from various international journals and 70 clinical cases were reviewed to get a better understanding to design this wilckodontic - meta analysis. Various journals like the Journal Of Clinical And Diagnostic Research, Journal Of Indian Society Of Periodontology, Journal Of Periodontology, Pubmed, Boston Orthodontic University Journal, Good Practice Orthodontics Volume 2, have been referred to attain valuable information on wilckodontics which was then compiled in this single review study. Result: As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, wilckodontics consists of regional acceleratory phenomenon by alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. The surgical wounding of alveolar bone potentiates tissue reorganization and healing by a way of transient burst of localized hard and soft tissue remodelling.This phenomenon causes bone healing to occur 10-50 times faster than normal bone turnover. Conclusion: This meta analysis helps understanding that the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. The main benefits being reduced orthodontic treatment time, increased bone volume and post-orthodontic stability.

Keywords: periodontal osteogenic accelerated orthodontics, alveolar corticotomy, bone augmentation, win-win situation

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1519 Urban Form of the Traditional Arabic City in the Light of Islamic Values

Authors: Akeel Noori Al-Mulla Hwaish

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The environmental impact, economics, social and cultural factors, and the processes by which people define history and meaning had influenced the dynamic shape and character of the traditional Islamic Arabic city. Therefore, in regard to the period when Islam was at its peak (7th- 13th Centuries), Islamic city wasn’t the highly dynamited at the scale of buildings and city planning that demonstrates a distinguished city as an ‘Islamic’ as appeared after centuries when the function of the buildings and their particular arrangement and planning scheme in relation to one another that defined an Islamic city character. The architectural features of the urban fabric of the traditional Arabic Islamic city are a ‎reflection of the spiritual, social, and cultural characteristics of the people. It is a ‎combination of Islamic values ‘Din’ and life needs ‘Dunia’ as Prophet Muhammad built the first Mosque in ‎Madinah in the 1st year of his migration to it, then the Suq or market on 2nd of Hijrah, attached to ‎the mosque to signify the birth of a new Muslims community which considers both, ‎‎’Din’ and ‘Dunia’ and initiated nucleus for what which called after that as an ‘Islamic’ city. This research will discuss the main characteristics and components of the traditional Arab cities and demonstrate the impact of the Islamic values on shaping the planning layout and general built environment features of the early traditional Arab cities.

Keywords: urban, Islamic, Arabic, city

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1518 An Observational Study of Vitamin B12 Levels and Peripheral Neuropathy Profile in Patients of Diabetes Mellitus on Metformin Therapy

Authors: Kamesh Gupta, Nitin Jain, Anurag Rohatgi

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Objective: To study Vitamin B12 levels and presence of peripheral neuropathy among diabetes mellitus patients on metformin therapy. Method: The observational study was conducted from November 2014 to March 2015. Patients were selected from the Lady Hardinge Medical College, Delhi, India. Exhaustive history regarding dietary habits and metformin usage was taken. Lab tests including HbA1c levels and Vit B12 assays were done, on the basis of which patients were classified into subgroups. Peripheral neuropathy was detected by both clinical scoring and electrophysiological studies. Appropriate Statistical analysis for observational studies was done to evaluate the data. Results: The average duration of metformin usage was higher in patients with definite B12 deficiency (9.4y) than patients with normal B12 levels (5.6 y). Patients in the definite B12 deficiency group had much higher incidence of neuropathy (89%) than patients with no deficiency (27%). The incidence of neuropathy was higher in cases with longer metformin usage (100% with 18-22y of use and 83% with 14-17y of use) than shorter periods (29% with 2-5y of use and 75% with 6-9y of use). Conclusion: Thus patients on long-term metformin therapy are at a high risk for Vitamin B12 deficiency. Definite and possible Vitamin B12 deficiency on metformin had an earlier onset of neuropathy than the subgroup with normal Vitamin B12 levels.

Keywords: diabetic neuroptahy, cobalamine deficiency, metformin, nerve conduction studies

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1517 The Concepts of Urban Sustainable Development and Smart Cities: In the Understanding of Academia and the European Union

Authors: Wolfgang Haupt

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When considering the future city one repeatedly comes across two sometimes sparsely differentiated terms: Sustainable and smart. ‘A European Strategy for Smart, Sustainable, and Inclusive Growth’, this is how the European Commission named its current growth strategy. Thus, Europe should become smarter and more sustainable. Both, the smart and the sustainable city represent a positive vision of urban development as well as a subject area for contemporary and future urban policies. However, more clarity on what is actually behind these terminologies is required. The paper analyses how the terms are defined academically and how this academic understanding is represented in the funding mechanisms of European urban policies. The theoretical framework is mainly based on sources such as journal articles and policy reports. It became clear that despite some similarities, such as the broad field of work or the tendency to operationalize the terms by defining sub-categories, both ideas are distinctly different in terms of the development history, the main driving forces behind and the theoretical scope. Moreover, the significantly more comprehensively defined term sustainability has found its way into the centre of European regional funding policies. On the contrary, the smart city vision still lacks terminological and content-related clarity and as a consequence, the corresponding European funding landscape is more small-scaled and less customized.

Keywords: European spatial policy, European union, smart city, urban sustainable development

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1516 Interpretable Deep Learning Models for Medical Condition Identification

Authors: Dongping Fang, Lian Duan, Xiaojing Yuan, Mike Xu, Allyn Klunder, Kevin Tan, Suiting Cao, Yeqing Ji

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Accurate prediction of a medical condition with straight clinical evidence is a long-sought topic in the medical management and health insurance field. Although great progress has been made with machine learning algorithms, the medical community is still, to a certain degree, suspicious about the model's accuracy and interpretability. This paper presents an innovative hierarchical attention deep learning model to achieve good prediction and clear interpretability that can be easily understood by medical professionals. This deep learning model uses a hierarchical attention structure that matches naturally with the medical history data structure and reflects the member’s encounter (date of service) sequence. The model attention structure consists of 3 levels: (1) attention on the medical code types (diagnosis codes, procedure codes, lab test results, and prescription drugs), (2) attention on the sequential medical encounters within a type, (3) attention on the medical codes within an encounter and type. This model is applied to predict the occurrence of stage 3 chronic kidney disease (CKD3), using three years’ medical history of Medicare Advantage (MA) members from a top health insurance company. The model takes members’ medical events, both claims and electronic medical record (EMR) data, as input, makes a prediction of CKD3 and calculates the contribution from individual events to the predicted outcome. The model outcome can be easily explained with the clinical evidence identified by the model algorithm. Here are examples: Member A had 36 medical encounters in the past three years: multiple office visits, lab tests and medications. The model predicts member A has a high risk of CKD3 with the following well-contributed clinical events - multiple high ‘Creatinine in Serum or Plasma’ tests and multiple low kidneys functioning ‘Glomerular filtration rate’ tests. Among the abnormal lab tests, more recent results contributed more to the prediction. The model also indicates regular office visits, no abnormal findings of medical examinations, and taking proper medications decreased the CKD3 risk. Member B had 104 medical encounters in the past 3 years and was predicted to have a low risk of CKD3, because the model didn’t identify diagnoses, procedures, or medications related to kidney disease, and many lab test results, including ‘Glomerular filtration rate’ were within the normal range. The model accurately predicts members A and B and provides interpretable clinical evidence that is validated by clinicians. Without extra effort, the interpretation is generated directly from the model and presented together with the occurrence date. Our model uses the medical data in its most raw format without any further data aggregation, transformation, or mapping. This greatly simplifies the data preparation process, mitigates the chance for error and eliminates post-modeling work needed for traditional model explanation. To our knowledge, this is the first paper on an interpretable deep-learning model using a 3-level attention structure, sourcing both EMR and claim data, including all 4 types of medical data, on the entire Medicare population of a big insurance company, and more importantly, directly generating model interpretation to support user decision. In the future, we plan to enrich the model input by adding patients’ demographics and information from free-texted physician notes.

Keywords: deep learning, interpretability, attention, big data, medical conditions

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1515 The Role of Instruction in Knowledge Construction in Online Learning

Authors: Soo Hyung Kim

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Two different learning approaches were suggested: focusing on factual knowledge or focusing on the embedded meaning in the statements. Each way of learning has positive effects on different question categories, where factual knowledge helps more with simple fact questions, and searching for meaning in given information helps learn causal relationship and the embedded meaning. To test this belief, two groups of learners (12 male and 39 female adults aged 18-37) watched a ten-minute long Youtube video about various factual events of American history, their meaning, and the causal relations of the events. The fact group was asked to focus on factual knowledge in the video, and the meaning group was asked to focus on the embedded meaning in the video. After watching the video, both groups took multiple-choice questions, which consisted of 10 questions asking the factual knowledge addressed in the video and 10 questions asking embedded meaning in the video, such as the causal relationship between historical events and the significance of the event. From ANCOVA analysis, it was found that the factual knowledge showed higher performance on the factual questions than the meaning group, although there was no group difference on the questions about the meaning between the two groups. The finding suggests that teacher instruction plays an important role in learners constructing a different type of knowledge in online learning.

Keywords: factual knowledge, instruction, meaning-based knowledge, online learning

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1514 Maternal-Fetal Outcome in Pregnant Women with Ebola Virus Disease: A Systematic Review

Authors: Garba Iliyasu, Lamaran Dattijo

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Introduction: Ebola virus disease (EVD) is a disease of humans and other primates caused by Ebola viruses. The most widespread epidemic of EVD in history occurred recently in several West African countries. The burden and outcome of EVD in pregnant women remains uncertain. There are very few studies to date reporting on maternal and fetal outcomes among pregnant women with EVD, hence the justification for this comprehensive review of these published studies. Methods: Published studies in English that reported on maternal and or fetal outcome among pregnant women with EVD up to May 2016 were searched in electronic databases (Google Scholar, Medline, Embase, PubMed, AJOL, and Scopus). Studies that did not satisfy the inclusion criteria were excluded. We extracted the following variables from each study: geographical location, year of the study, settings of the study, participants, maternal and fetal outcome.Result: There were 12 studies that reported on 108 pregnant women and 110 fetal outcomes. Six of the studies were case reports, 3 retrospective studies, 2 cross-sectional studies and 1 was a technical report. There were 91(84.3%) deaths out of the 108 pregnant women, while only 1(0.9%) fetal survival was reported out of 110. Survival rate among the 15 patients that had spontaneous abortion/stillbirth or induced delivery was 100%. Conclusion: There was a poor maternal and fetal outcome among pregnant women with EVD, and fetal evacuation significantly improves maternal survival.

Keywords: Africa, ebola, maternofetal, outcome

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1513 Case Report: Peripartum Cardiomyopathy, a Rare but Fatal Condition in Pregnancy and Puerperium

Authors: Sadaf Abbas, HimGauri Sabnis

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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.

Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium

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1512 Causes and Implications of Obesity in Urban School Going Children

Authors: Mohammad Amjad, Muhammad Iqbal Zafar, Ashfaq Ahmed Maan, Muhammad Tayyab Kashif

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Obesity is an abnormal physical condition where an increased and undesirable fat accumulates in the human body. Obesity is an international phenomenon. In the present study, 12 schools were randomly selected from each district considering the areas i.e. Elite Private Schools in the private sector, Government schools in urban areas and Government schools in rural areas. Interviews were conducted with male students studying in grade 5 to grade 9 in each school. The sample size was 600 students; 300 from Faisalabad district and 300 from Rawalpindi district in Pakistan. A well-structured and pre-tested questionnaire was used for data collection. The calibrated scales were used to attain the heights and weights of the respondents. Obesity of school-going children depends on family types, family size, family history, junk food consumption, mother’s education, weekly time spent in walking, and sports facility at school levels. Academic performance, physical health and psychological health of school going children are affected with obesity. Concrete steps and policies could minimize the incidence of obesity in children in Pakistan.

Keywords: body mass index, cardiovascular disease, fast food, morbidity, overweight

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1511 Torture and Turkey: Legal Situation Related to Torture in Turkey and the Issue of Impunity of Torture

Authors: Zeynep Üskül Engin

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Looking upon the world’s history, one can easily understand that the most drastic and evil comes to the human from his own kind. Human, proving that Hobbs was actually right, finally have agreed on taking some necessary measures after the destructive effects of the great World Wars. Surely after this, human rights have been more commonly mentioned in written form and now the priority of the values and goals of a democratic society is to protect its individuals. Due to this fact, the right of living is found to be valuable and all the existing forms of torture, anti-human and humiliating activities have been banned. Turkey, having signed the international papers of human rights, has aimed for eliminating torture through changing its laws and regulations to a certain extent. Monitoring Turkey’s experience, it is likely to say that during certain periods of time systematic torture has been applied. The urge to enter the European Union and verdicts against Turkey, have led to considerable progress in human rights. Besides, changes in law and the comprehensive training for the police, judges, medical and prison staff have resulted in positive improvement related to this issue. Certainly, this current legal update does not completely mean the total elimination of the practice of torture; however, in the commitment of this crime, the ones who have committed are standing a trial and facing severe punishments. In this article, Turkey, with a notorious reputation in international arena is going to be examined through its policy towards torture and defects in practice.

Keywords: torture, human rights, impunity of torture, sociology

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1510 Defying the Walls of Autocracy: The Role of the Catholic Church in the Resistance against Dictatorships in South Korea and the Philippines during the Early 1960s and Late 1980s

Authors: Marvin R. Tenecio

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The analysis of "religious resistance" has been prevalent in Asian and Philippine studies. Discussions on religious resistance from a variety of perspectives are deemed as crucial turning points in the concept's ongoing development and expansion. By broadening the backdrop of religious protest between the early 1960s and the late 1980s, the researchers contend that a study examining the role carried by the Catholic Church in the upheavals against dictatorships in South Korea and the Philippines would be beneficial to the body of knowledge. This study examines a variety of historical writings about the activities occurring at that time. The researchers also compare and contrast the Catholic Church's contributions to the Korean and Philippine resistance against Park Chung-Hee and Ferdinand Marcos Sr., respectively, during the early 1960s until the late 1980s, using the lens of history from below, particularly the Pasyon and Revolution. The Catholic Church stood out against human rights abuses, promoted social justice, and mobilized the public for political reform in response to the dictatorships in South Korea and the Philippines. Even though the specific circumstances and personalities may have changed, the Church's position in both countries was vital in opposing authoritarian governments and supporting democratic movements.

Keywords: resistance, movements, catholic, church, dictatorship

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1509 Prevalence of Periodontal Diseases in Children with Herpetic Stomatitis in City Tashkent

Authors: Akhad Ibrokhimov

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Update of preventive medicine has exacerbated the problem of cause-and-effect relationship between the presence of herpetic stomatitis (HS) and periodontal disease. Comprehensive survey of children with herpetic stomatitis, according to WHO equirements, on the territory of Tashkent years was conducted. Objective: To analyze the prevalence and intensity of periodontal tissue diseases in children with herpetic stomatitis. Materials and methods. Dental disease in Tashkent was studied in 156 children with herpetic stomatitis, as a control, the incidence of dental studied in 153 children of comparable age and sex never without a history of herpetic stomatitis. Results and discussion. The study revealed that 42,86 ± 13,23% of children with Herpetic stomatitis in the age group 6 years, 1 month - 10 years suffered from periodontal disease, the incidence of periodontal disease in the control group was 14,29 ± 9,35% (R≥0 05) corresponding to the frequency of detection of sextants with bleeding and tartar was equal to 35,71 ± 12,80% vs. 7,14 ± 6,88% (R≥0,05) and 14,29 ± 9,35% against 7 14 ± 6,88% (R≥0,05). Status of periodontal tissues was assessed in age groups 6 years, 1 month - 10 years and 10 years, 1 month - 15 years. The intensity of periodontal lesions observed at the level of 1,79 ± 0,06 vs. 0,66 ± 0,03 (P ≤ 0,05) affected sextant, including sextants with bleeding 1,62 ± 0,07 vs. 0.65 ± 0 , 03 (P ≤ 0,05) and sextants tartar - 0,17 ± 0,008 vs. 0,10 ± 0,008 (P ≤ 0,05). At age 10 years, 1 month - 15 years, a higher prevalence of signs of periodontal lesion was identified in patients with table of contents in 80,00 ± 12,65% of cases versus 30,00 ± 14,49% (P ≤ 0,05), and prevailed bleeding gums 70,00 ± 14,49% against 20,00 ± 11,83% (p ≤ 0.05), tartar was diagnosed respectively in 30,00 ± 14,49% against 10,00 ± 9,48% (R≥0,05) surveyed.

Keywords: vestibular surface, abnormal abrasion, composites, prosthesis

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1508 Suicidal Ideation and Associated Factors among Students Aged 13-15 Years in Association of Southeast Asian Nations (ASEAN) Member States, 2007-2014

Authors: Karl Peltzer, Supa Pengpid

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Introduction: The aim of this study was to assess suicidal ideation and associated factors in school-going adolescents in the Association of Southeast Asian Nations (ASEAN) Member States. Methods: The analysis included 30284 school children aged 13-15 years from seven ASEAN that participated in the cross-sectional Global School-based Student Health Survey (GSHS) between 2007 and 2013. Results: The overall prevalence of suicidal ideation across seven ASEAN countries (excluding Brunei) was 12.3%, significantly higher in girls (15.1%) than boys (9.3%). Among eight ASEAN countries with the highest prevalence of suicidal ideation was in the Philippines (17.0%) and Vietnam (16.9%) and the lowest in Myanmar (1.1%) and Indonesia (4.2%). In multivariate logistic regression analysis, female gender, older age (14 or 15 years), living in a low income or lower middle income country, having no friends, loneliness, bullying victimization, having been in a physical fight in the past 12 months, lack of parental or guardian support, tobacco use and having a history of ever got drunk were associated with suicidal ideatiion. Conclusion: Different rates of suicidal ideation were observed in ASEAN member states. Several risk factors for suicidal ideation were identified which can help guide preventive efforts.

Keywords: adolesents, ASEAN, correlates, suicidal behaviour

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1507 Evaluation of Percutaneous Tube Thoracostomy Performed by Trainee in Both Trauma and Non-Trauma Patients

Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

Abstract:

Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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1506 Changing Landscape of International Law of Governance: ‘One Belt One Road Initiative’ as a Case Study

Authors: Tikumporn Rodkhunmuang

Abstract:

The importance of ‘international law of governance’ is the means and end to deal with international affairs. This research paper seeks to first study the historical development of international law of governance from the classical period of the international legal framework of global governance until the contemporary period of its framework. Second, the international law of governance is extremely turning into the crucial point in its long history because of the changing of China's foreign policies towards ‘One Belt One Road Initiative’. Third, the proposing model of the existing international law of governance within Chinese characteristics will be the new rules and modalities of modern diplomacy and governed international affairs. Methodologically speaking, this research paper is conducting under mixed methods research, which are also included numerical analysis and theoretical considerations. As a result, this research paper is the critical point of the international legal framework of global governance that changing the diplomatic paradigm as well as turning China into a great-power in international politics. So, this research paper is useful for international legal scholars and diplomats for slightly changing their understanding of the rapidly changing their norms from western norms to the eastern norms of international law. Therefore, the outcome of the research is the modern model of China to make a diplomatic relationship with other countries in the global society.

Keywords: global governance, international law, landscape, one belt one road

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1505 Success of Trabeculectomy: May Not Always Depend on Mitomycin C

Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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1504 Women in the Soviet Press during the Great Patriotic War (1941-1945)

Authors: Nani Manvelishvili

Abstract:

Soviet propaganda tried to shape common public opinion through Soviet Press. The activation of propaganda gained special importance to increase the fighting ability of the military and people behind the front During the Great Patriotic war (1941-1945). The state propaganda used unnecessary intervention in Press and created characters who were supposed to be role models for society. The new female role models were identified, which were supported by the authorities. The representation of the mother, warrior woman, working woman, victim, feminine woman, etc., in the works aimed to raise the fighting ability of the Soviet citizen and incite patriotism. This paper analyzes the soviet Press (The newspaper “Komunisti”) that was written and published during the Great Patriotic war in Soviet Georgia. The study aims to find propagandistic content in Press that used Soviet ideology during the Great Patriotic war. We analyzed the Soviet Newspaper "Komunisti," published during wartime. Soviet Press had the most significant impact on the formation of public opinion. The Soviet government actively used this resource to increase combat capability. While at the beginning of the war, women were supposed to replace men, propaganda by the end of the war moved to reassert conservative gender politics. Women returned to their traditional roles.

Keywords: Great Patriotic War, Soviet Georgia, women in war, women's history, Soviet press

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1503 Underdiagnosis of Supraclavicular Brachial Plexus Metastasis in the Shadow of Cervical Disc Herniation: Insights from a Lung Cancer Case Study

Authors: Eunhwa Jun

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This case report describes the misdiagnosis of a patient who presented with right arm pain as cervical disc herniation. The patient had several underlying conditions, including hypertension, diabetes mellitus, liver cirrhosis, a history of lung cancer with left lower lobe lobectomy, and adjuvant chemoradiotherapy. An external cervical spine MRI revealed central protruding discs at the C4-5-6-7 levels. Despite treatment with medication and epidural blocks, the patient's pain persisted. A C-RACZ procedure was planned, but the patient's pain had worsened before admission. Using ultrasound, a brachial plexus block was attempted, but the brachial plexus eluded clear visualization, hinting at underlying neurological complexities. Chest CT revealed a new, large soft tissue mass in the right supraclavicular region with adjacent right axillary lymphadenopathy, leading to the diagnosis of metastatic squamous cell carcinoma. Palliative radiation therapy and chemotherapy were initiated as part of the treatment plan, and the patient's pain score decreased to 3 out of 10 on the Numeric Rating Scale (NRS), revealing the pain was due to metastatic lung cancer.

Keywords: supraclavicula brachial plexus metastasis, cervical disc herniation, brachial plexus block, metastatic lung cancer

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1502 Exploration of Abuse of Position for Sexual Gain by UK Police

Authors: Terri Cole, Fay Sweeting

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Abuse of position for sexual gain by police is defined as behavior involving individuals taking advantage of their role to pursue a sexual or improper relationship. Previous research has considered whether it involves ‘bad apples’ - individuals with poor moral ethos or ‘bad barrels’ – broader organizational flaws which may unconsciously allow, minimize, or do not effectively deal with such behavior. Low level sexual misconduct (e.g., consensual sex on duty) is more common than more serious offences (e.g., rape), yet the impact of such behavior can have severe implications not only for those involved but can also negatively undermine public confidence in the police. This ongoing, collaborative research project has identified variables from 514 historic case files from 35 UK police forces in order to identify potential risk indicators which may lead to such behavior. Quantitative analysis using logistic regression and the Cox proportion hazard model has resulted in the identification of specific risk factors of significance in prediction. Factors relating to both perpetrator background such as a history of intimate partner violence, debt, and substance misuse coupled with in work behavior such as misusing police systems increase the risk. Findings are able to provide pragmatic recommendations for those tasked with identifying potential or investigating suspected perpetrators of misconduct.

Keywords: abuse of position, forensic psychology, misconduct, sexual abuse

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1501 A Social Identity Analysis of Ottoman and Safavid Architects in the Historical Documents of the 16th to 17th Centuries

Authors: Farzaneh Farrokhfar, Mohammad Khazaie

Abstract:

The 16th and 17th centuries coincide with the classical age of Ottoman art history. Simultaneously with this age and in the eastern neighborhood of the Ottoman state, the Safavid Shiite state emerged, which, despite political and religious differences with the Ottomans, played an important role in cultural and artistic exchanges with Anatolia. The harmony of arts, including architecture, is one of the most important manifestations of cultural exchange between the two regions, which shows the intellectual commonalities of the two regions. In parallel with the production of works of art, the registration of information and identities of Ottoman and Safavid artists and craftsmen has been done by many historians and biographers, some of whom, fortunately, are available to us today and can be evaluated. This research first intends to read historical documents and reports related to the architects of the two Ottoman states in Anatolia and Safavid states in Iran in the 16th and 17th centuries and then examines the status of architects' information records and their location in the two regions. The results reveal the names and identities of some Ottoman and Safavid architects in the 16th and 17th centuries and show the method of recording information in the documents of the two regions. This research is done in a comparative historical method, and the method of collecting its resources is a documentary library.

Keywords: classical era, Ottoman architecture, Safavid architecture, Central Asian historical documents

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1500 Law and its Implementation and Consequences in Pakistan

Authors: Amir Shafiq, Asif Shahzad, Shabbar Mehmood, Muhammad Saeed, Hamid Mustafa

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Legislation includes the law or the statutes which is being reputable by a sovereign authority and generally can be implemented by the courts of law time to time to accomplish the objectives. Historically speaking upon the emergence of Pakistan in 1947, the intact laws of the British Raj remained effective after ablution by Islamic Ideology. Thus, there was an intention to begin the statutes book afresh for Pakistan's legal history. In consequence thereof, the process of developing detailed plans, procedures and mechanisms to ensure legislative and regulatory requirements are achieved began keeping in view the cultural values and the local customs. This article is an input to the enduring discussion about implementing rule of law in Pakistan whereas; the rule of law requires the harmony of laws which is mostly in the arrangement of codified state laws. Pakistan has legal plural civilizations where completely different and independent systems of law like the Mohammadan law, the state law and the traditional law exist. The prevailing practiced law in Pakistan is actually the traditional law though the said law is not acknowledged by the State. This caused the main problem of the rule of law in the difference between the state laws and the cultural values. These values, customs and so-called traditional laws are the main obstacle to enforce the State law in true letter and spirit which has caused dissatisfaction of the masses and distrust upon the judicial system of the country.

Keywords: consequences, implement, law, Pakistan

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1499 South Asia as an Emerging Region of the World in the 21st Century

Authors: Shazia Shinwari

Abstract:

In the 21st century, South Asia is becoming one of the rising sub-regions of the world. In the whole of Asia, South Asia is going to be the center part of opportunities, development, and challenges. The increasing economy and its geopolitical importance are changing the landscape of South Asia. Despite intensifying the opportunities and development, the region is also facing the challenges of security, poverty, and conflicts. It is one of the most populated sub-regions and has many internal conflicts because of which the region remains for a long time a least developed region in the world. But now South Asia is transforming into the developing process and trying to utilize its potentials and to remove the hurdles in the way of development. South Asia is one of the distinctive regions of the world and could play an important role at the global level if the potentials of the region are properly utilized. South Asia is one of the most important regions of the world and assumed more importance after the British withdrawal from the region. Now South Asia is playing an important role in world politics due to its strategic and geographical location. That is why the importance of this region in the international political systems cannot be ignored. Day by day, changes have been taking place in the structure of the global economy, and South Asia could take advantage of these changes to advance as an economic region. For this, South Asia will need to look at its history, and that changes, particularly in the India and Pakistan relations, are necessary for the development of the South Asian region. Despite having challenges in the region, South Asia is also rising as the land of opportunities and development if the potentials of the region are properly utilized and smoothen the way for regional integration.

Keywords: challenges, development, opportunities, South Asia

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1498 The Effect of Stent Coating on the Stent Flexibility: Comparison of Covered Stent and Bare Metal Stent

Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

Abstract:

Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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