Search results for: screening of ocular diseases
Commenced in January 2007
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Edition: International
Paper Count: 3794

Search results for: screening of ocular diseases

1874 A Longitudinal Examination of the Impact of Treatment Modality on Relationship Satisfaction and Mental Health Quality of Life Outcomes among Prostate Cancer Survivors

Authors: Gabriela Ilie, Robert D. H. Rutledge

Abstract:

A review of the literature reveals a need for longitudinal studies to properly understand the quality of life of prostate cancer survivors during their prostate cancer journey in order to identify opportunities for patient support and care during prostate cancer survivorship. In this study, mental health and relationship satisfaction were assessed longitudinally and by treatment modality among a population-based sample of Canadian adult men with a history of prostate cancer diagnosis. A total of 98 men, aged 51 or older with a history of prostate cancer completed an on-line 15-minute survey between May 2017 and February 2018, assessing mental health (Kessler Psychological Distress Scale) and relationship satisfaction (Dyadic Adjustment Scale) at baseline and at three months post-treatment with either active or nonactive prostate cancer treatment. Almost 1 in 6 men in this sample screened positive for mental health issues (17.34%, n=17) irrespective of treatment modality and most (n=11) were not currently on medication for depression, anxiety or both. Mental health outcomes were poorer for men with multimorbidity. For every instance of screening positive for mental health issues, 2.021 (95% CI:1.1 to 3.8) times more comorbidities were recorded. Relationship satisfaction and dyadic cohesion were statistically significantly lower from first assessment to 3 months for men who underwent multiple treatment modalities (surgery and radiation with hormonal therapy). Relationship satisfaction was also lower at 3 months for men who underwent radiation therapy. Almost 1 in 2 men in this sample (74%) indicated they did not attend a prostate cancer support group. Results suggest that treatment for mental health is underutilized in men with prostate cancer. Men who undergo multiple forms of active treatment appear more vulnerable to relationship dissatisfaction and feeling disconnected from their partner. Data points to important opportunities for patient education and care support during survivorship.

Keywords: prostate cancer survivorship, mental health, quality of life, relationship satisfaction

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1873 Association of Glutathione S-transferase M1 and T1 Gene Polymorphisms with Vitiligo in Saudi Population

Authors: Ghaleb Bin Huraib, Fahad Al Harthi, Mohammad Mustafa, Abdulrahman Al-Asmari

Abstract:

Introduction: Vitiligo is an acquired pigmentary skin disorder with the regional disappearance of melanocytes. Vitiligo affects 0.1 to 2% of the global population, and the incidence varies substantially depending on ethnicity. Glutathione S-transferase (GST) is a multigene family of enzymes that detoxify oxidative stress products. The oxidative stress-related GSTM1/GSTT1 genes deletion may cause epidermal melanocytes destruction and the development of vitiligo. Hence, the present study aimed to investigate the association of GST gene polymorphisms with vitiligo in the Saudi population, if any. Materials and Methods: The present study includes 129 vitiligo cases and 130 age-matched healthy controls. The proportion of male and female patients with vitiligo is almost equal. The multiplex polymerase chain reaction (PCR) method was used for polymorphic analysis. Results: Increased odds of generalized vitiligo was observed with the null genotypes of GSTT1- gene (OR = 1.91, 95% CI = 1.07-3.42, p = 0.019). The possible genetic combinations of GSTM1/GSTT1 and their genotypic distribution showed the frequency of GSTM1+/GSTT1+ 62/130 (47.69%) and GSTM1-/GSTT1+ 52/130 (40.00%) were higher in controls than in cases 44/129 (34.11%), 43/129 (33.34%), respectively while GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were higher 22/129 (17.05%) and 20/129 (15.50%) in vitiligo patients as compared to controls 11/130 (8.46%), 5/130 (3.84%), respectively. The strength of association of different genetic combinations with cases have shown GSTM1+/GSTT1- (OR = 2.81, 95% CI = 1.24-6.40, p = 0.009) and GSTM1-/GSTT1- (OR = 5.63, 95% CI = 1.96 - 16.16, p = 0.0004) were significantly higher in vitiligo cases as compared to controls. We did not observe any significant association of age and gender of patients with GST gene polymorphisms. Conclusions: The GSTT1-, GSTM1+/GSTT1- and GSTM1-/GSTT1- null genotypes were significantly associated with vitiligo. These genetic polymorphisms may be the associative genetic risk factor for vitiligo among Saudis. It could be used as a genetic marker for screening vitiligo patients among Saudis. Further studies on GSTs gene polymorphism in larger sample sizes from different geographical areas and ethnicity are needed to strengthen the present findings.

Keywords: vitiligo, GSTM1, GSTT1, gene polymorphism, oxidative stress

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1872 Assessment of Sperm Aneuploidy Using Advanced Sperm Fish Technique in Infertile Patients

Authors: Archana. S, Usha Rani. G, Anand Balakrishnan, Sanjana.R, Solomon F, Vijayalakshmi. J

Abstract:

Background: There is evidence that male factors contribute to the infertility of up to 50% of couples, who are evaluated and treated for infertility using advanced assisted reproductive technologies. Genetic abnormalities, including sperm chromosome aneuploidy as well as structural aberrations, are one of the major causes of male infertility. Recent advances in technology expedite the evaluation of sperm aneuploidy. The purpose of the study was to de-termine the prevalence of sperm aneuploidy in infertile males and the degree of association between DNA fragmentation and sperm aneuploidy. Methods: In this study, 75 infertile men were included, and they were divided into four abnormal groups (Oligospermia, Terato-spermia, Asthenospermia and Oligoasthenoteratospermia (OAT)). Men with children who were normozoospermia served as the control group. The Fluorescence in situ hybridization (FISH) method was used to test for sperm aneuploidy, and the Sperm Chromatin Dispersion Assay (SCDA) was used to measure the fragmentation of sperm DNA. Spearman's correla-tion coefficient was used to evaluate the relationship between sperm aneuploidy and sperm DNA fragmentation along with age. P < 0.05 was regarded as significant. Results: 75 partic-ipants' ages varied from 28 to 48 years old (35.5±5.1). The percentage of spermatozoa bear-ing X and Y was determined to be statistically significant (p-value < 0.05) and was found to be 48.92% and 51.18% of CEP X X 1 – nucish (CEP XX 1) [100] and CEP Y X 1 – nucish (CEP Y X 1) [100]. When compared to the rate of DNA fragmentation, it was discovered that infertile males had a greater frequency of sperm aneuploidy. Asthenospermia and OAT groups in sex chromosomal aneuploidy were significantly correlated (p<0.05). Conclusion: Sperm FISH and SCDA assay results showed increased sperm aneuploidy frequency, and DNA fragmentation index in infertile men compared with fertile men. There is a significant relationship observed between sperm aneuploidy and DNA fragmentation in OAT patients. When evaluating male variables and idiopathic infertility, the sperm FISH screening method can be used as a valuable diagnostic tool.

Keywords: ale infertility, dfi (dna fragmentation assay) (scd-sperm chromatin dispersion).art (artificial reproductive technology), trisomy, aneuploidy, fish (fluorescence in-situ hybridization), oat (oligoasthoteratospermia)

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1871 Use of Beta Blockers in Patients with Reactive Airway Disease and Concomitant Hypertension or Ischemic Heart Disease

Authors: Bharti Chogtu Magazine, Dhanya Soodana Mohan, Shruti Nair, Tanwi Trushna

Abstract:

The study was undertaken to analyse the cardiovascular drugs being prescribed in patients with concomitant reactive airway disease and hypertension or ischemic heart diseases (IHD). Also, the effect of beta-blockers on respiratory symptoms in these patients was recorded. Data was collected from medical records of patients with reactive airway disease and concomitant hypertension and IHD. It included demographic details of the patients, diagnosis, drugs prescribed and the patient outcome regarding the exacerbation of asthma symptoms with intake of beta blockers. Medical records of 250 patients were analysed.13% of patients were prescribed beta-blockers. 12% of hypertensive patients, 16.6% of IHD patients and 20% of patients with concomitant hypertension and IHD were prescribed beta blockers. Of the 33 (13%) patients who were on beta-blockers, only 3 patients had an exacerbation of bronchial asthma symptoms. Cardioselective beta-blockers under supervision appear to be safe in patients with reactive airway disease and concomitant hypertension and IHD.

Keywords: beta blockers, hypertension, ischemic heart disease, asthma

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1870 Prevalence and Effect of Substance Use and Psychological Co-Morbidities in Medical and Dental Students of a Medical University of Nepal

Authors: Nidesh Sapkota, Garima Pudasaini, Dikshya Agrawal, Binav Baral, Umesh Bhagat, Dharanidhar Baral

Abstract:

Background: Medical and Dental students are vulnerable to higher levels of Psychological distress than other age matched peers. Many studies reveals that there is high prevalence of psychoactive substance use and Psychiatric co-morbidities among them. Objectives: -To study the prevalence of substance use among medical and dental students of a Medical University. -To study the prevalence of depression and anxiety in medical and dental students of a Medical University. Materials and Method: A cross-sectional descriptive study in which simple random sampling was done. Semi-structured questionnaire, AUDIT for alcohol use, Fagerstrom test for Nicotine dependence, Cannabis screening test (CAST), Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI) were used for the assessment. Results: Total sample size was 588 in which the mean age of participants was 22±2years. Among them the prevalence of alcohol users was 47.75%(281) in which 32%(90) were harmful users. Among 19.55%(115) nicotine users 56.5%(65), 37.4%(43), 6.1%(7) had low, low to moderate and moderate dependence respectively. The prevalence of cannabis users was 9%(53) with 45.3%(24), 18.9%(10) having low and high addiction respectively. Depressive symptoms were recorded in 25.3%(149) out of which 12.6%(74), 6.5%(38), 5.3%(31), 0.5%(3), 0.5%(3) had mild, borderline, moderate, severe and extreme depressive symptoms respectively. Similarly anxiety was recorded among 7.8%(46) students with 42 having moderate and 4 having severe anxiety symptoms. Among them 6.3%(37) had suicidal thoughts and 4(0.7%) of them had suicide attempt in last one year. Statistically significant association was noted with harmful alcohol users, Depression and suicidal attempts. Similar association was noted between Depression and suicide with moderate use of nicotine. Conclusion: There is high prevalence of Psychoactive substance use and psychiatric co-morbidities noted in the studies sample. Statistically significant association was noted with Psychiatric co-morbidities and substance use.

Keywords: alcohol, cannabis, dependence, depression, medical students

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1869 Building an Integrated Relational Database from Swiss Nutrition National Survey and Swiss Health Datasets for Data Mining Purposes

Authors: Ilona Mewes, Helena Jenzer, Farshideh Einsele

Abstract:

Objective: The objective of the study was to integrate two big databases from Swiss nutrition national survey (menuCH) and Swiss health national survey 2012 for data mining purposes. Each database has a demographic base data. An integrated Swiss database is built to later discover critical food consumption patterns linked with lifestyle diseases known to be strongly tied with food consumption. Design: Swiss nutrition national survey (menuCH) with approx. 2000 respondents from two different surveys, one by Phone and the other by questionnaire along with Swiss health national survey 2012 with 21500 respondents were pre-processed, cleaned and finally integrated to a unique relational database. Results: The result of this study is an integrated relational database from the Swiss nutritional and health databases.

Keywords: health informatics, data mining, nutritional and health databases, nutritional and chronical databases

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1868 Parental Awareness and Willingness to Vaccinate Adolescent Daughters against Human Papilloma Virus for Cervical Cancer Prevention in Eastern Region of Kenya: Towards Affirmative Action

Authors: Jacinta Musyoka, Wesley Too

Abstract:

Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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1867 Progression Rate, Prevalence, Incidence of Black Band Disease on Stony (Scleractinia) in Barranglompo Island, South Sulawesi

Authors: Baso Hamdani, Arniati Massinai, Jamaluddin Jompa

Abstract:

Coral diseases are one of the factors affect reef degradation. This research had analysed the progression rate, incidence, and prevalence of Black Band Disease (BBD) on stony coral (Pachyseris sp.) in relation to the environmental parameters (pH, nitrate, phospate, Dissolved Organic Matter (DOM), and turbidity). The incidence of coral disease was measured weekly for 6 weeks using Belt Transect Method. The progression rate of BBD was measured manually. Furthermore, the prevalence and incidence of BBD were calculated each colonies infected. The relationship between environmental parameters and the progression rate, prevalence and incidence of BBD was analysed by Principal Component Analysis (PCA). The results showed the average of progression rate is 0,07 ± 0,02 cm/ hari. The prevalence of BBD increased from 0,92% - 19,73% in 7 weeks observation with the average incidence of new infected colonies coral 0,2 - 0,65 colony/day The environment factors which important were pH, Nitrate, Phospate, DOM, and Turbidity.

Keywords: progression rate, incidence, prevalence, Black Band Disease, Barranglompo

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1866 Neuroprotective Effects of Rosmarinic Acid in the MPTP Mouse Model of Parkinson's Disease

Authors: Huamin Xu, Wenting Jia, Hong Jiang, Junxia Xie

Abstract:

Rosmarinic acid (RA) is a natural acid that is found in a variety of herbs, such as rosemary and has multiple biological activities such as antioxidative, anti-inflammatory and antiviral activities. In this study, we investigated the neuroprotective effects of RA on dopaminergic system in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induced mouse model of Parkinson’s disease (PD). The mice received oral administration of RA before MPTP injection. Results showed that the tyrosine hydroxylase expression in SN reduced and the levels of dopamine and its metabolites in the striatum decreased in MPTP intoxicated PD mice. Pretreatment with RA significantly inhibited these changes. Further studies demonstrated that MPTP treatment increased the iron content, which was counteracted by pre-treatment with RA. In addition, RA could restore the decrease of superoxide dismutase (SOD) induced by MPTP. This study provides evidence that RA could suppress MPTP-induced degeneration of the nigrostriatal dopaminergic system by regulating iron content and the expression of SOD. Thus, RA might be clinically evaluated for the prevention of neurodegenerative diseases.

Keywords: rosmarinic acid, Parkinson's disease, MPTP, dopaminergic system

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1865 Seroprevalence and Potential Risk Factors of Bovine Brucellosis under Diverse Production Systems in Central Punjab, Paksitan

Authors: A. Khan, I. Khan, M. Younus, S. E. Haque, U. Waheed, H. Neubauer, A. A. Anjum, S. A. Muhammad, A. Idrees T. Abbas, S. Raza, M. A. Ali, M. Farooq, M. Mahmood, A. Hussain, H. Danish, U. Tayyab, M. Zafar, M. Aslam.

Abstract:

Brucellosis is one of the major problems of milk producing animals in our country which deteriorate the health of livestock. It is a disease of zoonotic significance which is capable of producing disease in humans leading to infertility, orchitis, abortions, and synovitis. In this particular study, milk and serum samples of cattle and buffalo (n=402) were collected from different districts of Punjab including Narowal, Gujranwala and Gujrat. Milk samples were analyzed by Milk Ring Test (MRT), while serum samples were tested through Rose Bengal Plate agglutination Test (RBPT) and Indirect Enzyme Linked Immunosorbant Assay (i-ELISA). The sample tested with MRT were 9.5% positive, including cattle 9.6% and buffalo 9.3%. While using the RBPT test for the detection of serum samples and for screening purpose it was observed that 16.4% animals were seropositive, cattle were 18.8% and buffalo were 13.9% seropositive. The higher prevalence of brucellosis indicates the danger of the disease to human population. The serum samples positive by RBPT were further confirmed by the use of most specific and sensitive serological test known as i-ELISA. 11.4% animals were confirmed as seropositive by i-ELISA including cattle 13.5% seropositive and buffalo 9.3%. The results indicated high seroprevalence of brucellosis in cattle as compared to buffalos. Different risk factors were also studied to know the association between disease and their spread. Advanced age, larger herds, history of abortion and pregnancy of the animals is considered to be the important factors for the prevalence and spread of the hazardous zoonotic disease. It is a core issue of developing countries like Pakistan and has major public health impact.

Keywords: humans, bovines, infertility, orchitis, abortions, seroprevalence, brucellosis

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1864 Histopathological Examination of Lung Surgery Camel in Iran

Authors: Ali Chitgar

Abstract:

Respiratory infections including diseases in camels are important not only because of the threat of animal health but also to reduce their production. Since that deal with respiratory problems and their treatment requires adequate knowledge of the existing respiratory problems, unfortunately, there is limited information about the species of camels. This study aimed to identify lung lesions camels slaughtered in a slaughterhouse more important was performed using histopathology. Respiratory camels (n = 477) was examined after the killing fully and tissue samples were placed in 10% formalin. The samples and histological sections using hematoxylin and eosin staining and color were evaluated. In this study 79.6 % (236 of 477 samples) of the samples was at least a lung lesion. Rate acute interstitial pneumonia, chronic interstitial pneumonia, bronchopneumonia, bronchiolitis, an inflammation of the pleura and 52.8 % respectively atelectasis (236 of 477 samples), 5.4 % (24 of 477 samples), 7.8 % (35 of 477 samples), 6.7 % (30 of 477 samples), 3.4 % (15 of 477 samples) and 15.2% (68 of 477 samples). The lung lesions, acute interstitial pneumonia and bronchopneumonia in autumn winter rather than spring and summer (p <0/05) and as a result, this study showed that high rates of lung lesions in the camel population. Waste higher results in cold seasons (fall and winter) shows.

Keywords: camel, surgery, histopathology, breathing organ

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1863 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

Abstract:

Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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1862 Design, Molecular Modeling, Synthesize, and Biological Evaluation of Some Dual Inhibitors of Soluble Epoxide Hydrolase (sEH) and Cyclooxygenase 2 (COX-2)

Authors: Elham Rezaee, Sayyed Abbas Tabatabai

Abstract:

Dual inhibition of COX-2 and sEH enzymes represents one of the distinct pharmaceutical approaches for the treatment of inflammation, pain, cancers, and other diseases. The discovery of these inhibitors for treatment is a great deal of attention because of some advantages such as increased efficacy, a promising safety profile, ease of formulation, and better target engagement. In this research, based on the structure-activity relationship of COX-2 and sEH inhibitors, some amide derivatives with oxadiazole and dihydropyrimidinone rings against sEH and COX-2 enzymes were developed. The designed compounds showed high affinity to the active site of both enzymes in docking studies and were synthesized in good yield and characterized by IR, Mass, 1HNMR, and 13CNMR. All of the novel compounds exhibited considerable in-vitro sEH and COX-2 inhibitory activities in comparison with 12-(3-Adamantan-1-yl-ureido)- dodecanoic acid and celecoxib (a potent urea-based sEH inhibitor and selective nonsteroidal anti-inflammatory drug, respectively). Ethyl 6-methyl-4-(4-(4-(methylsulfonyl)benzamido)phenyl)-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate was found to be the most selective COX-2 inhibitor (COX-2/COX-1 ratio: 683) with IC50 value of 2.1 nM targeting sEH enzyme.

Keywords: COX-2, dual inhibitors, sEH, synthesis

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1861 Identification of Quantitative Trait Loci Conferring Downy Mildew Resistance in Cucumis sativus

Authors: Pawinee Innark, Hudsaya Punyanitikul, Chanuluk Khanobdee, Chatchawan Jantasuriyarat, Sompid Samipak

Abstract:

One of the most devastating diseases in cucumber is downy mildew caused by the fungus Pseudoperonospora cubensis. To enable the use of marker-assisted breeding for resistance cultivars, sixty six microsatellite markers were used to map (quantitative trait loci) QTLs for DM resistance. Total of 315 F2 population from the cross between DM-resistant inbred line CSL0067 and susceptible CSL0139 were evaluated for downy mildew resistance in cotyledon, first and second true leaf at 7, 10, and 14 day after inoculation. The QTL analysis revealed that the downy mildew resistant genes were controlled by multiple recessive genes. From eight linkage groups (LG 1.1, 1.2, 2, 3, 4, 5.1, 5.2 and 6), fourteen QTL positions were detected on 4 linkage groups (LG 1.1, 2, 5.1 and 6) with the log of odd scores ranged from 3.538 to 9.165. Among them, Cot7_5.1_2 and Cot10_5.1 had major-effect QTL with the R2 values of 10.9 and 12.5%, respectively. The flanking markers for Cot7_5.1_2 were SSR19172 - SSR07531 markers and for Cot10_5.1 were SSR03943 - SSR00772. Besides QTLs on chromosome 1, 5 and 6 that were previously reported, this study also revealed a QTL for DM resistance on chromosome 2 that can be used as a new source in cucumber breeding program.

Keywords: cucumber, DNA marker, downy mildew, QTL

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1860 Antimicrobial Activity of Sour Cherry Pomace

Authors: Sonja Djilas, Aleksandra Velićanski, Dragoljub Cvetković, Siniša Markov, Eva Lončar, Vesna Tumbas Šaponjac, Milica Vinčić

Abstract:

Due to high content of bioactive compounds, sour cherry possesses antioxidant and antimicrobial activity. Additionally, waste material from industrial processing of sour cherry is also a good source of bioactive compounds. The aim of this study was to screen the antimicrobial activity and determine the minimal inhibitory (MIC) and minimal bactericidal concentrations (MBC) of sour cherry pomace extract. Tested strains were Gram-negative bacteria (Escherichia coli ATCC 25922, Salmonella typhimurium ATCC 14028 and wild isolates Escherichia coli and Salmonella sp.), Gram-positive bacteria (Staphylococcus aureus ATCC 11632, Bacillus cereus ATCC 10876 and wild isolates Staphylococcus saprophyticus and Bacillus sp.) and yeasts (Saccharomyces cerevisiae 112, Hefebank Weihenstephan and Candida albicans ATCC 10231). Antimicrobial activity was tested by disc-diffusion method and agar-well diffusion method. MIC and MBC were determined by microdilution method. Screening tests showed that Gram-negative bacteria were resistant to tested extract, with exception of Salmonella typhimurium and Salmonella sp. for which only zones of reduced growth appeared. However, Gram-positive bacteria were more sensitive where the highest clear zones appeared with 100 µl of extract applied. There was no activity against tested yeasts. MIC and MBC values were in the range 3.125-37.5 mg/ml and 6.25-100 mg/ml, respectively. The most susceptible strain was Staphylococcus aureus while the most resistant was Bacillus sp. where MBC was not found in tested concentration range. Sour cherry pomace possesses high antibacterial potential, which indicates that this waste material is a promising source of bioactive compounds and could be used as a functional food ingredient.

Keywords: antimicrobial activity, sour cherry, pomace, bioactive compounds

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1859 Efficient GIS Based Public Health System for Disease Prevention

Authors: K. M. G. T. R. Waidyarathna, S. M. Vidanagamachchi

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Public Health System exists in Sri Lanka has a satisfactory complete information flow when compared to other systems in developing countries. The availability of a good health information system contributed immensely to achieve health indices that are in line with the developed countries like US and UK. The health information flow at the moment is completely paper based. In Sri Lanka, the fields like banking, accounting and engineering have incorporated information and communication technology to the same extent that can be observed in any other country. The field of medicine has behind those fields throughout the world mainly due to its complexity, issues like privacy, confidentially and lack of people with knowledge in both fields of Information Technology (IT) and Medicine. Sri Lanka’s situation is much worse and the gap is rapidly increasing with huge IT initiatives by private-public partnerships in all other countries. The major goal of the framework is to support minimizing the spreading diseases. To achieve that a web based framework should be implemented for this application domain with web mapping. The aim of this GIS based public health system is a secure, flexible, easy to maintain environment for creating and maintaining public health records and easy to interact with relevant parties.

Keywords: DHIS2, GIS, public health, Sri Lanka

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1858 Simplified Measurement of Occupational Energy Expenditure

Authors: J. Wicks

Abstract:

Aim: To develop a simple methodology to allow collected heart rate (HR) data from inexpensive wearable devices to be expressed in a suitable format (METs) to quantitate occupational (and recreational) activity. Introduction: Assessment of occupational activity is commonly done by utilizing questionnaires in combination with prescribed MET levels of a vast range of previously measured activities. However for any individual the intensity of performing a specific activity can vary significantly. Ideally objective measurement of individual activity is preferred. Though there are a wide range of HR recording devices there is a distinct lack methodology to allow processing of collected data to quantitate energy expenditure (EE). The HR index equation expresses METs in relation to relative HR i.e. the ratio of activity HR to resting HR. The use of this equation provides a simple utility for objective measurement of EE. Methods: During a typical occupational work period of approximately 8 hours HR data was recorded using a Polar RS 400 wrist monitor. Recorded data was downloaded to a Windows PC and non HR data was stripped from the ASCII file using ‘Notepad’. The HR data was exported to a spread sheet program and sorted by HR range into a histogram format. Three HRs were determined, namely a resting HR (the HR delimiting the lowest 30 minutes of recorded data), a mean HR and a peak HR (the HR delimiting the highest 30 minutes of recorded data). HR indices were calculated (mean index equals mean HR/rest HR and peak index equals peak HR/rest HR) with mean and peak indices being converted to METs using the HR index equation. Conclusion: Inexpensive HR recording devices can be utilized to make reasonable estimates of occupational (or recreational) EE suitable for large scale demographic screening by utilizing the HR index equation. The intrinsic value of the HR index equation is that it is independent of factors that influence absolute HR, namely fitness, smoking and beta-blockade.

Keywords: energy expenditure, heart rate histograms, heart rate index, occupational activity

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1857 Preliminary Evaluation of Maximum Intensity Projection SPECT Imaging for Whole Body Tc-99m Hydroxymethylene Diphosphonate Bone Scanning

Authors: Yasuyuki Takahashi, Hirotaka Shimada, Kyoko Saito

Abstract:

Bone scintigraphy is widely used as a screening tool for bone metastases. However, the 180 to 240 minutes (min) waiting time after the intravenous (i.v.) injection of the tracer is both long and tiresome. To solve this shortcoming, a bone scan with a shorter waiting time is needed. In this study, we applied the Maximum Intensity Projection (MIP) and triple energy window (TEW) scatter correction to a whole body bone SPECT (Merged SPECT) and investigated shortening the waiting time. Methods: In a preliminary phantom study, hot gels of 99mTc-HMDP were inserted into sets of rods with diameters ranging from 4 to 19 mm. Each rod set covered a sector of a cylindrical phantom. The activity concentration of all rods was 2.5 times that of the background in the cylindrical body of the phantom. In the human study, SPECT images were obtained from chest to abdomen at 30 to 180 min after 99mTc- hydroxymethylene diphosphonate (HMDP) injection of healthy volunteers. For both studies, MIP images were reconstructed. Planar whole body images of the patients were also obtained. These were acquired at 200 min. The image quality of the SPECT and the planar images was compared. Additionally, 36 patients with breast cancer were scanned in the same way. The delectability of uptake regions (metastases) was compared visually. Results: In the phantom study, a 4 mm size hot gel was difficult to depict on the conventional SPECT, but MIP images could recognize it clearly. For both the healthy volunteers and the clinical patients, the accumulation of 99mTc-HMDP in the SPECT was good as early as 90 min. All findings of both image sets were in agreement. Conclusion: In phantoms, images from MIP with TEW scatter correction could detect all rods down to those with a diameter of 4 mm. In patients, MIP reconstruction with TEW scatter correction could improve the detectability of hot lesions. In addition, the time between injection and imaging could be shortened from that conventionally used for whole body scans.

Keywords: merged SPECT, MIP, TEW scatter correction, 99mTc-HMDP

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1856 A Game-Based Methodology to Discriminate Executive Function – a Pilot Study With Institutionalized Elderly People

Authors: Marlene Rosa, Susana Lopes

Abstract:

There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

Procedia PDF Downloads 139
1855 Study of the Antimicrobial Potential Of a Rich Polyphenolic Extract Obtained from Cytisus scoparius

Authors: Lorena G. Calvo, Marta Lores, Trinidad de Miguel

Abstract:

Natural extracts containing high polyphenolic concentration possess antibacterial and antifungal activity. The present research characterizes a hydro-organic extract with a high polyphenolic content as an antimicrobial candidate. As a result of this composition, the extract showed pronounced bioactivities with potential uses in agricultural, veterinary, pharmaceutical, and cosmetic industries. Polyphenol compounds were extracted by using hydro-organic solvent mixtures from the shrub Cytisus scoparius. The in vitro antimicrobial activity of this extract was evaluated on Gram-positive and Gram-negative bacteria and the fungus Candida albicans. Microbial species investigated, Bacillus cereus, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, are causing agents of several human and animal diseases. The extract showed activity against all tested species. So, it could be used for the development of biocides to control a wide range of pathogenic agents and contribute to the creation of economic and eco-friendly alternatives to antibiotics.

Keywords: antimicrobial properties, antioxidant properties, Cytisus scoparius, polyphenolic extract

Procedia PDF Downloads 143
1854 Integrated Approach to Reduce Intimate Partner Violence and Improve Mental Health among Pregnant Women: Mixed-Method Study from Nepal

Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

Abstract:

Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

Procedia PDF Downloads 258
1853 Reintroduction and in vitro Propagation of Declapeis arayalpathra: A Critically Endangered Plant of Western Ghats, India

Authors: Zishan Ahmad, Anwar Shahzad

Abstract:

The present studies describe a protocol for high frequency in vitro propagation through nodal segments and shoot tips in D. arayalpathra, a critically endangered medicinal liana of the Western Ghats, India. Nodal segments were more responsive than shoot tips in terms of shoot multiplication. Murashige and Skoog’s (MS) basal medium supplemented with 2.5 µM 6-benzyladenine (BA) was optimum for shoot induction through both the explants. Among different combinations of plant growth regulator (PGRs) and growth additive screened, MS medium supplemented with BA (2.5 µM) + indole-3-acetic acid (IAA) (0.25 µM) + adenine sulphate (ADS) (10.0 µM) induced a maximum of 9.0 shoots per nodal segment and 3.9 shoots per shoot tip with mean shoot length of 8.5 and 3.9 cm respectively. Half-strength MS medium supplemented with Naphthaleneacetic acid (NAA) (2.5 µM) was the best for in vitro root induction. After successful acclimatization in SoilriteTM, 92 % plantlets were survived in field conditions. Acclimatized plantlets were studied for chlorophyll and carotenoid content, net photosynthetic rate (PN) and related attributes such as stomatal conductance (Gs) and transpiration rate during subsequent days of acclimatization. The rise and fall of different biochemical enzymes (SOD, CAT, APX and GR) were also studies during successful days of acclimatization. Moreover, the effect of acclimatization on the synthesis of 2-hydroxy-4-methoxy benzaldehyde (2H4MB) was also studied in relation to the biomass production. Maximum fresh weight (2.8 gm/plant), dry weight (0.35 gm/plant) of roots and 2H4MB content (8.5 µg/ ml of root extract) were recorded after 8 weeks of acclimatization. The screening of in vitro raised plantlet root was also carried out by using GC-MS analysis which witnessed more than 25 compounds. The regenerated plantlets were also screened for homogeneity by using RAPD and ISSR. The proposed protocol surely can be used for the conservation and commercial production of the plant.

Keywords: 6-benzyladenine, PGRs, RAPD, 2H4MB

Procedia PDF Downloads 191
1852 Targeting Trypanosoma brucei Using Antibody Drug Conjugates against the Transferrin Receptor

Authors: Camilla Trevor, Matthew K. Higgins, Andrea Gonzalez-Munoz, Mark Carrington

Abstract:

Trypanosomiasis is a devastating disease affecting both humans and livestock in sub-Saharan Africa. The diseases are caused by infection with African trypanosomes, protozoa transmitted by tsetse flies. Treatment currently relies on the use of chemotherapeutics with ghastly side effects. Here, we describe the development of effective antibody-drug conjugates that target the T. brucei transferrin receptor. The receptor is essential for trypanosome growth in a mammalian host but there are approximately 12 variants of the transferrin receptor in the genome. Two of the most divergent variants were used to generate recombinant monoclonal immunoglobulin G using phage display and we identified cross-reactive antibodies that bind both variants using phage ELISA, fluorescence resonance energy transfer assays and surface plasmon resonance. Fluorescent antibodies were used to demonstrate uptake into trypanosomes in culture. Toxin-conjugated antibodies were effective at killing trypanosomes at sub-nanomolar concentrations. The approach of using antibody-drug conjugates has proven highly effective.

Keywords: antibody-drug conjugates, phage display, transferrin receptor, trypanosomes

Procedia PDF Downloads 154
1851 Comparative Performance of Standing Whole Body Monitor and Shielded Chair Counter for In-vivo Measurements

Authors: M. Manohari, S. Priyadharshini, K. Bajeer Sulthan, R. Santhanam, S. Chandrasekaran, B. Venkatraman

Abstract:

In-vivo monitoring facility at Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, caters to the monitoring of internal exposure of occupational radiation workers from various radioactive facilities of IGCAR. Internal exposure measurement is done using Na(Tl) based Scintillation detectors. Two types of whole-body counters, namely Shielded Chair Counter (SC) and Standing Whole-Body Monitor (SWBM), are being used. The shielded Chair is based on a NaI detector of 20.3 cm diameter and 10.15 cm thick. The chair of the system is shielded using lead shots of 10 cm lead equivalent and the detector with 8 cm lead bricks. Counting geometry is sitting geometry. Calibration is done using 95 percentile BOMAB phantom. The minimum Detectable Activity (MDA) for 137Cs for the 60s is 1150 Bq. Standing Wholebody monitor (SWBM) has two NaI(Tl) detectors of size 10.16 x 10.16 x 40.64 cm3 positioned serially, one over the other. It has a shielding thickness of 5cm lead equivalent. Counting is done in standup geometry. Calibration is done with the help of Ortec Phantom, having a uniform distribution of mixed radionuclides for the thyroid, thorax and pelvis. The efficiency of SWBM is 2.4 to 3.5 times higher than that of the shielded chair in the energy range of 279 to 1332 keV. MDA of 250 Bq for 137Cs can be achieved with a counting time of 60s. MDA for 131I in the thyroid was estimated as 100 Bq from the MDA of whole-body for one-day post intake. Standing whole body monitor is better in terms of efficiency, MDA and ease of positioning. In case of emergency situations, the optimal MDAs for in-vivo monitoring service are 1000 Bq for 137Cs and 100 Bq for 131I. Hence, SWBM is more suitable for the rapid screening of workers as well as the public in the case of an emergency. While a person reports for counting, there is a potential for external contamination. In SWBM, there is a feasibility to discriminate them as the subject can be counted in anterior or posterior geometry which is not possible in SC.

Keywords: minimum detectable activity, shielded chair, shielding thickness, standing whole body monitor

Procedia PDF Downloads 44
1850 Barriers and Drivers Towards the Use of Childhood Vaccination Services by Undocumented Migrant Caregivers in Sabah, Malaysia: A Qualitative Analysis

Authors: Michal Christina Steven, Mohd. Yusof Hj Ibrahim, Haryati Abdul Karim, Prabakaran Dhanaraj, Kelly Alexius Mansin

Abstract:

After 27 years, Malaysia reported polio cases in 2019 involving the children of the undocumented migrants living in Sabah. These undocumented migrants present a significant challenge in achieving the elimination of vaccine-preventable diseases (VPD). Due to the recent polio outbreak among the undocumented migrant children in Sabah, an in-depth interview was conducted among the caregivers of undocumented migrant children to identify the barriers and drivers towards vaccinating their children. Financial barriers, legal citizenship status, language barrier, the COVID-19 pandemic, and physical barriers have been the barriers to access vaccination services by undocumented migrants. Five significant drivers for undocumented migrants to vaccinate their children are social influence, fear of disease, parental trust in healthcare providers, good support, and vaccine availability. Necessary action should be taken immediately to address the problems of vaccinating the children of undocumented migrants to prevent the re-emergence of VPD.

Keywords: Malaysia, polio, Sabah, undocumented migrants

Procedia PDF Downloads 153
1849 Geometry of the Bandaging Procedure and Its Application while Wrapping Bandages for Treatment of Leg Ulcers

Authors: Monica Puri Sikka, Subrato Ghosh Arunangshu Mukhopadhyay

Abstract:

Appropriate compression bandaging is important for compression therapeutic medical diseases. The high compression approach employed for treating venous leg ulcers should be used correctly so that sufficient (but not excessive) pressure is applied. Bandages used to treat venous disease by compression should achieve and sustain effective levels and gradients of pressure and minimise the risk of pressure trauma. To maintain graduated compression on the limb the bandage needs to be applied at same tension for each layer from ankle to the knee. In this paper the geometry for various bandaging procedures is used to wrap each layer of bandage by marking the relaxed length of the bandage. The relaxed length is calculated depending on the stretch, average circumference of the limb on which it is to be applied and the bandaging technique to be used. This paper aims at developing a scientific approach while applying the bandage to reduce the inter operator variability in applying same tension on each successive layer of bandage.

Keywords: bandaging, compression, inter operator variability, graduated, relaxed length, stretch

Procedia PDF Downloads 493
1848 Management of Coronary Heart Disease through Yoga

Authors: Subramaniam Iyer

Abstract:

The most common disease that is pertaining to all human beings is heart-related. The reasons for coronary artery disease are due to lifestyle and eating habits. Due to this, many people mentally become sick, feeling that soon they will die due to their heart problems. This results in stress and anxiety, which has become common amongst all the Indians. Medicines are the commonest curative remedy in India, but it is proposed through this article some remedies through yoga. This article does not guarantee a 100% result, but it is a preventive remedy for coronary artery disease. Yoga is giving a new lease of life to many, so to tackle chronic diseases, it provides remedies that will be lifelong. It is brought to many people by Patanjali. Yoga will provide support to patients having coronary artery disease through its various relevant postures (asanas), which can be done very easily. Yoga does not send a message that if you do it regularly, you will be relieved from a particular disease. If it is performed every day, it will add vital energy for a smooth life, even if you are suffering from any chronic disease. In this article, we will be providing 6 postures (asanas), which can be performed at any time in the day, but the early morning will always be preferred (empty stomach) to get a good result. Secondly, these postures must be implemented after due consultation with your physician. If your physician disapproves, don’t do these postures as it will be harmful to your body.

Keywords: coronary artery, yoga, disease, remedy, medicine

Procedia PDF Downloads 162
1847 Comparison of Catalyst Support for High Pressure Reductive Amination

Authors: Tz-Bang Du, Cheng-Han Hsieh, Li-Ping Ju, Hung-Jie Liou

Abstract:

Polyether amines synthesize by secondary hydroxyl polyether diol play an important role in epoxy hardener. The low molecular weight product is used in low viscosity and high transparent polyamine product for the logo, ground cover, especially for wind turbine blade, while the high molecular weight products are used in advanced agricultures such as a high-speed railway. High-pressure reductive amination process is required for producing these amines. In the condition of higher than 150 atm pressure and 200 degrees Celsius temperature, supercritical ammonia is used as a reactant and also a solvent. It would be a great challenge to select a catalyst support for such high-temperature alkaline circumstance. In this study, we have established a six-autoclave-type (SAT) high-pressure reactor for amination catalyst screening, which six experiment conditions with different temperature and pressure could be examined at the same time. We synthesized copper-nickel catalyst on different shaped alumina catalyst support and evaluated the catalyst activity for high-pressure reductive amination of polypropylene glycol (PPG) by SAT reactor. Ball type gamma alumina, ball type activated alumina and pellet type gamma alumina catalyst supports are evaluated in this study. Gamma alumina supports have shown better activity on PPG reductive amination than activated alumina support. In addition, the catalysts are evaluated in fixed bed reactor. The diamine product was successfully synthesized via this catalyst and the strength of the catalysts is measured. The crush strength of blank supports is about 13.5 lb for both gamma alumina and activated alumina. The strength increases to 20.3 lb after synthesized to be copper-nickel catalyst. After test in the fixed bed high-pressure reductive amination process for 100 hours, the crush strength of the used catalyst is 3.7 lb for activated alumina support, 12.0 lb for gamma alumina support. The gamma alumina is better than activated alumina to use as catalyst support in high-pressure reductive amination process.

Keywords: high pressure reductive amination, copper nickel catalyst, polyether amine, alumina

Procedia PDF Downloads 226
1846 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

Abstract:

The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

Procedia PDF Downloads 51
1845 Fractured Neck of Femur Patients; The Feeding Problems

Authors: F. Christie, M. Staber

Abstract:

Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

Procedia PDF Downloads 322