Search results for: group CBT

Authors: Bo Keun Lee, Doo Yeon Kwon, Ji Hoon Park, Gun Hee Lee, Ji Hye Baek, Heung Jae Chun, Young Joo Koh, Moon Suk Kim

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Thermo-responsive materials are viscoelastic materials that undergo a sol-to-gel phase transition at a specific temperature and many materials have been developed. MPEG-b-PCL (MPC) as a thermo-responsive material contained hydrophilic and hydrophobic segments and it formed an ordered crystalline structure of hydrophobic PCL segments in aqueous solutions. The ordered crystalline structure packed tightly or aggregated and finally induced an aggregated gel through intra- and inter-molecular interactions as a function of temperature. Thus, we introduced anionic and cationic groups into the end positions of the PCL chain to alter the hydrophobicity of the PCL segment. Introducing anionic and cationic groups into the PCL end position altered their solubility by changing the crystallinity and hydrophobicity of the PCL block domains. These results indicated that the properties of the end group in the hydrophobic PCL blockand the balance between hydrophobicity and hydrophilicity affect thermo-responsivebehavior of the copolymers in aqueous solutions. Thus, we concluded that determinant of the temperature-dependent thermo-responsive behavior of MPC depend on the ionic end group in the PCL block. So, we introduced zwitterionic end groups to investigate the thermo-responsive behavior of MPC. Methoxypoly(ethylene oxide) and ε-caprolactone (CL) were randomly copolymerized that introduced varying hydrophobic PCL lengths and an MPC featuring a zwitterionic sulfobetaine (MPC-ZW) at the chain end of the PCL segment. The MPC and MPC-ZW copolymers were obtained formed sol-state at room temperature when prepared as 20-wt% aqueous solutions. The solubility of MPC decreased when the PCL block was increased from molecular weight. The solubilization time of MPC-2.4k was around 20 min and MPC-2.8k, MPC-3.0k increased to 30 min and 1 h, respectively. MPC-3.6k was not solubilized. In case of MPC-ZW 3.6k, However, the zwitterion-modified MPC copolymers were solubilized in 3–5 min. This result indicates that the zwitterionic end group of the MPC-ZW diblock copolymer increased the aqueous solubility of the diblock copolymer even when the length of the hydrophobic PCL segment was increased. MPC and MPC-ZW diblock copolymers that featuring zwitterionic end groups were synthesized successfully. The sol-to-gel phase-transition was formed that specific temperature depend on the length of the PCL hydrophobic segments introduced and on the zwitterion groups attached to the MPC chain end. This result indicated that the zwitterionic end groups reduced the hydrophobicity in the PCL block and changed the solubilization. The MPC-ZW diblock copolymer can be utilized as a potential injectable drug and cell carrier.

Keywords: thermo-responsive material, zwitterionic, hydrophobic, crystallization, phase transition

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Authors: In-Hwan Baek

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Valsartan is a potent and highly selective antagonist of the angiotensin II type 1 receptor, and is widely used for the treatment of hypertension. The aim of this study was to investigate the pharmacokinetic properties of the valsartan in dogs following oral administration of a single dose using quantitative modeling approaches. Forty beagle dogs were randomly divided into two group. Group A (n=20) was administered a single oral dose of valsartan 80 mg (Diovan® 80 mg), and group B (n=20) was administered a single oral dose of valsartan 160 mg (Diovan® 160 mg) in the morning after an overnight fast. Blood samples were collected into heparinized tubes before and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24 h following oral administration. The plasma concentrations of the valsartan were determined using LC-MS/MS. Non-compartmental pharmacokinetic analyses were performed using WinNonlin Standard Edition software, and modeling approaches were performed using maximum-likelihood estimation via the expectation maximization (MLEM) algorithm with sampling using ADAPT 5 software. After a single dose of valsartan 80 mg, the mean value of maximum concentration (Cmax) was 2.68 ± 1.17 μg/mL at 1.83 ± 1.27 h. The area under the plasma concentration-versus-time curve from time zero to the last measurable concentration (AUC24h) value was 13.21 ± 6.88 μg·h/mL. After dosing with valsartan 160 mg, the mean Cmax was 4.13 ± 1.49 μg/mL at 1.80 ± 1.53 h, the AUC24h was 26.02 ± 12.07 μg·h/mL. The Cmax and AUC values increased in proportion to the increment in valsartan dose, while the pharmacokinetic parameters of elimination rate constant, half-life, apparent of total clearance, and apparent of volume of distribution were not significantly different between the doses. Valsartan pharmacokinetic analysis fits a one-compartment model with first-order absorption and elimination following a single dose of valsartan 80 mg and 160 mg. In addition, high inter-individual variability was identified in the absorption rate constant. In conclusion, valsartan displays the dose-dependent pharmacokinetics in dogs, and Subsequent quantitative modeling approaches provided detailed pharmacokinetic information of valsartan. The current findings provide useful information in dogs that will aid future development of improved formulations or fixed-dose combinations.

Keywords: dose-dependent, modeling, pharmacokinetics, valsartan

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Authors: Ilma Robo, Saimir Heta, Nedja Hysi, Vera Ostreni

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Introduction: Marginal gingivitis is a disease with considerable frequency among patients who present routinely for periodontal control and treatment. In fact, this disease may not have alarming symptoms in patients and may go unnoticed by themselves when personal hygiene conditions are optimal. The aim of this study was to collect retrograde data on the prevalence of marginal gingiva in the respective group of patients, evaluated according to specific periodontal diagnostic tools. Materials and methods: The study was conducted in two patient groups. The first group was with 34 patients, during December 2019-January 2020, and the second group was with 64 patients during 2010-2018 (each year in the mentioned monthly period). Bacterial plaque index, hemorrhage index, amount of gingival fluid, presence of xerostomia and candidiasis were recorded in patients. Results: Analysis of the collected data showed that susceptibility to marginal gingivitis shows higher values according to retrograde data, compared to cross-sectional ones. Susceptibility to candidiasis and the occurrence of xerostomia, even in the combination of both pathologies, as risk factors for the occurrence of marginal gingivitis, show higher values ​​according to retrograde data. The female are presented with a reduced bacterial plaque index than the males, but more importantly, this index in the females is also associated with a reduced index of gingival hemorrhage, in contrast to the males. Conclusions: Cross-sectional data show that the prevalence of marginal gingivitis is more reduced, compared to retrograde data, based on the hemorrhage index and the bacterial plaque index together. Changes in production in the amount of gingival fluid show a higher prevalence of marginal gingivitis in cross-sectional data than in retrograde data; this is based on the sophistication of the way data are recorded, which evolves over time and also based on professional sensitivity to this phenomenon.

Keywords: marginal gingivitis, cross-sectional, retrograde, prevalence

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Authors: László L. Lippai

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In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

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Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

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Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

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Authors: Maria Korman, Carmit Gal, Ella Gabitov, Avi Karni

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The main question addressed in this study was whether the time-of-day wherein training is afforded is a significant factor for motor skill ('how-to', procedural knowledge) acquisition and consolidation into long term memory in the healthy elderly population. Twenty-nine older adults (60-75 years) practiced an explicitly instructed 5-element key-press sequence by repeatedly generating the sequence ‘as fast and accurately as possible’. Contribution of three parameters to acquisition, 24h post-training consolidation, and 1-week retention gains in motor sequence speed was assessed: (a) time of training (morning vs. evening group) (b) sleep quality (actigraphy) and (c) chronotype. All study participants were moderately morning type, according to the Morningness-Eveningness Questionnaire score. All participants had sleep patterns typical of age, with average sleep efficiency of ~ 82%, and approximately 6 hours of sleep. Speed of motor sequence performance in both groups improved to a similar extent during training session. Nevertheless, evening group expressed small but significant overnight consolidation phase gains, while morning group showed only maintenance of performance level attained at the end of training. By 1-week retention test, both groups showed similar performance levels with no significant gains or losses with respect to 24h test. Changes in the tapping patterns at 24h and 1-week post-training were assessed based on normalized Pearson correlation coefficients using the Fisher’s z-transformation in reference to the tapping pattern attained at the end of the training. Significant differences between the groups were found: the evening group showed larger changes in tapping patterns across the consolidation and retention windows. Our results show that morning-oriented older adults effectively acquired, consolidated, and maintained a new sequence of finger movements, following both morning and evening practice sessions. However, time-of-training affected the time-course of skill evolution in terms of performance speed, as well as the re-organization of tapping patterns during the consolidation period. These results are in line with the notion that motor training preceding a sleep interval may be beneficial for the long-term memory in the elderly. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype.

Keywords: time-of-day, elderly, motor learning, memory consolidation, chronotype

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Authors: Insiya Kapasi, Roshni Udyavar Yehuda

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Cluster Redevelopment is a new concept in the city of Mumbai. Its regulations were laid down by the government in 2009. The concept of cluster redevelopment encompasses a group of buildings defined by a boundary as specified by the municipal authority (in this case, Mumbai), which may be dilapidated or approved for redevelopment. The study analyses the effect of cluster redevelopment in the form of renewal of old group of buildings as compared to refurbishment or restoration - on energy consumption. The methodology includes methods of assessment to determine increase or decrease in energy consumption in cluster redevelopment based on different criteria such as carpet area of the units, building envelope and its architectural elements. Results show that as the area and number of units increase the Energy consumption increases and the EPI (energy performance index) decreases as compared to the base case. The energy consumption per unit area declines by 29% in the proposed cluster redevelopment as compared to the original settlement. It is recommended that although the development is spacious and provides more light and ventilation, aspects such as glass type, traditional architectural features and consumer behavior are critical in the reduction of energy consumption.

Keywords: Cluster Redevelopment, Energy Consumption, Energy Efficiency, Typologies

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Authors: Soo Min Kim, Soo-Won Chae, Soung-Yon Kim, Haea Lee, Ju Yong Kang, Juneyong Lee, Seung-Ho Han

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Reverse total shoulder arthroplasty (RTSA) has become an effective treatment option for cuff tear arthropathy and massive, irreparable rotator cuff tears and indications for its use are expanding. Numerous methods for optimal fixation of the glenoid component have been suggested, such as inferior overhang, inferior tilt, to maximize initial fixation and prevent glenoid component loosening. The inferior tilt fixation of a glenoid component has been suggested, which is expected to decrease scapular notching and to improve the stability of a glenoid component fixation in reverse total shoulder arthroplasty. Inferior tilt fixation of the glenoid component has been suggested, which can improve stability and, because it provides the most uniform compressive forces and imparts the least amount of tensile forces and micromotion, reduce the likelihood of mechanical failure. Another study reported that glenoid component inferior tilt improved impingement-free range of motion as well as minimized the scapular notching. Several authors have shown that inferior tilt of a glenoid component reduces scapular notching. However, controversy still exists regarding its importance in the literature. In this study the influence of inferior tilt fixation on the primary stability of a glenoid component has been investigated. Finite element models were constructed from cadaveric scapulae and glenoid components were implanted with neutral and 10° inferior tilts. Most previous biomechanical studies regarding the effect of glenoid component inferior tilt used a solid rigid polyurethane foam or sawbones block, not cadaveric scapulae, to evaluate the stability of the RTSA. Relative micromotions at the bone-glenoid component interface, and the distribution of bone stresses under the glenoid component and around the screws were analyzed and compared between neutral and 10° inferior tilt groups. Contact area between bone and screws and cut surface area of the cancellous bone exposed after reaming of the glenoid have also been investigated because of the fact that cancellous and cortical bone thickness vary depending on the resection level of the inferior glenoid bone. The greater relative micromotion of the bone-glenoid component interface occurred in the 10° inferior tilt group than in the neutral tilt group, especially at the inferior area of the bone-glenoid component interface. Bone stresses under the glenoid component and around the screws were also higher in the 10° inferior tilt group than in the neutral tilt group, especially at the inferior third of the glenoid bone surface under the glenoid component and inferior scapula. Thus inferior tilt fixation of the glenoid component may adversely affect the primary stability and longevity of the reverse total shoulder arthroplasty.

Keywords: finite element analysis, glenoid component, inferior tilt, reverse total shoulder arthroplasty

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Authors: N. Anand, P. S. Nayyer, V. Rana, S. Verma

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Background: Diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular and macrovascular complications. Among the lesser known complications is the involvement of respiratory system. Changes in pulmonary volume, diffusion and elastic properties of lungs as well as the performance of the respiratory muscles lead to a restrictive pattern in lung functions. The present study was aimed to determine the changes in various parameters of pulmonary function tests amongst patients with Type 2 Diabetes Mellitus and also try to study the effect of duration of Diabetes Mellitus on pulmonary function tests. Methods: It was a cross sectional study performed at Dr Baba Saheb Ambedkar Hospital and Medical College in, Delhi, A Tertiary care referral centre which included 200 patients divided into 2 groups. The first group included diagnosed patients with diabetes and the second group included controls. Cases and controls symptomatic for any acute or chronic Respiratory or Cardiovascular illness or a history of smoking were excluded. Both the groups were subjected to spirometry to evaluate for the pulmonary function tests. Result: The mean Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) was found to be significantly decreased ((P < 0.001) as compared to controls while the mean ratio of Forced Expiratory Volume in First second to Forced Vital Capacity was not significantly decreased( p>0.005). There was no correlation seen with duration of the disease. Conclusion: Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) were found to be significantly decreased in patients of Diabetes mellitus while ratio of Forced Expiratory Volume in First second to Forced Vital Capacity (FEV1/FVC) was not significantly decreased. The duration of Diabetes mellitus was not found to have any statistically significant effect on Pulmonary function tests (p > 0.005).

Keywords: diabetes mellitus, pulmonary function tests, forced vital capacity, forced expiratory volume in first second

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Authors: Anna Słupik, Krzysztof Jaworski, Anna Mosiołek, Dariusz Białoszewski

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Background: Maintaining the correct body balance is essential in the prevention of falls in the elderly, which is especially important for women because of postmenopausal osteoporosis and the serious consequences of falls. One of the exercise methods which is very popular among adults, and which may affect body balance in a positive way is the pilates method. The aim of the study was to evaluate the effect of regular pilates exercises on the ability to maintain body balance in static conditions in adult healthy women. Material and methods: The study group consisted of 20 healthy women attending pilates twice a week for at least 1 year. The control group consisted of 20 healthy women physically inactive. Women in the age range from 35 to 50 years old without pain in musculoskeletal system or other pain were only qualified to the groups. Body balance was assessed using MatScan VersaTek platform with Sway Analysis Module based on Matscan Clinical 6.7 software. The balance was evaluated under the following conditions: standing on both feet with eyes open, standing on both feet with eyes closed, one-leg standing (separately on the right and left foot) with eyes open. Each test lasted 30 seconds. The following parameters were calculated: estimated size of the ellipse of 95% confidence, the distance covered by the Center of Gravity (COG), the size of the maximum shift in the sagittal and frontal planes and load distribution between the left and right foot, as well as between rear- and forefoot. Results: It was found that there is significant difference between the groups in favor of the study group in the size of the confidence ellipse and maximum shifts of COG in the sagittal plane during standing on both feet, both with the eyes open and closed (p < 0.05). While standing on one leg both on the right and left leg, with eyes opened there was a significant difference in favor of the study group, in terms of the size of confidence ellipse, the size of the maximum shifts in the sagittal and in the frontal plane (p < 0.05). There were no differences between the distribution of load between the right and left foot (standing with both feet), nor between fore- and rear foot (in standing with both feet or one-leg). Conclusions: 1. Static balance in women exercising regularly by pilates method is better than in inactive women, which may in the future prevent falls and their consequences. 2. The observed differences in maintaining balance in frontal plane in one-leg standing may indicate a positive impact of pilates exercises on the ability to maintain global balance in terms of the reduced support surface. 3. Pilates method can be used as a form preventive therapy for all people who are expected to have problems with body balance in the future, for example in chronic neurological disorders or vestibular problems. 4. The results have shown that further prospective randomized research on a larger and more representative group is needed.

Keywords: balance exercises, body balance, pilates, pressure distribution, women

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Authors: Costrie Ganes Widayanti

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Learning Disabilities (LDs) are less understood by the Indonesia’s educational practitioners. As a result, students with LDs are at risk of being outcast from the learning process that requires participation, which potentially disconnects them academically and socially. Its objective is to raise the voice of students with LDs regarding their engagement in the classroom. This research is conducted in two urban regular public primary schools in Indonesia. The study uses an ethnographic case study research design, which explores the views and experiences of four (4) students with LDs. The data were collected using participant observations and interviews. The preliminary findings highlighted two areas: 1) the stigmatization about LDs; and 2) perceived membership. Having LDs was a barrier to fully engage in the academic and social life. Interestingly, they were more likely dependent on each other for support as limited assistance was offered by teachers and peers. Their peers did not take a keen interest in helping them when they found difficulties with the assignments. Furthermore, due to their low academic performance, they were not in favor of being nominated as a group member. In a situation that required them to do a group assignment, they were not expected to give a contribution, positioning themselves as incompatible. These findings indicated that such practices legitimate the hegemony of the superior over those who are powerless and left behind.

Keywords: engagement, experiences, learning disability, qualitative design

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Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur

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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.

Keywords: etomidate, intraocular pressure, thiopentone, traumatic

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Authors: Sandeep Vasaikar, Lary Obi

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Rapid and discriminative genotyping methods are useful for determining the clonality of the isolates in nosocomial or household outbreaks. Multilocus sequence typing (MLST) is a nucleotide sequence-based approach for characterising bacterial isolates. The genetic diversity and the clinical relevance of the drug-resistant Klebsiella isolates from Mthatha are largely unknown. For this reason, prospective, experimental study of the molecular epidemiology of Klebsiella isolates from patients being treated in Mthatha over a three-year period was analysed. Methodology: PCR amplification and sequencing of the drug-resistance-associated genes, and multilocus sequence typing (MLST) using 7 housekeeping genes mdh, pgi, infB, FusAR, phoE, gapA and rpoB were conducted. A total of 32 isolates were analysed. Results: The percentages of multidrug-resistant (MDR), extensively drug-resistance (XDR) and pandrug-resistant (PDR) isolates were; MDR 65.6 % (21) and XDR and PDR with 0 % each. In this study, K. pneumoniae was 19/32 (59.4 %). MLST results showed 22 sequence types (STs) were identified, which were further separated by Maximum Parsimony into 10 clonal complexes and 12 singletons. The most dominant group was Klebsiella pneumoniae with 23/32 (71.8 %) isolates, Klebsiella oxytoca as a second group with 2/32 (6.25 %) isolates, and a single (3.1 %) K. varricola as a third group while 6 isolates were of unknown sequences. Conclusions/significance: A phylogenetic analysis of the concatenated sequences of the 7 housekeeping genes showed that strains of K. pneumoniae form a distinct lineage within the genus Klebsiella, with K. oxytoca and K. varricola its nearest phylogenetic neighbours. With the analysis of 7 genes were determined 1 K. variicola, which was mistakenly identified as K. pneumoniae by phenotypic methods. Two misidentifications of K. oxytoca were found when phenotypic methods were used. No significant differences were observed between ESBL blaCTX-M, blaTEM and blaSHV groups in the distribution of Sequence types (STs) or Clonal complexes (CCs).

Keywords: phylogenetic analysis, phylogeny, klebsiella phylogenetic, klebsiella

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Authors: Syed Ibrahim, Syed Muneer Ahmed

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It is a global phenomenon that fitness is a pre-requisite to the desired end of optimum efficiency in elite class basketballers achieved through appropriate conditioning program. This study was undertaken to find out the effect of gymnastic oriented training program on the physical fitness and the level of technical performance of basketball players. Method: 27 basketballers were divided into 12 experimental and 15 control groups aged between 19 to 25 years. Physical fitness tests comprising of vertical jump, push-ups, chin ups, sit ups, back strength, 30 m sprint, boomerangs test, 600 m run, sit and reach, bridge up and shoulder rotation and technical skill tests like dribbling, layup shots and rebound collection were used for the study. A pre- and post-test was conducted before and after the training program of 6 weeks. Results: The results indicated no significant difference in the anthropometric measurements of age, height and weight between the experimental and control group as the ‘t’ values observed were 0.28, 1.63 and 1.60 respectively . There were significant improvements in vertical jump, push-ups, sit-ups, modified boomerang test, bridge test and shoulder rotation index with the ‘t’ values being 2.60, 3.41, 3.91, 4.02, 3.55 and 2.33 respectively. However, no significant differences existed in chin-ups, back strength, 30 m sprint and 6000 m run with the ‘t’ values being 2.08, 1.77, 1.28 and 0.80 respectively. There was significant improvement in the post-test for the technical skills tests in the experimental group with ‘t’ values being 3.65, 2.57, and 3.62 for the dribble, layup shots and rebound collection respectively. There was no significant difference in the values of the control group except in the rebound collection which showed significant difference. Conclusion: It was found that both the physical fitness and skill proficiency of the basketballers increased through the participation in the gymnastics oriented program.

Keywords: gymnastic, technical, pre-requisite, elite class

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Authors: Wei-Han Wang, Hsiang-Yu Yu, Mau-Sun Hua

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Theory of Mind (ToM) refers to the ability to infer another’s mental state. With appropriate ToM, one can behave well in social interactions. A growing body of evidence has demonstrated that patients with temporal lobe epilepsy (TLE) may have damaged ToM due to impact on regions of the underlying neural network of ToM. However, the question of whether there is cerebral laterality for ToM functions remains open. This study aimed to examine whether there is cerebral lateralization for ToM abilities in TLE patients. Sixty-seven adult TLE patients and 30 matched healthy controls (HC) were recruited. Patients were classified into right (RTLE), left (LTLE), and bilateral (BTLE) TLE groups on the basis of a consensus panel review of their seizure semiology, EEG findings, and brain imaging results. All participants completed an intellectual test and four tasks measuring basic and advanced ToM. The results showed that, on all ToM tasks; (1)each patient group performed worse than HC; (2)there were no significant differences between LTLE and RTLE groups; (3)the BTLE group performed the worst. It appears that the neural network responsible for ToM is distributed evenly between the cerebral hemispheres.

Keywords: cerebral lateralization, social cognition, temporal lobe epilepsy, theory of mind

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Authors: Jamal Abdi

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This paper is largely a response/critique of Samuel P. Huntington´s Clash of Civilizations thesis. The overriding argument is that Huntington´s thesis is characterized by failure to distinguish between ´groups´ and ´categories´. Multinational civilizations overcoming their internal collective action problems, which would enable them to pursue a unified strategy vis-à-vis the West, is a rather foundational assumption in his theory. Without assigning sufficient intellectual attention to the processes through which multinational civilizations may gain capacity for concerted action i.e. become a group, he contended that the post-cold-war world would be shaped in large measure by interactions among seven or eight major civilizations. Thus, failure in providing a convincing analysis of multi-national civilizations´ transition from categories to groups is a significant weakness in Huntington´s clash theory. It is also suggested that so-called Islamic terrorism and the war on terror is not to be taken as an expression of presence of clash between a Western and an Islamic civilization, as terrorist organizations would be superfluous in a world characterized by clash of civilizations. Consequences of multinational civilizations becoming a group are discussed in relation to contemporary Western superiority.

Keywords: categories, civilizations, clash, groups, groupness

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Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

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Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

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Authors: Yeoju Chung

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Adolescents internet and smartphone addiction are increasing in Korea. But differences between internet addiction and smartphone addiction have been researched in these days. The main objective of this article is to explore the presence of clusters within a sample of adolescents based on dimensions associated with addiction and internet usage needs. The sample consists of 617 adolescents in the 14-19 year age group who were recruited in Korea A cluster analysis identified four groups of participants: internet overuse(IO), smartphone overuse(SO), both overuse(B) and normal(N) use group. MANOVA analysis based on internet usage showed that there are differences among four groups in internet usage needs. IO has higher cyber self-seeking needs and emotion and thought expression needs than SO. SO has higher real relationship and life needs with cyberworld than IO, B, and N. B has the highest cyber self-seeking needs and emotion and thought expression needs, however, game fun seeking needs is the highest in IO. These results support that IO seeks game fun needs, SO seeks real relationship and life needs, and B seeks cyber self and expression in cyberworld.

Keywords: addiction, internet, needs, smartphone

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Authors: Sayyed-Javad Ziaolhagh, Mojtaba Hokmabadi

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Introduction: Childhood obesity is a serious medical condition that affects children and adolescents even in the central nervous system. Semaphorins also play a role in the inflammatory process of the nervous system. On the other hand, it has been stated that garlic and stevia extracts following aerobic exercise are effective on immune system inflammation in addition to aerobic activity. Materials and Methods: For 15 weeks, 50 3-week-old male Wistar rats were fed with conventional rodent chow for control and a high-fat diet to induce obesity. Obese rats then were randomly assigned into 7 groups (n=5) based on the Lee index: healthy control (C), obese (OBS), obese + garlic (OBS+GAR), obese + Stevia (OBS+STV), obese + aerobic exercise (OBS+EXE), obese + garlic + aerobic exercise (OBS+GAR+EXE), and obese + stevia + aerobic exercise (OBS+STV+EXE). Training groups completed a progressive aerobic running program (at 8-15 m/min, 5-20 min/day, 5 days/week), and Stevia and garlic extract group (250 mg/kg/day, 5 days/week) were given orally once a day. Real-time PCR was used to determine the levels of Semaphorin 4A, and Plexin D1 gene expressions in the hypothalamus. Fold change analysis with ANOVA was performed for statistical analysis, with a significance threshold of P<0.05. Results: Body weight increased significantly in OBS compared to C (p= 0.013), but was not significantly changed in all treatment rats. Moreover, Semaphorin 4A was significantly increased in obese compared to control group (p= 0.041) and after 8 weeks, stevia extract (p=0.006), aerobic exercise (p=0.012) and garlic extract + aerobic exercise (p=0.008) significantly decreased compared to obese rats. In addition, Plexin D1 genes were also found in the hypothalamus of both obese and control rats but were insignificantly up-regulated when compared with the obese group (p=0.950). Conclusion: High-fat diet caused neuroinflammation by elevation of sema4A in obese rats and stevia, stevia with aerobic and garlic with aerobic could reduce this inflammation in rats. Also, none of them could alter Plexin D1.

Keywords: sema 4A, plexin D1, garlic, stevia

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Authors: Linda Frost, Lindsay Anderson, Jana Borras, Ariel Dysangco, Vimabayi Makwaira

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The academic environment in which nursing students are immersed in comes with many demands and expectations. Course load, clinical placements, and financial expenses are examples of the pressures facing students each semester. These pressures contribute to student stress and impact their overall well-being and mental fitness. Students' ability to cope with stress and bounce back from adversity is enhanced when we build their mental fitness. Building mental fitness has the benefit of improving physical health, relationships, self-esteem, resilience, work productivity, and overall contentment, happiness and life satisfaction. While self-care is encouraged to avoid burnout, there is a gap in literature on programs to help build nursing students’ mental health and ability to engage in self-care. There is an opportunity and a need to design programs and implement actions aimed at reducing stress and its adverse effects on nursing students. Nursing students require the support of people who understand the complexities of the nursing profession, multifaceted work environments in which they operate, and the impact these environments have on their mental fitness. Nursing academia is in the best position to ensure that tools are in place to support the next generation of nurses who face a career with significant emotional and physical demands. This is a mixed-method study using an embedded design. We utilized a pretest-posttest design to compare the difference in psychological capital (PsyCap) and burnout in students who have received the Mastering My Mental Fitness-Nurses™ (MMMF-N™) workshops (n=8) and the control group (n=9) who have not. Semi structured interviews were conducted with the eight nursing students in the intervention group, along with data from feedback forms to explore the impact of the workshops on student’s burnout and PsyCap and determine how to improve the workshops for future students. The quantitative and qualitative data will be merged using a side-by-side comparison. This will be in a discussion format that allows for the comparison of the results from both phases. The findings will be available January 2025. We anticipate that students in the control and intervention group will report similar levels of burnout. As well, students in the intervention group will indicate the benefits of the MMMF-N™ workshops through qualitative interviews and workshop feedback forms.

Keywords: burnout, mental fitness, nursing students, psychological capital

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Authors: V. Viliene, A. Raceviciute-Stupeliene, V. Sasyte, V. Slausgalvis, R. Gruzauskas, J. Al-Saifi

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Animal nutritionists and scientists have searched for alternative measures to improve the production. One of such alternative is use of organic acids as feed additive in animal nutrition. The study was conducted to investigate the impact of butyric acids, calcium formate, organic acids, and its salts (BCOS) additives on rabbit’s productive performance, carcass traits and meat quality. The study was conducted with 14 Californian breed rabbits. The rabbits were assigned to two treatment groups (seven rabbits per each treatment group). The dietary treatments were 1) control diet, 2) diet supplemented with a mixture BCOS - 2 kg/t of feed. Growth performance characteristics (body weight, daily weight gain, daily feed intake, feed conversion ratio, mortality) were evaluated. Rabbits were slaughtered; carcass characteristics and meat quality were evaluated. Samples loin and hind leg meat were analysed to determine carcass characteristics, pH and colour measurements, cholesterol, and malonyldialdehyde (MDA) content in loin and hind leg meat. Differences between treatments were significant for body weight (1.30 vs. 1.36 kg; P<0.05), daily weight gain (16.60 vs. 17.85 g; P<0.05), and daily feed intake (78.25 vs. 80.58 g; P<0.05) for control and experimental group respectively for the entire experimental period (from 28–77 days old). No significant differences were found in feed conversion ratio and mortality. The feed additives insertion in the diets did not significantly influence the carcass yield or the proportions of the various carcass parts and organs. Differences between treatments were significant for pH value after 48h in loin (5.86 vs. 5.74; P<0.05), hind leg meat (6.62 vs. 6.65; P<0.05), more intense colour b* of loin (5.57 vs. 6.06; P<0.05), less intense colour a* (14.99 vs. 13.15; P<0.05) in hind leg meat. Cholesterol content in hind leg meat decreased by 17.67 mg/100g compared to control group (P<0.05). After storage for three months, MDA concentration decreased in loin and hind leg meat by 0.3 μmol/kg and 0.26 μmol/kg respectively compared to that of the control group (P<0.05). The results of this study suggest that BCOS could potentially be used in rabbit nutrition with consequent benefits on the rabbits’ productivity and nutritional quality of rabbit meat for consumers.

Keywords: butyric acids, Ca formate, meat quality, organic acids salts, rabbits, productivity

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Authors: Diana Kwok

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Introduction: There is a rising concern on the educational needs of school guidance teachers, counselors, and sex educators to work effectively with students from multicultural groups, such as racial minorities, gender minorities, sexual minorities, and disability groups etc., and to respect cultural diversities. A specialized training model, the multicultural framework based on contact theory is recognized as necessary training model for professional training programs. Methodology: While the major focus of this project is on improving teaching and learning in teacher training courses within the department of Special Education and Counselling, it specifically aims to enhance the cultural competence of 102 participants enrolled in counseling and sexuality education courses by integrating the following teaching and learning strategies: 1) Panel presentation; 2) Case studies; 3) Experiential learning. Data sources from the participants consisted of the following: (a) questionnaires (MCKAS and ATLG) administered in classes; (b) weekly reflective journals, and c) focus group interviews with panel members. The focus group interviews with panel members were documented. Qualitatively, the weekly reflections were content analyzed. The presentation in this specific conference put focus on themes we found from qualitative content analysis of weekly reflective journals from 102 participants. Findings: Content analysis had found the following preliminary emergent themes: Theme I) Cultural knowledge and challenges to personal limitation. Students had gained a new perspective that specific cultural knowledge involved unique values and worldview. Awareness of limitation of counsellors is very important after actively acquiring the cultural knowledge. Theme 2 - Observation, engagement and active learning. Through the sharing and case studies, as well as visits to the communities, students recognized that observation and listening to the needs of cultural group members were the essential steps before taking any intervention steps. Theme 3 - Curiosity and desire for further inter-group dialogue. All students expressed their desire, curiosity, and motivation to have further inter-group dialogue in their future work settings. Theme 4: Experience with teaching and learning strategies. Students shared their perspectives on how teaching and learning strategies had facilitated their acquisition of cultural competence. Results of this analysis suggests that diverse teaching and learning strategies based on contact perspective had stimulated their curiosity to re-examine their values and motivated them to acquire cultural knowledge relevant to the cultural groups. Acknowledgment: The teaching and learning project was funded by the Teaching and Development Grant, Hong Kong Institute of Education (Project Number T0142).

Keywords: cultural competence, Chinese teacher students, teaching and learning, contacts

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Authors: Hatem Ghith

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This research paper experimentally investigates the effect of burning by fire flame from one face on the behavior and load carrying capacity for reinforced columns. Residual ultimate load carrying capacity, axial deformation, crack pattern and maximum crack width for column specimens with and without burning were recorded and discussed. Tested six reinforced concrete columns were divided into control specimen and two groups. The first group was exposed to a fire with a different temperature (300, 500, 700 °C) for an hour with reinforcement ratio 0.89% and the second group was exposed to a fire with a temperature 500 °C for an hour with different reinforcement ratio (0.89%, 2.18%, and 3.57%), then all columns were tested under short-term axial loading. From the obtained results, it could be concluded that the fire parameters significantly influence the fire resistance of R.C columns. The fire parameters cause axial deformation and moment on the column due to the eccentricity that generated from the difference in temperature and consequently the compressive stresses of both faces of the columns but the increased reinforcement ratio enhanced the resistance of columns for axial deformation and moment on the column due to the eccentricity.

Keywords: columns, reinforcement ratio, strength, time exposure

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Authors: Saad Al-Shibli, Nasser Amjad, Muna Al Kubaisi, Norra Harun, Shaikh Mizan

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Leptin is a multifunctional hormone produced mainly by adipocyte. Leptin and its receptor have long been found associated with breast cancer. The main aim of this study is to investigate the correlation between Leptin/Leptin receptor and the clinicopathological features of breast cancer. Blood samples for ELISA, tissue samples from tumors and adjacent breast tissue were taken from 51 women with breast cancer with a control group of 40 women with a negative mammogram. Leptin and Leptin receptor in the tissues were estimated by immunohistochemistry (IHC). They were localized at the subcellular level by immunocytochemistry using transmission electron microscopy (TEM). Our results showed significant difference in serum leptin level between control and the patient group, but no difference between pre and post-operative serum leptin levels in the patient group. By IHC, we found that the majority of the breast cancer cells studied, stained positively for leptin and leptin receptors with co-expression of leptin and its receptors. No significant correlation was found between leptin/leptin receptors expression with the race, menopausal status, lymph node metastasis, estrogen receptor expression, progesterone receptor expression, HER2 expression and tumor size. Majority of the patients with distant metastasis were associated with high leptin and leptin receptor expression. TEM views both Leptin and Leptin receptor were found highly concentrated within and around the nucleus of the cancer breast cells, indicating nucleus is their principal seat of actions while the adjacent breast epithelial cells showed that leptin gold particles are scattered all over the cell with much less than that of the cancerous cells. However, presence of high concentration of leptin does not necessarily prove its over-expression, because it could be internalized from outside by leptin receptor in the cells. In contrast, leptin receptor is definitely over-expressed in the ductal breast cancer cells. We conclude that reducing leptin levels, blocking its downstream tissue specific signal transduction, and/or blocking the upstream leptin receptor pathway might help in prevention and therapy of breast cancer.

Keywords: breast cancer, expression, leptin, leptin receptors

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Authors: Rehan Mohammad

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

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

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Authors: Ehsan Samimi, Mohammaa Ali Shahosseeni, Ali Abasltian, Shahriar Shafaghi

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Background/Objectives: Voluntary turnover and early retirement request by specialists and experienced people in project-based organizations (PBO) has caused many problems in finding suitable experts to execute the projects. Methods/Statistical analysis: The present study is a descriptive and applied research. Research population consists of KWs in oil and gas PBO. The engineers in these organizations were considered as research sample. Interviews and questionnaire were used to gather information. Interviews with experts were used to identify factors and questionnaires were utilized to identify the importance and prioritization. 72 factors were identified and categorized into 9 groups within organizational and HR initiative levels. Results: Results of the research indicate the priority of each group of factors according to the proposed model in the view of KWs in oil, gas and petrochemical industries. On this basis, the following factors have the highest effect ratio based on the respondents’ point of view: 1. knowledge management 2. Performance appraisal system 3. Communication 4.Training and development 5.Job design and analysis 6. Employment policies 7. Career planning 8. Project/organizational factors 9. Salary and rewards. Additionally, in each group the priority of effective sub-factors has been identified as the result of the research .The results support the definitions of KWs and influence of factors examined and specified by similar studies in retention and development of KWs. The high importance of knowledge management and low rank for salary and rewards can be mentioned as example in this regard. Despite the priority of each group of factors the uniqueness of the result is due to identification of effective factors in the specific industry (oil and gas) and type of organization (PBO). Conclusion/Application: The findings of present study can be used to devise plans for retaining and developing KWs in PBO especially in oil and gas industry.

Keywords: project–based organizations, knowledge workers, HR management, turnover, retaining and developing employees

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Authors: Masomeh Jamshid Nejad

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Nowadays, statistical literacy is no longer a necessary skill but an essential skill with broad applications across diverse fields, especially in operational decision areas such as business management, finance, and economics. As such, learning and deep understanding of statistical concepts are essential in the context of business studies. One of the crucial topics in statistical theory and its application is the normal distribution, often called a bell-shaped curve. To interpret data and conduct hypothesis tests, comprehending the properties of normal distribution (the mean and standard deviation) is essential for business students. This requires undergraduate students in the field of economics and business management to visualize and work with data following a normal distribution. Since technology is interconnected with education these days, it is important to teach statistics topics in the context of Python, R-studio, and Microsoft Excel to undergraduate students. This research endeavours to shed light on the effect of Excel-based instruction on learners’ knowledge of statistics, specifically the central concept of normal distribution. As such, two groups of undergraduate students (from the Business Management program) were compared in this research study. One group underwent Excel-based instruction and another group relied only on traditional teaching methods. We analyzed experiential data and BBA participants’ responses to statistic-related questions focusing on the normal distribution, including its key attributes, such as the mean and standard deviation. The results of our study indicate that exposing students to Excel-based learning supports learners in comprehending statistical concepts more effectively compared with the other group of learners (teaching with the traditional method). In addition, students in the context of Excel-based instruction showed ability in picturing and interpreting data concentrated on normal distribution.

Keywords: statistics, excel-based instruction, data visualization, pedagogy

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Authors: U. P. Rathnakar, Sejpal Jaykumar, Shenoy K. Ashok

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The effect of Shilajit was investigated for lipid lowering activity and its effect on weight gain in Wistar albino rats. Shilajit, semi-hard brownish black resin formed through long-term humidification of several plant types, mainly bryophytes, can be obtained from steep rocks of the Himalayas at altitudes between 1000 to 5000 meters. Hyperlipidemia was produced by feeding the rats with the cholesterol-rich high-fat diet (HFD) for 2 months. This diet contained deoxycholic acid, cholesterol and warm coconut oil in powdered rat chow diet. At the end of study, Shilajit treated rats showed significant decrease in serum LDL, triglyceride and total cholesterol level as well as increase in serum HDL level, in comparison to rats fed on high-fat diet with no treatment. Also during study period, increase in weight in Shilajit treated group was significantly less than in the other group of rats fed on high-fat diet with no treatment. Thus, Shilajit has significantly controlled the development of hyperlipidemia and weight gain in high-fat diet fed rats in the present study.

Keywords: Shilajit, hyperlipidemia, weight control, cholesterol-rich high-fat diet

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure, and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity is the most severe clinical form of obesity, and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate morbid obese children with (MOMetS+) and without (MOMetS-) MetS. Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. A recently introduced anthropometric obesity index, waist circumference + hip circumference/2 ((WC+HC)/2), was confirmed to differ OB children from those with N-BMI, however it has not been tested whether it will find clinical usage for the differential diagnosis of MOMetS+ and MOMetS-. This study was designed to find out the availability of (WC+HC)/2 for the purpose and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. Forty-five MOMetS+ and forty-five MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. Body mass index (BMI), waist-to-hip circumference (W/H), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data was analyzed statistically, and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for W/H, TLFR, TAFR, D2I, and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r=0.961; p<0.001) and MOMetS+ (r=0.936; p<0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r=0.726; p<0.001 in MOMetS- group and r=0.932; p<0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as W/H, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: children, hip circumference, metabolic syndrome, morbid obesity, waist circumference

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Authors: Hamed Delrobai Ghoochan Atigh

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Androgenic alopecia (AGA) is a common form of hair loss, impacting approximately 50% of females, which leads to reduced self-esteem and quality of life. It causes progressive follicular miniaturization in genetically predisposed individuals. Mesotherapy -- a minimally invasive procedure, topical 2% minoxidil, and oral finasteride have emerged as popular treatment options in the realm of cosmetics. However, the efficacy of mesotherapy compared to other options remains unclear. This study aims to assess the effectiveness of mesotherapy when it is added to topical 2% minoxidil treatment on female androgenic alopecia. Mesotherapy, also known as intradermotherapy, is a technique that entails administering multiple intradermal injections of a carefully composed mixture of compounds in low doses, applied at various points in close proximity to or directly over the affected areas. This study involves a randomized controlled trial with 100 female participants diagnosed with androgenic alopecia. The subjects were randomly assigned to two groups: Group A used topical 2% minoxidil twice daily and took Finastride oral tablet. For Group B, 10 mesotherapy sessions were added to the prior treatment. The injections were administered every week in the first month of treatment, every two weeks in the second month, and after that the injections were applied monthly for four consecutive months. The response assessment was made at baseline, the 4th session, and finally after 6 months when the treatment was complete. Clinical photographs, 7-point Likert scale patient self-evaluation, and 7-point Likert scale assessment tool were used to measure the effectiveness of the treatment. During this evaluation, a significant and visible improvement in hair density and thickness was observed. The study demonstrated a significant increase in treatment efficacy in Group B compared to Group A post-treatment, with no adverse effects. Based on the findings, it appears that mesotherapy offers a significant improvement in female AGA over minoxidil. Hair loss was stopped in Group B after one month and improvement in density and thickness of hair was observed after the third month. The findings from this study provide valuable insights into the efficacy of mesotherapy in treating female androgenic alopecia. Our evaluation offers a detailed assessment of hair growth parameters, enabling a better understanding of the treatments' effectiveness. The potential of this promising technique is significantly enhanced when carried out in a medical facility, guided by appropriate indications and skillful execution. An interesting observation in our study is that in areas where the hair had turned grey, the newly regrown hair does not retain its original grey color; instead, it becomes darker. The results contribute to evidence-based decision-making in dermatological practice and offer different insights into the treatment of female pattern hair loss.

Keywords: androgenic alopecia, female hair loss, mesotherapy, topical 2% minoxidil

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