Search results for: women
959 Correlation of Clinical and Sonographic Findings with Cytohistology for Diagnosis of Ovarian Tumours
Authors: Meenakshi Barsaul Chauhan, Aastha Chauhan, Shilpa Hurmade, Rajeev Sen, Jyotsna Sen, Monika Dalal
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Introduction: Ovarian masses are common forms of neoplasm in women and represent 2/3rd of gynaecological malignancies. A pre-operative suggestion of malignancy can guide the gynecologist to refer women with suspected pelvic mass to a gynecological oncologist for appropriate therapy and optimized treatment, which can improve survival. In the younger age group preoperative differentiation into benign or malignant pathology can decide for conservative or radical surgery. Imaging modalities have a definite role in establishing the diagnosis. By using International Ovarian Tumor Analysis (IOTA) classification with sonography, costly radiological methods like Magnetic Resonance Imaging (MRI) / computed tomography (CT) scan can be reduced, especially in developing countries like India. Thus, this study is being undertaken to evaluate the role of clinical methods and sonography for diagnosis of the nature of the ovarian tumor. Material And Methods: This prospective observational study was conducted on 40 patients presenting with ovarian masses, in the Department of Obstetrics and Gynaecology, at a tertiary care center in northern India. Functional cysts were excluded. Ultrasonography and color Doppler were performed on all the cases.IOTA rules were applied, which take into account locularity, size, presence of solid components, acoustic shadow, dopper flow etc . Magnetic Resonance Imaging (MRI) / computed tomography (CT) scans abdomen and pelvis were done in cases where sonography was inconclusive. In inoperable cases, Fine needle aspiration cytology (FNAC) was done. The histopathology report after surgery and cytology report after FNAC was correlated statistically with the pre-operative diagnosis made clinically and sonographically using IOTA rules. Statistical Analysis: Descriptive measures were analyzed by using mean and standard deviation and the Student t-test was applied and the proportion was analyzed by applying the chi-square test. Inferential measures were analyzed by sensitivity, specificity, negative predictive value, and positive predictive value. Results: Provisional diagnosis of the benign tumor was made in 16(42.5%) and of the malignant tumor was made in 24(57.5%) patients on the basis of clinical findings. With IOTA simple rules on sonography, 15(37.5%) were found to be benign, while 23 (57.5%) were found to be malignant and findings were inconclusive in 2 patients (5%). FNAC/Histopathology reported that benign ovarian tumors were 14 (35%) and 26(65%) were malignant, which was taken as the gold standard. The clinical finding alone was found to have a sensitivity of 66.6% and a specificity of 90.9%. USG alone had a sensitivity of 86% and a specificity of 80%. When clinical findings and IOTA simple rules of sonography were combined (excluding inconclusive masses), the sensitivity and specificity were 83.3% and 92.3%, respectively. While including inconclusive masses, sensitivity came out to be 91.6% and specificity was 89.2. Conclusion: IOTA's simple sonography rules are highly sensitive and specific in the prediction of ovarian malignancy and also easy to use and easily reproducible. Thus, combining clinical examination with USG will help in the better management of patients in terms of time, cost and better prognosis. This will also avoid the need for costlier modalities like CT, and MRI.Keywords: benign, international ovarian tumor analysis classification, malignant, ovarian tumours, sonography
Procedia PDF Downloads 81958 The Role of the Founding Ideals of a University in Higher Education
Authors: Masanori Kimura
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The “founding spirit” of a Japanese university is similar to the mission statement of a Western university, but the difference between the two is that the former more closely reflects the founder’s inner world because it usually originates from the strong personal beliefs that the founder held when establishing the university. To find how much this ideology actually valued in today’s higher education, this paper surveys 2091 job openings for foreign language full-time faculty positions, posted by Japanese private universities from 2012 to 2016. The results suggest that women’s universities and universities with religious affiliations have a tendency to request that successful candidates observe their founding spirit, or at least demonstrate some understanding of the ideology after being hired. On the other hand, co-ed universities and universities with no religious affiliations do not show such a distinct tendency. A chi-square test revealed that this difference between the two groups was statistically significant (p<.01). Furthermore, the paper argues that it is not always appropriate for universities to evaluate themselves based on a single evaluation scale such as university rankings, and that both faculty and staff members need to be more aware of the founding spirit to improve the quality of the education the university provides.Keywords: founding spirit, higher education, university administrative management, university evaluation
Procedia PDF Downloads 279957 Error Analysis of the Pronunciation of English Consonants and Arabic Consonants by Egyptian Learners
Authors: Marwa A. Nasser
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This is an empirical study that provides an investigation of the most significant errors of Egyptian learners in producing English consonants and Arabic consonants, and advice on how these can be remedied. The study adopts a descriptive approach and the analysis is based on audio recordings of two groups of people. The first group includes six volunteers of Egyptian learners belonging to the English Department at Faculty of Women who learn English as a foreign language. The other group includes six Egyptian learners who are studying Tajweed (how to recite Quran correctly). The audio recordings were examined, and sounds were analyzed in an attempt to highlight the most common error done by the learners while reading English or reading (or reciting) Quran. Results show that the two groups of learners have problems with certain phonemic contrasts. Both groups share common errors although both languages are different and not related (e.g. pre-aspiration of fortis stops, incorrect articulation of consonants and velarization of certain sounds).Keywords: consonant articulations, Egyptian learners of English, Egyptian learners of Quran, empirical study, error analysis, pronunciation problems
Procedia PDF Downloads 271956 Gender Differences in the Prediction of Smartphone Use While Driving: Personal and Social Factors
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This study examines gender as a boundary condition for the relationship between the psychological variable of mindfulness and the social variable of income with regards to the use of smartphones by young drivers. The use of smartphones while driving increases the likelihood of a car accident, endangering young drivers and other road users. The study sample included 186 young drivers who were legally permitted to drive without supervision. The subjects were first asked to complete questionnaires on mindfulness and income. Next, their smartphone use while driving was monitored over a one-month period. This study is unique as it used an objective smartphone monitoring application (rather than self-reporting) to count the number of times the young participants actually touched their smartphones while driving. The findings show that gender moderates the effects of social and personal factors (i.e., income and mindfulness) on the use of smartphones while driving. The pattern of moderation was similar for both social and personal factors. For men, mindfulness and income are negatively associated with the use of smartphones while driving. These factors are not related to the use of smartphones by women drivers. Mindfulness and income can be used to identify male populations that are at risk of using smartphones while driving. Interventions that improve mindfulness can be used to reduce the use of smartphones by male drivers.Keywords: mindfulness, using smartphones while driving, income, gender, young drivers
Procedia PDF Downloads 174955 Blood Thicker Than Water: A Case Report on Familial Ovarian Cancer
Authors: Joanna Marie A. Paulino-Morente, Vaneza Valentina L. Penolio, Grace Sabado
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Ovarian cancer is extremely hard to diagnose in its early stages, and those afflicted at the time of diagnosis are typically asymptomatic and in the late stages of the disease, with metastasis to other organs. Ovarian cancers often occur sporadically, with only 5% associated with hereditary mutations. Mutations in the BRCA1 and BRCA2 tumor suppressor genes have been found to be responsible for the majority of hereditary ovarian cancers. One type of ovarian tumor is Malignant Mixed Mullerian Tumor (MMMT), which is a very rare and aggressive type, accounting for only 1% of all ovarian cancers. Reported is a case of a 43-year-old G3P3 (3003), who came into our institution due to a 2-month history of difficulty of breathing. Family history reveals that her eldest and younger sisters both died of ovarian malignancy, with her younger sister having a histopathology report of endometrioid ovarian carcinoma, left ovary stage IIIb. She still has 2 asymptomatic sisters. Physical examination pointed to pleural effusion of right lung, and presence of bilateral ovarian new growth, which had a Sassone score of 13. Admitting Diagnosis was G3P3 (3003), Ovarian New Growth, bilateral, Malignant; Pleural effusion secondary to malignancy. BRCA was requested to establish a hereditary mutation; however, the patient had no funds. Once the patient was stabilized, TAHBSO with surgical staging was performed. Intraoperatively, the pelvic cavity was occupied by firm, irregularly shaped ovaries, with a colorectal metastasis. Microscopic sections from both ovaries and the colorectal metastasis had pleomorphic tumor cells lined by cuboidal to columnar epithelium exhibiting glandular complexity, displaying nuclear atypia and increased nuclear-cytoplasmic ratio, which are infiltrating the stroma, consistent with the features of Malignant Mixed Mullerian Tumor, since MMMT is composed histologically of malignant epithelial and sarcomatous elements. In conclusion, discussed is the clinic-pathological feature of a patient with primary ovarian Malignant Mixed Mullerian Tumor, a rare malignancy comprising only 1% of all ovarian neoplasms. Also, by understanding the hereditary ovarian cancer syndromes and its relation to this patient, it cannot be overemphasized that a comprehensive family history is really fundamental for early diagnosis. The familial association of the disease, given that the patient has two sisters who were diagnosed with an advanced stage of ovarian cancer and succumbed to the disease at a much earlier age than what is reported in the general population, points to a possible hereditary syndrome which occurs in only 5% of ovarian neoplasms. In a low-resource setting, being in a third world country, the following will be recommended for monitoring and/or screening women who are at high risk for developing ovarian cancer, such as the remaining sisters of the patient: 1) Physical examination focusing on the breast, abdomen, and rectal area every 6 months. 2) Transvaginal sonography every 6 months. 3) Mammography annually. 4) CA125 for postmenopausal women. 5) Genetic testing for BRCA1 and BRCA2 will be reserved for those who are financially capable.Keywords: BRCA, hereditary breast-ovarian cancer syndrome, malignant mixed mullerian tumor, ovarian cancer
Procedia PDF Downloads 290954 Pursuing Professional Status in Women’s Football: A Qualitative Analysis of Empowerment and Social Independence
Authors: G. Obrentri, C. Whajah, E. Yeboah Acheampong
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Professional status for African male players guarantees them socioeconomic benefits that may not necessarily be the case for female footballers. The study’s rationale is to understand how female footballers achieve professional status abroad. That contributes to analyzing how female players from Africa especially, Ghana, manage their professional status to improve their family’s social welfare and the community. Relying on football migration and feminization, we identify their migration process and its relevance to their social mobility in society. Analysis through interviews with some female footballers revealed the importance of playing professional abroad that goes to increase their social status and national identity. Findings show that some female footballers with secondary education achieved career empowerment and social independence via their profession. Thus becoming medical doctors and nurses, sports administrators, football coaches and welfare officers for clubs. These achievements of the female footballers can provide useful information and lessons for young female African players aspiring to play professionally abroad.Keywords: empowerment, female footballers, football migration, professional status, social independence
Procedia PDF Downloads 175953 Faith-Based Humanitarian Intervention: The Catholic Church and the Biafran Refugee Crisis during the Nigerian Civil War, 1967-1970
Authors: Edidiong Ekefre
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The Nigerian civil war was one of the foremost postcolonial conflicts in West Africa that attracted a serious humanitarian problem due to an unprecedented refugee crisis that affected the Biafran region. Due to its geographical location, the Nigerian government used blockades and starvation as a weapon of war against the Biafran. Faced with strong opposition from the Nigerian government, most humanitarian organizations withdrew their support from Biafra, whose death toll was rapidly growing daily due to starvation, malnutrition, and chronic ailment. Thus, the Catholic Church, a major Christian denomination in Biafra, had to see it as its religious obligation to support the humanitarian needs of the Biafrans. Thus, applying oral history methods with archival research, this paper examines the humanitarian activities of the Catholic Church in the Nigerian civil war. It contends that the Catholic Church was a key player in the humanitarian aspect of the Nigerian civil war. The paper concludes that faith-based humanitarian intervention in the Biafran refugee crisis was essential for the survival of the Biafran war-stricken women and children.Keywords: refugee crisis, humanitarian intervention, Caritas International, blockades, airlifts, starvation
Procedia PDF Downloads 81952 Nexus of Socio-Demographic Factors and Water Fetching Practices: A Study in South-Western Bangladesh
Authors: Mufti Nadimul Quamar Ahmed
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Universal and equitable access to safe and inexpensive water is one of the core goals of UN Sustainable Development (Goal-6). Rainwater harvesting and drinkable water scarcity are also prominent themes in the current literature. However, the lack of readily available drinking water sources is a serious roadblock in achieving this major goal in developing countries, especially in Bangladesh. In this study, we aimed to explore how water collecting activities in Bangladesh's coastal region are influenced by participants’ selected socio-demographic characteristics. We gathered information using a structured questionnaire from 154 people who were chosen at random from two of Bangladesh's most susceptible subdistricts situated in the country's southwest coast. Our results show that majority of the respondents think water fetching is a job for the woman as like their other day-day to household works and it’s not a man's duty. Interestingly, we found that person's age, family structure, monthly income and religion all play important roles in how they see and behave water-gathering techniques. Moreover, the local taboo on women and men's roles in water-gathering is also evident in the studied areas.Keywords: water fetching, socio-demographic characteristic, coastal region, Bangladesh, SDG
Procedia PDF Downloads 125951 Determinants of Child Anthropometric Indicators: A Case Study of Mali in 2015
Authors: Davod Ahmadigheidari
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The main objective of this study was to explore prevalence of anthropometric indicators as well the factors associated with the anthropometric indications in Mali. Data on 2015, downloaded from the website of Unicef, were analyzed. A total of 16,467 women (ages 15-49 years) and 16,467 children (ages 0-59 months) were selected for the sample. Different statistical analyses, such as descriptive, crosstabs and binary logistic regression form the basis of this study. Child anthropometric indicators (i.e., wasting, stunting, underweight and BMI for age) were used as the dependent variables. SPSS Syntax from WHO was used to create anthropometric indicators. Different factors, such as child’s sex, child’s age groups, child’s diseases symptoms (i.e., diarrhea, cough and fever), maternal education, household wealth index and area of residence were used as independent variables. Results showed more than forty percent of Malian households were in nutritional crises (stunting (42%) and underweight (34%). Findings from logistic regression analyses indicated that low score of wealth index, low maternal education and experience of diarrhea in last two weeks increase the probability of child malnutrition.Keywords: Mali, wasting, stunting, underweight, BMI for age and wealth index
Procedia PDF Downloads 159950 Effect of Unilateral Unoperated Ovarian Endometrioma on Responsiveness to Hyperstimulation
Authors: Abdelmaguid Ramzy, Mohamed Bahaa
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Introduction: The effects of ovarian endometrioma on fertility outcomes with IVF have been always related to poor outcomes. Objective: To evaluate the effect of unilateral unoperated ovarian endometrioma < 2cm on the number of developing follicles and compare them with the contralateral ovary as a control. Design: Retrospective case control study. Setting: KasrEl-Aini IVF center. Patient(s): We studied 32 women with unilateral endometrioma who underwent their first IVF cycle. Methods: 32 Patients aged between 20-35 years selected for IVF who were diagnosed with one unilateral endometrioma (diameter <2 cm) and who did not undergo previous ovarian surgery were retrospectively identified. The number of follicles > 17 mm during folliculometry on the day of HCG trigger in the ovary that contained endometrioma were compared with those from the contralateral ovary. They were all hyperstimulated using long protocol with (225-300 IU) gonadotrophins. Primary outcome: The number of follicles > 17 mm during folliculometry on the day of HCG trigger. Result(s): The mean ± SD age, Day 3 serum FSH and LH were 27± 3.7 years, 5.8 ± 1.6 IU/ml and 4.5 ± 1.7 IU/ml respectively. There was no significant difference in the number of follicles > 17 mm on the day of HCG trigger in the ovary that contained endometrioma (4.4 ±2.5) and in the opposite ovary (4.5 ± 2.8) (P= 0.48). Conclusion: The presence of ovarian endometrioma in a controlled ovarian hyperstimulation cycle for IVF treatment is not associated with a reduced number of follicles > 17 mm during folliculometry on the day of HCG trigger.Keywords: endometrioma, folliculometry, hyperstimulation, fertility
Procedia PDF Downloads 210949 Perfectionism and its Impact on Body Image in Emerging Adults
Authors: Marianne John
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This study explores the complex relationship between perfectionism and body image among young adults, focusing on self-oriented, socially prescribed, and other-oriented dimensions of perfectionism. Using the Multidimensional Perfectionism Scale (MPS) and the Body Image Scale (BIS), data from 200 participants revealed moderate levels of perfectionism and body image concerns, with both scales showing significant deviations from normality. Gender comparisons indicated no significant difference in body image perceptions, suggesting comparable societal pressures across genders, but a significant difference in perfectionism scores, with women showing higher socially influenced perfectionism tendencies. Correlation analysis found no significant associations between self-oriented or socially prescribed perfectionism and body image perceptions; however, a weak yet significant negative correlation emerged between other-oriented perfectionism and body dissatisfaction, indicating that heightened expectations of others may relate to greater body image concerns. These findings emphasize the multidimensional nature of perfectionism and its nuanced relationship with body image, highlighting the need for gender-sensitive interventions and further exploration of mediating factors like self-esteem and coping strategies in future research.Keywords: perfectionism, body image, self-oriented, socially prescribed, other-oriented
Procedia PDF Downloads 13948 Influence of Entrepreneurial Passion in the Relationship between the Entrepreneurship Education and Entrepreneurial Intention: The Case of Moroccan Students
Authors: Soukaina Boutaky, Abdelhak Sahibeddine
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A study was carried out among students who have especially a scientific and technical educational background and who had opportunities to benefit from a program entrepreneurship course of 50 hours; at Higher School of Technology Khenifra, Morocco. This article has as a goal to explain the relationship between entrepreneurial education, entrepreneurial passion and entrepreneurial intention. The authors chose Bandura’s theory of social cognition as a theoretical framework. The modeling methods equation is adopted to analyze the hypotheses by SMART PLS for 188 students. The results show a strong positive relationship between entrepreneurial education and entrepreneurial passion. They also reveal that entrepreneurship education affects entrepreneurial intention through the effect of entrepreneurial passion, particularly among women than men. In addition, this study contributes in a theoretical way to the level of the relationship between entrepreneurial education and entrepreneurial passion, and these results provide educators and public decision-makers with advice on the importance of entrepreneurship training based on emotional traits such as passion; which constitutes a key and essential element to encourage young graduates to choose an entrepreneurial career as an alternative option or to develop entrepreneurial passion among the business leaders of tomorrow.Keywords: entrepreneurship education, entrepreneurial passion, entrepreneurial intention, equation modeling methods
Procedia PDF Downloads 194947 Evaluation of Anticancer and Antioxidant Activity of Purified Lovastatin from Aspergillus terreus (KM017963)
Authors: Bhargavi Santebennur Dwarakanath, Praveen Vadakke Kamath, Savitha Janakiraman
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Cervical cancer is one of the leading causes of mortality in women and is the second most common malignancy worldwide. Lovastatin, a non polar, anticholesterol drug which also exerts antitumour activity in vitro. In the present study, lovastatin from Aspergillus terreus (KM017963) was purified by adsoprtion chromatography and evaluated for its anticancer and anti-oxidant properties in human cervical cancer cell lines (HeLa). The growth inhibitory and proapoptotic effects of purified lovastatin on HeLa cell lines were investigated by determining its influence on cytotoxicity, Mitochondrial Membrane Potential (MMP), DNA fragmentation and antioxidant property (Hydroxy radical scavenging effect and the levels of total reduced glutathione). Flow cytometry analysis by propidium iodide staining confirmed the induction of apoptotic cell death and revealed cell cycle arrest at G0/G1 phase. Results of the study give leads for anticancer effects of lovastatin and its potential efficacy in the chemotherapy of cervical cancer.Keywords: apoptosis, Aspergillus terreus, cervical cancer, lovastatin
Procedia PDF Downloads 308946 Autoimmune Diseases Associated to Autoimmune Hepatitis: A Retrospective Study of 24 Tunisian Patients
Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia
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Introduction: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease of unknown cause. Concomitant autoimmune disorders have been described in 30–50% of patients with AIH. The aim of our study is to determine the prevalence and the type of autoimmune disorders associated with AIH. Material and Methods: It is a retrospective study over a period of 16 years (2000-2015) including all patients followed for AIH. The diagnosis of AHI was based on the criteria of the revised International AIH group scoring system (IAIHG). Results: Twenty-for patients (21 women and 3 men) followed for AIH were collected. The mean age was 39 years (17-65 years). Among these patients, 11 patients(45.8%) had at least one autoimmune disease associated to AIH. These diseases were Hashimoto's thyroiditis (n = 5), Gougerot Sjogren syndrome (n=5), Primary biliary cirrhosis (n=2), Primitive sclerosant Cholangitis (n=1), Addison disease (n = 1) and systemic sclerosis (n=1). Patients were treated with corticosteroids alone or with azathioprine associated to the specific treatment of associated diseases with complete remission of AIH in 90% of cases and clinical improvement of other diseases. Conclusion: In our study, the prevalence of autoimmune diseases in AIH patients was 45.8%. These diseases were dominated by autoimmune thyroiditis and Gougerot Sjogren syndrome. The investigation of autoimmune diseases in autoimmune hepatitis must be systematic because of their frequency and the importance of adequate management.Keywords: autoimmune diseases, autoimmune hepatitis, autoimmune thyroiditis, gougerot sjogren syndrome
Procedia PDF Downloads 266945 Socio-Economic Determinants of Physical Activity of Non-Manual Workers, Including the Early Senior Group, from the City of Wroclaw in Poland
Authors: Daniel Puciato, Piotr Oleśniewicz, Julita Markiewicz-Patkowska, Krzysztof Widawski, Michał Rozpara, Władysław Mynarski, Agnieszka Gawlik, Małgorzata Dębska, Soňa Jandová
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Physical activity as a part of people’s everyday life reduces the risk of many diseases, including those induced by lifestyle, e.g. obesity, type 2 diabetes, osteoporosis, coronary heart disease, degenerative arthritis, and certain types of cancer. That refers particularly to professionally active people, including the early senior group working on non-manual positions. The aim of the study is to evaluate the relationship between physical activity and the socio-economic status of non-manual workers from Wroclaw—one of the biggest cities in Poland, a model setting for such investigations in this part of Europe. The crucial problem in the research is to find out the percentage of respondents who meet the health-related recommendations of the World Health Organization (WHO) concerning the volume, frequency, and intensity of physical activity, as well as to establish if the most important socio-economic factors, such as gender, age, education, marital status, per capita income, savings and debt, determine the compliance with the WHO physical activity recommendations. During the research, conducted in 2013, 1,170 people (611 women and 559 men) aged 21–60 years were examined. A diagnostic poll method was applied to collect the data. Physical activity was measured with the use of the short form of the International Physical Activity Questionnaire with extended socio-demographic questions, i.e. concerning gender, age, education, marital status, income, savings or debts. To evaluate the relationship between physical activity and selected socio-economic factors, logistic regression was used (odds ratio statistics). Statistical inference was conducted on the adopted ex ante probability level of p<0.05. The majority of respondents met the volume of physical effort recommended for health benefits. It was particularly noticeable in the case of the examined men. The probability of compliance with the WHO physical activity recommendations was highest for workers aged 21–30 years with secondary or higher education who were single, received highest incomes and had savings. The results indicate the relations between physical activity and socio-economic status in the examined women and men. People with lower socio-economic status (e.g. manual workers) are physically active primarily at work, whereas those better educated and wealthier implement physical effort primarily in their leisure time. Among the investigated subjects, the youngest group of non-manual workers have the best chances to meet the WHO standards of physical activity. The study also confirms that secondary education has a positive effect on the public awareness on the role of physical activity in human life. In general, the analysis of the research indicates that there is a relationship between physical activity and some socio-economic factors of the respondents, such as gender, age, education, marital status, income per capita, and the possession of savings. Although the obtained results cannot be applied for the general population, they show some important trends that will be verified in subsequent studies conducted by the authors of the paper.Keywords: IPAQ, nonmanual workers, physical activity, socioeconomic factors, WHO
Procedia PDF Downloads 536944 The FINDRISC Score for Prediabetes and Diabetes Screening in Adult Libyan Males
Authors: Issam M Hajjaji, Adel Tajoury, Salah R Benhamid
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The MENA region has the highest prevalence of diabetes in the world. Various risk scores were developed, not all appropriate locally. The objective of this study is to apply the FINDRISC Score to adult Libyan males to determine its significance, sensitivity, specificity and Positive Predictive Values as an initial screening tool for type 2 diabetes, and suggest a cut-off point. Methods: 600 subjects answered the questionnaire at their place of work, and their waist, weight, height & BP were measured. Thereafter, after excluding those with known diabetes, an Oral Glucose Tolerance Test was done. Results: 414 subjects aged 19-78 completed the questionnaire and tests. 35 (8.4%) had impaired glucose tolerance (IGT) and 13 (3.1%) had diabetes (DM). The AUC-ROC for IGT was 0.614 (95% CI: 0.527-0.701), for DM 0.810 (95% CI: 0.709-0.911) and for both 0.689 (95% CI: 0.609-0.769). The Positive Predictive Value for a cut-off score of 5 were 15.5%, 11.7% & 5.7% for both conditions combined, prediabetes & diabetes respectively. The equivalent values for a cut-off score of 8 were 16.1%, 9.0% & 7.7%. The Negative Predictive Values were uniformly above 90%. Conclusions & Recommendations: The FINDRISC Score had a low predictive value for dysglycaemia in this sample and performed at a level of significance for IGT that is similar to other MENA countries, but did better for DM. A larger sample that included women is suggested, with a view of adjusting the Score to suit the local population.Keywords: diabetes, FINDRISK, Libya, prediabetes
Procedia PDF Downloads 128943 Assessing Students’ Attitudinal Response towards the Use of Virtual Reality in a Mandatory English Class at a Women’s University in Japan
Authors: Felix David
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The use of virtual reality (VR) technology is still in its infancy. This is especially true in a Japanese educational context with very little to no exposition of VR technology inside classrooms. Technology is growing and changing rapidly in America, but Japan seems to be lagging behind in integrating VR into its curriculum. The aim of this research was to expose 111 students from Hiroshima Jogakuin University (HJU) to seven classes that involved virtual reality content and assess students’ attitudinal responses toward this new technology. The students are all female, and they are taking the “Kiso Eigo/基礎英語” or “Foundation English” course, which is mandatory for all first-year and second-year students. Two surveys were given, one before the treatment and a second survey after the treatment, which in this case means the seven VR classes. These surveys first established that the technical environment could accommodate VR activities in terms of internet connection, VR headsets, and the quality of the smartphone’s screen. Based on the attitudinal responses gathered in this research, VR is perceived by students as “fun,” useful to “learn about the world,” as well as being useful to “learn about English.” This research validates VR as a worthy educational tool and should therefore continue being an integral part of the mandatory English course curriculum at HJU University.Keywords: virtual reality, smartphone, English learning, curriculum
Procedia PDF Downloads 67942 Ethnomedicinal Uses of Plants in Bridim Village Development Committee in Langtang National Park, Nepal
Authors: Ila Shrestha
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Bridim Village Development Committee (VDC) is one of the medicinal plants hot spots of Nepal. It is located on a ridge above the lower Langtang Khola, steep and narrow spot in between 1944 m to 4833 m altitude. The study area is homogeneously inhabited by Tamang communities. An investigation on folk herbal medicine on the basis of traditional uses of medicinal plants was done in 2014. The local traditional healers, elder men and women, traders and teachers, were consulted as key informants for documentation of indigenous knowledge on the medicinal plants. It was found that altogether seventy-one medicinal plant species belonging to sixty genera and thirty-three families were used by local people for twenty-seven diseases. Roots of thirty-four species were the most frequently used plant parts and bigger numbers of species were found to be used in fever of ten species. Most medicines were prepared in the form of juice of forty species. The attempt of the study was to document ethno medicinal practices to treat different diseases in the study area for conservation of indigenous knowledge.Keywords: Bridim village, ethnomedicine, national park, plants
Procedia PDF Downloads 299941 Role of Toll Like Receptor-2 in Female Genital Tuberculosis Disease Infection and Its Severity
Authors: Swati Gautam, Salman Akhtar, S. P. Jaiswar, Amita Jain
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Background: FGTB is now a major global health problem mostly in developing countries including India. In humans, Mycobacterium Tuberculosis (M.tb) is a causating agent of infection. High index of suspicion is required for early diagnosis due to asymptomatic presentation of FGTB disease. In macrophages Toll Like Receptor-2 (TLR-2) is one which mediated host’s immune response to M.tb. The expression of TLR-2 on macrophages is important to determine the fate of innate immune responses to M.tb. TLR-2 have two work. First its high expression on macrophages worsen the outer of infection and another side, it maintains M.tb to its dormant stage avoids activation of M.tb from latent phase. Single Nucleotide Polymorphism (SNP) of TLR-2 gene plays an important role in susceptibility to TB among different populations and subsequently, in the development of infertility. Methodology: This Case-Control study was done in the Department of Obs and Gynae and Department of Microbiology at King George’s Medical University, U.P, Lucknow, India. Total 300 subjects (150 Cases and 150 Controls) were enrolled in the study. All subjects were enrolled only after fulfilling the given inclusion and exclusion criteria. Inclusion criteria: Age 20-35 years, menstrual-irregularities, positive on Acid-Fast Bacilli (AFB), TB-PCR, (LJ/MGIT) culture in Endometrial Aspiration (EA). Exclusion criteria: Koch’s active, on ATT, PCOS, and Endometriosis fibroid women, positive on Gonococal and Chlamydia. Blood samples were collected in EDTA tubes from cases and healthy control women (HCW) and genomic DNA extraction was carried out by salting-out method. Genotyping of TLR2 genetic variants (Arg753Gln and Arg677Trp) were performed by using single amplification refractory mutation system (ARMS) PCR technique. PCR products were analyzed by electrophoresis on 1.2% agarose gel and visualized by gel-doc. Statistical analysis of the data was performed using the SPSS 16.3 software and computing odds ratio (OR) with 95% CI. Linkage Disequiliribium (LD) analysis was done by SNP stats online software. Results: In TLR-2 (Arg753Gln) polymorphism significant risk of FGTB observed with GG homozygous mutant genotype (OR=13, CI=0.71-237.7, p=0.05), AG heterozygous mutant genotype (OR=13.7, CI=0.76-248.06, p=0.03) however, G allele (OR=1.09, CI=0.78-1.52, p=0.67) individually was not associated with FGTB. In TLR-2 (Arg677Trp) polymorphism a significant risk of FGTB observed with TT homozygous mutant genotype (OR= 0.020, CI=0.001-0.341, p < 0.001), CT heterozygous mutant genotype (OR=0.53, CI=0.33-0.86, p=0.014) and T allele (OR=0.463, CI=0.32-0.66, p < 0.001). TT mutant genotype was only found in FGTB cases and frequency of CT heterozygous more in control group as compared to FGTB group. So, CT genotype worked as protective mutation for FGTB susceptibility group. In haplotype analysis of TLR-2 genetic variants, four possible combinations, i.e. (G-T, A-C, G-C, and A-T) were obtained. The frequency of haplotype A-C was significantly higher in FGTB cases (0.32). Control group did not show A-C haplotype and only found in FGTB cases. Conclusion: In conclusion, study showed a significant association with both genetic variants of TLR-2 of FGTB disease. Moreover, the presence of specific associated genotype/alleles suggest the possibility of disease severity and clinical approach aimed to prevent extensive damage by disease and also helpful for early detection of disease.Keywords: ARMS, EDTA, FGTB, TLR
Procedia PDF Downloads 308940 Perception of Reproductive Age Group Females of a Central University in India about Body Image
Authors: Rajani Vishal, C. P. Mishra
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Background: Self-perception of an individual about own body has a strong influence on their food preference and thereby on their nutritional status. Body image is gaining importance in social theory. Globally, women in particular seem to be favour of one ideal body type (Viz A slim, tall and perfectly proportionate body). Beauty and body image ideals among research scholars can play a significant influence on their own actions. Objectives: 1) To assess perception of study subjects about body image; 2)To analyze the relationship between body image and residential status of study subjects. Material and Method: 176 female research scholars of Banaras Hindu University were selected through multistage sampling. They were interviewed with pre designed and pre-tested proforma about area of residence and perception about body image. Result: As much as 86.4% subjects were happy with the way they looked whereas 83.0% subjects considered themselves as attractive. In case of 13.6%, 27.3%, 31.8%, 14.2% and 13.1% subjects, best-described body shapes were thin, normal, curvy, athletic and overweight, respectively. Area of residence was significantly (p< o.o5) associated with perception of attractiveness and description of body shape. Conclusion: In spite of varied description of body image, majority of subjects had positive perception about their body image.Keywords: attractiveness, body image, body shape, nutritional status
Procedia PDF Downloads 267939 Social Marketing – An Integrated and Comprehensive Nutrition Communication Strategy to Improve the Iron Nutriture among Preschool Children
Authors: Manjula Kola, K. Chandralekha
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Anaemia is one of the world’s most widespread health problems. Prevalence of anemia in south Asia is among the highest in the world. Iron deficiency anemia accounts for almost 85 percent of all types of anemia in India and affects more than half of the total population. Women of childbearing age particularly pregnant women, infants, preschool children and adolescents are at greatest risk of developing iron deficiency anemia. In India, 74 percent children between 6-35 months of age are anemic. Children between 1-6 years in major cities are found with a high prevalence rate of 64.8 percent. Iron deficiency anemia is not only a public health problem, but also a development problem. Its prevention and reduction must be viewed as investment in human capital that will enhance development and reduce poverty. Ending this hidden hunger in the form of iron deficiency is the most important achievable international health goal. Eliminating the underlying problem is essential to the sustained elimination of the iron deficiency anemia. The intervention programmes toward the sustained elimination need to be broadly based so that interventions become accepted community practices. Hence, intervention strategies need to go well beyond traditional health and nutrition systems and based upon empowering people and communities so that they will be capable of arranging for and sustaining an adequate intake of foods with respect to iron, independent of external support. Such strategies must necessarily be multisectoral and integrate interventions with social communications, evaluation and surveillance. The main objective of the study was to design a community based Nutrition intervention using theoretical framework of social marketing to sustain improvement of iron nutriture among preschool children. In order to carryout the study eight rural communities In Chittoor district of Andhra Pradesh, India were selected. A formative research was carryout for situational analysis and baseline data was generated with regard to demographic and socioeconomic status, dietary intakes, Knowledge, Attitude and Practices of the mothers of preschool children, clinical and hemoglobin status of the target group. Based on the formative research results, the research area was divides into four groups as experimental area I,II,III and control area. A community based, integrated and comprehensive social marketing intervention was designed based on various theories and models of nutrition education/ communication. In Experimental area I, Nutrition intervention using social marketing and a weekly iron folic acid supplementation was given to improve iron nutriture of preschool children. In experimental area II, Social marketing alone was implemented and in experimental area III Iron supplementation alone was given. No intervention was given in control area. The Impact evaluation revealed that among different interventions tested, the integrated social marketing intervention resulted best outcomes. The overall observations of the study state that social marketing, an integrated and functional strategy for nutrition communication to prevent and control iron deficiency. Various theoretical frame works / models for nutrition communication facilitate to design culturally appropriate interventions thus achieved improvements in the knowledge, attitude and practices there by resulting successful impact on nutritional status of the target groups.Keywords: anemia, iron deficiency, social marketing, theoretical framework
Procedia PDF Downloads 406938 Pre-Cancerigene Injuries Related to Human Papillomavirus: Importance of Cervicography as a Complementary Diagnosis Method
Authors: Denise De Fátima Fernandes Barbosa, Tyane Mayara Ferreira Oliveira, Diego Jorge Maia Lima, Paula Renata Amorim Lessa, Ana Karina Bezerra Pinheiro, Cintia Gondim Pereira Calou, Glauberto Da Silva Quirino, Hellen Lívia Oliveira Catunda, Tatiana Gomes Guedes, Nicolau Da Costa
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The aim of this study is to evaluate the use of Digital Cervicography (DC) in the diagnosis of precancerous lesions related to Human Papillomavirus (HPV). Cross-sectional study with a quantitative approach, of evaluative type, held in a health unit linked to the Pro Dean of Extension of the Federal University of Ceará, in the period of July to August 2015 with a sample of 33 women. Data collecting was conducted through interviews with enforcement tool. Franco (2005) standardized the technique used for DC. Polymerase Chain Reaction (PCR) was performed to identify high-risk HPV genotypes. DC were evaluated and classified by 3 judges. The results of DC and PCR were classified as positive, negative or inconclusive. The data of the collecting instruments were compiled and analyzed by the software Statistical Package for Social Sciences (SPSS) with descriptive statistics and cross-references. Sociodemographic, sexual and reproductive variables were analyzed through absolute frequencies (N) and their respective percentage (%). Kappa coefficient (κ) was applied to determine the existence of agreement between the DC of reports among evaluators with PCR and also among the judges about the DC results. The Pearson's chi-square test was used for analysis of sociodemographic, sexual and reproductive variables with the PCR reports. It was considered statistically significant (p<0.05). Ethical aspects of research involving human beings were respected, according to 466/2012 Resolution. Regarding the socio-demographic profile, the most prevalent ages and equally were those belonging to the groups 21-30 and 41-50 years old (24.2%). The brown color was reported in excess (84.8%) and 96.9% out of them had completed primary and secondary school or studying. 51.5% were married, 72.7% Catholic, 54.5% employed and 48.5% with income between one and two minimum wages. As for the sexual and reproductive characteristics, prevailed heterosexual (93.9%) who did not use condoms during sexual intercourse (72.7%). 51.5% had a previous history of Sexually Transmitted Infection (STI), and HPV the most prevalent STI (76.5%). 57.6% did not use contraception, 78.8% underwent examination Cancer Prevention Uterus (PCCU) with shorter time interval or equal to one year, 72.7% had no cases of Cervical Cancer in the family, 63.6% were multiparous and 97% were not vaccinated against HPV. DC identified good level of agreement between raters (κ=0.542), had a specificity of 77.8% and sensitivity of 25% when compared their results with PCR. Only the variable race showed a statistically significant association with CRP (p=0.042). DC had 100% acceptance amongst women in the sample, revealing the possibility of other experiments in using this method so that it proves as a viable technique. The DC positivity criteria were developed by nurses and these professionals also perform PCCU in Brazil, which means that DC can be an important complementary diagnostic method for the appreciation of these professional’s quality of examinations.Keywords: gynecological examination, human papillomavirus, nursing, papillomavirus infections, uterine lasmsneop
Procedia PDF Downloads 303937 Femicide in the News: Jewish and Arab Victims and Culprits in the Israeli Hebrew Media
Authors: Ina Filkobski, Eran Shor
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This article explores how newspapers cover murder of women by family members and intimate partners. Three major Israeli newspapers were compared in order to analyse the coverage of Jewish and Arab victims and culprits and to examine whether and in what ways the media contribute to the construction of symbolic boundaries between minority and dominant social groups. A sample of some 459 articles that were published between 2013 and 2015 was studied using a systematic qualitative content analysis. Our findings suggest that the treatment of murder cases by the media varies according to the ethnicity of both victims and culprits. The murder of Jews by family members or intimate partners was framed as a shocking and unusual event, a result of the individual personality or pathology of the culprit. Conversely, when Arabs were the killers, murders were often explained by focusing on the culture of the ethnic group, described as traditional, violent, and patriarchal. In two-thirds of the cases in which Arabs were involved, so-called ‘honor killing’ or other cultural explanations were proposed as the motive for the murder. This was often the case even before a suspect was detected, while police investigation was at its very early stages, and often despite forceful denials from victims’ families. In case of Jewish culprits, more than half of the articles in our sample suggested mental disorder to explain the acts and cultural explanations were almost entirely absent. Beyond the emphasis on psychological vs. cultural explanations, newspaper articles also tend to provide much more detail about Jewish culprits than about Arabs. Such detailed examinations convey a desire to make sense of the event by understanding the supposedly unique and unorthodox nature of the killer. The detailed accounts were usually absent from the reports on Arab killers. Thus, even if reports do not explicitly offer cultural motivations for the murder, the fact that reports often remain laconic leaves people to draw their own conclusions, which would then be likely based on existing cognitive scripts and previous reports on family murders among Arabs. Such treatment contributes to the notion that Arab and Muslim cultures, religions, and nationalities are essentially misogynistic and adhere to norms of honor and shame that are radically different from those of modern societies, such as the Jewish-Israeli one. Murder within the family is one of the most dramatic occurrences in the social world, and in societies that see themselves as modern it is a taboo; an ultimate signifier of danger. We suggest that representations of murder provide a valuable prism for examining the construction of group boundaries. Our analysis, therefore, contributes to the scholarly effort to understand the creation and reinforcement of symbolic boundaries between ‘society’ and its ‘others’ by systematically tracing the media constructions of ‘otherness’. While our analysis focuses on Israel, studies on the United States, Canada, and various European countries with ethnically and racially heterogeneous populations, make it clear that the stigmatisation and exclusion of visible, religious, and language minorities are not unique to the Israeli case.Keywords: comparative study of media coverege of minority and majority groups, construction of symbolic group boundaries, murder of women by family members and intimate partners, Israel, Jews, Arabs
Procedia PDF Downloads 187936 Effect of Reflective Practices on the Performance of Prospective Teachers
Authors: Madiha Zahid, Afifa Khanam
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The present study aims to investigate the effect of reflective teaching practices on prospective teachers’ performance. Reflective teaching practice helps teachers to plan, implement and improve their performance by rethinking about their strengths and weaknesses. An action research was conducted by the researcher. All prospective teachers of sixth semester in a women university’s teacher education program were the population of the study. From 40 students, 20 students were taken as experimental group, and the rest of 20 students were taken as control group. During the action research a cyclic process of producing a module, training teachers for the reflective practices and then observing them during their class for reflective practice was done by the researchers. The research used a set of rubrics and checklists for assessing prospective teachers’ performance during their class. Finally, the module was modified with the help of findings. It was found that the training has improved the performance of teachers as they revised and modified their teaching strategies through reflective practice. However, they were not able to train their students for reflective practice as per expectation. The study has implications for teacher training programs to include reflective practice modules as part of their course work for making them better teachers.Keywords: reflective practices, prospective teacher, effect, performance
Procedia PDF Downloads 176935 The Links between Cardiovascular Risk and Psychological Wellbeing in Elderly
Authors: Laura Sapranaviciute-Zabazlajeva, Abdonas Tamosiunas, Dalia Luksiene, Dalia Virviciute
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The cardiovascular diseases (CVD) is the leading cause of death in the EU, especially in the middle aged and elderly population. Psychological wellbeing (PWB) has been linked with better cardiovascular health and survival in the elderly. The aim of the study is to evaluate associations between CVD risk and PWB in middle-aged and elderly population. 10,940 middle aged and older Lithuanians of age 45-74 years, were invited to participate in the study. A study sample was a random and stratified by gender and age. In 2006-2008 7,087 responders participated in the survey, so the response rate was 64.8%. A follow-up study was conducted from 2006 till 2015. New CVD cases and deaths from CVD were evaluated using the Kaunas population-based CVD register and death register of Kaunas. Study results revealed that good PWB predicts longer life in female participants (Log Rank = 13.7, p < 0.001). In the fully adjusted model for socio-demographic, social and CVD risk factors, hazard ratio for CVD mortality risk was lower amongst women with good PWB (HR = 0.28, 95% CI 0.11-0.72), but not significantly for men. Our study concludes, that lower CVD mortality rates is being associated with better PWB in female aged 45-74 years.Keywords: psychological well-being, cardiovascular disease, elderly, survival
Procedia PDF Downloads 362934 Gender Discrepancies in Current Pedagogical and Curricular Practices in EFL Higher Education Settings
Authors: Hamad Aldosari
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The purpose of this study is to investigate the status of sexism, or gender discrepancies, in current pedagogical and curricular practices in EFL learning higher education settings. Qualitative and quantitative analyses of both course contents and pedagogies in Saudi higher education institutions are to be discussed with reference to female/male topic presentation in dialogs and reading passages, sex-based activity types, stereotyped sex roles and the masculine generic conceptions of male superiority subliminally related in EFL curriculum and pedagogical practices, as well as the causes and effects of segregated language education practices in Saudi Arabia from a holistic vantage point of analysis. Analysis findings show that language educational practices including educational settings and segregation are gender-biased in attitude, but with regard to curriculum, sexism has not been traced. Findings also show that sexism is rampant due to socio-cultural aspects of language education rather than to religious reasons: a finding that seems to mirror the institutionalized unfair sex discrimination to the disadvantage of women in the Arabian societies at large.Keywords: genderism, sex segregation, Saudi Arabia, EFL
Procedia PDF Downloads 283933 Social Representations: Unplanned and Unwanted Pregnancy in Adolescents from Leon-Mexico
Authors: Alejandra Sierra, Maria de los Angeles Covarrubias, Guillermo Julian Gonzalez, Noe Alfaro
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The objective of this study was to identify the cultural dimensions of the terms unplanned pregnancy and unwanted pregnancy built by adolescent women, through the focus of the social representations. Two associative methods were used: free listings and the paired comparison. 72 female students between the ages of 15 and 19 were interviewed, from the downtown area of Leon Guanajuato, Mexico. Words related to inducer terms were classified into five thematic categories: facilitators, consequences, reactions, expectations, and lexicon. The results showed that the social representations of unplanned pregnancy highlighted elements related to economic difficulties and negative emotional aspects, while unwanted pregnancy was associated with negative emotional aspects such as anger, anxiety, and sadness. The meanings each person attributes to terms related to pregnancy are culturally constructed and differ between populations; therefore, more attention should be paid to understanding the cultural meanings and attitudes of people in fertility decision-making, including also the views of adolescent men and other types of population, stratified by age groups and social conditions.Keywords: adolescent, qualitative research, unplanned pregnancy, unwanted pregnancy
Procedia PDF Downloads 213932 Outcome of Induction of Labour by Cervical Ripening with an Osmotic Dilator in a District General Hospital
Authors: A. Wahid Uddin
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Osmotic dilator for cervical ripening bypasses the initial hormonal exposure necessary for a routine method of induction. The study was a clinical intervention with an osmotic dilator followed by prospective observation. The aim was to calculate the percentage of women who had successful cervical ripening using modified BISHOP score as evidenced by artificial rupture of membrane. The study also estimated the delivery interval following a single administration of osmotic dilators. Randomly selected patients booked for induction of labour accepting the intervention were included in the study. The study population comprised singleton term pregnancy, cephalic presentation, intact membranes with a modified BISHOP score of less than 6. Initial sample recruited was 30, but 6 patients left the study and the study was concluded on 24 patients. The data were collected in a pre-designed questionnaire and analysis were expressed in percentages along with using mean value for continuous variables. In 70 % of cases, artificial rupture of the membrane was possible and the mean time from insertion of the osmotic dilator to the delivery interval was 30 hours. The study concluded that an osmotic dilator could be a suitable alternative for hormone-based induction of labour.Keywords: dilator, induction, labour, osmotic
Procedia PDF Downloads 139931 The Influence of Gender and Harmful Alcohol Consumption on Academic Performance in Spanish University Students
Authors: M. S. Rodríguez, F. Cadaveira, M. F. Páramo
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First year university students comprise one of the groups most likely to indulge in hazardous alcohol consumption. The transition from secondary school to university presents a range of academic, social and developmental challenges requiring new responses that will meet the demands of this highly competitive environment. The main purpose of this research was to analyze the influence of gender and hazardous alcohol consumption on academic performance of 300 university students in Spain in a three-year follow-up study. Alcohol consumption was measured using the Alcohol Use Identification Test (AUDIT), and the average university grades were provided by the Academic Management Services of the University. Analysis of variance showed that the level of alcohol consumption significantly affected academic performance. Students undertaking hazardous alcohol consumption obtained the lowest grades during the first three years at university. These effects were particularly marked in the sample of women with a hazardous pattern of alcohol consumption, although the interaction between gender and this type of consumption was not significant. The study highlights the impact of hazardous alcohol consumption on the academic trajectory of university students. The findings confirm that alcohol consumption predicts poor academic performance in first year students and that the low level of performance is maintained throughout the university career.Keywords: academic performance, alcohol consumption, gender, university students
Procedia PDF Downloads 312930 Dizziness in the Emergency: A 1 Year Prospective Study
Authors: Nouini Adrâa
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Background: The management of dizziness and vertigo can be challenging in the emergency department (ED). It is important to rapidly diagnose vertebrobasilar stroke (VBS), as therapeutic options such as thrombolysis and anticoagulation require prompt decisions. Objective: This study aims to assess the rate of misdiagnosis in patients with dizziness caused by VBS in the ED. Methods and Results: The cohort was comprised of 82 patients with a mean age of 55 years; 51% were women and 49% were men. Among dizzy patients, 15% had VBS. We used Cohen’s kappa test to quantify the agreement between two raters – namely, emergency physicians and neurologists – regarding the causes of dizziness in the ED. The agreement between emergency physicians and neurologists is low for the final diagnosis of central vertigo disorders and moderate for the final diagnosis of VBS. The sensitivity of ED clinal examination for benign conditions such as BPPV was low at 56%. The positive predictive value of the ED clinical examination for VBS was also low at 50%. Conclusion: There is a substantial rate of misdiagnosis in patients with dizziness caused by VBS in the ED. To reduce the number of missing diagnoses of VBS in the future, there is a need to train emergency physicians in neuro vestibular examinations, including the HINTS examination for acute vestibular syndrome (AVS) and the Dix-Hallpike (DH) maneuver for episodic vestibular syndrome. Using video head impulse tests could help reduce the rate of misdiagnosis of VBS in the ED.Keywords: dizziness, vertigo, vestibular disease, emergency
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