Search results for: metabolic syndrome index

Authors: P. Pasomboon, P. Chumnanpuen, T. E-kobon

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Hyaluronic acid (HA) consists of linear heteropolysaccharides repeat of D-glucuronic acid and N-acetyl-D-glucosamine. HA has various useful properties to maintain skin elasticity and moisture, reduce inflammation, and lubricate the movement of various body parts without causing immunogenic allergy. HA can be found in several animal tissues as well as in the capsule component of some bacteria including Pasteurella multocida. This study aimed to modify a genome-scale metabolic model of Escherichia coli using computational simulation and flux analysis methods to predict HA productivity under different carbon sources and nitrogen supplement by the addition of two enzymes (GLMU2 and HYAD) from P. multocida to improve the HA production under the specified amount of carbon sources and nitrogen supplements. Result revealed that threonine and aspartate supplement raised the HA production by 12.186%. Our analyses proposed the genome-scale metabolic model is useful for improving the HA production and narrows the number of conditions to be tested further.

Keywords: Pasteurella multocida, Escherichia coli, hyaluronic acid, genome-scale metabolic model, bioinformatics

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Authors: Nayera E. Hassan, Sahar A. El-Masry, Mones M. Abu Shady, Rokia A. El Banna, Muhammad Al-Tohamy, Mehrevan M. Abd El-Moniem, Mona Anwar

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Circulating oxidized LDL (ox-LDL) is associated with obesity, insulin resistance (HOMA), metabolic syndrome, and cardiovascular disease in adults. Little is known about relations in children. Aim: To assess association of ox-LDL with fat distribution and insulin resistance in a group of obese Egyptian children. Methods: Study is cross-sectional consisting of 68 obese children, with a mean age of 9.96 ± 1.32. Each underwent a complete physical examination; blood pressure (SBP, DBP) and anthropometric measurements (weight, height, BMI; waist, hip circumferences, waist/hip ratio), biochemical tests of fasting blood glucose (FBS), insulin levels; lipid profile (TC, LDL,HDL, TG) and ox-LDL; calculated HOMA. Sample was classified according to waist/hip ratio into: group I with and group II without central obesity. Results: ox-LDL showed significant positive correlation with LDL and TC in all groups of obesity. After adjustment for age and sex, significant positive correlation was detected between ox-LDL with SBP, DBP, TC, LDL, insulin, and HOMA in group II and with TC and FBS in group I. Insignificant association was detected between ox-LDL and other anthropometric parameters including BMI in any group of obese children (p > 0.05). Conclusions: ox-LDL, as a marker of oxidative stress is not correlated with BMI among all studied obese children (aged 6-12 years). Increased oxidative stress has causal effects on insulin resistance in obese children without central obesity and on fasting blood sugar in those with central obesity. These findings emphasize the importance of obesity during childhood and suggest that the metabolic complications of obesity and body fat distribution are detectable early in life.

Keywords: ox-LDL, obesity, insulin resistance, children

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Authors: Ruolan Zhou

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Trisomy of human chromosome 21 is the primary cause of Down Syndrome (DS), and this genetic disease has significantly burdened families and countries, causing great controversy. To address this problem, the research takes an approach in exploring the relationship between genetic abnormality and this disease's symptoms, adopting several techniques, including data analysis and enrichment analysis. It also explores open-source websites, such as NCBI, DAVID, SOURCE, STRING, as well as UCSC, to complement its result. This research has analyzed the variety of genes on human chromosome 21 with simple coding, and by using analysis, it has specified the protein-coding genes, their function, and their location. By using enrichment analysis, this paper has found the abundance of keratin production-related coding-proteins on human chromosome 21. By adopting past researches, this research has attempted to disclose the relationship between trisomy of human chromosome 21 and keratin production abnormality, which might be the reason for common diseases in patients with Down Syndrome. At last, by addressing the advantage and insufficiency of this research, the discussion has provided specific directions for future research.

Keywords: Down Syndrome, protein production, genome, enrichment analysis

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Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

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Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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Authors: Somayeh Khanjani, Samaneh Nabavi, Shirin Jalili

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Aluminum phosphide (ALP) is an inorganic phosphide used to control insects and is a highly effective insecticide and rodenticide used frequently to protect stored grain. Acute poisoning with this compound is common in some countries including India and Iran, and is a serious health problem. In Iran it was known as "rice tablet", for its use to preserve rice. Two kinds of rice tablets one being herbal while other containing 3g aluminum phosphide (AlP) are available for use in Iranian households to protect stored food grains from pests and rodents. The toxicity of Aluminum phosphide is attributed to the liberation of phosphine gas in contact with water or weak acid and is the major cause of poisoning and deaths. Rice tablet (Aluminum Phosphid) poisoning may be associated with serious and sometimes incurable complications. In 61.3% of patients were shown uniform ingestion. Vomiting was the most common symptoms reported by 96.4% patients. Agitation was reported in 36.9% and felling of thirsty in 27.9 %. Although many complications such as Hypotension, Adult Respiratory Distress Syndrome (ARDS), Acute Renal Failure (ARF) AND Multi Organ Failure (MOF) were the common complications observed in these patients, but the most lethal complication was Cardiac Arrhythmias occurred in 36.9% of cases. Abdominal pain in 31.4% of the patients, nausea in 79.4% of the patients and 41.1% of the patients showed metabolic acidosis. Suicidal intention was the most common cause of poisoning leading to deaths in 18.6% of the patients. Aluminum phosphide can cause either elevation, decrease or no change in electrolytes, bicarbonate and blood glucose level. The possible mechanism for changes in blood glucose levels are complex and depend on the balance of factors which increase its concentration and those which reduce it. AlP poisoning has been postulated to stimulate cortisol which leads to increasing blood level of cortisol, also it may cause stimulation of glucagon, and Adrenaline secretion; in addition, it can inhibit insulin synthesis which may lead to hyperglycemia. Another suggested mechanism of hyperglycemia is rennin activity in some cases, an increase in magnesium level of plasma and that of tissues, and high phosphate level. Although hyperglycemia is most frequent in this poisoning and also is known as a marker of poor prognostic, hypoglycemia in aluminum phosphide poisoning is a rare finding which may be so dangerous. Patients showed sever hypotension and sever acidosis in addition to sever hypoglycemia. The presenting features of AlP intoxication are rapid onset of shock, severe metabolic acidosis, cardiac dysrhythmias and adult respiratory distress syndrome (ARDS).

Keywords: aluminum phosphide (ALP), rice tablet, poisoning, phosphine gas

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Authors: Fangfang Wang, Fan Qu

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Polycystic ovary syndrome (PCOS), the most common endocrinopathy among women of reproductive age, is characterized by ovarian dysfunction, hyperandrogenism and reduced fecundity. The aim of this study is to investigate whether the circadian disruption is involved in pathogenesis of PCOS in androgen-induced animal model. We established a rat model of PCOS using single subcutaneous injection with testosterone propionate on the ninth day after birth, and confirmed their PCOS-like phenotypes with vaginal smears, ovarian hematoxylin and eosin (HE) staining and serum androgen measurement. The control group rats received the vehicle only. Gene expression was detected by real-time quantitative PCR. (1) Compared with control group, PCOS model rats of 10-week group showed persistently keratinized vaginal cells, while all the control rats showed at least two consecutive estrous cycles. (2) Ovarian HE staining and histological examination showed that PCOS model rats of 10-week group presented many cystic follicles with decreased numbers of granulosa cells and corpora lutea in their ovaries, while the control rats had follicles with normal layers of granulosa cells at various stages of development and several generations of corpora lutea. (3) In the 10-week group, serum free androgen index was notably higher in PCOS model rats than controls. (4) Disturbed mRNA expression patterns of core clock genes were found in ovaries of PCOS model rats of 10-week group. Abnormal expression of key genes associated with circadian rhythm in ovary may be one of the mechanisms for ovarian dysfunction in PCOS model rats induced by androgen.

Keywords: polycystic ovary syndrome, androgen, animal model, circadian disruption

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Authors: A. Bruce Janati, Muhammad Umair Khan, Naif Alghassab, Ibrahim Alzeir, Assem Mahmoud, M. Sammour

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Rationale: Lennox-Gastaut syndrome(LGS) is an electro-clinical syndrome composed of the triad of mental retardation, multiple seizure types, and the characteristic generalized slow spike-wave complexes in the EEG. In this article, we report on two patients with LGS whose brain MRI showed dysgenesis of corpus callosum(CC). We review the literature and stress the role of CC in the genesis of secondary bilateral synchrony(SBS). Method: This was a clinical study conducted at King Khalid Hospital. Results: The EEG was consistent with LGS in patient 1 and unilateral slow spike-wave complexes in patient 2. The MRI showed hypoplasia of the splenium of CC in patient 1, and global hypoplasia of CC combined with Joubert syndrome in patient 2. Conclusion: Based on the data, we proffer the following hypotheses: 1-Hypoplasia of CC interferes with functional integrity of this structure. 2-The genu of CC plays a pivotal role in the genesis of secondary bilateral synchrony. 3-Electrodecremental seizures in LGS emanate from pacemakers generated in the brain stem, in particular the mesencephalon projecting abnormal signals to the cortex via thalamic nuclei. 4-Unilateral slow spike-wave complexes in the context of mental retardation and multiple seizure types may represent a variant of LGS, justifying neuroimaging studies.

Keywords: EEG, Lennox-Gastaut syndrome, corpus callosum , MRI

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Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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Authors: Ahmed M. F. El Shiwi

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Background: Low back pain affects about 60% to 90% of the working-age population in modern industrial society. Myofascial pain syndrome is a condition characterized by muscles shortening with increased tone and associated with trigger points that aggravated with the activity of daily living. Purpose: To examine the effects of magnetic field therapy in patients with lower back myofascial pain syndrome. Methods: Thirty patients were assigned randomly into two groups. Subjects in the experimental group (n=15) with main age of 36.73 (2.52) received traditional physical therapy program (Infrared radiation, ultrasonic, stretching and strengthening exercises for back muscles) as well as magnetic field, and control group (n=15) with main age of 37.27 (2.52) received traditional physical therapy only. The following parameters including pain severity, functional disability and lumbar range of motion (flexion, extension, right side bending, and left side bending) were measured before and after four weeks of treatment. Results: The results showed significant improvement in all parameters in the experimental group compared with those in the control group. Interpretation/Conclusion: By the present date, it is possible to conclude that a magnetic field is effective as a method of treatment for lower back myofascial pain syndrome patients with the parameters used in the present study.

Keywords: magnetic field, lower back pain, myofascial pain syndrome, biological systems engineering

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Authors: N. Fuad, M. N. Taib, R. Jailani, M. E. Marwan

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In this paper, the comparison between k-Nearest Neighbor (kNN) algorithms for classifying the 3D EEG model in brain balancing is presented. The EEG signal recording was conducted on 51 healthy subjects. Development of 3D EEG models involves pre-processing of raw EEG signals and construction of spectrogram images. Then, maximum PSD values were extracted as features from the model. There are three indexes for the balanced brain; index 3, index 4 and index 5. There are significant different of the EEG signals due to the brain balancing index (BBI). Alpha-α (8–13 Hz) and beta-β (13–30 Hz) were used as input signals for the classification model. The k-NN classification result is 88.46% accuracy. These results proved that k-NN can be used in order to predict the brain balancing application.

Keywords: power spectral density, 3D EEG model, brain balancing, kNN

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Authors: A. Sathiya Susuman, Hamisi F. Hamisi

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Background: Many socio-economic and demographic data are age-sex attributed. However, a variety of irregularities and misstatement are noted with respect to age-related data and less to sex data because of its biological differences between the genders. Noting the misstatement/misreporting of age data regardless of its significance importance in demographics and epidemiological studies, this study aims at assessing the quality of 2012 Tanzania Population and Housing Census Results. Methods: Data for the analysis are downloaded from Tanzania National Bureau of Statistics. Age heaping and digit preference were measured using summary indices viz., Whipple’s index, Myers’ blended index, and Age-Sex Accuracy index. Results: The recorded Whipple’s index for both sexes was 154.43; male has the lowest index of about 152.65 while female has the highest index of about 156.07. For Myers’ blended index, the preferences were at digits ‘0’ and ‘5’ while avoidance were at digits ‘1’ and ‘3’ for both sexes. Finally, Age-sex index stood at 59.8 where sex ratio score was 5.82 and age ratio scores were 20.89 and 21.4 for males and female respectively. Conclusion: The evaluation of the 2012 PHC data using the demographic techniques has qualified the data inaccurate as the results of systematic heaping and digit preferences/avoidances. Thus, innovative methods in data collection along with measuring and minimizing errors using statistical techniques should be used to ensure accuracy of age data.

Keywords: age heaping, digit preference/avoidance, summary indices, Whipple’s index, Myer’s index, age-sex accuracy index

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Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

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Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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Authors: Mahmoud Eldeeb, Yousri Mohamed

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Background: May-Thurner Syndrome (MTS) is a rare vascular condition caused by the compression of the left common iliac vein by the overlying right common iliac artery, leading to venous stasis and an increased risk of deep vein thrombosis (DVT). While MTS typically presents in young adults, its diagnosis is often delayed due to its nonspecific presentation, which can lead to catastrophic complications like massive pulmonary embolism (PE). Early recognition and intervention are paramount to prevent fatal outcomes. Objectives: Highlight the importance of early recognition and management of critically ill patients presenting with life- and limb-threatening conditions. Raise awareness of May-Thurner Syndrome as a rare but significant cause of extensive DVT in young adults. Emphasize the necessity of a multidisciplinary approach to managing complex vascular emergencies. Methodology: A 21-year-old female presented with a 7-day history of progressive left leg swelling, pain, and skin discoloration following immobilization due to gastroenteritis. Clinical suspicion for massive DVT and compartment syndrome prompted immediate initiation of a heparin bolus and referrals to vascular and orthopedic surgery teams. Bedside Doppler ultrasound confirmed extensive DVT, and subsequent CT venography revealed thrombi extending to the inferior vena cava, consistent with MTS. Despite anticoagulation therapy, angioplasty and stenting were required to restore venous patency. Tragically, the patient experienced a massive PE during the procedure, requiring cardiopulmonary resuscitation (CPR) and transfer to a tertiary center for cardiothoracic intervention. Results: The case highlights the aggressive and life-threatening progression of MTS. The patient’s presentation was characterized by massive DVT with severe pain and discoloration, rapidly culminating in a PE during intervention. The combination of bedside imaging and CT venography facilitated an accurate diagnosis. Despite timely management, the patient’s course underscores the high mortality risk associated with MTS-related thromboembolism. Conclusion: May-Thurner Syndrome, though rare, can lead to devastating complications in young adults if not promptly recognized and treated. This case emphasizes the need for a high index of suspicion in patients presenting with unexplained extensive DVT, especially in the context of limited mobility or other precipitating factors. Multidisciplinary collaboration, including vascular imaging, anticoagulation, and interventional procedures, is critical to optimize outcomes. Urgent recognition and treatment of MTS are vital to prevent progression to massive PE and death.

Keywords: may-thurner syndrome, deep venous thrombosis, pulmonary embolism, vascular emergency, iliac vein compression syndrome

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Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

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47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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Authors: Rong Guo, Mengshi Huang, Yujing Bai

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With the rapid development of urbanization, the urban population increases and urban sprawl appeared. And these issues led to a sharp deterioration of the ecological environment. So, the urban ecological security evaluation was imminent. The weights identify of index was a key step of the research of ecological security evaluation. The AHP was widely used in the extensive research of weights identify of ecological security index. The characteristics of authority and quantitative can fully reflect the views of relevant experts. On the basis of building the ecological security evaluation index of Harbin, the paper combed and used the basic principle of the AHP, and calculated the weights of Harbin ecological security evaluation index through the process of the expert opinions “summary-feedback-summary”. And lay a foundation of future study of Harbin ecological security index, and guide the quantitative evaluation of Harbin ecological security.

Keywords: AHP, ecological security, evaluation Index, weights identify, harbin

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Authors: Encarnación Álvarez, Rosa M. García-Fernández, Juan F. Muñoz, Francisco J. Blanco-Encomienda

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The problem of estimating a proportion has important applications in the field of economics, and in general, in many areas such as social sciences. A common application in economics is the estimation of the headcount index. In this paper, we define the general headcount index as a proportion. Furthermore, we introduce a new quantitative method for estimating the headcount index. In particular, we suggest to use the logistic regression estimator for the problem of estimating the headcount index. Assuming a real data set, results derived from Monte Carlo simulation studies indicate that the logistic regression estimator can be more accurate than the traditional estimator of the headcount index.

Keywords: poverty line, poor, risk of poverty, Monte Carlo simulations, sample

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Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

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High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

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Authors: Sachin Singh, Thomas Penzel, Dinesh Nandan

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Accurate identification of Sleep Apnea Hypopnea Syndrom Diagnosis is difficult problem for human expert because of variability among persons and unwanted noise. This paper proposes the diagonosis of Sleep Apnea Hypopnea Syndrome (SAHS) using airflow, ECG, Pulse and SaO2 signals. The features of each type of these signals are extracted using statistical methods and ANN learning methods. These extracted features are used to approximate the patient's Apnea Hypopnea Index(AHI) using sample signals in model. Advance signal processing is also applied to snore sound signal to locate snore event and SaO2 signal is used to support whether determined snore event is true or noise. Finally, Apnea Hypopnea Index (AHI) event is calculated as per true snore event detected. Experiment results shows that the sensitivity can reach up to 96% and specificity to 96% as AHI greater than equal to 5.

Keywords: neural network, AHI, statistical methods, autoregressive models

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Authors: Lizhou Chen, Abdelhamid Belgaid, Assem Elsayed, Xiaoming Yang

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Compression index is essential in foundation settlement calculation. The traditional method for determining compression index is consolidation test which is expensive and time consuming. Many researchers have used regression methods to develop empirical equations for predicting compression index from soil properties. Based on a large number of compression index data collected from consolidation tests, the accuracy of some popularly empirical equations were assessed. It was found that primary compression index is significantly overestimated in some equations while it is underestimated in others. The sensitivity analyses of soil parameters including water content, liquid limit and void ratio were performed. The results indicate that the compression index obtained from void ratio is most accurate. The ANOVA (analysis of variance) demonstrates that the equations with multiple soil parameters cannot provide better predictions than the equations with single soil parameter. In other words, it is not necessary to develop the relationships between compression index and multiple soil parameters. Meanwhile, it was noted that secondary compression index is approximately 0.7-5.0% of primary compression index with an average of 2.0%. In the end, the proposed prediction equations using power regression technique were provided that can provide more accurate predictions than those from existing equations.

Keywords: compression index, clay, settlement, consolidation, secondary compression index, soil parameter

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Authors: Maria Francesca Lavadia-Gumabao, Mary Antoinette Salvamante-Torallo

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Introduction: The fibrous intrauterine adhesions forming inside the uterus and/or cervix in Asherman syndrome can obstruct the internal cervical orifice and may present as a case of outflow tract obstruction. Asherman syndrome is often overlooked since it has no specific presentation and is undetectable by routine physical examinations or diagnostic procedures such as an ultrasound. This paper highlights the delay and elusive diagnosis of Asherman syndrome which negatively impacted the patient’s fertility and quality of life. Case presentation: A 33-year-old woman (gravida 3, para 3) who presented with secondary amenorrhea for thirteen years associated with cyclic pelvic pain and secondary infertility sought a consultation at our institution for evaluation and specialty management. The patient had no other well-established risk factors for Asherman syndrome aside from pregnancy. For more than a decade, she delayed seeking medical care. At presentation, history taking, physical examination, and ultrasound were not helpful in identifying the cause of outflow tract obstruction. Diagnostic hysteroscopy was then performed, during which extensive scarring and fibrosis completely obscured the internal cervical orifice were observed, consistent with the diagnosis of Asherman syndrome (Grade 5B). The patient then underwent ultrasound guided hysteroscopy outflow tract dilatation and responded well to the treatment as she had her menstrual period a month after the procedure and no longer had cyclic pelvic pain with a repeat ultrasound finding of an unremarkable uterus. The hispathology result of the tissues retrieved revealed myometrial fragments with associated old hemorrhage benign endometrial stromal tissues, which failed to show endometrial glands. Conclusion: The delay and elusive diagnosis of Asherman syndrome can be brought about by poor health seeking behavior of patients and difficulty in detecting this condition by routine physical examinations or diagnostic procedures such as an ultrasound. It is, therefore, necessary to include Asherman syndrome in the differential diagnosis of secondary amenorrhea and secondary infertility. With expertise in hysteroscopy, early diagnosis, proper classification in the advent of hysteroscopy, and optimal management can improve patient outcomes.

Keywords: Asherman syndrome, outflow tract obstruction, secondary amenorrhea, infertility, hysteroscopy

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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Authors: Ji-Yuan Lin, Yu-Ming Liou, Yi-Ting Chen, Chen-Syuan Lin

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Soil water index obtained by tank model is now commonly used in soil and sand disaster alarm system in Japan. Comparing with the rainfall trigging index in Taiwan, the tank model is easy to predict the slope water content on large-scale landslide. Therefore, this study aims to estimate the threshold value of large-scale landslide using the soil water index Sixteen typhoons and heavy rainfall events, were selected to establish the, to relationship between landslide event and soil water index. Finally, the proposed threshold values for landslides on country road No.89 are suggested in this study. The study results show that 95% landslide cases occurred in soil water index more than 125mm, and 30% of the more serious slope failure occurred in the soil water index is greater than 250mm. Beside, this study speculates when soil water index more than 250mm and the difference value between second tank and third tank less than -25mm, it leads to large-scale landslide more probably.

Keywords: soil water index, tank model, landslide, threshold values

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Authors: Ahsan Ullah

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The aim of this study is to measure the relationship between sedentary behaviour and metabolic rate among adult professionals. An intervention (e-mobile) approach was used for gathered the information from the participants. A total of 40 participants (men = 30, and women = 10) with an average age of (36.53 years ± 8.85) were randomly assigned to an intervention group (n= 20) and control group (n= 20). All the participants completed the Sedentary Behaviour Questionnaire (SBQ) and The International Physical Activity Questionnaire (IPAQ) at baseline and at the end of eight weeks. The participants in the intervention group were given physical activity guidelines targeted at increasing physical activity levels during daily activities. On the other side, the control group was advised to continue with their routine daily physical activity. Statistical analyses, including descriptive statistics and inferential analysis like mean, SD, T-tests, and ANOVA, were used to analyze the data and determine relationships between variables. After analyzing the data, the results showed that significant difference in pre and post metabolic rate scores (1488.31 ± 179.13 to 1468.44 ± 128.19) (f = 10.83, p < 0.000) were noted in the experimental group after eight week. The experimental group increased their walking (863.78 METs per week to 1625.55 METs per week), moderate activity (295 METs per week to 743 METs per week) and vigorous activity (362 METs per week to 1366 METs per week) physical activity (all p<0.001). There were no significant differences observed in any outcome measured before and after eight weeks in the control group. These findings suggest that engaging in physical activity can effectively improve metabolic rate and reduce sedentary behavior among physically active adults.

Keywords: sedentary behavior, metabolic rate, adult’s professionals, physical activity

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Authors: Serdar Öge, Alpay Karasoy, Özlem Kara

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Although women have merit in their jobs, they still are located very few in the top management in many sectors. There are many causes of such situation. Such a situation creates obstacles; especially invisible ones are called “glass ceiling syndrome”. Also, studies which handle this subject in academic community are very few. The aim of this research is to reach the results about glass ceiling obstacles in terms of female teaching staff (academics) working in higher education institutions. To this end, our study was performed on female academics working at Selcuk University, Konya / Turkey. Our study's main aim can be expressed as to determine whether there are glass ceiling obstacles for female academics working at the higher education institution in question, to measure their glass ceiling perceptions and, thus, to identify what the glass ceiling barrier components for them to promotion to senior management positions are.

Keywords: career, career barriers, glass ceiling syndrome, academics

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Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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Authors: Kaveh Shahi, Helmi Z. M. Shafri, Ebrahim Taherzadeh

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In remote sensing, shadow causes problems in many applications such as change detection and classification. It is caused by objects which are elevated, thus can directly affect the accuracy of information. For these reasons, it is very important to detect shadows particularly in urban high spatial resolution imagery which created a significant problem. This paper focuses on automatic shadow detection based on a new spectral index for multispectral imagery known as Shadow Detection Index (SDI). The new spectral index was tested on different areas of World-View 2 images and the results demonstrated that the new spectral index has a massive potential to extract shadows effectively and automatically.

Keywords: spectral index, shadow detection, remote sensing images, World-View 2

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Authors: Pedro Ferraz-Gameiro

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Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

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Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor

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Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.

Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus

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Authors: Joanna Bajerska, Agata Chmurzyńska, Agata Muzsik, Patrycja Krzyżanowska, Klaudia Łochocka, Jarosław Walkowiak

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The Mediterranean diet (MED) is regarded as beneficial in the therapy of central obesity-associated metabolic abnormalities. However, in the traditional diet of the Central European countries, food items with positive nutritional profiles (rye bread, oats, buckwheat, herrings, linseed and rapeseed oil, berries, apples, plums, root vegetables etc.) are also used. We hypothesized that the Central European Diet (CED) may be comparatively effective in reducing symptoms of central obesity as MED. We tested the health effects of the CED, which is an environmentally friendly regional diet and the traditional MED diet in a group of postmenopausal centrally obese women. A total 58 with a mean age of 60 y (50-70y), body mass index (in kg/m(2)) of 33.4 (22.6-47.3), and waist circumference of 105 cm (87.5-137 cm) were randomly assigned to receive either the diet based on food items commonly used in Central Europe (the CED group; n = 29) or the Mediterranean diet (the MED group; n = 29) for 15 weeks. Body mass and body composition were measured with a Bod Pod (Cosmed, Italy). A non-elastic flexible measuring tape was used to measure waist circumference. Additionally, blood pressure, plasma lipid and glucose levels were assessed with the use of a biochemical analyzer. A total of 50 subjects [86% (CED 83%; MED 90%)] completed the intervention. A high dietary compliance for both described diets was achieved. The mean (±SEM) weight and waist circumference changes were -7.4 ± 0.7 kg; -8.3 ± 0.7 cm and -8.1 ± 0.5 kg; -7.1 ± 0.6 cm for the CED and MED groups, respectively. Moreover, there were no differences between the effectiveness of the diets used in terms of the influence on fat mass, blood pressure, and biochemical parameters. The preliminary data suggest that both described diets may be successfully used for improving central obesity-associated metabolic abnormalities. The project was financed by the National Science Centre awarded based on the number of decision DEC-013/09/B/NZ9/02365

Keywords: central european diet, central obesity, Mediterranean diet, metabolic abnormalities

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Authors: Alexander Dao, Oscar Wambuguh

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Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.

Keywords: irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder

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