Search results for: herbal drug of depression

Authors: Praveen Adusumilli, Meher Lakshmi Konatam, Sadashivudu Gundeti, Stalin Bala

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The invention of trastuzumab has changed the treatment of breast cancer and lives of many patients all over the world. Despite many patients getting benefitted from the drug, it is out of reach for most of the patients. There is very limited real world data regarding the epidemiology and clinical outcome of Her2neu positive breast cancer patients. Materials and Methods: This is a retrospective analysis of breast cancer patients presenting to a tertiary care cancer centre in Southern India from 2007 to2013. All early and locally advanced breast cancer patients, who were Her2neu 3+ on IHC are included in the study and evaluated in terms of epidemiology, 3-year disease free survival (DFS)and 5-year overall survival(OS). Chemotherapy regimens used were-FAC 6 cycles or AC 4 cycles followed by 12 cycles of weekly paclitaxel . Trastuzumab was given after 6 cycles of FAC or weekly with paclitaxel followed by 3weekly maintenance until 1 year. Results: Over the period of this study there were 885 newly diagnosed cases of carcinoma breast, of which 242 (27%) were Her2neu positive, 360(40%) were hormone receptor positive, and 212(24%) were triple negative. A total of 71(8%) were Her2neu equivocal of which only 10 patients got FISH test done. Of the 212 newly diagnosed patients, only 74 (29%) opted to have standard of care therapy with trastuzumab at our centre, out of which 52(24%), 8(3%), received under insurance, paying basis respectively. 14(9%) patients received the care as part of clinical trial program (ALTTO trial). 7 (9.72%) patients developed decrease of ejection fraction by greater than 10%, requiring stoppage of trastuzumab out of which 5 were restarted in 2 months. Patients receiving trastuzumab along with chemotherapy had longer 3year DFS 92% vs. 60% (p value<0.0001) when compared to chemotherapy alone. 5 year OS was 87% vs 44% (p-value <0.0001) compared to chemotherapy alone. Conclusion: Trastuzumab with chemotherapy improves the DFS and OS in Her2neu positive patients. The biggest constraint is the cost of the treatment and absence of universal health security net to treat all patients with this diagnosis.

Keywords: breast cancer, Her 2 neu positive, real world data, Trastuzumab

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Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.

Keywords: Neonatal infection , bacteria, puppies, newborn

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Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

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Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

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Authors: Manali Chakraborty

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In the developing countries the most prevalent pathological state is malnutrition and under nutrition due to deficiency of essential nutrients. This condition is more seen between the woman population, especially in the adolescent girls. It is causing childhood deaths along with others cognitive, degenerative diseases. Born of low weight babies and stillbirth are also major problems associated with the malnutrition. Along with the increased level of population, people not only should concern about their quantity of food but also for the quality of the food to be healthy. Lethargy, depression caused due to iron deficiency often quoted as normal or unimportant issues. Children of malnourished women are more likely associated with cognitive impairment, immune dysfunction leading to a higher risk of being attacked by diseases. Malnourishment also affects the productivity of women. Low social status, lack of proper nutritional education is an important cause of this nutrient deficiency among women. Iron deficiency and anemia are mostly famous nutritional deficiencies among women worldwide. Mostly women from below poverty lined area are anemic due to less consumption of iron-rich foods or having foods that might inhibit the iron absorption. Growing females like adolescents or lactating females need more iron supply. Less supplement causes iron deficiency. Though malaria also might cause anemia, it is more likely endemic one in some specific areas. Folate deficiency in females also may cause neurological defects in the infants. Other Vitamin B, A deficiencies along with low iodine level is also noted in malnourished women. According to tradition, still in some areas in developing countries females have their food at the end. According to some survey and collected data, these females are often into the risk zone of being malnourished. Regularly they have the very lesser amount, or food sometimes may start to lose its nutrients. Women are the one who maintains the responsibility to cook foods in the home. Lack of proper nutritional education and proper food preparation not only make those foods lose the nutrients leading to impairment in proper nutrient intake of the family members but also impairing own nutritional status. Formulation and development of food products from iron or other nutrient affluent sources viz., traditional herbs can be helpful in the prevention of such malnutrition condition in females. Keeping low cost and smooth maintenance of the food product development from the natural sources like pulses, cereals or other vegetation also can be beneficial to sustain socio-economic condition. Consumption of such kind of foodstuff is much healthier rather than taking continuous supplements like capsules. Utilization of proper scientific and cost-effective techniques for this food product development and their distribution among rural women population might be an enormous initiative.

Keywords: anemia, food supplements, malnutrition, rural places, women population

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Authors: Abhishek Pandey

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Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis and rheumatoid arthritis. Acetaminophen is used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression and top spray granulation technique. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimized formulation, nine different formulations were generated among them batch F7, F8, F9 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of dissolution study. Furtherly, directly compressible granules of both drugs were prepared by using top spray granulation technique in fluidized bed processor equipment and compressed .In order to obtain best product process optimization was carried out by performing four trials in which various parameters like inlet air temperature, spray rate, peristaltic pump rpm, % LOD, properties of granules, blending time and hardness were optimized. Batch T3 coined as optimized batch on the basis physical & chemical evaluation. Finally formulations prepared by both techniques were compared.

Keywords: direct compression, top spray granulation, process optimization, blending time

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Authors: Deborah Bailey-Rodriguez, Maria Paula Valdivieso Rueda, Gemma Reynolds

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In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counseling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues, with 94% of HE institutions recently reporting an increase in the need for counseling services. One way of improving the well-being and mental health of HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group was required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group was required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15 minutes per day for four consecutive days. Baseline mental health and well-being measures were taken before the intervention via a battery of standardized questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. Preliminary findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity mean it can be easily implemented and can be freely available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.

Keywords: expressive writing, higher education, psychology in education, mixed-methods, mental health, academic stress

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Authors: John Dimopoulos

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This proposal attempts a refabrication of Heidegger’s classic thing-being and object-being analysis in order to provide better ontological tools for understanding contemporary culture, technology, and society. In his work, Heidegger sought to understand and comment on the problem of technology in an era of rampant innovation and increased perils for society and the planet. Today we seem to be at another crossroads in this course, coming after postmodernity, during which dreams and dangers of modernity augmented with critical speculations of the post-war era take shape. The new era which we are now living in, referred to as hypermodernity by researchers in various fields such as architecture and cultural theory, is defined by the horizontal implementation of digital technologies, cybernetic networks, and mixed reality. Technology today is rapidly approaching a turning point, namely the point of no return for humanity’s supervision over its creations. The techno-scientific civilization of the 21st century creates a series of problems, progressively more difficult and complex to solve and impossible to ignore, climate change, data safety, cyber depression, and digital stress being some of the most prevalent. Humans often have no other option than to address technology-induced problems with even more technology, as in the case of neuron networks, machine learning, and AI, thus widening the gap between creating technological artifacts and understanding their broad impact and possible future development. As all technical disciplines and particularly design, become enmeshed in a matrix of digital hyper-objects, a conceptual toolbox that allows us to handle the new reality becomes more and more necessary. Weaponized design, prevalent in many fields, such as social and traditional media, urban planning, industrial design, advertising, and the internet in general, hints towards an increase in conflicts. These conflicts between tech companies, stakeholders, and users with implications in politics, work, education, and production as apparent in the cases of Amazon workers’ strikes, Donald Trump’s 2016 campaign, Facebook and Microsoft data scandals, and more are often non-transparent to the wide public’s eye, thus consolidating new elites and technocratic classes and making the public scene less and less democratic. The new category proposed, weapon-being, is outlined in respect to the basic function of reducing complexity, subtracting materials, actants, and parameters, not strictly in favor of a humanistic re-orientation but in a more inclusive ontology of objects and subjects. Utilizing insights of Object-Oriented Ontology (OOO) and its schematization of technological objects, an outline for a radical ontology of technology is approached.

Keywords: design, hypermodernity, object-oriented ontology, weapon-being

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Authors: Bui Phuong Linh, Yuki Sakakibara, Ryuto Tanaka, Elizabeth H. Pigney, Taishi Hashiguchi

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Non-alcoholic steatohepatitis (NASH) is a chronic liver disease, often associated with type II diabetes, which sometimes progresses to more serious conditions such as liver fibrosis and hepatocellular carcinoma (HCC). NASH has become an important health problem worldwide, buttherapeutic agents for NASH have not yet been approved, and animal models with high clinical correlation are required. TheSTAM™ mouse shows the same pathological progression as human NASH patients and has been widely used for both drug efficacy and basic research, such as lipid profiling and gut microbiota research. In this study, we analyzed the RNA-seq data of STAM™mice at each pathological stage (steatosis, steatohepatitis, liver fibrosis, and HCC) and examined the clinical correlation at the genetic level. NASH was induced in male mice by a single subcutaneous injection of 200 µg streptozotocin solution 2 days after birth and feeding with high fat dietafter 4 weeks of age. The mice were sacrificed and livers collected at 6, 8, 10, 12, 16, and 20 weeks of age. For liver samples, the left lateral lobe was snap frozen in liquid nitrogen and stored at -80˚C for RNA-seq analysis. Total RNA of the cells was isolated using RNeasy mini kit. The gene expression of the canonical pathways in NASH progression from steatosis to hepatocellular carcinoma were analyzed, such as immune system process, oxidation-reduction process, lipid metabolic process. Moreover, since it has been reported that genetic traits are involved in the development of NASH-HCC, we next analyzed the genetic mutations in the STAM™mice. The number of individuals showing mutations in Mtorinvolved in Insulin signaling increases as the disease progresses, especially in the liver cancer phase. These results indicated a clinical correlation of gene profiles in the STAM™mouse.

Keywords: steatosis, non-alcoholic steatohepatitis, fibrosis, hepatocellular carcinoma, RNA-seq

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Authors: M. A. Munteanu, A. M. Lungu, A. I. Chivescu, V. Teodorescu, E. Tufanoiu, C. Nicolae, T. I. Nanea

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Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i), which were first developed as antidiabetic medications, have demonstrated numerous positive benefits on the cardiovascular system, especially in the prevention of heart failure (HF). HF is a challenging, multifaceted disease that needs all-encompassing therapy. It should not be viewed as a limited form of heart illness but rather as a systemic disease that leads to multiple organ failure and death. SGLT2i is an extremely effective tool for treating HF by using its pleiotropic effects. In addition to its use in patients with diabetes mellitus who are at high cardiovascular risk or who have already experienced a cardiovascular event, SGLT2i administration has been shown to have positive effects on a variety of HF manifestations and stages, regardless of the patient's presence of diabetes mellitus. Material and Methods: According to the guide, 110 patients (83 males and 27 females) with heart failure with mildly reduced ejection fraction (HFmrEF), with T2D and neoplasia, were enrolled in the prospective study. The structural and functional state of the left ventricle myocardium and ejection fraction was assessed through echocardiography. Patients were randomized to receive once-daily dapagliflozin 10 mg. Results: Patients with HFmrEF were divided into 3 subgroups according to age. 7% (8) patients aged < 45 years, 35% (28) patients aged between 46-59 years, and 58% (74) patients aged> 60 years. The most prevalent comorbidities were hypertension (43.1%), coronary heart disease (40%), and obesity (33.2%). Study drug discontinuation and serious adverse events were not frequent in the subgroups, in either men or women, until now. Conclusions: SGLT-2 inhibitors are a novel class of antidiabetic agents that have demonstrated positive efficacy and safety outcomes in the setting of HFmrEF. Until now, in our study, dapagliflozin was safe and well-tolerated irrespective of sex.

Keywords: diabetes mellitus type 2, Sodium-glucose co-transporters-2 inhibitors, heart failure, neoplasia

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Authors: Ana-María Gómez-Carvajal, Hernando Santamaría-García, Mateo Bernal, Mario Valderrama, Daniela Lizarazo, Juliana Restrepo, María Fernanda Barreto, Angélica Parra, Paula Torres, Diana Matallana, Jaime Silva, José Santamaría-García, Sandra Baez

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Higher levels of oxytocin are associated with better performance on social cognition tasks. However, higher levels of oxytocin have also been associated with increased levels of envy and schadenfreude. Considering these antecedents, this study aims to explore social emotions (i.e., envy and schadenfreude) and other components of social cognition (i.e. ToM and empathy), in women in the puerperal period and their respective partners, compared to a control group of men and women without children or partners. Control women should be in the luteal phase of the menstrual cycle or taking oral contraceptives as they allow oxytocin levels to remain stable. We selected this population since increased levels of oxytocin are present in both mothers and fathers of newborn babies. Both groups were matched by age, sex, and education level. Twenty-two parents of newborns (11 women, 11 men) and 15 controls (8 women, 7 men) performed an experimental task designed to trigger schadenfreude and envy. In this task, each participant was shown a real-life photograph and a description of two target characters matched in age and gender with the participant. The task comprised two experimental blocks. In the first block, participants read 15 sentences describing fortunate events involving either character. After reading each sentence, participants rated the event in terms of how much envy they felt for the character (1=no envy, 9=extreme envy). In the second block, participants read and reported the intensity of their pleasure (schadenfreude, 1=no pleasure, 9=extreme pleasure) in response to 15 unfortunate events happening to the characters. Five neutral events were included in each block. Moreover, participants were assessed with ToM and empathy tests. Potential confounding variables such as general cognitive functioning, stress levels, hours of sleep and depression symptoms were also measured. Results showed that parents of newborns showed increased levels of envy and schadenfreude. These effects are not explained by any confounding factor. Moreover, no significant differences were found in ToM or empathy tests. Our results offer unprecedented evidence of specific differences in envy and schadenfreude levels in parents of newborns. Our findings support previous studies showing a negative relationship between oxytocin levels and negative social emotions. Further studies should assess the direct relationship between oxytocin levels in parents of newborns and the performance in social emotions tasks.

Keywords: envy, empathy, oxytocin, schadenfreude, social emotions, theory of mind

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Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

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Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

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Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

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Authors: Hadeer E. Eliwa, Naglaa S. Bazan, Ebtissam A. Darweesh, Nagwa A. Sabri

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Background: Generic substitution of brand ivabradine prescriptions can reduce drug expenditures and improve adherence. However, the distrust of generic medicines by practitioners and patients due to doubts regarding their quality and fear of counterfeiting compromise the acceptance of this practice. Aim: The goal of this study is to compare the therapeutic equivalence of brand product versus the generic product of ivabradine in adult patients with chronic heart failure with reduced ejection fraction (≤ 40%) (HFrEF). Methodology: Thirty-two Egyptian patients with chronic heart failure with reduced ejection fraction (HFrEF) were treated with branded ivabradine (Procrolan ©) and generic (Bradipect ©) during 24 (2x12) weeks. Primary outcomes were resting heart rate (HR), NYHA FC, Quality of life (QoL) using Minnesota Living with Heart Failure (MLWHF) and EF. Secondary outcomes were the number of hospitalizations for worsening HFrEF and adverse effects. The washout period was not allowed. Findings: At the 12th week, the reduction in HR was comparable in the two groups (90.13±7.11 to 69±11.41 vs 96.13±17.58 to 67.31±8.68 bpm in brand and generic groups, respectively). Also, the increase in EF was comparable in the two groups (27.44 ±4.59 to 33.38±5.62 vs 32±5.96 to 39.31±8.95 in brand and generic groups, respectively). The improvement in NYHA FC was comparable in both groups (87.5% in brand group vs 93.8% in the generic group). The mean value of the QOL improved from 31.63±15.8 to 19.6±14.7 vs 35.68±17.63 to 22.9±15.1 for the brand and generic groups, respectively. Similarly, at end of 24 weeks, no significant changes were observed from data observed at 12th week regarding HR, EF, QoL and NYHA FC. Only minor side effects, mainly phosphenes, and a comparable number of hospitalizations were observed in both groups. Conclusion: The study revealed no statistically significant differences in the therapeutic effect and safety between generic and branded ivabradine. We assume that practitioners can safely interchange between them for economic reasons.

Keywords: bradipect©, heart failure, ivabradine, Procrolan ©, therapeutic equivalence

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: Demetrio L. Valle Jr., Juliana Janet M. Puzon, Windell L. Rivera

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From the various medicinal plants available in the Philippines, crude ethanol extracts of twelve (12) Philippine medicinal plants, namely: Senna alata L. Roxb. (akapulko), Psidium guajava L. (bayabas), Piper betle L. (ikmo), Vitex negundo L. (lagundi), Mitrephora lanotan (Blanco) Merr. (Lanotan), Zingiber officinale Roscoe (luya), Curcuma longa L. (Luyang dilaw), Tinospora rumphii Boerl (Makabuhay), Moringga oleifera Lam. (malunggay), Phyllanthus niruri L. (sampa-sampalukan), Centella asiatica (L.) Urban (takip kuhol), and Carmona retusa (Vahl) Masam (tsaang gubat) were studied. In vitro methods of evaluation against selected Gram-positive and Gram-negative multidrug-resistant (MDR), bacteria were performed on the plant extracts. Although five of the plants showed varying antagonistic activities against the test organisms, only Piper betle L. exhibited significant activities against both Gram-negative and Gram-positive multidrug-resistant bacteria, exhibiting wide zones of growth inhibition in the disk diffusion assay, and with the lowest concentrations of the extract required to inhibit the growth of the bacteria, as supported by the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Further antibacterial studies of the Piper betle L. leaf, obtained by three extraction methods (ethanol, methanol, supercritical CO2), revealed similar inhibitory activities against a multitude of Gram-positive and Gram-negative MDR bacteria. Thin layer chromatography (TLC) assay of the leaf extract revealed a maximum of eight compounds with Rf values of 0.92, 0.86, 0.76, 0.53, 0.40, 0.25, 0.13, and 0.013, best visualized when inspected under UV-366 nm. TLC- agar overlay bioautography of the isolated compounds showed the compounds with Rf values of 0.86 and 0.13 having inhibitory activities against Gram-positive MDR bacteria (MRSA and VRE). The compound with an Rf value of 0.86 also possesses inhibitory activity against Gram-negative MDR bacteria (CRE Klebsiella pneumoniae and MBL Acinetobacter baumannii). Gas Chromatography-Mass Spectrometry (GC-MS) was able to identify six volatile compounds, four of which are new compounds that have not been mentioned in the medical literature. The chemical compounds isolated include 4-(2-propenyl)phenol and eugenol; and the new four compounds were ethyl diazoacetate, tris(trifluoromethyl)phosphine, heptafluorobutyrate, and 3-fluoro-2-propynenitrite. Phytochemical screening and investigation of its antioxidant, cytotoxic, possible hemolytic activities, and mechanisms of antibacterial activity were also done. The results showed that the local variant of Piper betle leaf extract possesses significant antioxidant, anti-cancer and antimicrobial properties, attributed to the presence of bioactive compounds, particularly of flavonoids (condensed tannin, leucoanthocyanin, gamma benzopyrone), anthraquinones, steroids/triterpenes and 2-deoxysugars. Piper betle L. is also traditionally known to enhance wound healing, which could be primarily due to its antioxidant, anti-inflammatory and antimicrobial activities. In vivo studies on mice using 2.5% and 5% of the ethanol leaf extract cream formulations in the excised wound models significantly increased the process of wound healing in the mice subjects, the results and values of which are at par with the current antibacterial cream (Mupirocin). From the results of the series of studies, we have definitely proven the value of Piper betle L. as a source of bioactive compounds that could be developed into therapeutic agents against MDR bacteria.

Keywords: Philippine herbal medicine, multidrug-resistant bacteria, Piper betle, TLC-bioautography

Procedia PDF Downloads 741

Authors: Benjaporn Buranrat, Nootchanat Mairuae

Abstract:

Cratoxylum formosum (Jack) Dyer (CF) has been used for the traditional medicines in South East Asian and Thailand. Normally, northeast Thai vegetables have proven cytotoxic to many cancer cells. Therefore, the present study aims to explore the molecular mechanisms underlying CF-induced cancer cell death and apoptosis on breast and liver cancer cells. The cytotoxicity and antiproliferative effects of CF on the human breast MCF-7 and liver HepG2 cancer cell lines were evaluated using sulforhodamine B assay and colony formation assay. Cell migration assay was measured using wound healing assay. The apoptosis induction mechanisms were investigated through reactive oxygen species formation, caspase 3 activity, and JC-1 activity. Gene expression by real-time PCR and apoptosis related protein levels by Western blot analysis. CF induced MCF-7 and HepG2 cell death by time- and dose-dependent manner. Furthermore, CF had the greater cytotoxic potency on MCF-7 more than HepG2 cells with IC50 values of 85.70+4.52 μM and 219.03±9.96 μM respectively, at 24 h. Treatment with CF also caused a dose-dependent decrease in colony forming ability and cell migration, especially on MCF-7 cells. CF induced ROS formation, increased caspase 3 activities, and decreased the mitochondrial membrane potential, and causing apoptotic body production and DNA fragmentation. CF significantly decreased expression of the cell cycle regulatory protein RAC1 and downstream proteins, cdk6. Additionally, CF enhanced p21 and reduced cyclin D1 protein levels. CF leaf extract induced cell death, apoptosis, antimigration in both of MCF-7 and HepG2 cells. CF could be useful for developing to anticancer drug candidate for breast and liver cancer therapy.

Keywords: cratoxylum formosum (jack) dyer, breast cancer, liver cancer, cell death

Procedia PDF Downloads 200

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

Procedia PDF Downloads 68

Authors: Himanshu Kumar Gupta

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The Jaisalmer Basin is one of the parts of the Rajasthan basin in northwestern India. The presence of five major unconformities/hiatuses of varying span i.e. at the top of Archean basement, Cambrian, Jurassic, Cretaceous, and Eocene have created the foundation for constructing a sequence stratigraphic framework. Based on basin formative tectonic events and their impact on sedimentation processes three first-order sequences have been identified in Rajasthan Basin. These are Proterozoic-Early Cambrian rift sequence, Permian to Middle-Late Eocene shelf sequence and Pleistocene - Recent sequence related to Himalayan Orogeny. The Permian to Middle Eocene I order sequence is further subdivided into three-second order sequences i.e. Permian to Late Jurassic II order sequence, Early to Late Cretaceous II order sequence and Paleocene to Middle-Late Eocene II order sequence. In this study, Late Jurassic to Early Cretaceous sequence was identified and log-based interpretation of smaller order T-R cycles have been carried out. A log profile from eastern margin to western margin (up to Shahgarh depression) has been taken. The depositional environment penetrated by the wells interpreted from log signatures gave three major facies association. The blocky and coarsening upward (funnel shape), the blocky and fining upward (bell shape) and the erratic (zig-zag) facies representing distributary mouth bar, distributary channel and marine mud facies respectively. Late Jurassic Formation (Baisakhi-Bhadasar) and Early Cretaceous Formation (Pariwar) shows a lesser number of T-R cycles in shallower and higher number of T-R cycles in deeper bathymetry. Shallowest well has 3 T-R cycles in Baisakhi-Bhadasar and 2 T-R cycles in Pariwar, whereas deeper well has 4 T-R cycles in Baisakhi-Bhadasar and 8 T-R cycles in Pariwar Formation. The Maximum Flooding surfaces observed from the stratigraphy analysis indicate major shale break (high shale content). The study area is dominated by the alternation of shale and sand lithologies, which occurs in an approximate ratio of 70:30. A seismo-geological cross section has been prepared to understand the stratigraphic thickness variation and structural disposition of the strata. The formations are quite thick to the west, the thickness of which reduces as we traverse towards the east. The folded and the faulted strata indicated the compressional tectonics followed by the extensional tectonics. Our interpretation is supported with seismic up to second order sequence indicates - Late Jurassic sequence is a Highstand Systems Tract (Baisakhi - Bhadasar formations), and the Early Cretaceous sequence is Regressive to Lowstand System Tract (Pariwar Formation).

Keywords: Jaisalmer Basin, sequence stratigraphy, system tract, T-R cycle

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Authors: Iman Nezamzadeh, Ali Faghih, Behnam Oveisi

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In order to reduce earthquake hazards in urban areas, it is necessary to perform comprehensive studies to understand the dynamics of the active faults and identify potentially high risk areas. The fault slip-rates in Late Quaternary sediment are critical indicators of seismic hazard and also provide valuable data to recognize young crustal deformations. To measure slip-rates accurately, is needed to displacement of geomorphic markers and ages of quaternary sediment samples of alluvial deposit that deformed by movements on fault. In this study we produced information about Intermediate term slip rate of Sabzpushan Fault Zone (SPF) within the central part of the Zagros Mountains of Iran using OSL dating technique to make better analysis of seismic hazard and seismic risk reduction for Shiraz city. For this purpose identifiable geomorphic fluvial surfaces help us to provide a reference frame to determine differential or absolute horizontal and vertical deformation. Optically stimulated luminescence (OSL) is an alternative and independent method of determining the burial age of mineral grains in Quaternary sediments. Field observation and satellite imagery show geomorphic markers that deformed horizontally along the Sabzpoushan Fault. Here, drag folds is forming because of evaporites material of Miocen Formation. We estimate 2.8±0.5 mm/yr (mm/y) horizontal slip rate along the Sabzpushan fault zone, where ongoing deformation is involve with drug folding. The Soltan synclinal structure, close to the Sabzpushan fault, shows slight uplift rate due to active core-extrousion.

Keywords: slip rate, active tectonics, OSL, geomorphic markers, Sabzpushan Fault Zone, Zagros, Iran

Procedia PDF Downloads 339

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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Authors: Mohd Aslam Aslam

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Chronic renal failure is a debilitating condition responsible for high morbidity and mortality. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. According to researchers, the number of adults aged 30 or older who have chronic kidney disease is projected to increase from 13.2 percent currently, to 14.4 percent in 2020 and 16.7 percent in 2030. The aerial part of Aerva lanata (Busehri booti) have been used in kidney disorders by the Unani physicians. In the present study, the effect of extract of Aerva lanata was investigated on cisplatin-induced nephrotoxicity in rats. The renal effects of this drug was evaluated by monitoring levels of blood urea nitrogen (BUN), serum creatinine, serum uric acid in blood and histopathological examination of kidney. Aerva lanata was evaluated at two different doses (1400 mg/kg and 2800 mg/kg). The effect of higher dose was more pronounced in terms of inhibition in the rise of BUN, serum creatinine and uric acid. Higher dose show greater prevention in the rise of BUN, serum creatinine, and uric acid. The histopathological examination of the kidney tissue of the rats treated with aqueous methanolic extract of Aerva lanata (Higher dose-2800 mg/kg) showed marked inhibition of glomerular congestion, tubular casts, peritubular congestion, epithelial desquamation, blood vessel congestion, interstitial edema and inflammatory cells produced by the cisplatin-induced nephrotoxicity. This finding clearly indicates the protective role of Aerva lanata at higher dose. Present investigation validates the use of Aerva lanata in kidney disorders by Unani physicians.

Keywords: Aerva lanata, Busehri booti, nephroprotective, unani medicine

Procedia PDF Downloads 213

Authors: Kasipandi Muniyandi, Parimelazhagan Thangaraj

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Plants are important prospective wealth of a country, combination of local health care information about a specific plant together with data published by several groups of scientists, can help in deciding whether it should be considered acceptable for medicinal use. In the developed countries, too, plant-derived drugs may be of importance. The wide variety of ailments that are being treated with Plectranthus is an indication of the medicinal value of the genus. A number of species are not toxic and so may be taken orally, whilst others are used topically on the skin or as enemas. This study was designed to evaluate the different properties of Plectranthus stocksii and the aerial parts were collected and extracted with petroleum ether, chloroform, ethyl acetate, acetone and methanol by Soxhlet apparatus and finally macerated with hot water. The quantification assays revealed that, leaf methanol extract showed higher total phenolic (415.41 mg GAE/ g extract) and tannin (177.53 mg GAE/ g extract) contents whereas leaf ethyl acetate exhibited higher flavonoids (777.11 mg RE/ g extract) content. The antioxidant efficiency of the extracts was analyzed by various radical scavenging assays. Among the different antioxidant assays, leaf ethyl acetate extract showed higher free radical scavenging activities against DPPH (IC50 = 3.46 µg/mL), ABTS (27417.65 µM TE/ g extract), FRAP (152.17 mM Fe(II)E/ mg extract) NO• radical (21.46%) and Superoxide radical (IC50 = 24.16 µg/mL) assays. All the parts P. stocksii extracts showed significant protection against OH• induced DNA damage at 50 µg concentration. The HPLC analysis of leaf ethyl acetate extract revealed the presence of Quercetin (30.29 µg/mg of extract) was the major compound. Anticancer activity of leaf ethyl acetate extract showed better IC50 values were 48.87 and 36.08 µg/ mL against MCF-7 and Caco-2 respectively. From this study, P. stocksii can act as a potent antioxidant and cytotoxic antimicrobial agent. The scope for drug development from this plant is endless and there is undoubtedly a call for further research in pharmaceutical industries.

Keywords: antioxidant, cytotoxicity, phenolics, plectranthus stocksii

Procedia PDF Downloads 368

Authors: Godwin Ojochogu Adejo, Evelyn UnekwuOjo Adejo, Sunday UnenwOjo Adejo

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The mainstream contemporary approach to controlling the impact of diseases among poultry birds rely largely on curative measures through the administration of drugs to infected birds. Most times as observed in the deep liter poultry farming system, entire flocks including uninfected birds receive the treatment they do not need. As such, unguarded use of chemical drugs and antibiotics has led to wastage and accumulation of chemical residues in poultry products with associated health hazards to humans. However, wanton and frequent drug usage in poultry is avoidable if feeding and drinking equipment are designed to curb infection transmission among birds. Using toxicological assays as guide and with efficiency and simplicity in view, two newly field-tested and recently patented equipments called 'healthy liquid drinking trough (HDT)' and 'healthy feeding trough (HFT)' that systematically eliminate contamination of the feeding and drinking channels, thereby, curbing wide-spread infection and transmission of diseases in the (intensive) deep litter poultry farming system were designed. Upon combined usage, they automatically and drastically reduced both the amount and frequency of antibiotics use in poultry by over > 50%. Additionally, they conferred optimization of feed and water utilization/elimination of wastage by > 80%, reduced labour by > 70%, reduced production cost by about 15%, and reduced chemical residues in poultry meat or eggs by > 85%. These new and cheap technologies which require no energy input are likely to elevate safety of poultry products for consumers' health, increase marketability locally and for export, and increase output and profit especially among poultry farmers and poor people who keep poultry or inevitably utilize poultry products in developing countries.

Keywords: healthy, trough, toxicological, assay-guided, poultry

Procedia PDF Downloads 139

Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: palliative care, breathing training, bio-psycho-social model, heart rate variability

Procedia PDF Downloads 249

Authors: Tamer Shehata

Abstract:

Recently, nanotechnology acquired a great interest in the field of pharmaceutical production. Several pharmaceutical equipment were introduced into the research field for production of nanoparticles, among them, BÜCHI’ fourth generation nano-spray dryer B-90. B-90 is specialized with single step of production and drying of nano and microparticles. Currently, our research group is investigating several pharmaceutical formulations utilizing BÜCHI Nano-Spray Dryer B-90 technology. One of our projects is the formulation and evaluation of metformin hydrochloride mucoadhesive microparticles for treatment of type 2-diabetis. Several polymers were investigated, among them, gelatin and sodium alginate. The previous polymers are natural polymers with mucoadhesive properties. Preformulation studies such as atomization head mesh size, flow rate, head temperature, polymer solution viscosity and surface tension were performed. Postformulation characters such as particle size, flowability, surface scan and dissolution profile were evaluated. Finally, the pharmacological activity of certain selected formula was evaluated in streptozotocin-induced diabetic rats. B-90’spray head was 7 µm hole heated to 120 with air flow rate 3.5 mL/min. The viscosity of the solution was less than 11.5 cP with surface tension less than 70.1 dyne/cm. Successfully, discrete, non-aggregated particles and free flowing powders with particle size was less than 2000 nm were obtained. Gelatin and Sodium alginate combination in ratio 1:3 were successfully sustained the in vitro release profile of the drug. Hypoglycemic evaluation of the previous formula showed a significant reduction of blood glucose level over 24 h. In conclusion, mucoadhesive metformin hydrochloride microparticles obtained from B-90 could offer a convenient dosage form with enhanced hypoglycemic activity.

Keywords: mucoadhesive, microparticles, metformin hydrochloride, nano-spray dryer

Procedia PDF Downloads 297

Authors: Zhuo Job Chen, Kevin Nute

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The work reported examines potential linkages between spatial and temporal prospects, and more specifically, between variations in the spatial depth and foreground obstruction of window views, and observers’ sense of connection to the future. It was found that external views from indoor spaces were strongly associated with a sense of the future, that partially obstructing such a view with foreground objects significantly reduced its association with the future, and replacing it with a pictorial representation of the same scene (with no real actual depth) removed most of its temporal association. A lesser change in the spatial depth of the view, however, had no apparent effect on association with the future. While the role of spatial depth has still to be confirmed, the results suggest that spatial prospects directly affect temporal ones. The word “prospect” typifies the overlapping of the spatial and temporal in most human languages. It originated in classical times as a purely spatial term, but in the 16th century took on the additional temporal implication of an imagined view ahead, of the future. The psychological notion of prospection, then, has its distant origins in a spatial analogue. While it is not yet proven that space directly structures our processing of time at a physiological level, it is generally agreed that it commonly does so conceptually. The mental representation of possible futures has been a central part of human survival as a species (Boyer, 2008; Suddendorf & Corballis, 2007). A sense of the future seems critical not only practically, but also psychologically. It has been suggested, for example, that lack of a positive image of the future may be an important contributing cause of depression (Beck, 1974; Seligman, 2016). Most people in the developed world now spend more than 90% of their lives indoors. So any direct link between external views and temporal prospects could have important implications for both human well-being and building design. We found that the ability to see what lies in front of us spatially was strongly associated with a sense of what lies ahead temporally. Partial obstruction of a view was found to significantly reduce that sense connection to the future. Replacing a view with a flat pictorial representation of the same scene removed almost all of its connection with the future, but changing the spatial depth of a real view appeared to have no significant effect. While foreground obstructions were found to reduce subjects’ sense of connection to the future, they increased their sense of refuge and security. Consistent with Prospect and Refuge theory, an ideal environment, then, would seem to be one in which we can “see without being seen” (Lorenz, 1952), specifically one that conceals us frontally from others, without restricting our own view. It is suggested that these optimal conditions might be translated architecturally as screens, the apertures of which are large enough for a building occupant to see through unobstructed from close by, but small enough to conceal them from the view of someone looking from a distance outside.

Keywords: foreground obstructions, prospection, spatial depth, window views

Procedia PDF Downloads 110

Authors: Jane E. Hill

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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

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Authors: Atena Sadat Hosseini, Mohammadhossein Habibi

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Acute myeloid leukemia (AML) is the most typically diagnosed leukemia. In older adults, AML imposes a dismal outcome. AML originates with a dominant mutation, then adds collaborative, transformative mutations leading to myeloid transformation and clinical/biological heterogeneity. Several chemotherapeutic drugs are used for this cancer. These drugs are naturally associated with several side effects, and finding a more accurate molecular mechanism of these drugs can have a significant impact on the selection and better candidate of drugs for treatment. In this study, we evaluated bortezomibin myeloma cells using bioinformatics analysis and evaluation of RNA-Seq data. Then investigated the molecular pathways proteins- proteins interactions associated with this chemotherapy drug. A total of 658upregulated genes and 548 downregulated genes were sorted.AUF1 (hnRNP D0) binds and destabilizes mRNA, degradation of GLI2 by the proteasome, the role of GTSE1 in G2/M progression after G2 checkpoint, TCF dependent signaling in response to WNT demonstrated in upregulated genes. Besides insulin resistance, AKT phosphorylates targets in the nucleus, cytosine methylation, Longevity regulating pathway, and Signal Transduction of S1P Receptor were related to low expression genes. With respect to this results, HIST2H2AA3, RP11-96O20.4, ZED9, PRDX1, and DOK2, according to node degrees and betweenness elements candidates from upregulated genes. in the opposite side, PYURF, NRSN1, FGF23, UPK3BL, and STAG3 were a prominent role in downregulated genes. Sum up, Using in silico analysis in the present study, we conducted a precise study ofbortezomib molecular mechanisms in myeloma cells. so that we could take further evaluation to discovermolecular cancer therapy. Naturally, more additional experimental and clinical procedures are needed in this survey.

Keywords: myeloma cells, acute myeloid leukemia, bioinformatics analysis, bortezomib

Procedia PDF Downloads 85

Authors: Muhammad Aasim, Mehmet Karataş, Fatih Erci, Şeyma Bakırcı, Ecenur Korkmaz, Burak Kahveci

Abstract:

Water hyssop (Bacopa monnieri L. Wettst.) is an important medicinal aquatic/semi aquatic plant native to India where it is used in traditional medicinal system. The plant contains bioactive compounds mainly Bacosides which are the main ingridient of commercial drug available as memory enhancer tonic. The local name of water hyssop is Brahmi and brahmi based drugs are available against for curing chronic diseases and disorders Alzheimer’s disease, anxiety, asthma, cancer, mental illness, respiratory ailments, and stomach ulcers. The plant is not a cultivated plant and collection of plant from nature make palnt threatened to endangered. On the other hand, low seed viability and availability make it difficult to propagate plant through traditional techniques. In recent years, plant tissue culture techniques have been employed to propagate plant for its conservation and production for continuous availability of secondary metabolites. On the other hand, application of nanoparticles has been reported for increasing biomass, in vitro regeneration and secondary metabolites production. In this study, silver nanoparticles (AgNPs) were applied at the rate of 2, 4, 6, 8 and 10 ppm to Murashihe and Skoog (MS) medium supplemented with 1.0 mg/l Benzylaminopurine (BAP), 3.0% sucrose and 0.7% agar. Leaf explants of water hyssop were cultured on AgNPs containing medium. Shoot induction from leaf explants were relatively slow compared to medium without AgNPs. Multiple shoot induction was recorded after 3-4 weeks of culture comapred to control that occured within 10 days. Regenerated shoots were rooted successfully on MS medium supplemented with 1.0 mg/l IBA and acclimatized in the aquariums for further studies.

Keywords: Water hyssop, Silver nanoparticles, In vitro, Regeneration, Secondary metabolites

Procedia PDF Downloads 174