Search results for: disease severity

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Ashok D. Satpute

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Ayurveda, the ancient Indian Medical system is practiced all over India and abroad, is rich in natural source of medicines, including marine products. The marine drugs which prominently used are pravala (coral), mukta (pearl), kapardika (cowry).Shukti (oyster shell), shankha (conch), agnijara (amber) etc. Except agnijara (amber) all are rich in calcium. Interestingly they are not used as supplements in calcium deficiency as done in conventional medical practice. They are used as medicines in the disease like fever, tuberculosis, bleeding disorders, eye problems, digestive complaints etc. Many scientific studies have shown their potent medicinal value. Each has its own properties and used therapeutically after subjecting them to various purificatory processes which are called shodhana in which several medicinal plants are used which also help in enhancing therapeutical activity. Then these purified marine products are subjected to marana (incineration) process and obtained in the form of Bhasma (a finest form of medicine). Agnijara, a derivative of whale is useful as aphrodisiac and prescribed in neuromuscular disorders and tetanus. The ancient scriptures written in Sanskrit language thousands of years back have rich information about all these natural marine products and their medicinal usage.

Keywords: Ayurveda, bhasma, marana, shodhana

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Authors: İbrahi̇m Kara, Seher Arslankaya

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Frequently preferred in the field of engineering in particular, data mining has now begun to be used in the field of health as well since the data in the health sector have reached great dimensions. With data mining, it is aimed to reveal models from the great amounts of raw data in agreement with the purpose and to search for the rules and relationships which will enable one to make predictions about the future from the large amount of data set. It helps the decision-maker to find the relationships among the data which form at the stage of decision-making. In this study, it is aimed to determine the risk of heart attack at the first stage, to control it, and to make its resource planning with the method of data mining. Through the early and correct diagnosis of heart attacks, it is aimed to reveal the factors which affect the diseases, to protect health and choose the right treatment methods, to reduce the costs in health expenditures, and to shorten the durations of patients’ stay at hospitals. In this way, the diagnosis and treatment costs of a heart attack will be scrutinized, which will be useful to determine the risk of the disease at the first stage, to control it, and to make its resource planning.

Keywords: data mining, decision support systems, heart attack, health sector

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Authors: Michael Ricardo Lang, AdriéLle Costa, Ivana Iesbik, Karine Haag, Leonardo Trindade Buffara, Oscar Reimann Junior, Chelin Auswaldt Steclan

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Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with SAH being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyspilipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: biomarkers, sex, stroke, stroke unit, population

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Authors: A. Bentley, A. Prost, N. Daruwalla, D. Osrin

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Background: This study aims to investigate the relationship between experiences of violence against women in the family, and levels of self-esteem in women residing in informal settlement (slum) areas of Mumbai, India. The authors hypothesise that violence against women in Indian households extends beyond that of intimate partner violence (IPV), to include other members of the family and that experiences of violence are associated with lower levels of self-esteem. Methods: Experiences of violence were assessed through a cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points, and the main perpetrator of each. Self-esteem was assessed using the Rosenberg self-esteem questionnaire. A global score for self-esteem was calculated and the relationship between violence in the past year and Rosenberg self-esteem score was assessed using multivariable linear regression models, adjusted for years of education completed, and clustering using robust standard errors. Results: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 6 years of education and had been married 9.5 years. 88% were Muslim and 46% lived in joint families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 24% physical, 12% sexual). Of the women who experienced violence after marriage, 70% cited a perpetrator other than the husband for at least one of the acts. 5% had low self-esteem (Rosenberg score < 15). For women who experienced emotional violence in the past year, the Rosenberg score was 2.6 points lower (p < 0.001). It was 1.2 points lower (p = 0.03) for women who experienced economic violence. For physical or sexual violence in the past year, no statistically significant relationship with Rosenberg score was seen. However, for a one-unit increase in the number of different acts of each type of violence experienced in the past year, a decrease in Rosenberg score was seen (-0.62 for emotional, -0.76 for economic, -0.53 for physical and -0.47 for sexual; p < 0.05 for all). Discussion: The high prevalence of violence experiences across the lifetime was likely due to the detailed assessment of violence and the inclusion of perpetrators within the family other than the husband. Experiences of emotional or economic violence in the past year were associated with lower Rosenberg scores and therefore lower self-esteem, but no relationship was seen between experiences of physical or sexual violence and Rosenberg score overall. For all types of violence in the past year, a greater number of different acts were associated with a decrease in Rosenberg score. Emotional violence showed the strongest relationship with self-esteem, but for all types of violence the more complex the pattern of perpetration with different methods used, the lower the levels of self-esteem. Due to the cross-sectional nature of the study causal directionality cannot be attributed. Further work to investigate the relationship between severity of violence and self-esteem and whether self-esteem mediates relationships between violence and poorer mental health would be beneficial.

Keywords: family violence, India, informal settlements, Rosenberg self-esteem scale, self-esteem, violence against women

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Authors: F. J. Puertas, M. Castro, A. Tebar, P. J. Fito, R. Gadea, J. M. Monzó, R. J. Colom

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There is a great diversity of diseases that affect the integrity of the walls of the esophagus, generally of a digestive nature. Among them, gastroesophageal reflux is a common disease in the general population, affecting the patient's quality of life; however, there are still unmet diagnostic and therapeutic issues. The consequences of untreated or asymptomatic acid reflux on the esophageal mucosa are not only pain, heartburn, and acid regurgitation but also an increased risk of esophageal cancer. Currently, the diagnostic methods to detect problems in the esophageal tract are invasive and annoying, as 24-hour impedance-pH monitoring forces the patient to be uncomfortable for hours to be able to make a correct diagnosis. In this work, the development of a sensor able to measure in depth is proposed, allowing the detection of liquids circulating in the esophageal tract. The multisensor detection system is based on radiofrequency photospectrometry. At an experimental level, consumers representative of the population in terms of sex and age have been used, placing the sensors between the trachea and the diaphragm analyzing the measurements in vacuum, water, orange juice and saline medium. The results obtained have allowed us to detect the appearance of different liquid media in the esophagus, segregating them based on their ionic content.

Keywords: bioimpedance, dielectric spectroscopy, gastroesophageal reflux, GERD

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Authors: Sandeep Pandey, Nimra Habib, Ranjana Singh, Abbas Ali Mahdi

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Leukemia is a malignancy of blood that mainly affects children and young adults; while advancement in the early diagnosis will have the potential to improve the outcome of diseases. A wide range of disease including leukemia shows inflammatory signals in their pathogenesis. In a pilot study conducted in our laboratory, 52 people were screened, of which 26 had leukemia and 26 were free from any kind of malignancy. We performed the estimation of the inflammatory cytokine Interleukin-8 and it was found significantly raised in all the leukemia patients concerning healthy volunteers who participated in the study. Flow cytometry had been performed for the confirmation of leukemia and further genomic, and proteomic, analyses of the sample revealed that IL-8 levels showed a positive correlation in patients with leukemia. The results had shown constitutive secretion of interleukin-8 by leukemia cells. So, our finding demonstrated that IL-8 is considered to have a role in the pathogenesis of leukemia, and quantification of IL-8 levels in leukemia conditions might be more useful and feasible in the clinical setting for the prediction of drug responses where it may represent a putative target for innovative diagnostic toward effective therapeutic approaches. However, further research explorations in this area are needed that include a greater number of patients with all different forms of leukemia, and estimating their IL-8 levels may hold the key for the additional predictive values on the recurrence of leukemia and its prognosis.

Keywords: T-ALL, IL-8, leukemia pathogenesis, cancer therapeutics

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Authors: Ali Oztuna, Meral Sarper, Deniz Torun, Fatma Bayrakdar, Selcuk Kilic, Mehmet Baysallar

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Bacillus anthracis is one of the biological agents most likely to be used in case of bioterrorist attack as well as being the cause of anthrax. The bacterium's major virulence factors are the anthrax toxins and an antiphagocytic polyglutamic capsule. TEM8 (ANTXR1) and CMG2 (ANTXR2) are ubiquitously expressed type I transmembrane proteins, and ANTXR2 is the major receptor for anthrax toxins. MicroRNAs are 21-24 bp small noncoding RNAs that regulate gene expression by base pairing with the 3' UTR (untranslated regions) of their target mRNAs resulting in mRNA degradation and/or translational repression. MicroRNAs contribute to regulation of most biological processes and influence numerous pathological states like infectious disease. In this study, post-exposure (toxins) protective effect of the hsa-miR-124-3p against Bacillus anthracis was examined. In this context, i) THP-1 and U937 cells were differentiated to MΦ macrophage, ii) miRNA transfection efficiencies were evaluated by flow cytometry and qPCR, iii) protection against Bacillus anthracis toxins were investigated by XTT, cAMP ELISA and MEK2 cleavage assays. Acknowledgements: This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Grant SBAG-218S467.

Keywords: ANTXR2, hsa-miR-124-3p, MΦ macrophage, THP-1, U937

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Authors: Ghoul Rachid Brahim, Trad Khodja Rafik

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Vertebral localization of the hydatid cyst is a severe form of bone hydatidosis, is a parasitic infection caused by the larval forms of the tapeworms Echinococcus granulosus, The disease is slowly remaining silent (a long incubation period) which may explain why this pathology is often discovered at the stage of neurological complications. The objective of this study is to recall the clinical and radiological aspects of this condition and the importance of early diagnosis and appropriate management. We report a study of 5 patients with vertebral hydatidosis, four men and one woman, four (04) patients operated in the emergency setting for spinal cord compression (decompression by wide laminectomy with evacuation of intra and extra canal vesicles).Albendazole-based medical treatment is instituted in all patients. Results: The evolution was favorable for three patients, the other two patients reoperated for a local recurrence. Conclusion: Vertebral hydatidosis is a rare condition with a poor prognosis due to the risk of neurological damage, the infiltrating nature of bone lesions, the frequency of relapses and therapeutic difficulties. The only curative method remains surgery, which must aim for complete and large excision of the lesions as if it were a “malignant tumour”.

Keywords: hydatidosis, Echinococcosis granulosus, hydatid cyst, spinal cord compression, laminectomy

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Authors: Ye Wei, Sitalakshmi Venkatraman, Fahri Benli, Fiona Wahr

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The present digital world poses many challenges to various stakeholders in the education sector. In particular, lecturers of higher education (HE) are faced with the problem of ensuring that students are able to achieve the required learning outcomes despite rapid changes taking place worldwide. Different strategies are adopted to retain student engagement and commitment in classrooms to address the differences in learning habits, preferences, and styles of the digital generation of students recently. Further, the onset of the coronavirus disease (COVID-19) pandemic has resulted in online teaching being mandatory. These changes have compounded the problems in the learning engagement and short attention span of HE students. New agile methodologies that have been successfully employed to manage projects in different fields are gaining prominence in the education domain. In this paper, we present the application of Scrum as an agile methodology to enhance student learning and engagement in an online smart classroom environment. We demonstrate the use of our proposed approach using a case study to teach key topics in information technology that require students to gain technical and business-related data analytics skills.

Keywords: agile methodology, Scrum, online learning, smart classroom environment, student engagement, active learning

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Authors: Patricia Abigail B. Miranda, Imelda A. Luna

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Introduction: COVID-19 infection is a novel viral illness that began as a local epidemic in December 2019 in Wuhan, China which quickly emerged into a pandemic by February 2020. The virus causes a spectrum of signs and symptoms, ranging from mild upper respiratory symptoms to acute respiratory distress syndrome, which may lead to death. Among children and neonates, those afflicted with the disease may present asymptomatically or with mild symptoms. To date, there has been limited local data that describes the outcomes of the growing number of COVID-19 cases, specifically in neonates. Methods: A cross-sectional study was conducted to determine the outcomes of neonates born to COVID-19 Positive Mothers from March 2020 until June 2022. The prevalence of COVID-19 among these neonates was also determined. Results: COVID-positive prevalence after 24 hours of life is at 8%, while prevalence after 48 hours among those who still underwent testing was at 13.51%. Moreover, among those COVID-19-negative neonates who had symptoms, they mostly presented with tachypnea (5.7%). The prevalence of complications among COVID-19-negative neonates delivered to COVID-19-positive mothers is 22.7%. Conclusion: Neonates born to COVID-19-positive mothers who yielded positive COVID-19 results are generally asymptomatic. Moreover, there are no associated mortalities among those who yielded positive results.

Keywords: COVID-19, neonates, outcomes, clinical profile

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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Authors: M. Golzade Gangraj, A. Abdi, H.faraji

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Aim: The aim of this study was to evaluate the effects of six weeks of moderate-intensity aerobic exercise with pomegranate juice (PJ) on plasma leptin in adult women selection of type-2 diabetes. Methods: Survey postmenopausal diabetic women aged 45 to 60 years in the city of Babylon, who coordinated Diabetes Association presented the city, among them 34 were selected as subjects were randomly divided into four groups: control, PJ, practice and PJ. Experimental groups consisted of 6 weeks of aerobic exercise training program three times a week for at least 45 minutes per meeting. Two days before and after the training period in the fasting state (12 h) blood samples from the brachial vein was performed in a sitting position. Results: Results showed that aerobic exercise with consumption of pomegranate juice alone and interaction with each significantly decrease levels of leptin plasma in older women with type 2 diabetes compared to control group. Conclusion: According to the research findings can be stated the exercise with pomegranate juice beneficially effects fat tissue and decreases plasma leptin in adult women with type 2 diabetes and thereby reduce risk of cardiovascular disease.

Keywords: aerobic exercise, pomegranate, leptin, diabetes

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Authors: Zahra Ghasemi, Fatemeh Babaei

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Plasma-derived medicinal products are vital categories of biological therapies. These products are used to treat rare, chronic, severe, and life-threatening conditions, such as bleeding disorders (Hemophilia A and B), hemolytic disease of the fetus and newborn, severe infections, burns and liver diseases, and other diseases caused by the absence or malfunction of certain proteins. In addition, they improve the patient’s quality of life. The process of producing plasma-derived medicinal products begins with the collection of human plasma from healthy donors. This initial stage is complex and is monitored with high precision and sensitivity by global authorities to maintain the quality and safety of the final products as well as the health of the donors. The amount of manufactured plasma-derived medicinal products depends on the availability of its raw material, human plasma, so collecting enough plasma for fractionation is essential. Therefore, adopting a suitable national policy regarding plasma donation, establishing collection centers, and increasing public awareness of the importance of plasma donation will improve any country’s conditions regarding the timely and sufficient supply of these medicines. In this study, we tried to briefly examine the importance of sustainability of the plasma industry and its situation in our beloved country of Iran.

Keywords: plasma, source plasma, plasma-derived medicinal products, fractionation

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Authors: Okanlawon Simon Ayorinde, Odunjo Oluronke Omolola, Fadamiro Joseph Akinlabi, Adedibu Afolabi Adebgite

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A road is a path established over land, especially prepared way between places for the use of pedestrian, riders, and vehicles: a hard surface built for vehicles to travel on. The social, economic and health importance of roads in any community and nation cannot be underestimated. Roads provide access to properties and they also provide mobility which is ability to transport goods and services from one place to another. In the residential zones of many indigenous cities in Nigeria, roads are usually blocked for social ceremonies. Road blocked for ceremonies as used in this study are a temporary barrier across a road, used to stop or hinder traffic from passing through to the other side. Social ceremonies that could warrant road blockage include marriage, child naming, funeral, celebration of life’s achievement, birthday anniversary etc. These activities are likely to generate environmental hazards and their attendant risks. The assessment of these hazards and risks in residential zones of indigenous cities in Nigeria becomes imperative. The study is focused on Ogbomoso, Oyo State, Nigeria. The town has two local government councils namely Ogbomoso North and Ogbomoso South. Urban tracts that are easy to identify are political wards in the absence of land use segregation, houses numbering and street naming. The wards that had residential having a minimum of 60% of their land use components were surveyed and fifteen out of twenty wards identified in the town were surveyed. The study utilized primary data collected through questionnaire administration The three major road categories (Trunk A-Federal; Trunk B- State; Trunk C-Local) were identified and trunk C-Local roads were purposively selected being the concern of this study because they are the ones often blocked for social activities. The major stakeholders interviewed and the respective sampling methods are residents (random and systematic), social ceremony organizers (purposive), government officials (purposive) and road users namely commercial motorists and commercial motor cyclists (random and incidental). Data analysis was mainly descriptive. Two indices to measure respondents’ perception were developed. These are ‘Hazard Severity Index’ (HSI) and ‘Relative Awareness Index’ (RAI).Thereafter, policy implications and recommendations were provided.

Keywords: road, residential zones, indigenous cities, blocked, social ceremonies

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Authors: Zineb Ouahdi

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Spirocyclic compound derivatives, with their unique heterocyclic motifs, serve as a continual source of inspiration in the pursuit of developing potential therapeutic agents. These compounds are diverse in their chemical structures; some have fully saturated skeletons, while others are partially unsaturated. Nevertheless, these compounds share a characteristic feature with natural products - the presence of at least one heteroatom in one of their rings. The inclusion of a C = O dipolarophile in pyridazinones imparts an exciting aspect for 1,3-dipolar cycloaddition reactions, the focal point of our study. Our research has involved a detailed theoretical investigation of the reaction between ethyl (Z)-2-bromo-2-(2-(p-tolyl)hydrazono)acetate and 6-methyl-4,5-dihydropyridazine-3(2H)-one. This has been accomplished using the DFT/B3LYP/6-31g(d,p) method, intending to illuminate the chemical pathway of this reaction. The chemical reactivity theories we used for this purpose included FMO, TS, and local and global indices derived from conceptual DFT. The theoretical framework outlined in this study allowed us to propose a reaction mechanism for cycloaddition reactions. It also enabled the identification of the potential activities of the analyzed compounds (P1, P2, P3, P4, P5, and P6) against the major protease of the coronavirus disease (COVID-19). This was achieved using various computational tools, including AutoDock Tools, Autodock Vina, Autodock 4, and PYRX.

Keywords: MEDT, pyridazin, cycloaddition, FMO, DFT, docking

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Authors: Marcela Parra-Vargas, Ana Sandoval-Rodriguez, Roberto Rodriguez-Echevarria, Jose Dominguez-Rosales, Juan Armendariz-Borunda

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Non-alcoholic fatty liver disease (NAFLD) is characterized by an excess of hepatic lipids, and it is to author’s best knowledge, the most prevalent chronic liver disorder. Anthocyanin-rich food consumption is linked to health benefits in metabolic disorders associated with obesity and NAFLD, although the precise functional role of anthocyanidin delphinidin (Dp) has yet to be established. The aim of this study was to investigate the effect of the Dp in NAFLD metabolic alterations by evaluating prevention or amelioration of hepatic lipid accumulation, as well as molecular mechanisms in two experimental obesity-related models of NALFD. In vitro: HepG2 cells were incubated with sodium palmitate (PA, 1 mM) to induce lipotoxic damage, and concomitantly treated with Dp (180 uM) for 24 h. Subsequently, total lipid accumulation was measured by colorimetric staining with Oil Red O, and total intrahepatic triglycerides were determined by an enzymatic assay. To assess molecular mechanisms, cells were pre-treated with PA for 24 h and then exposed to Dp for 1 h. In vivo: four-week-old male C57BL/6Nhsd mice were allocated in two main groups. Mice were fed with standard diet (control) or high-fat and high-carbohydrate diet (45% fat, HFD) for 16 wk to induce NAFLD. Then HFD was divided into subgroups: one treated orally with Dp (15 mg/kg bw, HFD-Dp) every day for 4 wk, while HFD group treated with vehicle (DMSO). Weight and fasting glucose were recorded weekly, while dietary ingestion was measured daily. Insulin tolerance test was performed at the end of treatment. Liver histology was evaluated with H&E and Masson’s trichrome stain. RT-PCR was used to evaluate gene expression and Western Blot to determine levels of protein in both experimental models. Parametric data were analyzed with one-way ANOVA and Tukey’s post-hoc test. Kruskal-Wallis and Mann-Whitney U test for non-parametric data, and P < 0.5 were considered significant. Dp prevented hepatic lipid accumulation by PA in HepG2 hepatocytes. Furthermore, Dp down-regulated gene expression of SREBP1c, FAS, and CPT1a without modifying AMPK phosphorylation levels. In vivo, Dp oral administration did not ameliorate lipid metabolic alterations raised by HFD. Adiposity, dietary ingestion, fasting glucose, and insulin sensitivity after Dp treatment remained similar to HFD group. Histological analysis showed hepatic damage in HFD groups and no differences between HFD and HFD-Dp groups were found. Hepatic gene expression of ACC and FAS were not altered by HFD. SREBP1c was similar in both HFD and HFD-Dp groups. No significant changes were observed in SREBP1c, ACC, and FAS adipose tissue gene expression by HFD or Dp treatment. Additionally, immunoblotting analysis revealed no changes in pathway SIRT1-LKB-AMPK and PPAR alpha by both HFD groups compared to control. In conclusion, the antioxidant Dp may provoke beneficial effects in the prevention of hepatic lipid accumulation. Nevertheless, the oral dose administrated in mice that simulated the total intake of anthocyanins consumed daily by humans has no effect as a treatment on hepatic lipid metabolic alterations and histological abnormalities associated with exposure to chronic HFD. A healthy lifestyle with regular intake of antioxidants such as anthocyanins may prevent metabolic alterations in NAFLD.

Keywords: anthocyanins, antioxidants, delphinidin, non-alcoholic fatty liver disease, obesity

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Authors: Adineh Tajmousavilangerudi, Ali Zein Alabiden Tlais, Raffaella Di Cagno

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The SARS-Cov-2 pandemic has exposed our vulnerability to new illnesses and novel viruses that attack our immune systems, particularly in the elderly. The vaccine is being gradually introduced over the world, but new strains of the virus and COVID-19 will emerge and continue to cause illness. Aging is associated with significant changes in intestinal physiology, which increases the production of inflammatory products, alters the gut microbiota, and consequently establish inadequate immune response to minimize symptoms and disease development. In this context, older people who followed a Mediterranean-style diet, rich in polyphenols and dietary fiber, performed better physically and mentally (1,2). This demonstrates the importance of the human gut microbiome in transforming complex dietary macromolecules into the most biologically available and active nutrients, which in turn help to regulate metabolism and both intestinal and systemic immune function (3,4). The role of lactic acid fermentation is prominent also as a powerful tool for improving the nutritional quality of the human diet by releasing nutrients and boosting the complex bioactive compounds and vitamin content. the PhD project aims to design fermented and functional foods/beverages capable of modulating human immune function via the gut microbiome.

Keywords: functional bevarage, fermented beverage, gut microbiota functionality, immun system

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Authors: Cassandra Springate, Alexandra Furber, Jack E. Hines

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Objectives: To create an evidence map of the cost-utility studies available with non-small cell lung cancer patients, and identify the geographical settings and interventions used. Methods: Using the Disease, Study Type, and Model Type filters in heoro.com we identified all cost-utility studies published between 1960 and 2017 with patients with non-small cell lung cancer. These papers were then indexed according to pre-specified categories. Results: Heoro.com identified 89 independent publications, published between 1995 and 2017. Of the 89 papers, 74 were published since 2010, 28 were from the USA, and 35 were from Europe, 16 of which were from the UK. Other publications were from China and Japan (13), Canada (9), Australia and New Zealand (4), and other countries (8). Fifty-nine studies included a chemotherapy intervention, of which 23 included erlotinib or gefitinib, 21 included pemetrexed or docetaxel, others included nivolumab (3), pembrolizumab (2), crizotinib (2), denosumab (2), necitumumab (1), and bevacizumab (1). Also, 19 studies modeled screening, staging, or surveillance strategies. Conclusions: The cost-utility studies found for NSCLC most commonly looked at the effectiveness of different chemotherapy treatments, with some also evaluating the addition of screening strategies. Most were also conducted with patient data from the USA and Europe.

Keywords: cancer, cost-utility, economic model, non-small cell lung cancer

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Authors: Awdhesh Narayan Sharma

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The use of herbal medicines for the cure of various ailments among the tribal population is as old as human origin itself. Most of the tribal populations of Madhya Pradesh inhabit in remote and inaccessible ecological setup. From long back, tribals and forests are interrelated to each other. They use an enormous range of wild plants for their basic needs and medicines. The tribal developed a unique understanding with wild plants, herbs, etc., and earned specialized knowledge of disease pattern and curative therapy-through hard experiences, common sense, trial, and error methods. They have passed this knowledge through traditions, taboos, totems, folklore by words of mouth from generation to generation. Here, an attempt has been made to study the possible aspects of herbal medicine for the cure of Jaundice among the tribal populations of Madhya Pradesh, India, through primary data as well as available secondary data. The data have been collected from the 305 Bharias of Patalkot, Madhya Pradesh, India, and included available secondary source of data by various investigators. It may be concluded that a sizable herbal medicinal plants' wealth exists in Madhya Pradesh, India, which still awaits for scientific exploration. The existing herbal medicines used for the cure of jaundice need an extensive investigation from the pharmaceutical point of view.

Keywords: Bharias, herbal medicine, tribal, Madhya Pradesh

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Authors: Angelis P. Barlampas

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Target: The (SARS-CoV-2) is still a threat. AI software could be useful, categorizing the disease into different severities and indicate the extent of the lesions. Materials and methods: AI is a new revolutionary technique, which uses powered computerized systems, to do what a human being does more rapidly, more easily, as accurate and diagnostically safe as the original medical report and, in certain circumstances, even better, saving time and helping the health system to overcome problems, such as work overload and human fatigue. Results: It will be given an effort to describe to the inexperienced reader (see figures), as simple as possible, how an artificial intelligence system diagnoses computed tomography pictures. First, the computerized machine learns the physiologic motives of lung parenchyma by being feeded with normal structured images of the lung tissue. Having being used to recognizing normal structures, it can then easily indentify the pathologic ones, as their images do not fit to known normal picture motives. It is the same way as when someone spends his free time in reading magazines with quizzes, such as <> and <>. General conclusion: The AI mimics the physiological processes of the human mind, but it does that more efficiently and rapidly and provides results in a few seconds, whereas an experienced radiologist needs many days to do that, or even worse, he is unable to accomplish such a huge task.

Keywords: covid-19, artificial intelligence, automated imaging, CT, chest imaging

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Safa Safdar

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Breast cancer is a type of cancer which is developed by the formation of a tumor on the breast. This tumor invades and causes different electrolyte imbalance. The present study was designed to measure the serum calcium and inorganic phosphorous levels and to check the frequency of hypercalcemia and hypophosphatemia in breast cancer patients. Serum calcium and phosphorous levels of fifty breast cancer women of 18-70 years of age group and fifty healthy women of same age group were measured by using semi-automated chemistry analyzer ( Humalyzer 3000, Human, Germany ). Significant variation in these levels was observed. The mean calcium value in BC patients was higher 9.398 mg/dl as compared to controls which were 8.694 mg/dl. Whereas the mean value of inorganic phosphorus level was lower 4.060 mg/dl in BC patients as compared to controls having 4.456 mg/dl. In this study, the frequency of hypercalcemia in Breast cancer patients was 10% i.e. only 10 out of 50 Breast cancer patients were suffering from hypercalcemia. Whereas the frequency of hypophosphatemia in this study was only 2 % i.e. only 1 out of 50 patients was suffering from hypophosphatemia. Thus it is concluded that there is a significant change in serum calcium and inorganic phosphorous levels in Breast cancer patients as the disease progresses. So, this study will be helpful for the clinicians to maintain serum calcium and phosphorous levels in Breast cancer patients and also preventing them from further complications.

Keywords: serum analysis, calcium, inorganic phosphorus, hpercalcemia hypophosphatemia

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Authors: Saeed S. Al-Sokari, Nasser A. Awadh Ali, Lianet Monzote

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Leishmaniasis (CL) is endemic in at least 82 countries and considered to be a major public-health problem (1). The annual incidence of CL is 1–1.5 million cases of which 90% occur in only seven countries: Afghanistan, Algeria, Brazil, Iran, Peru, Saudi Arabia and Syria (2). In Saudi Arabia, the disease was first described in 1973 by Moursy and Shoura (3). Currently, CL is common in the human population in different localities, including the Eastern Province of Saudi Arabia and in particular the Al-Hassa Oasis that is a known endemic area for CL (4). Five methanolic extracts obtained from Achillea biebersteinii (flower leaf), Euphorbia antiquorm, Solanum incanum (leaf and fruit extracts), collected from Albaha region and selected from ethno-botanical data, were screened for their anti-leishmanial activity against Leishmania amazonensis (6). The cytotoxic activity against normal peritoneal macrophages from normal BALB/c mice was also determined (6). The five extracts had IC50 values ranging from < 12.5 to 37.8 µg/ml against promastigotes. Achillea biebersteinii flower, Euphorbia antiquorm, Solanum incanum leaf extracts showed anti-leishmanial activities with IC50 between < 12.5 - 26.9µg/mL and acceptable selectivity indices of 8 - 5.

Keywords: plant extracts, Albaha, Leishmania amazonensis, Medicinal

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Authors: A. Bouaouiche, M. S. Boulakoud

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The functioning of the pineal gland, the transducer body of environmental information to the neuroendocrine system is subject to a circadian rhythm. Melatonin is the main neuro-hormone expressing this operation. It is synthesized in the pinealocytes after conversion serotonin via N-acetyl-transferase enzyme, itself subject to a photoperiodic modulation (activation dark inhibition by light). Some authors have suggested that melatonin is involved in diabetic disease and found that it could have a diabetogenic effect. To this study the effect of this hormone on glucose metabolism has long been subject to controversy. Agreeing in effect and hyperinsulinemic hypoglycemic effect. In order to illustrate the level of interaction of melatonin with neuro-immune- corticotropin axis and its impact on carbohydrate metabolism, we studied the impact homeostatic (glucose) through the solicitation of two control systems (gland pineal and corticotropin axis). We then found that melatonin could have an indirect influence on insulin control (glucose metabolism) to the levels of the growth hormone axis (somatostatin) and adrenocorticotropic (corticotropin). In addition, we have suggested that melatonin might limit the hyperglycemic action of corticosteroids by direct action at peripheral level.

Keywords: pinéal gland, melatonin, neuro-immuno-corticotrop, metabolism

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Authors: Asma'u Mahe, Abdullahi A. Imam, Adamu J. Alhassan, Nasiru Abdullahi, Sadiya A. Bichi, Nura Lawal, Kamaluddeen Babagana

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Malaria is a disease with global health significance. It is caused by parasites and transmitted by Anopheles mosquitoes. Increase in insecticide resistance threatens the disease vector control. The strength of selection pressure acting on a mosquito population in relation to insecticide resistance can be assess by determining the genetic diversity of a fragment spanning exon- 20 of IIS6 of the voltage gated sodium channel (VGSC). Larval samples reared to adulthood were identified and kdr (knock down resistance) profile was determined. The DNA sequences were used to assess the patterns of genetic differentiation by determining the levels of genetic variability between the Anopheles mosquitoes. Genetic differentiation of the Anopheles mosquitoes based on a portion of the voltage gated sodium channel gene was obtained. Polymorphisms were detected; sequence variation and analysis were presented as a phylogenetic tree. Phylogenetic tree of VGSC haplotypes was constructed for samples of the Anopheles mosquitoes using the maximum likelihood method in MEGA 6.0 software. DNA sequences were edited using BioEdit sequence editor. The edited sequences were aligned with reference sequence (Kisumu strain). Analyses were performed as contained in dnaSP 5.10. Results of genetic parameters of polymorphism and haplotype reconstruction were presented in count. Twenty sequences were used for the analysis. Regions selected were 1- 576, invariable (monomorphic) sites were 460 while variable (polymorphic) sites were 5 giving the number of total mutations observed in this study. Mutations obtained from the study were at codon 105: TTC- Phenylalanine replaces TCC- Serine, codon 513: TAG- Termination replaces TTG- Leucine, codon 153, 300 and 553 mutations were non-synonymous. From the constructed phylogenetic tree, some groups were shown to be closer with Exon20Gambiae Kisumu (Reference strain) having some genetic distance, while 5-Exon20Gambiae-F I13.ab1, 18-Exon20Gambiae-F C17.ab1, and 2-Exon20Gambiae-F C13.ab1 clustered together genetically differentiated away from others. Mutations observed in this study can be attributed to the high insecticide resistance profile recorded in the study areas. Haplotype networks of pattern of genetic variability and polymorphism for the fragment of the VGSC sequences of sampled Anopheles mosquitoes revealed low haplotypes for the present study. Haplotypes are set of closely linked DNA variation on X-chromosome. Haplotypes were scaled accordingly to reflect their respective frequencies. Low haplotype number, four VGSC-1014F haplotypes were observed in this study. A positive association was previously established between low haplotype number of VGSC diversity and pyrethroid resistance through kdr mechanism. Significant values at (P < 0.05) of Tajima D and Fu and Li D’ were observed for some of the results indicating possible signature of positive selection on the fragment of VGSC in the study. This is the first report of VGSC-1014F in the study site. Based on the results, the mutation was present in low frequencies. However, the roles played by the observed mutations need further investigation. Mutations, environmental factors among others can affect genetic diversity. The study area has recorded increase in insecticide resistance that can affect vector control in the area. This finding might affect the efforts made against malaria. Sequences were deposited in GenBank for Accession Number.

Keywords: anopheles mosquitoes, insecticide resistance, kdr, malaria, voltage gated sodium channel

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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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Authors: Marina Charalambous, Phivos Phylactou, Thekla Elriz, Loukia Psychogios, Jean-Marie Annoni

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Background: Evidence-based practices for the evaluation and treatment of people with aphasia (PWA) in Greek are mainly impairment-based. Functional and multimodal communication is usually under assessed and neglected by clinicians. This study explores the adaptation and psychometric testing of the Greek (GR) version of The Scenario Test. The Scenario Test assesses the everyday functional communication of PWA in an interactive multimodal communication setting with the support of an active communication facilitator. Aims: To define the reliability and validity of The Scenario Test GR and discuss its clinical value. Methods & Procedures: The Scenario Test-GR was administered to 54 people with chronic stroke (6+ months post-stroke): 32 PWA and 22 people with stroke without aphasia. Participants were recruited from Greece and Cyprus. All measures were performed in an interview format. Standard psychometric criteria were applied to evaluate reliability (internal consistency, test-retest, and interrater reliability) and validity (construct and known – groups validity) of the Scenario Test GR. Video analysis was performed for the qualitative examination of the communication modes used. Outcomes & Results: The Scenario Test-GR shows high levels of reliability and validity. High scores of internal consistency (Cronbach’s α = .95), test-retest reliability (ICC = .99), and interrater reliability (ICC = .99) were found. Interrater agreement in scores on individual items fell between good and excellent levels of agreement. Correlations with a tool measuring language function in aphasia (the Aphasia Severity Rating Scale of the Boston Diagnostic Aphasia Examination), a measure of functional communication (the Communicative Effectiveness Index), and two instruments examining the psychosocial impact of aphasia (the Stroke and Aphasia Quality of Life questionnaire and the Aphasia Impact Questionnaire) revealed good convergent validity (all ps< .05). Results showed good known – groups validity (Mann-Whitney U = 96.5, p < .001), with significantly higher scores for participants without aphasia compared to those with aphasia. Conclusions: The psychometric qualities of The Scenario Test-GR support the reliability and validity of the tool for the assessment of functional communication for Greek-speaking PWA. The Scenario Test-GR can be used to assess multimodal functional communication, orient aphasia rehabilitation goal setting towards the activity and participation level, and be used as an outcome measure of everyday communication. Future studies will focus on the measurement of sensitivity to change in PWA with severe non-fluent aphasia.

Keywords: the scenario test GR, functional communication assessment, people with aphasia (PWA), tool validation

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Authors: Sabreen Al Shamli, Abdul Rahman Al azure

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Microscopic examination by histopathology is the gold standard for diagnosing many oral and maxillofacial pathologies. Current clinical guidelines and medicolegal regulations recommend the utilization of histopathology services for confirming pathologies being treated. The goal of this study was to determine the prevalence and distribution of oral and maxillofacial biopsies that had been histopathologically diagnosed at Anahdha Hospital (ANH). A total of 512 biopsies randomly selected from a ground total of 3310 biopsies, which were submitted for oral and maxillofacial histopathological specimens, were analyzed at Nahdha Hospital in Oman between January 2010 and December 2022. Data collected retrospectively selected from all case notes of patients who had oral histopathology examinations performed as part of their treatment. Data collected from the Shifa system was transferred to Microsoft Excel and analyzed using SPSS. Research ethics approval was obtained from the research committee of the hospital. This study provides background information on oral histopathology prevalence that could be helpful in future research in Oman. The findings of the present study are in agreement with the reported data from other investigations, even when it is taken into account how difficult it is to compare prevalence rates from different studies.

Keywords: oral biopsy, maxillofacial histopathology, oral disease, maxillofacial specimens

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