Search results for: advanced diagnostic obesity notation model assessment cardiac index

Authors: Sadaf Abbas, HimGauri Sabnis

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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.

Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium

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Authors: Tatiana Pratt, Benyamin Hanasabzadeh, Panayiota Courelli

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The COVID-19 pandemic is one of the largest global public health issues of this current century. COVID-19 puts people diagnosed with obesity at higher risk of not only contracting the virus but also being hospitalized and dying, making this a vital time to implement obesity prevention programs. However, COVID-19 is predicted to rapidly increase the obesity rate in the United States due to the mandatory sedentary lifestyle the pandemic demands; this is especially harmful to adolescent-aged children because it creates lifelong unhealthy habits and behaviors. Adolescent obesity prevention programs have been rigorously implemented throughout the last century to help diminish the ever-increasing adolescent obesity rate. Since the pandemic kept adolescents inside and away from in-person school, many programs have now become ineffective due to their in-person participation. Examples of in-person participation programs include school lunch programs, OSNAP and New Moves. Therefore, online programs or remote intervention measures are now more essential. This leads to programs such as Time2bHealthy, HEALTH[e]TEEN, and SWITCH should be looked at with more vitality. Adolescents have intertwined their lives with technology and screen usage. Therefore, online and remote prevention programs will continue to play a large role in the post-pandemic era. This literature review will be reviewing past and current adolescent obesity prevention programs and their effectiveness with the new remote, sedentary lifestyle adolescents. Furthermore, it will suggest new ways to more productively decrease adolescent obesity rates by analyzing the harmful factors that COVID-19 introduced into their lifestyles.

Keywords: adolescent, obesity, overweight, COVID-19, preventative care, public health, public policy, obesity prevention programs, online programs

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Authors: Geraldine Landon, Enora Clero, Jean-Rene Jourdain

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In 2005, the Institut de Radioprotection et de Sûreté Nucléaire (IRSN, France) launched a research program named EPICE (acronym for 'Evaluation of Pathologies potentially Induced by CaEsium') to collect scientific information on non-cancer effects possibly induced by chronic exposures to low doses of ionizing radiation with the view of addressing a question raised by several French NGOs related to health consequences of the Chernobyl nuclear accident in children. The implementation of the program was preceded by a pilot phase to ensure that the project would be feasible and determine the conditions for implementing an epidemiological study on a population of several thousand children. The EPICE program focused on childhood cardiac arrhythmias started in May 2009 for 4 years, in partnership with the Russian Bryansk Diagnostic Center. The purpose of this cross-sectional study was to determine the prevalence of cardiac arrhythmias in the Bryansk oblast (depending on the contamination of the territory and the caesium-137 whole-body burden) and to assess whether caesium-137 was or not a factor associated with the onset of cardiac arrhythmias. To address these questions, a study bringing together 18 152 children aged 2 to 18 years was initiated; each child received three medical examinations (ECG, echocardiography, and caesium-137 whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. The findings of the study, currently submitted to an international journal justifying that no results can be given at this step, allow us to answer clearly to the issue of radiation-induced childhood arrhythmia, a subject that has been debated for many years. Our results will be certainly helpful for health professionals responsible for the monitoring of population exposed to the releases from the Fukushima Dai-ichi nuclear power plant and also useful for future comparative study in children exposed to ionizing radiation in other contexts, such as cancer radiation therapies.

Keywords: Caesium-137, cardiac arrhythmia, Chernobyl, children

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Authors: Chengliang Xie, Jinhyun Ryu, Hyun Joon Kim, Gyeong Jae Cho, Wan Sung Choi, Sang Soo Kang, Kye Man Cho, Dong Hoon Lee

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Obesity has become a global health problem and a source of major metabolic diseases like type-2 diabetes, hypertension, heart disease, nonalcoholic fatty liver and cancer. Synthetic anti-obesity drugs are effective but very costly and with undesirable side effects, so natural products such as soybean are needed as an alternative for obesity treatment. Lactobacillus Plantarum P1201is a probiotic bacterial strain reported to produce conjugated linoleic acid (CLA) and increase the ratio of aglycone-isoflavone of soybean, both of which have anti-obesity effect. In this study, the anti-obesity effect of the fermented soybean extract with P1201 (FSE) will be evaluated compared with that of the soybean extract (SE) by 3T3-L1 cells as an in vitro model of adipogenesis. 3T3-L1 cells were treated with SE and FSE during the nine days of the differentiation, lipid accumulation was evaluated by oil-red staining and triglyceride content and the mRNA expression level of adipogenic or lipogenic genes were analyzed by RT-PCR and qPCR. The results showed that formation of lipid droplets in differentiated 3T3-L1 cells was inhibited and triglyceride content was reduced by 23.1% after treated with 1000 μg/mL of FSE compared with control. For SE-treated groups, no delipidating effect was observed. The effect of FSE on adipogenesis inhibition can be attributed to the down-regulation of mRNA expressionof CCAAT/enhancer binding protein (C/EBP-α), lipoprotein lipase (LPL), adiponectin, adipocyte fatty acid-binding protein (aP2), fatty acid synthesis (FAS) and CoA carboxylase (ACC). Our results demonstrated that the anti-obesity effect of soybean can be improved by fermentation with P1201, and P1201can be used as a potential probiotic bacterial strain to produce natural anti-obesity food.

Keywords: fermentation, Lactobacillus plantarum P1201, obesity, soybean

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Authors: U. Mary

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Let be a graph with a finite, nonempty set of objects called vertices together with a set of unordered pairs of distinct vertices of called edges. The vertex set is denoted by and the edge set by. Given two graphs and the wiener index of, wiener index for the splitting graph of a graph, the first Zagreb index of and its splitting graph, the 3-steiner wiener index of, the 3-steiner wiener index of a special graph are explored in this paper.

Keywords: complementary prism graph, first Zagreb index, neighborhood corona graph, steiner distance, splitting graph, steiner wiener index, wiener index

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Authors: Kavitha Thamadharan, Nurazean Maarop

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The implementation of e-assessment as tool to support the process of teaching and learning in university has become a popular technological means in universities. E-Assessment provides many advantages to the users especially the flexibility in teaching and learning. The e-assessment system has the capability to improve its quality of delivering education. However, there still exists a drawback in terms of security which limits the user acceptance of the online learning system. Even though there are studies providing solutions for identified security threats in e-learning usage, there is no particular model which addresses the factors that influences the acceptance of e-assessment system by lecturers from security perspective. The aim of this study is to explore security aspects of e-assessment in regard to the acceptance of the technology. As a result a conceptual model of secure acceptance of e-assessment is proposed. Both human and security factors are considered in formulation of this conceptual model. In order to increase understanding of critical issues related to the subject of this study, interpretive approach involving convergent mixed method research method is proposed to be used to execute the research. This study will be useful in providing more insightful understanding regarding the factors that influence the user acceptance of e-assessment system from security perspective.

Keywords: secure technology acceptance, e-assessment security, e-assessment, education technology

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Authors: Ujjval J. Solanki, Prof.(Dr.) P.J. Gundaliya, Prof.M.D. Barasara

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The application of Falling Weight Deflectometer is to evaluate structural performance of the flexible pavement. The exercise of back calculation is required to know the modulus of elasticity of existing in-service pavement. The process of back calculation needs in-depth field experience for the input of range of modulus of elasticity of bituminous, granular and subgrade layer, and its required number of trial to find such matching moduli with the observed FWD deflection on the field. The study carried out at Barnala-Mansa State Highway Punjab-India using FWD before and after overlay; the deflections obtained at 0 on the load cell, 300, 600, 900,1200, 1500 and 1800 mm interval from the load cell these seven deflection results used to calculate Surface Curvature Index (SCI), Base damage Index (BDI), Base curvature index (BCI). This SCI, BCI and BDI indices are useful to predict the structural performance of in-service pavement and also useful to identify homogeneous section for condition assessment. The SCI, BCI and BDI range are determined for before and after overlay the range of SCI 520 to 51 BDI 294 to 63 BCI 83 to 0.27 for old pavement and SCI 272 to 23 BDI 228 to 28, BCI 25.85 to 4.60 for new pavement. It also shows good correlation with back calculated modulus of elasticity of all the three layer.

Keywords: back calculation, base damage index, base curvature index, FWD (Falling Weight Deflectometer), surface curvature index

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Authors: Emran M. Badghish

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Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

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Authors: Hanady Hamdallah, H. Elyse Ireland, John H. H. Williams

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Conjugated linoleic acid (CLA) is a food supplement that is reported to have multiple beneficial health effects, including being anti-carcinogenic, anti-inflammatory and anti-obesity. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity related markers in women. Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords 'Conjugated linoleic acid', 'CLA', 'Women', and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Also, these trials provided information about body composition expressed as body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF %), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist. Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p < 0.001), BMI (0.6 ± 0.13kg/m², p < 0.001) and TBF (0.76 ± 0.26 kg, p= 0.003) in women, when supplemented over 6-16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p < 0.001), BMI (0.60 ± 0.14 kg/m², p < 0.001) and TBF (0.82 ± 0.28 kg, p= 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p < 0.001; 1.05 ± 0.36 kg, p= 0.003) and BMI (0.50 ± 0.17 kg/m², p= 0.003; 0.75 ± 0.2 kg/m², p < 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p= 0.003) was only significant in post-menopausal women. Interestingly, CLA supplementation was associated with a significant reduction in BW (1.05 ± 0.35 kg, p< 0.003), BMI (0.73 ± 0.2 kg/m², p < 0.001) and TBF (1.07 ± 0.36 kg, p= 0.003) in the trials without lifestyle monitoring or interventions. No significant effect of CLA on LBM was detected in this meta-analysis. This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6-16 weeks, particularly in overweight-obese women and post-menopausal women. However, this finding requires careful interpretation due to several issues in the designs of available CLA supplementation trials. More well-designed trials are required to confirm this meta-analysis results.

Keywords: body composition, body mass index, body weight, conjugated linoleic acid

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Authors: Archana S., Usha Rani G., Anand Balakrishnan, Sanjana R., Solomon F., Vijayalakshmi J.

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Background: There is evidence that male factors contribute to the infertility of up to 50% of couples, who are evaluated and treated for infertility using advanced assisted reproductive technologies. Genetic abnormalities, including sperm chromosome aneuploidy as well as structural aberrations, are one of the major causes of male infertility. Recent advances in technology expedite the evaluation of sperm aneuploidy. The purpose of the study was to de-termine the prevalence of sperm aneuploidy in infertile males and the degree of association between DNA fragmentation and sperm aneuploidy. Methods: In this study, 75 infertile men were included, and they were divided into four abnormal groups (Oligospermia, Terato-spermia, Asthenospermia and Oligoasthenoteratospermia (OAT)). Men with children who were normozoospermia served as the control group. The Fluorescence in situ hybridization (FISH) method was used to test for sperm aneuploidy, and the Sperm Chromatin Dispersion Assay (SCDA) was used to measure the fragmentation of sperm DNA. Spearman's correla-tion coefficient was used to evaluate the relationship between sperm aneuploidy and sperm DNA fragmentation along with age. P < 0.05 was regarded as significant. Results: 75 partic-ipants' ages varied from 28 to 48 years old (35.5±5.1). The percentage of spermatozoa bear-ing X and Y was determined to be statistically significant (p-value < 0.05) and was found to be 48.92% and 51.18% of CEP X X 1 – nucish (CEP XX 1) [100] and CEP Y X 1 – nucish (CEP Y X 1) [100]. When compared to the rate of DNA fragmentation, it was discovered that infertile males had a greater frequency of sperm aneuploidy. Asthenospermia and OAT groups in sex chromosomal aneuploidy were significantly correlated (p<0.05). Conclusion: Sperm FISH and SCDA assay results showed increased sperm aneuploidy frequency, and DNA fragmentation index in infertile men compared with fertile men. There is a significant relationship observed between sperm aneuploidy and DNA fragmentation in OAT patients. When evaluating male variables and idiopathic infertility, the sperm FISH screening method can be used as a valuable diagnostic tool.

Keywords: ale infertility, dfi (dna fragmentation assay) (scd-sperm chromatin dispersion).art (artificial reproductive technology), trisomy, aneuploidy, fish (fluorescence in-situ hybridization), oat (oligoasthoteratospermia)

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Authors: Muhammad Saqlain, Nazar Abbas Saqib, Muazzam A. Khan

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Heart Failure (HF) has become the major health problem in our society. The prevalence of HF has increased as the patient’s ages and it is the major cause of the high mortality rate in adults. A successful identification and progression of HF can be helpful to reduce the individual and social burden from this syndrome. In this study, we use a real data set of cardiac patients to propose a classification model for the identification and progression of HF. The data set has divided into three age groups, namely young, adult, and old and then each age group have further classified into four classes according to patient’s current physical condition. Contemporary Data Mining classification algorithms have been applied to each individual class of every age group to identify the HF. Decision Tree (DT) gives the highest accuracy of 90% and outperform all other algorithms. Our model accurately diagnoses different stages of HF for each age group and it can be very useful for the early prediction of HF.

Keywords: decision tree, heart failure, data mining, classification model

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Authors: Priti Saha, Biswajit Paul

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Rapid urbanization and industrialization have increased the demand of groundwater. However, the present era has evident an enormous level of groundwater pollution. Therefore, water quality assessment is paramount importance to evaluate its suitability for drinking, irrigation and industrial use. This study focus to evaluate the groundwater quality of an industrial city in eastern India through interdisciplinary techniques. The multi-purpose Water Quality Index (WQI) assess the suitability for drinking as well as irrigation of forty sampling locations, where 2.5% and 15% of sampling locations have excellent water quality (WQI:0-25) as well as 15% and 40% have good quality (WQI:25-50), which represents its suitability for drinking and irrigation respectively. However, the industrial water quality was assessed through Ryznar Stability Index (LSI), which affirmed that only 2.5% of sampling locations have neither corrosive nor scale forming properties (RSI: 6.2-6.8). These techniques with the integration of geographical information system (GIS) for spatial assessment indorsed its effectiveness to identify the regions where the water bodies are suitable to use for drinking, irrigation as well as industrial activities. Further, the sources of these contaminants were identified through factor analysis (FA), which revealed that both the geogenic as well as anthropogenic sources were responsible for groundwater pollution. This research demonstrates the effectiveness of statistical and GIS techniques for the analysis of environmental contaminants.

Keywords: groundwater, water quality analysis, water quality index, WQI, factor analysis, FA, spatial assessment

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Authors: Hisyam Hidayatullah

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This world events consciously or not realize everything has a pattern, until the events of the universe according to the Big Bang theory of the solar system which makes so regular in the rotation. The author would like to create a results curve area between the quadratic function y=kx2 and line y=ka2 using GeoGebra application version 4.2. This paper can provide a series that is no less interesting with Fourier series, so that will add new material about the series can be calculated with sigma notation. In addition, the ranks of the unique natural numbers of extensive changes in established areas. Finally, this paper provides analytical and geometric proof of the vast area in between the lines and curves that give the area is formed by y=ka2 dan kurva y=kx2, x-axis, line x=√a and x=-√a make a series of numbers for k=1 and a ∈ original numbers. ∑_(i=0)^n=(4n√n)/3=0+4/3+(8√2)/3+4√3+⋯+(4n√n)/3. The author calls the series “H154M”.

Keywords: sequence, series, sigma notation, application GeoGebra

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Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: Wiesława Klimek-Piotrowska, Mateusz K. Hołda, Mateusz Koziej, Katarzyna Piątek, Jakub Hołda

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Introduction: The coronary sinus venous system (CSVS), which has always been overshadowed by the coronary arterial tree, has recently begun to attract more attention. Since it is a target for clinicians the knowledge of its anatomy is essential. Cardiac resynchronization therapy, catheter ablation of cardiac arrhythmias, defibrillation, perfusion therapy, mitral valve annuloplasty, targeted drug delivery, and retrograde cardioplegia administration are commonly used therapeutic methods involving the CSVS. The great variability in the course of coronary veins and tributaries makes the diagnostic and therapeutic processes difficult. Our aim was to investigate detailed anatomy of most common clinically used CSVS`s structures: the coronary sinus with its ostium, great cardiac vein, posterior vein of the left ventricle, middle cardiac vein and oblique vein of the left atrium. Methodology: This is a prospective study of 70 randomly selected autopsied hearts dissected from adult humans (Caucasian) aged 50.1±17.6 years old (24.3% females) with BMI=27.6±6.7 kg/m2. The morphology of the CSVS was assessed as well as its precise measurements were performed. Results: The coronary sinus (CS) with its ostium was present in all hearts. The mean CS ostium diameter was 9.9±2.5mm. Considered ostium was covered by its valve in 87.1% with mean valve height amounted 5.1±3.1mm. The mean percentage coverage of the CS ostium by the valve was 56%. The Vieussens valve was present in 71.4% and was unicuspid in 70%, bicuspid in 26% and tricuspid in 4% of hearts. The great cardiac vein was present in all cases. The oblique vein of the left atrium was observed in 84.3% of hearts with mean length amounted 20.2±9.3mm and mean ostium diameter 1.4±0.9mm. The average length of the CS (from the CS ostium to the Vieussens valve) was 31.1±9.5mm or (from the CS ostium to the ostium of the oblique vein of the left atrium) 28.9±10.1mm and both were correlated with the heart weight (r=0.47; p=0.00 and r=0.38; p=0.006 respectively). In 90.5% the ostium of the oblique vein of the left atrium was located proximally to the Vieussens valve, in remaining cases was distally. The middle cardiac vein was present in all hearts and its valve was noticed in more than half of all the cases (52.9%). The posterior vein of the left ventricle was observed in 91.4% of cases. Conclusions: The CSVS is vastly variable and none of basic hearts parameters is a good predictor of its morphology. The Vieussens valve could be a significant obstacle during CS cannulation. Caution should be exercised in this area to avoid coronary sinus perforation. Because of the higher incidence of the presence of the oblique vein of the left atrium than the Vieussens valve, the vein orifice is more useful in determining the CS length.

Keywords: cardiac resynchronization therapy, coronary sinus, Thebesian valve, Vieussens valve

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity is associated with increased fat mass as well as fat percentage. Minerals are the elements, which are of vital importance. In this study, the relationships between body as well as bone mineral profile and the percentage as well as mass values of fat, fat-free portion, protein, skeletal muscle were evaluated in adult men with normal body mass index (N-BMI), and those classified according to different stages of obesity. A total of 103 adult men classified into five groups participated in this study. Ages were within 19-79 years range. Groups were N-BMI (Group 1), overweight (OW) (Group 2), first level of obesity (FLO) (Group 3), second level of obesity (SLO) (Group 4) and third level of obesity (TLO) (Group 5). Anthropometric measurements were performed. BMI values were calculated. Obesity degree, total body fat mass, fat percentage, basal metabolic rate (BMR), visceral adiposity, body mineral mass, body mineral percentage, bone mineral mass, bone mineral percentage, fat-free mass, fat-free percentage, protein mass, protein percentage, skeletal muscle mass and skeletal muscle percentage were determined by TANITA body composition monitor using bioelectrical impedance analysis technology. Statistical package (SPSS) for Windows Version 16.0 was used for statistical evaluations. The values below 0.05 were accepted as statistically significant. All the groups were matched based upon age (p > 0.05). BMI values were calculated as 22.6 ± 1.7 kg/m², 27.1 ± 1.4 kg/m², 32.0 ± 1.2 kg/m², 37.2 ± 1.8 kg/m², and 47.1 ± 6.1 kg/m² for groups 1, 2, 3, 4, and 5, respectively. Visceral adiposity and BMR values were also within an increasing trend. Percentage values of mineral, protein, fat-free portion and skeletal muscle masses were decreasing going from normal to TLO. Upon evaluation of the percentages of protein, fat-free portion and skeletal muscle, statistically significant differences were noted between NW and OW as well as OW and FLO (p < 0.05). However, such differences were not observed for body and bone mineral percentages. Correlation existed between visceral adiposity and BMI was stronger than that detected between visceral adiposity and obesity degree. Correlation between visceral adiposity and BMR was significant at the 0.05 level. Visceral adiposity was not correlated with body mineral mass but correlated with bone mineral mass whereas significant negative correlations were observed with percentages of these parameters (p < 0.001). BMR was not correlated with body mineral percentage whereas a negative correlation was found between BMR and bone mineral percentage (p < 0.01). It is interesting to note that mineral percentages of both body as well as bone are highly affected by the visceral adiposity. Bone mineral percentage was also associated with BMR. From these findings, it is plausible to state that minerals are highly associated with the critical stages of obesity as prominent parameters.

Keywords: bone, men, minerals, obesity

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Authors: Seung Hun Lee, Sang Yeoup Lee

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Objectives: To investigate associations between degrees of obesity using correlations between obesity indices and cardiometabolic risk factors. Methods: BMI, waist circumference (WC), fasting insulin, fasting glucose, lipids, and visceral adipose tissue (VAT) area using computed tomographic images were measured in 113 obese female without cardiovascular disease (CVD). Correlations between obesity indices and cardiometabolic risk factors were analyzed in obese subgroups defined using sequential obesity indices. Results: Mean BMI and WC were 29.6 kg/m2 and 92.8 cm. BMI showed significant correlations with all five cardiometabolic risk factors until the BMI cut-off point reached 27 kg/m2, but when it exceeded 30 kg/m2, correlations no longer existed. WC was significantly correlated with all five cardiometabolic risk factors up to a value of 85 cm, but when WC exceeded 90 cm, correlations no longer existed. Conclusions: Our data suggest that moderate weight-loss goals may not be enough to ameliorate cardiometabolic markers in severely obese patients. Therefore, individualized weight-loss goals should be recommended to such patients to improve health benefits.

Keywords: correlation, cardiovascular disease, risk factors, obesity

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: K. S. Vimal, D. Bodhini, K. Ramya, N. Lakshmipriya, R. M. Anjana, V. Sudha, J. A. Lovegrove, V. Mohan, V. Radha

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Gene-lifestyle interaction studies have been carried out in various populations. However, to date there are no studies in an Asian Indian population. Hence, we examined whether lifestyle factors such as diet and physical activity modify the association between fat mass and obesity–associated (FTO) gene variants and obesity and type 2 diabetes (T2D) in an Asian Indian population. We studied 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the Chennai Urban Rural Epidemiology Study (CURES) in Southern India. Obesity was defined according to the World Health Organization Asia Pacific Guidelines (non-obese, BMI < 25 kg/m2; obese, BMI ≥ 25 kg/m2). Six single nucleotide polymorphisms (SNPs) in the FTO gene (rs9940128, rs7193144, rs8050136, rs918031, rs1588413 and rs11076023) identified from recent genome-wide association studies for T2D were genotyped by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing. Dietary assessment was carried out using a validated food frequency questionnaire and physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the model. A joint likelihood ratio test of the main SNP effects and the SNP-diet/physical activity interaction effects was used in the linear regression analyses to maximize statistical power. Statistical analyses were performed using STATA version 13. There was a significant interaction between FTO SNP rs8050136 and carbohydrate energy percentage (Pinteraction=0.04) on obesity, where the ‘A’ allele carriers of the SNP rs8050136 had 2.46 times higher risk of obesity than those with ‘CC’ genotype (P=3.0x10-5) among individuals in the highest tertile of carbohydrate energy percentage. Furthermore, among those who had lower levels of physical activity, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times higher risk of obesity than those with ‘CC’ genotype (P=4.0x10-5). We also found a borderline interaction between SNP rs11076023 and carbohydrate energy percentage (Pinteraction=0.08) on T2D, where the ‘A’ allele carriers in the highest tertile of carbohydrate energy percentage, had 1.57 times higher risk of T2D than those with ‘TT’ genotype (P=0.002). There was also a significant interaction between SNP rs11076023 and physical activity (Pinteraction=0.03) on T2D. No further significant interactions between SNPs and macronutrient intake or physical activity on obesity and T2D were observed. In conclusion, this is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. These findings suggest that the association between FTO gene variants and obesity and T2D is influenced by carbohydrate intake and physical activity levels. Greater understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions will advance the development of behavioral intervention and personalised lifestyle strategies predicted to reduce the development of metabolic diseases in ‘A’ allele carriers of both SNPs in this Asian Indian population.

Keywords: dietary intake, FTO, obesity, physical activity, type 2 diabetes, Asian Indian.

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Authors: Kathryn Nderitu, Atunga Nyachieo, Ezekiel Mecha

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Introduction: Solanum nigrum , also known as black nightshade, biosynthesizes various phytochemical compounds with various pharmacological activities, including treating cardiovascular diseases and type 2 diabetes, among others. Materials and Methods: To assess the anti-obesity effects of Solanum nigrum using high-fat-fed diet rats, Sprague Dawley male rats (n = 35) of weights 160–180 g were assigned randomly into seven groups comprising n = 5 rats each. Each group was fed for 11 weeks as follows: normal group (normal chow rat feed); high-fat diet control (HFD); HFD and standard drug (Orlistat 30 mg/kg bw); HFD and methanolic extract 150 mg/kgbw; HFD and methanolic extract 300 mg/kgbw; HFD and dichloromethane extract 150 mg/kgbw; HFD and dichloromethane extract 300 mg/kgbw. Body mass index and food intake were monitored per week, and an oral glucose tolerance test was measured in weeks 5 and 10. Lipid profiles, liver function tests, adipose tissue, liver weights, and phytochemical analysis of Solanum nigrum were later carried out. Results: High-fat diet control group rats exhibited a significant increase in body mass index (BMI), while rats administered with leaf extracts of Solanum nigrum showed a reduction in BMI. Both low doses of dichloromethane (150 mg/kgbw) and high doses of methanol extracts (300 mg/kgbw) showed a better reduction in BMI than the other treatment groups. A significant decrease (p <0.05) in low-density lipoprotein-cholesterol, triglycerides, and cholesterol was observed among the rats administered with Solanum nigrum extracts compared to those of HFD control. Moreover, the HFD control group significantly increased liver and adipose tissue weights compared to other treatment groups (p<0.05). Solanum nigrum also decreased glycemic levels and normalized the hepatic enzymes of HFD control. However, food intake among the groups showed no significant difference (p>0.05). Qualitative analysis of Solanum nigrum leaf extracts indicated the presence of various bioactive compounds associated with anti-obesity. Conclusion: These results validate the use of Solanum nigrum in controlling obesity.

Keywords: solanum nigrum, High fat diet, phytocompounds, obesity

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Authors: Chih-Hung Liang, Jung-Jung Chen, Shen-Shih Chiang

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Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health, which are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Cordyceps militaris (CM) is a well-known traditional medicine in Asian countries and a rich source of biologically active components. Black rice (Oryza sativa L.) is a special cultivar of rice that contains rich anthocyanins and regarded as a health-promoting food in China and other Eastern. The aim of this study was to investigate the anti-obesity effect of Cordyceps militaris fermented black rice (CB) on HFD-induced BALB/c mice model. The results indicated that administration of low and high dosage of CB powder significantly reduced the body weights (7.38% and 7.78%), body fat ratio (2.37% and 2.78%), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared to the HF group (p<0.05). Histopathological analysis showed that the score of fatty liver in HF group (5.0) was significantly higher than CB groups (2.1 and 3.6) (p<0.05). In conclusion, Cordyceps militaris fermented black rice can reduce the body weight via inhibition of the fat accumulation in liver and body and possess the anti-obesity potency.

Keywords: Cordyceps militaris, black rice, obesity, HFD-induced mice

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Authors: P. V. Pramila , V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV, multivariate adaptive regression splines pulmonary function test, random forest

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Authors: Stephanie A. Schauder, Gosia Sylwestrzak

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Overweight and obese women report avoiding preventive care due to fear of weight-related bias from medical professionals. Gynecological exams, due to their sensitive and personally invasive nature, are especially susceptible to avoidance. This research investigates the association between body mass index (BMI) and screening rates for breast and cervical cancer using claims data from 1.3 million members of a large health insurance company. Because obesity is associated with increased cancer risk, screenings for these cancers should increase as BMI increases. However, this paper finds that the distribution of cancer screening rates by BMI take an inverted U-shape with underweight and obese members having the lowest screening rates. For cervical cancer screening, those in the target population with a BMI of 23 have the highest screening rate at 68%, while Obese Class III members have a screening rate of 50%. Those in the underweight category have a screening rate of 58%. This relationship persists even after controlling for health and demographic covariates in regression analysis. Interestingly, there is no association between BMI and BRCA (BReast CAncer gene) genetic testing. This is consistent with the narrative that stigma causes avoidance because genetic testing does not involve any assessment of a person’s body. More work must be done to determine how to increase cancer screening rates in those who may feel stigmatized due to their weight.

Keywords: cancer screening, cervical cancer, breast cancer, weight stigma, avoidance of care

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Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

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Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: adolescents, NCDs, overweight, obesity

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Authors: Peter Mc Coll, Alberto Caro, Chiara Gandolfo, Montserrat Labbe, Francisca Schnaidt, Michela Palazzi

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Self-esteem and emotional intelligence are variables that are related to people's nutritional status. Self-esteem may be at low levels in people living with obesity, while emotional intelligence can play an important role in the way people living with obesity cope. The objective of the study was to measure the association between self-esteem and emotional intelligence to nutritional status in adolescent population. Methodology: A cross-sectional study was carried out with 179 adolescent schoolchildren between 13 and 19 years old from a public school. The objective was to evaluate nutritional status; weight and height were measured by calculating the body mass index and Z score. Self-esteem was evaluated using the Coopersmith Self-esteem Inventory adapted by Brinkmann and Segure. Emotional intelligence was measured using the Emotional Quotient Inventory: short, by Bar On, adapted questionnaire, translated into Spanish by López Zafra. For statistical analysis: Pearson's Chi-square test, Pearson's correlation, and odd ratio calculation were used, with a p value at a significance level < 5%. Results: The study group was composed of 71% female and 29% male. The nutritional status was distributed as eutrophic 41.9%, overweight 20.1%, and obesity 21.1%. In relation to self-esteem, 44.1% presented low and very low levels, without differences by gender. Emotional intelligence was distributed: low 3.4%, medium 81%, and high 13.4% -no differences according to gender. The association between nutritional status (overweight and obesity) with low and very low self-esteem, an odds ratio of 2.5 (95% CI 1.12 – 5.59) was obtained with a p-value = 0.02. The correlation analysis between the intrapersonal sub-dimension emotional intelligence scores and the Z score of nutritional status presented a negative correlation of r = - 0.209 with a p-value < 0.005. The correlation between emotional intelligence subdimension stress management with Z score presented a positive correlation of r = 0.0161 with a p-value < 0.05. In conclusion, the group of adolescents studied had a high prevalence of overweight and obesity, a high prevalence of low self-esteem, and a high prevalence of average emotional intelligence. Overweight and obese adolescents were 2.5 times more likely to have low self-esteem. As overweight and obesity increase, self-esteem decreases, and the ability to manage stress increases.

Keywords: self-esteem, emotional intelligence, obesity, adolescent, nutritional status

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Authors: Ionel Zagan, Vasile Gheorghita Gaitan, Adrian Brezulianu

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This paper presents the contributions in designing a mobile system named Tele-ECG implemented for remote monitoring of cardiac patients. For a better flexibility of this application, the authors chose to implement a local memory and multiple communication interfaces. The project described in this presentation is based on the ARM Cortex M0+ microcontroller and the ADAS1000 dedicated chip necessary for the collection and transmission of Electrocardiogram signals (ECG) from the patient to the microcontroller, without altering the performances and the stability of the system. The novelty brought by this paper is the implementation of a remote monitoring system for cardiac patients, having a real-time behavior and multiple interfaces. The microcontroller is responsible for processing digital signals corresponding to ECG and also for the implementation of communication interface with the main server, using GSM/Bluetooth SIMCOM SIM800C module. This paper translates all the characteristics of the Tele-ECG project representing a feasible implementation in the biomedical field. Acknowledgment: This paper was supported by the project 'Development and integration of a mobile tele-electrocardiograph in the GreenCARDIO© system for patients monitoring and diagnosis - m-GreenCARDIO', Contract no. BG58/30.09.2016, PNCDI III, Bridge Grant 2016, using the infrastructure from the project 'Integrated Center for research, development and innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for fabrication and control', Contract No. 671/09.04.2015, Sectoral Operational Program for Increase of the Economic Competitiveness co-funded from the European Regional Development Fund.

Keywords: Tele-ECG, real-time cardiac monitoring, electrocardiogram, microcontroller

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Authors: Zhidong Zhang

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This study established a mixed method model in assessing statistics learning with Bayesian network models. There are three variants in exploratory sequential designs. There are three linked steps in one of the designs: qualitative data collection and analysis, quantitative measure, instrument, intervention, and quantitative data collection analysis. The study used a scoring model of analysis of variance (ANOVA) as a content domain. The research study is to examine students’ learning in both semantic and performance aspects at fine grain level. The ANOVA score model, y = α+ βx1 + γx1+ ε, as a cognitive task to collect data during the student learning process. When the learning processes were decomposed into multiple steps in both semantic and performance aspects, a hierarchical Bayesian network was established. This is a theory-driven process. The hierarchical structure was gained based on qualitative cognitive analysis. The data from students’ ANOVA score model learning was used to give evidence to the hierarchical Bayesian network model from the evidential variables. Finally, the assessment results of students’ ANOVA score model learning were reported. Briefly, this was a mixed method research design applied to statistics learning assessment. The mixed methods designs expanded more possibilities for researchers to establish advanced quantitative models initially with a theory-driven qualitative mode.

Keywords: exploratory sequential design, ANOVA score model, Bayesian network model, mixed methods research design, cognitive analysis

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Authors: A. Gazdzinska, P. Jagielski, E. Kaniewska, S. P. Gazdzinski, M. Wylezol

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Background: In the multi-factor etiology of obesity, an increasing degree of importance is attributed to behavioral factors. Lifestyle and health-oriented behaviors heavily influence the treatment of multiple diseases, including obesity. However, only a few studies evaluated health-related behaviors exhibited by patients qualified for bariatric surgery. None of them was performed in Polish population. Aim: Assessment of health behaviors of obese patients according to the degree of mood disorders. Method: The study involved 93 patients (66 females) who were qualified for bariatric surgery in the Department of Surgery of the Military Institute of Aviation Medicine in Warsaw. Diagnostic instrument was the Juczynski’s Inventory of Health Behavior (HBI), which evaluates health behavior in four categories, i.e. proper nutrition habits (PNH), preventive behavior (PH), health practices (HP) and positive mental attitude (PMA). The average HBI falls in the range between 24 and 120 points, for each category of health behaviors fall between 1 and 5 (higher score means higher severity declared healthy behaviors). The depressive symptoms in patients were assessed with Beck Depression Inventory (BDI). All analyses were conducted using STATISTICA 12. Results: The average age was 44.2 ± 11.5 years, mean BMI was 44.3 ± 10.5 kg/m2 and 46.8 ± 7.6 kg/m2, in females and males respectively. According to BDI, 32% patients had mild level of depression, 10% moderate and 14% severe depression. BDI scores were not different between females and males. Low results with regard to the health behaviors declared were obtained by 35.5 % of patients, medium by 44.0%, while high ones by only 20.5%. On average, patients gained 3.28 points in PNH, 3.37 points in PH, 3.29 points in HP, while 3.42 in the PMA category, showing average intensity of these behaviors. These health behaviors were practiced significantly more often by women (p = 0.04). The average HBI was 80.2; with average score of 81.5 for females and 76.6 for males, respectively (p = 0.03). Women were better in the PNH category (p = 0.02). A positive correlation was found between age and all categories of health behaviors, in particular PNH (R = 0.38; p = 0.001), PH (R = 0.26; p = 0.01), HP (R = 0.27; p = 0.01) and PMA (R = 0.24; p = 0.02), independent of gender. The severity of depression had a significant impact only on the behaviors associated with proper eating habits, which saw a negative correlation between BDI scores and the PNH (R = -0.21; p = 0.04). Conclusions: Majority of morbidly obese patients qualified for bariatric surgery obtained low to average scores in health behavior questionnaire. However, these results are similar in comparison with the Polish adult population. In accordance to these results, it seems that healthy behaviors, among them eating behaviors, do not appear to be a cause of obesity epidemic or they might be acquired when the disease is already underway. Female gender and age had a positive effect, and depression had a negative effect on the level of health behaviors among patients qualified for bariatric surgery.

Keywords: depression, habits, health behaviours, obesity

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Authors: I. P. Ezeugwunne, C. C. Onyenekwe, J. E. Ahaneku, G. I. Ahaneku

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Introduction: It has been reported that acute myocardial infarction (AMI) might occur at 1.5 ng/ml troponin level. HIV infection has been documented to influence antiviral drugs, stimulate the production of proteins that enhance fatty acids synthesis. Information on cardiac status in HIV-infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein profile of HIV subjects in pre-and-post 12 months of antiretroviral therapy (ART) using 1.5 ng/ml troponin diagnostic cut-off for myocardial infarction (MI) in Nnewi, South Eastern, Nigeria. Methodology: A total of 30 symptomatic HIV subjects without malaria co-infection with a mean age of 40.70 ±10.56 years were randomly recruited for this prospective case-controlled study. Serum apolipoproteins (Apo A1, A2, B, C2,C3 and Apo E), troponin and CD4 counts were measured using standard laboratory methods. Parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for MI. Analysis of variance and student paired t-tests were used for data analyses. Results: paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels of ApoA1, ApoB and ApoC3 in symptomatic HIV subjects before antiretroviral therapy (ART) when compared with after therapy at p<0.05 respectively. The troponin value was significantly higher amongst the group studied at p<0.05, respectively. Conclusion: The increased values of troponin observed among the groups were higher than the diagnostic cut-off for AMI. This may imply that AMI may occur at any group of studies. But the significant reduction in the serum levels of Apo A2, Apo B, Apo C3, Apo E and a significant increase in serum levels of Apo A1, Apo C2 and blood CD4 counts as the length of therapy lengthened may indicate possible cardio-protective effects of the ART on the heart, which may connote recovery.

Keywords: ART, apolipoprotein, HIV, myocardial infarction

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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