Search results for: diffuse coronary artery disease

Authors: H. Parameshwar Naik, Shripad Kulkarni

Abstract:

Powdery mildew is a serious disease among the fungal in high humid areas with varied temperature conditions. In recent days disease becomes very severe due to uncertain weather conditions and unique character of the disease is, it produces white mycelia growth on upper and lower leaf surfaces and in severe conditions it leads to defoliation. Results of the experiment revealed that sowing of crop in the I fortnight (FN) of July recorded the minimum mean disease severity (7.96 %) followed by crop sown in II FN of July (13.19 %) as against the crop sown in II FN of August (41.44 %) and I FN of September (33.78 %) and the I fortnight of October (33.77 %). In the first date of sowing infection started at 45 DAS and progressed till 73 DAS and it was up to 14.66 Percent and in second date of sowing disease progressed up to 22.66 percent and in the third date of sowing, it was up to 59.35 percent. Afterward, the disease started earlier and progressed up to 66.15 percent and in sixth and seventh date of sowing disease progressed up to 43.15 percent and 59.85 percent respectively. Disease progress is very fast after 45 days after sowing and highest disease incidence was noticed at 73 DAS irrespective of dates of sowing. From the results of the present study, it is very clear that disease development will be very high if crop sown in between 1st fortnight of August and the 1st fortnight of September.

Keywords: cucumber, India, Karnataka, powdery mildew

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Authors: Takanori Tanaka, Daisuke Kitao, Daisuke Ikeda

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The aurora is an attractive phenomenon but it is difficult to understand the whole mechanism of it. An approach of data-intensive science might be an effective approach to elucidate such a difficult phenomenon. To do that we need labeled data, which shows when and what types of auroras, have appeared. In this paper, we propose an image retrieval system for auroral all-sky images, some of which include discrete and diffuse aurora, and the other do not any aurora. The proposed system retrieves images which are similar to the query image by using a popular image recognition method. Using 300 all-sky images obtained at Tromso Norway, we evaluate two methods of image recognition methods with or without our original color filtering method. The best performance is achieved when SIFT with the color filtering is used and its accuracy is 81.7% for discrete auroras and 86.7% for diffuse auroras.

Keywords: data-intensive science, image classification, content-based image retrieval, aurora

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Authors: Anna Demian, Levi Howard, L. Ng, Leslie Simon, Mark Dragon, A. Desai, Timothy Devlantes, W. David Freeman

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Introduction: Out-of-hospital cardiac arrest (OHCA) can carry a high mortality. For survivors, the most common complication is hypoxic-ischemic brain injury (HIBI). Rarely, lumbosacral spinal cord and/or other spinal cord artery ischemia can occur due to anatomic variation and variable mean arterial pressure after the return of spontaneous circulation. We present a case of an OHCA survivor who later woke up with bilateral leg weakness with preserved sensation (ASIA grade B, L2 level). Methods: We describe a clinical, radiographic, and laboratory presentation, as well as a National Library of Medicine (NLM) search engine methodology, characterizing incidence/prevalence of this entity is discussed. A 70-year-old male, a longtime smoker, and alcohol user, suddenly collapsed at a bar surrounded by friends. He had complained of chest pain before collapsing. 911 was called. EMS arrived, and the patient was in pulseless electrical activity (PEA), cardiopulmonary resuscitation (CPR) was initiated, and the patient was intubated, and a LUCAS device was applied for continuous, high-quality CPR in the field by EMS. In the ED, central lines were placed, and thrombolysis was administered for a suspected Pulmonary Embolism (PE). It was a prolonged code that lasted 90 minutes. The code continued with the eventual return of spontaneous circulation. The patient was placed on an epinephrine and norepinephrine drip to maintain blood pressure. ECHO was performed and showed a “D-shaped” ventricle worrisome for PE as well as an ejection fraction around 30%. A CT with PE protocol was performed and confirmed bilateral PE. Results: The patient woke up 24 hours later, following commands, and was extubated. He was found paraplegic below L2 with preserved sensation, with hypotonia and areflexia consistent with “spinal shock” or anterior spinal cord syndrome. MRI thoracic and lumbar spine showed a conus medullaris level spinal cord infarction. The patient was given IV steroids upon initial discovery of cord infarct. NLM search using “cardiac arrest” and “spinal cord infarction” revealed 57 results, with only 8 review articles. Risk factors include age, atherosclerotic disease, and intraaortic balloon pump placement. AoA (Artery of Adamkiewicz) anatomic variation along with existing atherosclerotic factors and low perfusion were also known risk factors. Conclusion: Acute paraplegia from anterior spinal cord infarction of the AoA territory after cardiac arrest is rare. Larger prospective, multicenter trials are needed to examine potential interventions of hypothermia, lumbar drains, which are sometimes used in aortic surgery to reduce ischemia and/or other neuroprotectants.

Keywords: cardiac arrest, spinal cord infarction, artery of Adamkiewicz, paraplegia

Procedia PDF Downloads 189

Authors: Shashi Sharma, Uaday Singh, V. K. Katiyar

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Blood flow through a stenosed tube, which is of great interest to mechanical engineers as well as medical researchers. If stenosis exists in an artery, normal blood flow is disturbed. The deposition of fatty substances, cholesterol, cellular waste products in the inner lining of an artery results to plaque formation .The present study deals with a mathematical model for blood flow in constricted arteries. Blood is considered as a Newtonian, incompressible, unsteady and laminar fluid flowing in a cylindrical rigid tube along the axial direction. A time varying pressure gradient is applied in the axial direction. An analytical solution is obtained using the numerical inversion method for Laplace Transform for calculating the velocity profile of fluid as well as particles.

Keywords: blood flow, stenosis, Newtonian fluid, medical biology and genetics

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Authors: Agi Sunday

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A descriptive analysis of reported cases of sickle cell disease and the level of awareness about genetic counselling in 30 hospitals were carried out. Additionally, 150 individuals between ages 16-45 were randomly selected for evaluation of genetic counselling awareness. The main tools for this study were questionnaires which were taken to hospitals, and individuals completed the others. The numbers of reported cases of sickle cell disease recorded in private, public and teaching hospitals were 14 and 57; 143 and 89; 272 and 57 for the periods of 1995-2000 and 2001-2005, respectively. A general informal genetic counselling took place mostly in the hospitals visited. 122 (86%) individuals had the knowledge of genetic disease and only 43 (30.3%) individuals have been exposed to genetic counselling. 64% of individuals agreed that genetic counselling would help in the prevention of genetic disease.

Keywords: sickle disease, genetic counseling, genetic testing, advocacy

Procedia PDF Downloads 389

Authors: B.Benalioua, I.Benyamina, A.Bentouami, B.Boury

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The objective of this study is based on the synthesis of a new photocatalyst based on TiO2 and its application in the photo-degradation of an acid dye under the visible light. The material obtained was characterized by different techniques like diffuse reflectance UV–Vis spectroscopy (DRS), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The photocatalytic efficiency of the Bi, Zn co-doped TiO2 treated at 670°C for 2 h was tested on the Indigo Carmine under the irradiation of visible light and compared with that of the commercial titanium oxide TiO2-P25 (Degussa). The XRD characterization of the material Bi-Zn-TiO2 (670°C) revealed the presence of the anatase phase and the absence of the rutile phase in comparison of the TiO2 P25 diffractogram. Characterization by UV- visible diffuse reflection (DRS) material showed that the Bi-Zn-TiO2 exhibits redshift (move visible) relative to commercial titanium oxide TiO2-P25, this property promises a photocatalytic activity of Bi-Zn-TiO2 under visible light. Indeed, the efficiency of photocatalytic Bi-Zn-TiO2 as a visible light is shown by a complete discoloration of indigo carmine solution of 16 mg/L after 70 minutes, whereas with the P25-TiO2 discoloration is achieved after 120 minutes.

Keywords: POA, heterogeneous photocatalysis, TiO2, co-doping

Procedia PDF Downloads 311

Authors: B. Benalioua, I. Benyamina, A. Bentouami, B. Boury

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The objective of this study is based on the synthesis of a new photocatalyst based on TiO2 and its application in the photo-degradation of an acid dye under the visible light. The material obtained was characterized by different techniques like diffuse reflectance UV–Vis spectroscopy (DRS), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The photocatalytic efficiency of the S, N co-doped TiO2 treated at 600°C for 1 h was tested on the Indigo Carmine under the irradiation of visible light and compared with that of the commercial titanium oxide TiO2-P25 (Degussa). The XRD characterization of the material S-N-TiO2 (600°C) revealed the presence of the anatase phase and the absence of the rutile phase in comparison of the TiO2 P25 diffractogram. Characterization by UV- visible diffuse reflection (DRS) material showed that the S-N-TiO2 exhibits redshift (move visible) relative to commercial titanium oxide TiO2-P25, this property promises a photocatalytic activity of S-N-TiO2 under visible light. Indeed, the efficiency of photocatalytic S-N-TiO2 as a visible light is shown by a complete discoloration of indigo carmine solution of 16 mg/L after 40 minutes, whereas with the P25-TiO2 discoloration is achieved after 90 minutes.

Keywords: POA, heterogeneous photocatalysis, TiO2, co-doping

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Authors: Anna Jeon, Seung-Ho Han, Je-Hun Lee

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The aim of this study was to determine the location and distribution pattern of neurovascular structures superior and inferior to the clavicle by detailed dissection. Fifteen adult non-embalmed cadavers with a mean age of 71.5 years were studied. For measurements, the most prominent point of the sternal end of the clavicle (SEC) on anterior view and the most prominent point of the acromial end of the clavicle (AEC) were identified before dissection. A line connecting the SEC and AEC was used as a reference line. The surrounding neurovascular structures were investigated. The supraclavicular nerve was densely distributed at 71.73% on the reference line. Branches of the thoracoacromial artery were located at 76.92%. Branches of subclavian vein were evenly distributed at all sections. The subclavian vein and artery and brachial plexus were located from 31.3% to 57.5%. That area needs caution because major neurovascular structures run underneath the clavicle.

Keywords: clavicle, ORIF, neurovascular structure, anatomical study

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Authors: Margarita Ivanova, Julia Dao, Andrew Friedman, Neil Kasaci, Rekha Gopal, Ozlem Goker-Alpan

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In Fabry disease (FD), α-galactosidase A (α-Gal A) deficiency leads to the accumulation of globotriaosylceramide (Lyso-Gb3 and Gb3), triggering a pathologic cascade that causes the severity of organs damage. The heart is one of the several organs with high sensitivity to the α-Gal A deficiency. A subgroup of patients with significant residual of α-Gal A activity with primary cardiac involvement is occasionally referred to as “cardiac variant.” The cardiovascular complications are most frequently encountered, contributing substantially to morbidity, and are the leading cause of premature death in male and female patients with FD. The deposition of Lyso-Gb-3 and Gb-3 within the myocardium affects cardiac function with resultant progressive cardiovascular pathology. Gb-3 and Lyso-Gb-3 accumulation at the cellular level trigger a cascade of events leading to end-stage fibrosis. In the cardiac tissue, Lyso-Gb-3 deposition is associated with the increased release of inflammatory factors and transforming growth factors. Infiltration of lymphocytes and macrophages into endomyocardial tissue indicates that inflammation plays a significant role in cardiac damage. Moreover, accumulated data suggest that chronic inflammation leads to multisystemic FD pathology even under enzyme replacement therapy (ERT). NF-κB activation plays a subsequent role in the inflammatory response to cardiac dysfunction and advanced heart failure in the general population. TNFalpha/NF-κB signaling protects the myocardial evoking by ischemic preconditioning; however, this protective effect depends on the concentration of TNF-α. Thus, we hypothesize that TNF-α is a critical factor in determining the grade of cardio-pathology. Cardiac hypertrophy corresponds to the expansion of the coronary vasculature to maintain a sufficient supply of nutrients and oxygen. Coronary activation of angiogenesis and fibrosis plays a vital role in cardiac vascularization, hypertrophy, and tissue remodeling. We suggest that the interaction between the inflammatory pathways and cardiac vascularization is a bi-directional process controlled by secreted cytokines and growth factors. The co-coordination of these two processes has never been explored in FD. In a cohort of 40 patients with FD, biomarkers associated with inflammation and cardio hypertrophic remodeling were studied. FD patients were categorized into three groups based on LVmass/DSA, LVEF, and ECG abnormalities: FD with no cardio complication, FD with moderate cardio complication, and severe cardio complication. Serum levels of NF-kB, TNFalpha, Il-6, Il-2, MCP1, ING-gamma, VEGF, IGF-1, TGFβ, and FGF2 were quantified by enzyme-linked immunosorbent assays (ELISA). Among the biomarkers, MCP-1, INF-gamma, VEGF, TNF-alpha, and TGF-beta were elevated in FD patients. Some of these biomarkers also have the potential to correlate with cardio pathology in FD. Conclusion: The study provides information about the role of inflammatory pathways and biomarkers of cardio hypertrophic remodeling in FD patients. This study will also reveal the mechanisms that link intracellular accumulation of Lyso-GB-3 and Gb3 to the development of cardiomyopathy with myocardial thickening and resultant fibrosis.

Keywords: biomarkers, Fabry disease, inflammation, growth factors

Procedia PDF Downloads 82

Authors: M. A. Anwar, K. Iqbal, M. Razzaq

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Background and Objectives: This numerical study reflects the magnetic field's effect on the reduction of plaque formation due to stenosis in a stenosed bifurcated artery. The entire arterythe wall is assumed as linearly elastic, and blood flow is modeled as a Newtonian, viscous, steady, incompressible, laminar, biomagnetic fluid. Methods: An Arbitrary Lagrangian-Eulerian (ALE) technique is employed to formulate the hemodynamic flow in a bifurcated artery under the effect of the asymmetric magnetic field by two-way Fluid-structure interaction coupling. A stable P2P1 finite element pair is used to discretize thenonlinear system of partial differential equations. The resulting nonlinear system of algebraic equations is solved by the Newton Raphson method. Results: The numerical results for displacement, velocity magnitude, pressure, and wall shear stresses for Reynolds numbers, Re = 500, 1000, 1500, 2000, in the presence of magnetic fields are presented graphically. Conclusions: The numerical results show that the presence of the magnetic field influences the displacement and flows velocity magnitude considerably. The magnetic field reduces the flow separation, recirculation area adjacent to stenosis and gives rise to wall shear stress.

Keywords: bifurcation, elastic walls, finite element, wall shear stress,

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Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

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Authors: Yousuf Al Suleimani, Ahmed Al Mahruqi

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A typical cannabinoid O-1602 induces vasorelaxation and activates the orphan G protein-coupled receptor GPR55 in human endothelial cells. The aim of this study is to characterize the mechanisms of endothelium-independent relaxation of O-1602 in the rat small mesenteric artery using wire myograph. In endothelium-denuded vessels, O-1602 partially produced concentration-dependent vasorelaxation. In vessels depleted of intracellular Ca2+ (by EGTA and methoxamine), CaCl2 produced concentration-dependent contraction. Preincubation with O-1602 (at 10 µM and 30 µM) abolished the contractile responses (P<0.01). The putative antagonist at novel “endothelial anandamide receptor” O-1918 (10 µM) significantly reversed the inhibitory effect of O-1602 on CaCl2-induced vasoconstriction. It is likely that the mechanism of endothelium-independent vasorelaxation to O-1602 is mediated by interfering with Ca2+ entry via an O-1918-sensitive pathway.

Keywords: O-1602, endothelium, vasorelaxation, calcium

Procedia PDF Downloads 359

Authors: Shraddha Gopal, Jayam Lazarus

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Aims: To study the referral practice and impact of DAT-scan in the diagnosis or exclusion of Parkinson’s disease. Settings and Designs: A retrospective study Materials and methods: A retrospective study of the results of 60 patients who were referred for a DAT scan over a period of 2 years from the Department of Neurology at Northern Lincolnshire and Goole NHS trust. The reason for DAT scan referral was noted under 5 categories against Parkinson’s disease; drug-induced Parkinson’s, essential tremors, diagnostic dilemma, not responding to Parkinson’s treatment, and others. We assessed the number of patients who were diagnosed with Parkinson’s disease against the number of patients in whom Parkinson’s disease was excluded or an alternative diagnosis was made. Statistical methods: Microsoft Excel was used for data collection and statistical analysis, Results: 30 of the 60 scans were performed to confirm the diagnosis of early Parkinson’s disease, 13 were done to differentiate essential tremors from Parkinsonism, 6 were performed to exclude drug-induced Parkinsonism, 5 were done to look for alternative diagnosis as the patients were not responding to anti-Parkinson medication and 6 indications were outside the recommended guidelines. 55% of cases were confirmed with a diagnosis of Parkinson’s disease. 43.33% had Parkinson’s disease excluded. 33 of the 60 scans showed bilateral abnormalities and confirmed the clinical diagnosis of Parkinson’s disease. Conclusion: DAT scan provides valuable information in confirming Parkinson’s disease in 55% of patients along with excluding the diagnosis in 43.33% of patients aiding an alternative diagnosis.

Keywords: DATSCAN, Parkinson's disease, diagnosis, essential tremors

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Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

Procedia PDF Downloads 310

Authors: B. Benalioua, I. Benyamina, A. Bentouami, B. Boury

Abstract:

The objective of this study is based on the synthesis of a new photocatalyst based on TiO2 and its application in the photo-degradation of an acid dye under the visible light. The material obtained was characterized by different techniques like diffuse reflectance UV–Vis spectroscopy (DRS), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The photocatalytic efficiency of the Bi, N co-doped TiO2 treated at 600°C for 1 h was tested on the Indigo Carmine under the irradiation of visible light and compared with that of the commercial titanium oxide TiO2-P25 (Degussa). The XRD characterization of the material Bi -N- TiO2 (600°C) revealed the presence of the anatase phase and the absence of the rutile phase in comparison of the TiO2 P25 diffractogram. Characterization by UV- visible diffuse reflection (DRS) material showed that the Bi-N-TiO2 exhibits redshift (move visible) relative to commercial titanium oxide TiO2-P25, this property promises a photocatalytic activity of Bi-N-TiO2 under visible light. Indeed, the efficiency of photocatalytic Bi-N-TiO2 as a visible light is shown by a complete discoloration of indigo carmine solution of 16 mg/L after 40 minutes, whereas with the P25-TiO2 discoloration is achieved after 90 minutes.

Keywords: POA, heterogeneous photocatalysis, TiO2, co-doping

Procedia PDF Downloads 378

Authors: Sanjeev Kumar Shukla, Govind Singh, Prabhat Pant Shahzad Ahmad

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Background: Graves’ disease is an autoimmune disorder with a genetic predisposition, and CD40 plays a pathogenic role in various autoimmune diseases. A single nucleotide polymorphism at position –1 of the Kozak sequence of the 5 untranslated regions of the CD40 gene of exon 1 has been reported to be associated with the development of Graves’ Disease. Objective: The aim of the present study was to investigate whether CD40 gene polymorphism confers susceptibility to Graves’ disease in the Kumaon region. CD40 gene polymorphisms were studied in Graves’ Disease patients (n=50) and healthy control subjects without anti-thyroid autoantibodies or a family history of autoimmune disorders (n=50). Material and Method: CD40 gene polymorphisms were studied in fifty Graves’ Disease patients and fifty healthy control subjects. All samples were collected from STG Hospital, Haldwani, Nainital. A C/T polymorphism at position –1 of the CD40 gene was measured using the polymerase chain reaction-restriction fragment length polymorphism. Results: There was no significant difference in allele or genotype frequency of the CD40 SNP between Graves’ Disease and control subjects. There was a significant decrease in the TT genotype frequency in the Graves’ Disease patients who developed Graves’ Disease after 40 years old than those under 40 years of age. These data suggest that the SNP of the CD40 gene is associated with susceptibility to the later onset of Graves’ Disease. Conclusion: The CD40 gene was a different susceptibility gene for Graves’ Disease within certain families because it was both linked and associated with Graves’ Disease.

Keywords: autoimmune diseases, pathogenesis, diagnosis, therapy

Procedia PDF Downloads 51

Authors: Armaghan Moravej Aleali, Seyed Mahmoud Latifi, Homeira Rashidi

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Objective: High blood pressure in a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. The aim of this present was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. Material & Methods: This descriptive-analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. Results: The subject participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls 46%). The prevalence of high blood pressure was 1.7% (boys 2.5% girls 0.8%). The prevalence of pre-hypertension was 9 % (7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. Conclusion: In this study, the prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies, showed a high correlation between being overweight and an increase in systolic and diastolic blood pressure.

Keywords: hypertension, pre-hypertension, childhood, adolescence

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Authors: Pármenas Costa Macedo do Nascimento

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Periodontal disease is the most common disease in the oral cavity of felines. It starts with the accumulation of bacteria on the tooth surface supporting the tissues of the periodontal tissue, namely gums, alveolar bone, cementum, and periodontal ligament. The main clinical symptom observed by the owner is bad breath, which may lead to local and systemic consequences depending on the stage of periodontal disease, such as bleeding and bone loss. Therefore, the study is important to educate tutors to take better care of the felines oral health in order to try to prevent the disease. For this epidemiological study, the target population has been felines, located on the outskirts of Manaus, in the state of Amazonas, with a geographic area of 155.68 km², with no defined breed, from October 1st to 10th, 2021, whose samples has been randomly selected, with a detailed profile. The variables of interest for this study have been: absence or presence of periodontal disease, gender, age (delimited by age group), and condition (domiciled or homeless). Using a sample of 40 felines from 4 districts of the east side of Manaus chosen at random, an oral exam has been made to identify the studied disease. The animal's apparent age, condition, sex, and presence or absence of periodontal disease has been noted. It has been observed that 70% (28/40) of them had periodontal disease, mostly females, aged between 0 and 5 years and domiciled, totaling 30% (12/40).

Keywords: felines, oral cavity, oral exam, periodontal disease

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Authors: A. Zaher, A. Traore, F. Thiéry, T. Talbert, B. Shaer

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In this paper, an intelligent approach is proposed to optimize the orientation of continuous solar tracking systems on cloudy days. Considering the weather case, the direct sunlight is more important than the diffuse radiation in case of clear sky. Thus, the panel is always pointed towards the sun. In case of an overcast sky, the solar beam is close to zero, and the panel is placed horizontally to receive the maximum of diffuse radiation. Under partly covered conditions, the panel must be pointed towards the source that emits the maximum of solar energy and it may be anywhere in the sky dome. Thus, the idea of our approach is to analyze the images, captured by ground-based sky camera system, in order to detect the zone in the sky dome which is considered as the optimal source of energy under cloudy conditions. The proposed approach is implemented using experimental setup developed at PROMES-CNRS laboratory in Perpignan city (France). Under overcast conditions, the results were very satisfactory, and the intelligent approach has provided efficiency gains of up to 9% relative to conventional continuous sun tracking systems.

Keywords: clouds detection, fuzzy inference systems, images processing, sun trackers

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Authors: A. Al Yousef, A. Toulon, L. Petit, S. Fraitag, F. Ruemmele, S. Hadj-Rabia, C. Bodemer

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Cutaneous Crohn’s disease (CCD) refers to an extremely rare granulomatous inflammation of the skin that is non-contiguous to the bowel tract. These cutaneous lesions can occur prior to, concurrent with, or after the gastrointestinal manifestations. In adults, CCD most frequently occurs in the setting of well-documented intestinal disease. Only 20% of cases occur prior to its development. Review of CCD in children, reveals that 86% of cases (24 of 28) occurring in patients without a known diagnosis of intestinal Crohn’s disease. Overall, the genitalia was the most commonly involved location, representing 21 of the 28 cases with 16 vulvar and 5 penile/scrotal lesions.

Keywords: Crohn’s disease, cutaneous manifestations, children, atypical axillary involvement

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Authors: Hitoshi Minakuchi, Izumi Takei, Shu Wakino, Koichi Hayashi, Hiroshi Itoh

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Objectives: Among type 2 diabetics, patients with CKD(chronic kidney disease), insulin resistance, impaired glyconeogenesis in kidney and reduced degradation of insulin are recognized, and we observed different fluctuational patterns of blood sugar between CKD patients and non-CKD patients. On the other hand, non-dipper type blood pressure change is the risk of organ damage and mortality. We performed cross-sectional study to elucidate the characteristic of the fluctuation of blood glucose and blood pressure at insulin-treated diabetic patients with chronic kidney disease. Methods: From March 2011 to April 2013, at the Ichikawa General Hospital of Tokyo Dental College, we recruited 20 outpatients. All participants are insulin-treated type 2 diabetes with CKD. We collected serum samples, urine samples for several hormone measurements, and performed CGMS(Continuous glucose measurement system), ABPM (ambulatory blood pressure monitoring), brain computed tomography, carotid artery thickness, ankle brachial index, PWV, CVR-R, and analyzed these data statistically. Results: Among all 20 participants, hypoglycemia was decided blood glucose 70mg/dl by CGMS of 9 participants (45.0%). The event of hypoglycemia was recognized lower eGFR (29.8±6.2ml/min：41.3±8.5ml/min, P<0.05), lower HbA1c (6.44±0.57%：7.53±0.49%), higher PWV (1858±97.3cm/s：1665±109.2cm/s), higher serum glucagon (194.2±34.8pg/ml：117.0±37.1pg/ml), higher free cortisol of urine (53.8±12.8μg/day：34.8±7.1μg/day), and higher metanephrin of urine (0.162±0.031mg/day：0.076±0.029mg/day). Non-dipper type blood pressure change in ABPM was detected 8 among 9 participants with hypoglycemia (88.9%), 4 among 11 participants (36.4%) without hypoglycemia. Multiplex logistic-regression analysis revealed that the event of hypoglycemia is the independent factor of non-dipper type blood pressure change. Conclusions: Among insulin-treated type 2 diabetic patients with CKD, the events of hypoglycemia were frequently detected, and can associate with the organ derangements through the medium of non-dipper type blood pressure change.

Keywords: chronic kidney disease, hypoglycemia, non-dipper type blood pressure change, diabetic patients

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Authors: Habu Musa, Nusaibah Binti Syd Ali

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Oil palm industries particularly in Malaysia and Indonesia are being devastated by Ganoderma disease caused by Ganoderma spp. To date, this disease has been causing serious oil palm yield losses and collapse of oil palm trees, thus affecting its contribution to the producer’s economy. Research on sustainable and eco-friendly remedy to counter Ganoderma disease is on the upsurge to avoid the current control measures via synthetic fungicides. Trichoderma species have been the most studied and valued microbes as biological control agents in an effort to combat a wide range of plant diseases sustainably. Therefore, in this current study, the potential of Trichoderma spp. (Trichoderma asperellum, Trichoderma harzianum, and Trichoderma virens) as a consortium approach was evaluated as biological control agents against Ganoderma disease on oil palm. The consortium of Trichoderma spp. applied found to be the most effective treatment in suppressing Ganoderma disease with 83.03% and 89.16% from the foliar and bole symptoms respectively. Besides, it exhibited tremendous enhancement in the oil palm seedling vegetative growth parameters. Also, it had highly induced significant activity of peroxidase, polyphenol oxidase and total phenolic content was recorded in the consortium treatment compared to the control treatment. Disease development was slower in the seedlings treated with consortium of Trichoderma spp. compared to the positive control, which exhibited with the highest percentage of disease severity.

Keywords: biological control, ganoderma disease, trichoderma, disease severity

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

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

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

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Santosh Sharma Parajuli, Diwas Manandhar

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Background: Perioperative pain management plays an integral part in patients undergoing cardiac surgery. We studied the effect of Erector Spinae Plane block on acute postoperative pain reduction and 24 hours opioid consumption in adult cardiac surgical patients. Methods: Twenty-five adult cardiac surgical patients who underwent cardiac surgery with sternotomy in whom ESP catheters were placed preoperatively were kept in group E, and the other 25 patients who had undergone cardiac surgery without ESP catheter and pain management done with conventional opioid injection were placed in group C. Fentanyl was used for pain management. The primary study endpoint was to compare the consumption of fentanyl and to assess the numeric rating scale in the postoperative period in the first 24 hours in both groups. Results: The 24 hours fentanyl consumption was 43.00±51.29 micrograms in the Erector Spinae Plane catheter group and 147.00±60.94 micrograms in the control group postoperatively which was statistically significant (p <0.001). The numeric rating scale was also significantly reduced in the Erector Spinae Plane group compared to the control group in the first 24 hours postoperatively. Conclusion: Erector Spinae Plane block is superior to the conventional opioid injection method for postoperative pain management in CABG patients. Erector Spinae Plane block not only decreases the overall opioid consumption but also the NRS score in these patients.

Keywords: erector, spinae, plane, numerical rating scale

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Authors: Asho Ali

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Tuberculosis is a disease of grave concern which infects one-third of the global population. The high incidence of tuberculosis is further compounded by the increasing emergence of drug resistant strains including multi drug resistant (MDR). Global incidence MDR-TB is ~4%. Molecular epidemiological studies, based on the assumption that patients infected with clustered strains are epidemiologically linked, have helped understand the transmission dynamics of disease. It has also helped to investigate the basis of variation in Mycobacterium tuberculosis (MTB) strains, differences in transmission, and severity of disease or drug resistance mechanisms from across the globe. This has helped in developing strategies for the treatment and prevention of the disease including MDR.

Keywords: Mycobcaterium tuberculosis, molecular epidemiology, drug resistance, disease

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Authors: Gurfateh Singh, Mu Khan, Razia Khanam, Govind Mohan

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Objective: The present study has been designed to investigate the beneficial role of Fenofibrate & Clofibrate in attenuated the cardioprotective effect of ischemic preconditioning (IPC) in hyperlipidemic rat hearts. Materials & Methods: Experimental hyperlipidemia was produced by feeding high fat diet to rats for a period of 28 days. Isolated langendorff’s perfused normal and hyperlipidemic rat hearts were subjected to global ischemia for 30 min followed by reperfusion for 120 min. The myocardial infarct size was assessed macroscopically using triphenyltetrazolium chloride staining. Coronary effluent was analyzed for lactate dehydrogenase (LDH) and creatine kinase-MB release to assess the extent of cardiac injury. Moreover, the oxidative stress in heart was assessed by measuring thiobarbituric acid reactive substance, superoxide anion generation and reduced form of glutathione. Results: The ischemia-reperfusion (I/R) has been noted to induce oxidative stress by increasing TBARS, superoxide anion generation and decreasing reduced form of glutathione in normal and hyperlipidemic rat hearts. Moreover, I/R produced myocardial injury, which was assessed in terms of increase in myocardial infarct size, LDH and CK-MB release in coronary effluent and decrease in coronary flow rate in normal and hyperlipidemic rat hearts. In addition, the hyperlipidemic rat hearts showed enhanced I/R-induced myocardial injury with high degree of oxidative stress as compared with normal rat hearts subjected to I/R. Four episodes of IPC (5 min each) afforded cardioprotection against I/R-induced myocardial injury in normal rat hearts as assessed in terms of improvement in coronary flow rate and reduction in myocardial infarct size, LDH, CK-MB and oxidative stress. On the other hand, IPC mediated myocardial protection against I/R-injury was abolished in hyperlipidemic rat hearts. However, Treatment with Fenofibrate (100 mg/kg/day, i.p.), Clofibrate (300mg/kg/day, i.p.) as a agonists of PPAR-α have not affected the cardioprotective effect of IPC in normal rat hearts, but its treatment markedly restored the cardioprotective potentials of IPC in hyperlipidemic rat hearts. Conclusion: It is noted that the high degree of oxidative stress produced in hyperlipidemic rat heart during reperfusion and consequent down regulation of PPAR-α may be responsible to abolish the cardioprotective potentials of IPC.

Keywords: Hyperlipidemia, ischemia-reperfusion injury, ischemic preconditioning, PPAR-α

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Authors: M. Fayez Al Homsi, Reem Al Homsi

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Renal disease is a major cause of morbidity and mortality. Glomerular diseases make a small portion of the renal disease. Lupus glomerulonephritis (GN) is the commonest among the GN of systemic diseases. More than a hundred and eighty-eight consecutive renal biopsies are performed and evaluated for clinically suspected glomerular diseases over a period of two years. As in a standard practice after receiving the ultrasound-guided renal biopsies, the fresh biopsy is divided to three parts, one part is frozen for immunofluorescence evaluation, the second part is placed in 4% glutaraldehyde for electron microscopic evaluation, and the third part is placed in 10% buffered formalin for light microscopic evaluation. Primary glomerular diseases are detected in 83 biopsies; glomerulonephritis (GN) of systemic diseases are identified in 88, glomerular lesions in vascular diseases in 3, glomerular lesions in metabolic diseases in 7, hereditary nephropathies in 2, end-stage kidney in 2, and glomerular lesions in transplantation in 3 biopsies. Among the primary lesions, focal segmental glomerulosclerosis (28) and mesangial proliferative GN (26) were the most common. Lupus GN (67) and Ig A nephropathy (20) were the most common of the GN of systemic diseases. Lupus nephritis biopsies included one biopsy diagnosed as class 1 (normal), 17 biopsies class 2 (mesangial proliferation), 5 biopsies class 3 (focal proliferative GN), 39 biopsies class 4 diffuse proliferative GN), 3 biopsies class 5 (membranous GN), and 2 biopsies class 6 (crescentic GN). Lupus GN is the most common among GN of systemic diseases. While diabetes is very common here, diabetic GN (3 biopsies) is not as common as might one expects. Most likely this is due to sampling and reluctance on part of nephrologists and patients in sampling the kidney in diabetes mellitus.

Keywords: diabetes, glomerulonephritis, lupus, mesangial proliferation, nephropathy

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Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

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Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

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Authors: Changhan Ouyang, Zhonglin Xie

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In response to proatherosclerotic factors such as oxidized lipids, or to therapeutic interventions such as angioplasty, stents, or bypass surgery, vascular smooth muscle cells (VSMCs) migrate from the media to the intima, resulting in intimal hyperplasia, restenosis, graft failure, or atherosclerosis. These proatherosclerotic factors also activate autophagy in VSMCs. However, the functional role of autophagy in vascular health and disease remains poorly understood. In the present study, we determined the role of autophagy in the regulation of VSMC migration. Autophagy activity in cultured human aortic smooth muscle cells (HASMCs) and mouse carotid arteries was measured by Western blot analysis of microtubule-associated protein 1 light chain 3 B (LC3B) and P62. The VSMC migration was determined by scratch wound assay and transwell migration assay. Ex vivo smooth muscle cell migration was determined using aortic ring assay. The in vivo SMC migration was examined by staining the carotid artery sections with smooth muscle alpha actin (alpha SMA) after carotid artery ligation. To examine the relationship between autophagy and neointimal hyperplasia, C57BL/6J mice were subjected to carotid artery ligation. Seven days after injury, protein levels of Atg5, Atg7, Beclin1, and LC3B drastically increased and remained higher in the injured arteries three weeks after the injury. In parallel with the activation of autophagy, vascular injury-induced neointimal hyperplasia as estimated by increased intima/media ratio. The en face staining of carotid artery showed that vascular injury enhanced alpha SMA staining in the intimal cells as compared with the sham operation. Treatment of HASMCs with platelet-derived growth factor (PDGF), one of the major factors for vascular remodeling in response to vascular injury, increased Atg7 and LC3 II protein levels and enhanced autophagosome formation. In addition, aortic ring assay demonstrated that PDGF treated aortic rings displayed an increase in neovessel formation compared with control rings. Whole mount staining for CD31 and alpha SMA in PDGF treated neovessels revealed that the neovessel structures were stained by alpha SMA but not CD31. In contrast, pharmacological and genetic suppression of autophagy inhibits VSMC migration. Especially, gene silencing of Atg7 inhibited VSMC migration induced by PDGF. Furthermore, three weeks after ligation, markedly decreased neointimal formation was found in mice treated with chloroquine, an inhibitor of autophagy. Quantitative morphometric analysis of the injured vessels revealed a marked reduction in the intima/media ratio in the mice treated with chloroquine. Conclusion: Autophagy activation increases VSMC migration while autophagy suppression inhibits VSMC migration. These findings suggest that autophagy suppression may be an important therapeutic strategy for atherosclerosis and intimal hyperplasia.

Keywords: autophagy, vascular smooth muscle cell, migration, neointimal formation

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