Search results for: cancer therapy

Authors: N. M. Aborehab, M. Helmy, N. E. Waly

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Resistin was identified as an adipocyte hormone that participates in regulation of glucose metabolism. Elevated levels of Resistin are postulated to cause insulin resistance. This may link obesity, and increased fat mass to type II diabetes and insulin resistance. We hypothesized that tomato and broccoli extract treatment regulates glucose homeostasis via modulation of resistin levels in high fat diet induced obesity rats (HFD). 63 male albino rats were divided into 8 groups as follows: control, HFD, stop fat diet (SD), Tomato 200 mg/kg (T200), Tomato 400mg/kg (T400), Broccoli 200 mg/kg (B200), Broccoli 400 mg/kg (B400), Chromax (CX). Treatment continued for 1 month. Serum levels of resistin, leptin, adiponectin, glucose and insulin were measured using ELISA, and spectrophotometry. Serum level of resistin was significantly reduced in T 200, T 400, B 200, B 400 and CX groups to: 4.13 ± 0.22 ng/ml, 1.51 ± 0.04 ng/ml, 4.13 ± 0.22 ng/ml, 2.32 ± 0.15 ng/ml and 1.37 ± 0.03 ng/ml respectively compared to HFD group and SD group (P value < 0.0001). Non-significant difference was found between T 400, B 400 and CX groups. Mean serum level of leptin was significantly reduced in T 400 (22.7 ± 0.84 Pg/ml) group compared to B 400 (41 ± 2.45 Pg/ml) and CX groups (45.7 ± 2.91 Pg/ml), P value < 0.001.The mean serum level of adiponectin was significantly increased in T 400 group (131 ± 3.84 Pg/ml) compared to CX group (112 ± 4.77 Pg/ml), P value was < 0.01. Our results demonstrate that tomato and broccoli extract treatment regulates glucose homeostasis via reduction of serum resistin and may be a useful non-pharmacological therapy for obesity. Further studies are required to assess the potential use of these extract as a treatment for type II diabetes and obesity.

Keywords: broccoli, obesity, resistin, tomato

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Authors: Mathew Nyashanu, George K. Kiggundu, Mandu S. Ekpenyong

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There is an increased number of young people engaging in early sexual relationships worldwide. Furthermore, statistics for early pregnancy among young people have also increased, especially in low and middle-income countries. This has health implications for both the parents and the baby. High uptake in family planning contraception among young people can reduce early pregnancy and subsequent negative health outcomes on the young parents and the baby. This study was set to explore the factors influencing the uptake of family planning contraceptive services among young people (18-24 years) at a community level in rural Budaka district, Uganda. The study utilised an explorative qualitative approach. The study found out that religion, partner resistance; perceived loss of libido, perceived barren, long waiting time and distance from the health facility, lack of privacy/confidentiality, excessive menstrual bleeding, cancer, and fear of having disabled babies, limited the utilisation of family planning contraceptive services while contraception as HIV prevention and child spacing encouraged young people to use family planning contraceptive services. There is a need for a culturally orientated community-based contraceptive health promotion approach to increase the uptake of family planning contraception services among young people.

Keywords: Young people, Family Planning, Contraceptives, Black sub-Sahara African

Procedia PDF Downloads 129

Authors: Marwa T. Badawy, Alaa F. Bakr, Nesrine Hegazi, Mohamed A. Farag, Ahmed Abdellatif

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Diabetes Mellitus (DM) is a chronic disease affecting a large population worldwide. Africa is rich in native medicinal plants with myriad health benefits, though less explored towards the development of specific drug therapy as in diabetes. This study aims to determine the in vivo antidiabetic potential of the well-reported and traditionally used fruits of Baobab (Adansonia digitata L.) using STZ induced diabetic model. The in-vitro cytotoxic and antioxidant properties were examined using MTT assay on L-929 fibroblast cells and DPPH antioxidant assays, respectively. The extract showed minimal cytotoxicity with an IC50 value of 105.7 µg/mL. Histopathological and immunohistochemical investigations showed the hepatoprotective and the renoprotective effects of A. digitata fruits’ extract, implying its protective effects against diabetes complications. These findings were further supported by biochemical assays, which showed that i.p., injection of a low dose (150 mg/kg) of A. digitata twice a week lowered the fasting blood glucose levels, lipid profile, hepatic and renal markers. For a comprehensive overview of extract metabolites composition, ultrahigh performance (UHPLC) analysis coupled to high-resolution tandem mass spectrometry (HRMS/MS) in synchronization with molecular networks led to the annotation of 77 metabolites, among which 50% are reported for the first time in A. digitata fruits.

Keywords: adansonia digital, diabetes mellitus, metabolomics, streptozotocin, Sprague, dawley rats

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Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

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Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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Authors: Mohammad Rawashdeh, Mark McEntee, Maha Zaitoun, Mostafa Abdelrahman, Patrick Brennan, Haytham Alewaidat, Sarah Lewis, Charbel Saade

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Despite the tremendous advancements that have been generated by Computed Tomography (CT) in the field of diagnosis, concerns have been raised about the potential cancer induction risk from CT because of the exponentially increased use of it in medicine. This study aims at investigating the application and knowledge of practicing radiographers in Jordan about CT radiation. In order to collect the primary data of this study, a questionnaire was designed and distributed by social media using a snow-balling sampling method. The respondents (n=54) have answered 36 questions including the questions about their demographic information, knowledge about Diagnostic Reference Levels (DRLs), CT exposure and adaptation of pediatric patients exposure. The educational level of the respondents was either at a diploma degree (35.2%) or bachelor (64.8%). The results of this study have indicated a good level of general knowledge between radiographers about the relationship between image quality, exposure parameters, and patient dose. The level of knowledge related to DRL was poor where less than 7.4 percent of the sample members were able to give specific values for a number of common anatomical fields, including abdomen, brain, and chest. Overall, Jordanian radiographers need to gain more knowledge about the expected levels of the dose when applying good practice. Additional education on DRL or DRL inclusion in educational programs is highlighted.

Keywords: computed tomography, CT scan, DRLs, exposure parameters, image quality, radiation dose

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Authors: Shahjada Selim

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Background: Erectile dysfunction (ED) is an important impediment to quality of life of men. ED is approximate, three times more common in diabetic than non-diabetic men, and diabetic men develop ED earlier than age-matched non-diabetic subjects. Glycemic control and other factors may contribute in developing and or deteriorating ED. Aim: The aim of the study was to determine the prevalence of ED and its risk factors in type 2 diabetic (T2DM) men in Bangladesh. Methods: During 2013-2014, 3980 diabetic men aged 30-69 years were interviewed at the out-patient departments of seven diabetic centers in Dhaka by using the validated Bengali version of the questionnaire of the International index of erectile function (IIEF) for evaluation of baseline erectile function (EF). The indexes indicate a very high correlation between the items and the questionnaire is consistently reliable. Data were analyzed with Chi-squared (χ²) test using SPSS software. P ≤ 0.05 was considered significant. Results: Out of 3790, ED was found in 2046 (53.98%) of T2DM men. The prevalence of ED was increased with age from 10.5% in men aged 30-39 years to 33.6% in those aged over 60 years (P < 0.001). In comparison with patients with reported diabetes lasting ≤ 5 years (26.4%), the prevalence of ED was less than in those with diabetes of 6-11 years (35.3%) and of 12-30 years (42.5%, P <0.001). ED increased significantly in those who had poor glycemic control. The prevalence of ED in patients with good, fair and poor glycemic control was 22.8%, 42.5% and 47.9% respectively (P = 0.004). Treatment modalities (medical nutrition therapy, oral agents, insulin, and insulin plus oral agents) had significant association with ED and its severity (P < 0.001). Conclusion: Prevalence of ED is very high among T2DM men in Bangladesh and can be reduced the burden by improving glycemic status. Glycemic control, duration of diabetes, treatment modalities, increasing age are associated with ED.

Keywords: erectile dysfunction, diabetes, men, Bangladesh

Procedia PDF Downloads 254

Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

Procedia PDF Downloads 244

Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

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Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

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Authors: Kazem Shakouri, Alireza Pishgahi, Homayoun Sadeghi-bBazargani, Shahla Dareshiri

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Introduction: Carpal Tunnel Syndrome has numerous nonsurgical treatments including splint, physical therapy and corticosteroid injections. Aim: The purpose of this study was to evaluate the effectiveness of an ultrasound guided treatment procedure, for individuals with severe carpal tunnel syndrome. Materials and Method: 20 patients with an electrodiagnostic evidence of severe carpal tunnel syndrome were treated by an office-based ultrasound guided procedure (combination of percutaneous needle release of carpal tunnel and corticosteroid injection). Electrodiagnostic (nerve conduction study), clinical (Boston Carpal Tunnel Questionnaire, grip strength) and ultrasonic (median nerve and carpal tunnel cross-sectional area) measurements were recorded at baseline and one month after intervention. Results: Our preliminary data analysis showed that in one month follow up, patients had a significantly smaller cross-sectional area of the median nerve compared to pretreatment values (mean difference 0.06; 95%CI: 0.02-0.1; p < 0.001). In addition, patients had significantly less functional impairment (mean difference 35; 95% CI:28.7-43.4 ; p < 0.001), and an improved hand grip strength in one month follow up (mean difference 5.4; 95%CI: 3.1-7.8; p < 0.001;). There were no significant complications. Conclusion: Patients with severe carpal tunnel syndrome, who are candidates for surgical intervention, can consider office-based ultrasound guided needle release of carpal tunnel as an alternative safe treatment.

Keywords: Carpal Tunnel Syndrome, needle release, pain, ultrasound

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Authors: Adegboyega Adedolapo Ola

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Globally, a country’s maritime security has a significant impact on its national development because it serves as a major source of a commercial contact and food supply. However, the country has been faced with a number of problems, such as piracy, kidnapping, illegal bunkering and oil theft. As such, the study examined the contribution and the relationship between maritime security and Nigeria’s development, as well as the prospects and challenges of maritime security in Nigeria. The study utilized a questionnaire and focused group discussion/interview as instruments for data collection. The method of analysis employed in the study is descriptive. A total of Three Hundred and Ninety (390) respondents were randomly selected. The result of the study showed that maritime security contributes to national development in Nigeria by guaranteeing food security in Nigeria, creating employment opportunities as well as increasing the Gross Domestic Product (GDP) of the economy. It was also found that maritime security is yet to provide sufficient support for national development in Nigeria. It is further established that it has prospects for development through the creation of employment opportunities, increase in foreign earnings, and fostering improved living standards for citizens. The study concluded that the high level of corruption, piracy and kidnapping, lack of political will by the government and the porosity of the Nigerian borders are serious obstacles, among others. In attempting to solve the problem of piracy and kidnapping in Nigerian maritime, to contribute to National development, it is primordial to address the cancer of corruption, poverty, and youth unemployment. In view of this, the study recommends: among other things, that the maritime industry should be well secured by removing its constraints/bottlenecks so as to enhance its contributions to national development.

Keywords: maritime security, national development, terrorism, piracy

Procedia PDF Downloads 66

Authors: Jarel Elgin Tolentino, Arby Denise Nera, Mary Rose Roco, Angela Vianca Aspa, Nikko Beltran, Else Dapat

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Drug resistance by cells has been the problem in the medical field for decades now. The use of medicinal plants as a source of creating powerful drugs has been nowadays recognized worldwide to treat such resistant diseases. In the present study, the potential for Diospyros philippinensis A. DC. to inhibit growth of both bacteria and cancer cell line was conducted. The leaf crude extracts were screened for the presence of phytochemicals and examined for potential bioactivities by employing several assays like Kirby-Bauer disc diffusion method, DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) assay and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium assay for the antibacterial, antioxidant and cytotoxic activities of the extract, respectively. Phytochemical test results of the extracts revealed the presence of alkaloids, flavonoids, saponins, phenols, quinones, cardiac glycosides, phlobatannins, carbohydrate, cardenolides and proteins. The leaf extracts were found to exhibit antibacterial activity against gram-positive bacteria, high antioxidant activity (99.22% ± 0.005) but did not show any sign of cytotoxicity towards HCT116 (ATCC CCL-247). The study therefore concludes that D. philippinensis A. DC. leaf extract can be a source of antibacterial and chemopreventive agents. This claim may be used as basis for future investigation.

Keywords: bioassay, medicinal plants, plant crude extracts, phytochemical screening

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Authors: Juan Antonio Mondragon Sanchez, Ruben Santamaria

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The DNA G-quadruplex is a four-stranded DNA structure conformed by stacked planes of four base paired guanines (G-quartet). The guanine rich DNA sequences are present in many sites of genomic DNA and can potentially lead to the formation of G-quadruplexes, especially at the 3'-terminus of the human telomeric DNA with many TTAGGG repeats. The formation and stabilization of a G-quadruplex by small ligands at the telomeric region can inhibit the telomerase activity. In turn, the ligands can be used to regulate oncogene expression making the G-quadruplex an attractive target for anticancer therapy. Clearly, the G-quadruplex structured in the telomeric DNA is of fundamental importance for rational drug design. In this context, we investigate two G-quadruplex structures, the first follows from the sequence TTAGGG(TTAGGG)3TT (HUT1), and the second from AAAGGG(TTAGGG)3AA (HUT2), both in a K+ solution. We determine the free energy surfaces of the HUT1 and HUT2 structures and investigate their conformations using replica-exchange metadynamics simulations. The carbonyl-carbonyl distances belonging to different guanines residues are selected as the main collective variables to determine the free energy surfaces. The surfaces exhibit two main local minima, compatible with experiments on the conformational transformations of HUT1 and HUT2 under substitution of the K+ ions by the Na+ ions. The conformational transitions are not observed in short MD simulations without the use of the metadynamics approach. The results of this work should be of help to understand the formation and stability of human telomeric G-quadruplex in environments including the presence of K+ and Na+ ions.

Keywords: g-quadruplex, metadynamics, molecular dynamics, replica-exchange

Procedia PDF Downloads 335

Authors: P. Akbartehrani, M. Khaledi Pour, M. Amini, M. Khani, M. Mohajeri Tehrani, E. Ghasemi, P. Charipoor, B. Shokri

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A common problem between diabetic patients is foot ulcers which are chronic and require specialized treatment. Previous studies illustrate that Cold atmospheric plasma (CAP) has beneficial effects on wound healing and infection. Nevertheless, the comparison of different cap exposure protocols in diabetic ulcer wound healing remained to be studied. This study aims to determine the effect of two different exposure protocols on wound healing in diabetic ulcers. A prospective, randomized clinical trial was conducted at two clinics. Diabetic patients with G1 and G2 wanger classification diabetic foot ulcers were divided into two groups of study. One group was treated by the first protocol, which was treating wounds by argon-generated cold atmospheric plasma jet once a week for five weeks in a row. The other group was treated by the second protocol, which was treating wounds every three days for five weeks in a row. The wounds were treated for 40 seconds/cubic centimeter, while the nozzle tip was moved nonlocalized 1 cm above the wounds. A patient with one or more wounds could participate in different groups as wounds were separately randomized, which allow a participant to be treated several times during the study. The study's significant findings were two different reductions rate in wound size, microbial load, and two different healing speeds. This study concludes that CAP therapy by the second protocol yields more effective healing speeds, reduction in wound sizes, and microbial loads of foot ulcers in diabetic patients.

Keywords: wound healing, diabetic ulcers, cold atmospheric plasma, cold argon jet

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Authors: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

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Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: 3D printing, knee orthotics, finite element analysis, design for additive manufacturing

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Authors: Murtada Ahmed Oshi, Jin-Wook Yoo

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Layer-by-layer (LBL) coating has gained popularity for drug delivery of therapeutic drugs. Herein we described a novel approach for enhancing the therapeutic efficiency of the locally administered dexamethasone (Dex) for inflammatory bowel disease (IBD). We utilized a LBL-coating technique on Dex microcrystals (DexMCs) with multiple layers of polyelectrolytes composed of poly (allylamine hydrochloride) (PAH), poly (sodium 4-styrene sulfonate) (PSS) and Eudragit® S100 (ES). The successful deposition of the layers onto DexMCs surfaces were confirmed through zeta potential measurement and confocal laser scanning microscopy. The surface morphology was investigated through scanning electron microscopy. The drug encapsulation efficiency was 95% with a mean particle size of 2 µm and negative surface charge (-40 mV). Moreover, in vitro drug release study showed a minimum release of the drug ( 15%) at an acidic condition during initial first 5 h, followed by sustained-release at an alkaline condition. For in vivo study, LBL-DxMCs were administered orally to ICR mice suffering from dextran sulfate sodium-induced colitis. LBL-DxMCs substantially enhanced anti-IBD activities as compared to DxMCs. Macroscopic, histological and biochemical (tumor necrosis factor-α, interleukin-6 and myeloperoxidase) examinations revealed marked improvements of colitis signs in the mice treated with LBL-DxMCs compared with those treated with DxMCs. Overall, LBL-DxMCs could be a suitable candidate for the treatment of IBD.

Keywords: dexamethasone, inflammatory bowel disease, LBL-coating, polyelectrolytes

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Efi Koutantou

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The foundation of successful therapy is the bond between the psychotherapist and the patient, Psychoanalysis would argue. The present study explores lived experiences of a psychotherapeutic relationship in different moments, initial and final with special reference to the transference love developed through the process. The fight between moments of ‘leaving a self’ behind and following ‘lines of flight’ in the process of creating a new subjectivity and ‘becoming-other’ will be explored. Moments between de-territorialisation – surpassing given constraints such as gender, family and religion, kinship bonds - freeing the space in favor of re-territorialisation – creation of oneself creation of oneself will also be analyzed. The generation of new possibilities of being, new ways of self-actualization for this patient will be discussed. The second part of this study will explore the extent to which this ‘transference love’ results for this specific patient to become ‘the discourse of the other’; it is a desideratum whether the patient finally becomes a subject of his/her own through his/her own self-exploration of new possibilities of existence or becomes alienated within the thought of the therapist. The way in which the patient uses or is (ab)used by the transference love in order to experience and undergo alienation from an ‘authority’ which may or may not sacrifice his/her own thought in favor of satisfying the therapist will be investigated. Finally, from an observer’s perspective and from the analysis of the results of this therapeutic relationship, the counter-transference will also be analyzed, in terms of an attempt of the analyst to relive and satisfy his/her own desires through the life of the analysand. The accession and fall of an idealized self will be analyzed, the turn of the transference love into ‘hate’ will conclude this case study through a lived experience in the therapeutic procedure; a relationship which can be called to be a mixture of a real relationship and remnants from a past object relationship.

Keywords: alienation, authority, counter-transference, hate, transference love

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Authors: Arash M. Shahidi, Tilak Dias, Gayani K. Nandasiri

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While graduated compression is the foundation of treatment and management of many medical complications such as leg ulcer, varicose veins, and lymphedema, monitoring the interface pressure has been conducted using different sensors that operate based on diverse approaches. The variations existed from the pressure readings collected using different interface pressure measurement systems would cause difficulties in taking a decision regarding the compression therapy. It is crucial to acknowledge the differences existing between direct and indirect pressure measurement systems while considering the commercially available systems such as AMI, Picopress and OPM which are under direct measurements systems, and HATRA (BSI), HOSY (RAL-GZ) and FlexiForce which comes under the indirect measurement system. Furthermore, Piezo-resistive sensors (Flexiforce) can measure the changes in resistance corresponding to the applied force on the sensing area. Direct pressure measuring systems are capable of measuring interface pressure on the three-dimensional states, while the indirect pressure measuring systems stretch the fabric in the two-dimensional direction and extrapolate pressure from surface tension measured on the device and neglect the vital factor which is the radius of curvature. In this study, a leg mannequin of known dimensions is selected with a knitted class 3 compression stocking. It has been decided to evaluate the data collected from different available systems (AMI, PicoPress, FlexiForce, and HATRA) and compare the results. The results showed a discrepancy between Hatra, AMI, Picopress, and Flexiforce against the pressure standard used to generate class 3 compression stocking. As predicted a higher pressure value with direct interface measuring systems were monitored against HATRA due to the effect of the radius of curvature.

Keywords: AMI, FlexiForce, graduated compression, HATRA, interface pressure, PicoPress

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Authors: Richard Nyanzi, Maupi E. Letsoalo, Jacobus N. Eloff, Piet J. Jooste

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Candida albicans naturally occurs in the gastrointestinal tract (GIT) of more than 50% of humans. Overgrowth of the fungus causes several forms of candidiasis including oral thrush. Overgrowth tends to occur in immunocompromised humans such as diabetic, cancer and HIV patients. Antifungal treatment is available, but not without shortcomings. In this study, inhibitory activity of five probiotic Lactobacillus strains was demonstrated against the growth of seven clinical strains of Candida albicans by co-culturing of the organisms in a maize gruel (MG) medium. Phenotypic tests, molecular techniques and phylogenetic analysis have enabled precise identification of the organisms used in the study. The quantitative pour plate technique was used to enumerate colonies of the yeasts and the lactobacilli and the Kruskal-Wallis test and ANOVA tests were employed to compare the distributions of the colonies of the organisms. The cereal medium, containing added carbon sources, was inoculated with a Candida and a Lactobacillus strain in combination and incubated at 37 °C for 168 h. Aliquots were regularly taken and subjected to pH determination and colony enumeration. Certain Lactobacillus strains proved to be inhibitory and also lethal to some Candida albicans strains. A low pH due to Lactobacillus acid production resulted in significant low Candida colony counts. Higher Lactobacillus colony counts did not necessarily result in lower Candida counts suggesting that inhibitory factors besides low pH and competitive growth by lactobacilli contributed to the reduction in Candida counts. Such anti-Candida efficacy however needs to be confirmed by in vivo studies.

Keywords: candida albicans, oral thrush, candidiasis, lactobacillus, probiotics

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Authors: Cheng-Chih Tsai, Yu-Hsuan Liu, Cheng-Ying Ho, Chun-Chin Huang

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The aim of this study evaluated the in vitro and in vivo antimicrobial activity of selected lactic acid bacteria (LAB) against Uropathogenic Escherichia coli (UPEC) for prevention and amelioration of UTIs. We screened LAB strains with antimicrobial effects on UPEC using a well-diffusion assay, bacterial adherence to the uroepithelium cell line SV-HUC-1 (BCRC 60358), and a coculture inhibition assay. The results showed that the 7 LAB strains (Lactobacillus paracasei, L. salivarius, two Pediococcus pentosaceus strains, two L. plantarum strains, and L. crispatus) and the fermented probiotic products produced by these multi-LAB strains exhibited potent zones of inhibition against UPEC. Moreover, the LAB strains and probiotic products adhered strongly to the uroepithelium SV-HUC-1 cell line. The growth of UPEC strains was also markedly inhibited after co-culture with the LAB strains and probiotic products in human urine. In addition, the enhanced levels of IL-6, IL-8 and lactic acid dehydrogenase were significantly decreased by treatments with the LAB strains and probiotic products in UPEC-induced SV-HUC-1 cells. Furthermore, oral administration of probiotic products reduced the number of viable UPEC in the urine of UPEC-challenged BALB/c mice. Taken together, this study demonstrates that probiotic supplementation may be useful as an adjuvant therapy for the treatment of bacterial-induced urinary tract infections.

Keywords: lactic acid bacterium, SV-HUC-1 uroepithelium, urinary tract infection, uropathogenic Escherichia coli, BALB/c mice

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Authors: Shohreh Ghasemi

Abstract:

Introduction: Melanoma is a complex disease with various clinical and histopathological features that impact prognosis and treatment decisions. Traditional methods of melanoma prognosis involve manual examination and interpretation of clinical and histopathological data by dermatologists and pathologists. However, the subjective nature of these assessments can lead to inter-observer variability and suboptimal prognostic accuracy. AI, with its ability to analyze vast amounts of data and identify patterns, has emerged as a promising tool for improving melanoma prognosis. Methods: A comprehensive literature search was conducted to identify studies that employed AI techniques for melanoma prognosis. The search included databases such as PubMed and Google Scholar, using keywords such as "artificial intelligence," "melanoma," and "prognosis." Studies published between 2010 and 2022 were considered. The selected articles were critically reviewed, and relevant information was extracted. Results: The review identified various AI methodologies utilized in melanoma prognosis, including machine learning algorithms, deep learning techniques, and computer vision. These techniques have been applied to diverse data sources, such as clinical images, dermoscopy images, histopathological slides, and genetic data. Studies have demonstrated the potential of AI in accurately predicting melanoma prognosis, including survival outcomes, recurrence risk, and response to therapy. AI-based prognostic models have shown comparable or even superior performance compared to traditional methods.

Keywords: artificial intelligence, melanoma, accuracy, prognosis prediction, image analysis, personalized medicine

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Authors: Okhee Woo, Hye Seon Shin

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Purpose: To investigate the diagnostic power of digital breast tomosynthesis (DBT) in evaluation of breast microcalcifications and usefulness as a pre-procedural study for stereotactic biopsy in comparison with full-field digital mammogram (FFDM) and FFDM plus magnification image (FFDM+MAG). Methods and Materials: An IRB approved retrospective observer performance study on DBT, FFDM, and FFDM+MAG was done. Image quality was rated in 5-point scoring system for lesion clarity (1, very indistinct; 2, indistinct; 3, fair; 4, clear; 5, very clear) and compared by Wilcoxon test. Diagnostic power was compared by diagnostic values and AUC with 95% confidence interval. Additionally, procedural report of biopsy was analysed for patient positioning and adequacy of instruments. Results: DBT showed higher lesion clarity (median 5, interquartile range 4-5) than FFDM (3, 2-4, p-value < 0.0001), and no statistically significant difference to FFDM+MAG (4, 4-5, p-value=0.3345). Diagnostic sensitivity and specificity of DBT were 86.4% and 92.5%; FFDM 70.4% and 66.7%; FFDM+MAG 93.8% and 89.6%. The AUCs of DBT (0.88) and FFDM+MAG (0.89) were larger than FFDM (0.59, p-values < 0.0001) but there was no statistically significant difference between DBT and FFDM+MAG (p-value=0.878). In 2 cases with DBT, petit needle could be appropriately prepared; and other 3 without DBT, patient repositioning was needed. Conclusion: DBT showed better image quality and diagnostic values than FFDM and equivalent to FFDM+MAG in the evaluation of breast microcalcifications. Evaluation with DBT as a pre-procedural study for breast stereotactic biopsy can lead to more accurate localization and successful biopsy and also waive the need for additional magnification images.

Keywords: DBT, breast cancer, stereotactic biopsy, mammography

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Authors: Akhtar Aman, Abida Raza, Shumaila Bashir, Mehboob Alam

Abstract:

The development of efficient delivery systems remains a major concern in cancer chemotherapy as many efficacious anticancer drugs are hydrophobic and difficult to formulate. Nanomedicines based on drug-loaded amphiphilic glycol chitosan micelles offer potential advantages for the formulation of drugs such as etoposide that may improve the pharmacokinetics and reduce the formulation-related adverse effects observed with current formulations. Amphiphilic derivatives of glycol chitosan were synthesized by chemical grafting of palmitic acid N-hydroxysuccinimide and quaternization to glycol chitosan backbone. To this end, a 7.9 kDa glycol chitosan was modified by palmitoylation and quaternization, yielding a 13 kDa amphiphilic polymer. Micelles prepared from this amphiphilic polymer had a size of 162nm and were able to encapsulate up to 3 mg/ml etoposide. Pharmacokinetic results indicated that the GCPQ micelles transformed the biodistribution pattern and increased etoposide concentration in the brain significantly compared to free drugs after intravenous administration. AUC 0.5-24h showed statistically significant difference in ETP-GCPQ vs. Commercial preparation in liver (25 vs.70, p<0.001), spleen (27 vs.36, p<0.05), lungs (42 vs.136,p<0.001),kidneys(25 vs.70,p< 0.05),and brain(19 vs.9,p<0.001). ETP-GCPQ crossed the blood-brain barrier, and 4, 3.5, 2.6, 1.8, 1.7, 1.5, and 2.5 fold higher levels of etoposide were observed at 0.5, 1, 2, 4, 6, 12, and 24hrs; respectively suggesting these systems could deliver hydrophobic anticancer drugs such as etoposide to tumors but also increased their transport through the biological barriers, thus making it a good delivery system

Keywords: glycol chitosan, micelles, pharmacokinetics, tissue distribution

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Authors: Ammar Aljabri, Alhussain Halawani, Alaa Ashqar, Omar Alageely

Abstract:

Objective: mild Traumatic Brain Injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of VRT as a treatment option for mTBI. Method: This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included RCTs and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: Medline, Embase, and Cochrane Register of Controlled Trials (CENTRAL). Results: Eight articles met the inclusion criteria, and six RCTs were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program, as shown by DHI scores (SMD= -0.33, 95% CI -0.62 to -0.03, p=0.03, I2= 0%). However, no significant reduction in DHI was evident after two months of follow-up (SMD= 0.15, 95% CI -0.23 to 0.52, p=0.44, I2=0%). Quantitative analysis also depicts significant reduction in both VOMS (SMD=-0.40, 95% CI -0.60 to -0.20, p<0.0001, I2=0%) and PCSS (SMD= -0.39, 95% CI -0.71 to -0.07, p=0.02, I2=0%) following the intervention. Lastly, there was no significant difference between intervention groups on BESS scores (SMD= -31, 95% CI -0.71 to 0.10, p=0.14, I2=0%) and return to sport/function (95% CI 0.32 to 30.80, p=0.32, I2=82%). Conclusions: Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provide evidence that supports the role of VRT in improving perceived symptoms following concussion. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.

Keywords: concussion, traumatic brain injury, vestibular rehabilitation, neurorehabilitation

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Authors: Betul Taspinar, Eda O. Okur, Ismail Saracoglu, Ismail Okur, Ferruh Taspinar

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Thoracic hyperkyphosis, is a well-known spinal phenomenon, refers to an excessive curvature (> 40 degrees) of the thoracic spine. The aim of this study was to explore the effectiveness of thrust manipulation on thoracic spine alignment. 31 young adults with hyperkyphosis diagnosed with Spinal Mouse® device were randomly assigned either thrust manipulation group (n=16, 11 female, 5 male) or sham manipulation group (n=15, 8 female, 7 male). Thrust and sham manipulations were performed by a blinded physiotherapist who is a certificated expert in musculoskeletal physiotherapy. Thoracic kyphosis degree was measured after the interventions via Spinal Mouse®. Wilcoxon test was used to analyse the data obtained before and after the manipulation for each group, whereas Mann-Whitney U test was used to compare the groups. The mean of baseline thoracic kyphosis degrees in thrust and sham groups were 50.69 o ± 7.73 and 48.27o ± 6.43, respectively. There was no statistically significant difference between groups in terms of initial thoracic kyphosis degrees (p=0.51). After the interventions, the mean of thoracic kyphosis degree in thrust and sham groups were measured as 44.06o ± 6.99 and 48.93o ± 6.57 respectively (p=0.03). There was no statistically significant difference between before and after interventions in sham group (p=0.33), while the mean of thoracic kyphosis degree in thrust group decreased significantly (p=0.00). Thrust manipulation can attenuate thoracic hyperkyphosis immediately in young adults by not using placebo effect. Manipulation might provide accurate proprioceptive (sensory) input to the spine joints and reduce kyphosis by restoring normal segment mobility. Therefore thoracic manipulation might be included in the physiotherapy programs to treat hyperkyphosis.

Keywords: hyperkyphosis, manual therapy, spinal mouse, physiotherapy

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Michaela Dušková, Kateřina Šimůnková, Martin Hill, Hana Hruškovičová, Hana Pospíšilová, Eva Králíková, Luboslav Stárka

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Smoking represents the most widespread substance dependence in the world. Several studies show the nicotine's ability to alter women hormonal homeostasis. Women smokers have higher testosterone and lower estradiol levels throughout life compared to non-smoker women. We monitored the effect of smoking discontinuation on steroid spectrum with 40 premenopausal and 60 postmenopausal women smokers. These women had been examined before they discontinued smoking and also after 6, 12, 24, and 48 weeks of abstinence. At each examination, blood was collected to determine steroid spectrum (measured by GC-MS), LH, FSH, and SHBG (measured by IRMA). Repeated measures ANOVA model was used for evaluation of the data. The study has been approved by the local Ethics Committee. Given the small number of premenopausal women who endured not to smoke, only the first 6 week period data could be analyzed. A slight increase in androgens after the smoking discontinuation occurred. In postmenopausal women, an increase in testosterone, dihydrotestosterone, dehydroepiandrosterone, and other androgens occurred, too. Nicotine replacement therapy, weight changes, and age does not play any role in the androgen level increase. The higher androgens levels correlated with failure in smoking cessation. Women smokers have higher androgen levels, which might play a role in smoking dependence development. Women successful in smoking cessation, compared to the non-successful ones, have lower androgen levels initially and also after smoking discontinuation. The question is what androgen levels women have before they start smoking.

Keywords: addiction, smoking, cessation, androgens

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Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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Authors: Ali Kuzu

Abstract:

There are about 800 thousand chemicals in our environment and the number is increasing more than a thousand every year. While most of these chemicals are used as components in various consumer products, some are faced as industrial waste in the environment. Unfortunately, many of these chemicals are hazardous and affect humans. According to the “International Program on Chemical Safety” of World Health Organization; Among the chronic health effects of chemicals, cancer is of major concern. Many substances have found in recent years to be carcinogenic in one or more species of laboratory animals. Especially with respect to long-term effects, the response to a chemical may vary, quantitatively or qualitatively, in different groups of individuals depending on predisposing conditions, such as nutritional status, disease status, current infection, climatic extremes, and genetic features, sex and age of the individuals. Understanding the response of such specific risk groups is an important area of toxicology research. People with age 65+ is defined as “aged (or elderly)”. The elderly population in the world is about 600 million, which corresponds to ~8 percent of the world population. While every 1 of each 4 people is aged in Japan, the elderly population is quite close to 20 percent in many developed countries. And elderly population in these countries is growing more rapidly than the total population. The negative effects of chemicals on elderly take an important place in health-care related issues in last decades. The aged population is more susceptible to the harmful effects of environmental chemicals. According to the poor health of the organ systems in elderly, the ability of their body to eliminate the harmful effects and chemical substances from their body is also poor. With the increasing life expectancy, more and more people will face problems associated with chemical residues.

Keywords: elderly, chemicals’ effects, aged care, care need

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Authors: Nasibullina A., Leonov D.

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The ultrasonography method is actively used for the early diagnosis of various le-sions in the human body, including the mammary gland. The incidence of breast cancer has increased by more than 20%, and mortality by 14% since 2008. The correctness of the diagnosis often directly depends on the qualifications and expe-rience of a diagnostic medical sonographer. That is why special attention should be paid to the practical training of future specialists. Anatomical phantoms are ex-cellent teaching tools because they accurately imitate the characteristics of real hu-man tissues and organs. The purpose of this work is to create a breast phantom for practicing ultrasound diagnostic skills in grayscale and elastography imaging, as well as ultrasound-guided biopsy sampling. We used silicone-like compounds ranging from 3 to 17 on the Shore scale hardness units to simulate soft tissue and lesions. Impurities with experimentally selected concentrations were added to give the phantom the necessary attenuation and reflection parameters. We used 3D modeling programs and 3D printing with PLA plastic to create the casting mold. We developed a breast phantom with inclusions of varying shape, elasticity and echogenicity. After testing the created phantom in B-mode and elastography mode, we performed a survey asking 19 participants how realistic the sonograms of the phantom were. The results showed that the closest to real was the model of the cyst with 9.5 on the 0-10 similarity scale. Thus, the developed breast phantom can be used for ultrasonography, elastography, and ultrasound-guided biopsy training.

Keywords: breast ultrasound, mammary gland, mammography, training phantom, tissue-mimicking materials

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