Search results for: aquatic therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2294

Search results for: aquatic therapy

2144 Two Cases of VACTERL Association in Pregnancy with Lymphocyte Therapy

Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed

Abstract:

Introduction: VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. Case presentation: The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. Conclusion: diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.

Keywords: anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy

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2143 The Empowerment of Reminiscence Group Play Therapy for Older People in Taiwan

Authors: Jiun-De Lin

Abstract:

The main purpose of this study was to investigate the empowerment effect of the older people through a structured reminiscence play therapeutic group program in Changhua county of Taiwan. This program was used Taiwanese traditional culture as the main concept based on the topic of reminiscence. In order to assimilate into the process for older people, thematic group activities were easy to operate. During the reminiscence play activities, they would improve their personal control and competence, the same as empowerment. A counselor who acted as a group leader led 10 elderly people participated in this reminiscence group play therapy. The participants of the study were 10 older people consisting of 7 males and 3 females who lived in a rehabilitation center in Changhua county of Taiwan. The participants’ average age was 72.5 years old. The study adopted the methods of survey research and the instruments in this study included subjects’ demographic information and the empowerment inventory for adults. A one-group pretest-posttest design was adopted by researchers to test the study hypothesis. The collected data were analyzed by descriptive statistics, and Wilcoxon matched paired signed-ranks test. The main finding of this study was that the reminiscence group play therapy had a significant effect (Z= 2.382, p < .05) to promote the state of empowerment of older people participated in this group play therapy. Based on the conclusion of this study, the suggestions and implications were proposed for the practices and future research.

Keywords: empowerment, group play therapy, older people, reminiscence

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2142 Treatment of Papillary Thyroid Carcinoma Metastasis to the Sternum: A Case Report

Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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2141 Application of Aquatic Plants for the Remediation of Organochlorine Pesticides from Keenjhar Lake

Authors: Soomal Hamza, Uzma Imran

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Organochlorine pesticides bio-accumulate into the fat of fish, birds, and animals through which it enters the human food cycle. Due to their persistence and stability in the environment, many health impacts are associated with them, most of which are carcinogenic in nature. In this study, the level of organochlorine pesticides has been detected in Keenjhar Lake and remediated using Rhizoremediation technique. 14 OC pesticides namely, Aldrin, Deldrin, Heptachlor, Heptachlor epoxide, Endrin, Endosulfun I and II, DDT, DDE, DDD, Alpha, Beta, Gamma BHC and two plants namely, Water Hyacinth and Slvinia Molesta were used in the system using pot experiment which processed for 11 days. A consortium was inoculated in both plants to increase its efficiency. Water samples were processed using liquide-liquid extraction. Sediments and roots samples were processed using Soxhlet method followed by clean-up and Gas Chromatography. Delta-BHC was the predominantly found in all samples with mean concentration (ppb) and standard deviation of 0.02 ± 0.14, 0.52 ± 0.68, 0.61 ± 0.06, in Water, Sediments and Roots samples respectively. The highest levels were of Endosulfan II in the samples of water, sediments and roots. Water Hyacinth proved to be better bioaccumulaor as compared to Silvinia Molesta. The pattern of compounds reduction rate by the end of experiment was Delta-BHC>DDD > Alpha-BHC > DDT> Heptachlor> H.Epoxide> Deldrin> Aldrin> Endrin> DDE> Endosulfun I > Endosulfun II. Not much significant difference was observed between the pots with the consortium and pots without the consortium addition. Phytoremediation is a promising technique, but more studies are required to assess the bioremediation potential of different aquatic plants and plant-endophyte relationship.

Keywords: aquatic plant, bio remediation, gas chromatography, liquid liquid extraction

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2140 Bioremediation of Arsenic from Industrially Polluted Soil of Vatva, Ahmedabad, Gujarat, India

Authors: C. Makwana, S. R. Dave

Abstract:

Arsenic is toxic to almost all living cells. Its contamination in natural sources affects the growth of microorganisms. The presence of arsenic is associated with various human disorders also. The attempt of this sort of study provides information regarding the performance of our isolated microorganisms in the presence of Arsenic, which have ample scope for bioremediation. Six isolates were selected from the polluted sample of industrial zone Vatva, Ahmedabad, Gujarat, India, out of which two were Thermophilic organisms. The thermophilic exopolysaccharide (EPS) producing Bacillus was used for microbial enhance oil recovery (MEOR) and in the bio beneficiation. Inorganic arsenic primarily exists in the form of arsenate or arsenite. This arsenic resistance isolate was capable of transforming As +3 to As+5. This isolate would be useful for arsenic remediation standpoint from aquatic systems. The study revealed that the thermophilic microorganism was growing at 55 degree centigrade showed considerable remediation property. The results on the growth and enzyme catalysis would be discussed in response to Arsenic remediation.

Keywords: aquatic systems, thermophilic, exopolysacchride, arsenic

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2139 Omalizumab Therapy Experience for Asthma, at Zayed Military Hospital (ZMH) in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

Abstract:

Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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2138 Simulating the Effect of Chlorine on Dynamic of Main Aquatic Species in Urban Lake with a Mini System Dynamic Model

Authors: Zhiqiang Yan, Chen Fan, Beicheng Xia

Abstract:

Urban lakes play an invaluable role in urban water systems such as flood control, landscape, entertainment, and energy utilization, and have suffered from severe eutrophication over the past few years. To investigate the ecological response of main aquatic species and system stability to chlorine interference in shallow urban lakes, a mini system dynamic model, based on the competition and predation of main aquatic species and TP circulation, was developed. The main species of submerged macrophyte, phytoplankton, zooplankton, benthos and TP in water and sediment were simulated as variables in the model with the interference of chlorine which effect function was attenuation equation. The model was validated by the data which was investigated in the Lotus Lake in Guangzhou from October 1, 2015 to January 31, 2016. Furthermore, the eco-exergy was used to analyze the change in complexity of the shallow urban lake. The results showed the correlation coefficient between observed and simulated values of all components presented significant. Chlorine showed a significant inhibitory effect on Microcystis aeruginosa,Rachionus plicatilis, Diaphanosoma brachyurum Liévin and Mesocyclops leuckarti (Claus).The outbreak of Spiroggra spp. inhibited the growth of Vallisneria natans (Lour.) Hara, caused a gradual decrease of eco-exergy, reflecting the breakdown of ecosystem internal equilibria. It was concluded that the study gives important insight into using chlorine to achieve eutrophication control and understand mechanism process.

Keywords: system dynamic model, urban lake, chlorine, eco-exergy

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2137 Narrative Family Therapy and the Treatment of Perinatal Mood and Anxiety Disorders

Authors: Jamie E. Banker

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For many families, pregnancy and the postpartum time are filled with both anticipation and change. For some pregnant or postpartum women, this time is marked by the onset of a mood or anxiety disorder. Experiencing a mood or anxiety disorders during this time of life differs from depression or anxiety at other times of life. Not only because of the physical changes occurring in the mother’s body but also the mental and physical preparation necessary to redefine family roles, responsibilities, and develop new identities in the life transition. The presence of a mood or anxiety disorder can influence the way in which a mother defines herself and can complicate her understanding of her abilities and competencies as a mother. The complexity of experiencing a mood or anxiety disorder in the midst of these changes necessitates specific treatment interventions to match both the symptomatology and psychological adjustments. This study explores the use of narrative family therapy techniques when treating a mother who is experiencing postpartum depression. Externalization is a common technique used in narrative family therapy and can help client’s separate their identity from the problems they are experiencing. This is crucial to a new mom who is in the middle of defining her identity during her transition to parenthood. The goal of this study is to examine how the use of externalization techniques help postpartum women separate their mood and anxiety symptoms from their identity as a mother. An exploratory case study design was conducted in a single setting, private practice therapy office, and explored how a narrative family therapy approach can be used to treat perinatal mood and anxiety disorders. The therapy sessions were audio recorded and transcribed. Constructivism and narrative theory are used as theoretical frameworks and data from the therapy sessions, and a follow-up survey was triangulated and analyzed. During the course of the treatment, the participant reports using the new externalizing labels for her symptoms. Within one month of treatment, the participant reports that she could stop herself from thinking the harmful thoughts faster, and within three months, the harmful thoughts went away. The main themes in this study were building courage and less self-blame. This case highlights the role narrative family therapy can play in the treatment of perinatal mood and anxiety disorders and the importance of separating a women’s mood from her identity as a mother. This conceptual framework was beneficial to the postpartum mother when treating perinatal mood and anxiety disorder symptoms.

Keywords: externalizing techniques, narrative family therapy, perinatal mood and anxiety disorders, postpartum depression

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2136 Construction of Submerged Aquatic Vegetation Index through Global Sensitivity Analysis of Radiative Transfer Model

Authors: Guanhua Zhou, Zhongqi Ma

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Submerged aquatic vegetation (SAV) in wetlands can absorb nitrogen and phosphorus effectively to prevent the eutrophication of water. It is feasible to monitor the distribution of SAV through remote sensing, but for the reason of weak vegetation signals affected by water body, traditional terrestrial vegetation indices are not applicable. This paper aims at constructing SAV index to enhance the vegetation signals and distinguish SAV from water body. The methodology is as follows: (1) select the bands sensitive to the vegetation parameters based on global sensitivity analysis of SAV canopy radiative transfer model; (2) take the soil line concept as reference, analyze the distribution of SAV and water reflectance simulated by SAV canopy model and semi-analytical water model in the two-dimensional space built by different sensitive bands; (3)select the band combinations which have better separation performance between SAV and water, and use them to build the SAVI indices in the form of normalized difference vegetation index(NDVI); (4)analyze the sensitivity of indices to the water and vegetation parameters, choose the one more sensitive to vegetation parameters. It is proved that index formed of the bands with central wavelengths in 705nm and 842nm has high sensitivity to chlorophyll content in leaves while it is less affected by water constituents. The model simulation shows a general negative, little correlation of SAV index with increasing water depth. Moreover, the index enhances capabilities in separating SAV from water compared to NDVI. The SAV index is expected to have potential in parameter inversion of wetland remote sensing.

Keywords: global sensitivity analysis, radiative transfer model, submerged aquatic vegetation, vegetation indices

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2135 MONDO Neutron Tracker Characterisation by Means of Proton Therapeutical Beams and MonteCarlo Simulation Studies

Authors: G. Traini, V. Giacometti, R. Mirabelli, V. Patera, D. Pinci, A. Sarti, A. Sciubba, M. Marafini

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The MONDO (MOnitor for Neutron Dose in hadrOntherapy) project aims a precise characterisation of the secondary fast and ultrafast neutrons produced in particle therapy treatments. The detector is composed of a matrix of scintillating fibres (250 um) readout by CMOS Digital-SPAD based sensors. Recoil protons from n-p elastic scattering are detected and used to track neutrons. A prototype was tested with proton beams (Trento Proton Therapy Centre): efficiency, light yield, and track-reconstruction capability were studied. The results of a MonteCarlo FLUKA simulation used to evaluated double scattering efficiency and expected backgrounds will be presented.

Keywords: secondary neutrons, particle therapy, tracking, elastic scattering

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2134 I Can’t Escape the Scars, Even If I Do Get Better”: A Discourse Analysis of Adolescent Talk About Their Self-Harm During Cognitive-Behavioural Therapy Sessions for Major Depressive Disorder

Authors: Anna Kristen

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There has been a pronounced increase in societal discourses around adolescent self-harm, yet there is a paucity of literature examining adolescent talk about self-harm that accounts for the sociocultural context. The objective of this study was to explore how adolescents with Depression talk about their self-harm engagement in consideration of both socio-cultural discourses and the therapy context during Cognitive-Behavioural Therapy (CBT) sessions. Utilizing a sample from the Improving Mood with Psychoanalytic and Cognitive Therapies study, discourse analysis was carried out on audio-recorded CBT sessions. The study established three groupings of results: (a) adolescent positioning as stuck in self-harm engagement; (b) adolescent positioning as ambivalent in the talk about ceasing self-harm; and (c) adolescent use of stigma discourses in self-harm talk & constructions of self-harm scars. These findings indicate that clinician awareness of adolescent use of language and discourse may inform interventions beyond Manualized CBT strategies. These findings are highly relevant in light of research that demonstrates CBT treatment for adolescent depression does not effectively address concurring self-harm and given that self-harm is the most significant risk factor predictive of subsequent suicidal behaviours.

Keywords: adolescence, cognitive-behavioral therapy, discourse, self-harm, stigma

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2133 Pioneering Conservation of Aquatic Ecosystems under Australian Law

Authors: Gina M. Newton

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Australia’s Environment Protection and Biodiversity Conservation Act (EPBC Act) is the premiere, national law under which species and 'ecological communities' (i.e., like ecosystems) can be formally recognised and 'listed' as threatened across all jurisdictions. The listing process involves assessment against a range of criteria (similar to the IUCN process) to demonstrate conservation status (i.e., vulnerable, endangered, critically endangered, etc.) based on the best available science. Over the past decade in Australia, there’s been a transition from almost solely terrestrial to the first aquatic threatened ecological community (TEC or ecosystem) listings (e.g., River Murray, Macquarie Marshes, Coastal Saltmarsh, Salt-wedge Estuaries). All constitute large areas, with some including multiple state jurisdictions. Development of these conservation and listing advices has enabled, for the first time, a more forensic analysis of three key factors across a range of aquatic and coastal ecosystems: -the contribution of invasive species to conservation status, -how to demonstrate and attribute decline in 'ecological integrity' to conservation status, and, -identification of related priority conservation actions for management. There is increasing global recognition of the disproportionate degree of biodiversity loss within aquatic ecosystems. In Australia, legislative protection at Commonwealth or State levels remains one of the strongest conservation measures. Such laws have associated compliance mechanisms for breaches to the protected status. They also trigger the need for environment impact statements during applications for major developments (which may be denied). However, not all jurisdictions have such laws in place. There remains much opposition to the listing of freshwater systems – for example, the River Murray (Australia's largest river) and Macquarie Marshes (an internationally significant wetland) were both disallowed by parliament four months after formal listing. This was mainly due to a change of government, dissent from a major industry sector, and a 'loophole' in the law. In Australia, at least in the immediate to medium-term time frames, invasive species (aliens, native pests, pathogens, etc.) appear to be the number one biotic threat to the biodiversity and ecological function and integrity of our aquatic ecosystems. Consequently, this should be considered a current priority for research, conservation, and management actions. Another key outcome from this analysis was the recognition that drawing together multiple lines of evidence to form a 'conservation narrative' is a more useful approach to assigning conservation status. This also helps to addresses a glaring gap in long-term ecological data sets in Australia, which often precludes a more empirical data-driven approach. An important lesson also emerged – the recognition that while conservation must be underpinned by the best available scientific evidence, it remains a 'social and policy' goal rather than a 'scientific' goal. Communication, engagement, and 'politics' necessarily play a significant role in achieving conservation goals and need to be managed and resourced accordingly.

Keywords: aquatic ecosystem conservation, conservation law, ecological integrity, invasive species

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2132 Identifying the Source of Stress and Coping Strategies of Undergraduate Occupational Therapy Students' of BHPI in Bangladesh

Authors: Md. Toufiq Hasan

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This research set out to explore the source of stress and coping strategies of undergraduate Occupational Therapy students’ of Bangladesh Health Professions Institute (BHPI) in Bangladesh. For that reason, a quantitative and prospective type survey has been conducted by the researcher with 27 student participants of BHPI Occupational Therapy department whose stress scores were ≥40 according to Zung’s self-rating depression scale. Data was collected by using Bengali and English joined questionnaire of Inventory of College Students’ Recent Life Experience and Ways of Coping Scale. The researcher followed ‘Comprehensive sampling’ procedure to study the entire group of population. From the in-depth analysis to data found some source of stress and coping strategies of the students’. Stress was found significantly more in 2nd year students rather than other years. Female students were more vulnerable for stress rather than male. The age ranges 18-20 years of students are more vulnerable for stress. The main sources of stresses are found that, a lot of responsibilities and too many things to do at once and not enough time to meet their obligation or duties. The important coping strategies are found that, they criticized or lectured their selves, tried not to burn their bridges, but leave things open somewhat and inspired to do something creative. Findings of the study highlighted the need for teachers-students interactive relationship for better academic performance. The study also discloses some important recommendations for the students and teachers. At last the findings of the study will help the Occupational Therapy students and teachers of BHPI.

Keywords: BHPI undergraduate occupational therapy students, stress, source of stress, coping strategies

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2131 Prevalence of Rituximab Efficacy Over Immunosuppressants in Therapy of Systemic Sclerosis

Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

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Abstract Objectives. Rituximab (RTX) shown a positive effect in the treatment of systemic sclerosis (SSc). But there is still not enough data on comparing the effectiveness of RTX with immunosuppressants (IS). The aim of our study was to compare changes of lung function and skin score in SSc between two groups of patients (pts) - on RXT therapy (prescribed after ineffectiveness of previous therapy with IS) and on therapy with IS only. Methods. This study included 103 pts received RTX as an addition to previous therapy (group 1) and 65 pts received therapy with IS and prednisolone (group 2). The mean follow-up period was 12.6±10.7months. In group 1 the mean age was 47±12.9 years, female – 88 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. 82% pts had interstitial lung disease (ILD) and 92% were positive for ANA, 67% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 11.3±4.5 mg/day, IS at inclusion received 47% of them. The cumulative mean dose of RTX was 1.7±0.6 g. In group 2 the mean age was 50.8±13.8 years, female-53 pts (82%), the diffuse cutaneous subset of the disease had 44 pts (68%). The mean disease duration was 8.8±7.7 years. 81% pts had ILD and 88% were positive for ANA, 58% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 8.69±4.28 mg/day, IS received 57% of them. Cyclophosphamide (CP) received 45% of pts. The cumulative mean dose of CP was 10.2±15.1g. D-penicillamine received 30% of pts. Other pts was on mycophenolate mofetil or methotrexate therapy in single cases. The pts of the compared groups did not differ in the main demographic and clinical parameters. The results are presented as delta (Δ) - difference between the baseline parameter and follow up point. Results. In group 1 there was an improvement of all outcome parameters: increased of forced vital capacity, % predicted - ΔFVC=4% (p=0.0004); Diffusing capacity for carbon monoxide, % predicted remained stable (ΔDLCO=0.1%); improvement of the Rodnan skin score-ΔmRss=3.4 (p=0.001); decrease of Activity index (EScSG-AI) - ΔActivity index=1.7 (p=0.001). In group 2 the changes was insignificant: ΔFVC=-2.3%, ΔmRss=0.87, ΔActivity index=0.3. But there was a significant decrease of DLCO: ΔDLCO=-5.1% (p=0.001). Conclusion. The results of our study confirm the data on the positive effect of RTX in complex therapy in pts with SSc (decrease of skin induration, increase of FVC, stabilization of DLCO). Meantime, pts on IS and prednisolone therapy shown the worsening of lung function and insignificant changes of other clinical parameters. RTX could be considered as a more effective option in complex treatment of SSc in comparison with IS therapy

Keywords: immunosuppressants, interstitial lung disease, systemic sclerosis, rituximab

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2130 Composition, Abundance and Diversity of Zooplankton in Sarangani Bay, Sarangani Province, Philippines

Authors: Jeter Canete, Noreen Joyce Estrella, Yedda Sachi Patrice Madelo

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Zooplankton plays a crucial role in aquatic ecosystems and a number of water parameters involved in it. Despite their relevance, there is inadequate information about zooplankton communities in Sarangani Bay, Sarangani Province: one of the most essential waterbodies in Mindanao. The aim of the present study was to determine the composition, abundance, and diversity of zooplankton as well as to provide more recent data about the physico-chemical characteristics of Sarangani Bay. Zooplankton samples were collected by vertical hauls using a zooplankton net (mouth diameter: 0.5m; mesh size opening: round, 350μm) in three stations in the coastal waters of Alabel, Malapatan, and Maasim during November 2018. A total of 74 species of zooplankton belonging mainly to Kingdom Protozoa, Phylum Arthropoda, Chaetognatha, and Chordata were identified. Results showed a total zooplankton abundance of 1,984,166 ind/m³ with the highest count recorded at Malapatan (717,169 ind/m³) and the lowest at Maasim (624,411 ind/m³). Among 22 zooplankton groups identified, subclass Copepoda was found to be the most dominant (73.10%), followed by Appendicularia (12.18%) and Vertebrata (3.54%). Diversity analysis revealed an even distribution of species and a diverse ecosystem in all stations sampled. Correlation analysis indicated a strong relationship between zooplankton abundance and physico-chemical parameters. Overall, the physico-chemical profile of Sarangani Bay did not differ from the standards set by DENR, and analysis of the zooplankton communities revealed that Sarangani Bay favorably supports marine organisms to flourish. The findings of this study provide useful knowledge on zooplankton communities and can be used to create management strategies to protect the aquatic biodiversity in Sarangani Bay.

Keywords: aquatic biomonitoring, biodiversity, physicochemical analysis, population survey, Sarangani Bay, Sarangani Province, zooplankton

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2129 Development and in vitro Evaluation of Polymer-Drug Conjugates Containing Potentiating Agents for Combination Therapy

Authors: Blessing A. Aderibigbe

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Combination therapy is a treatment approach that is used to prevent the emergence of drug resistance. This approach is used for the treatment of many chronic and infectious diseases. Potentiating agents are currently explored in combination therapy, resulting in excellent therapeutic outcomes. Breast cancer and malaria are two chronic conditions responsible globally for high death rates. In this research, a class of polymer-drug conjugates containing potentiating agents with either antimalarial or anticancer drugs were prepared by Michael Addition Polymerization reaction and ring-opening polymerization reaction. Conjugation of potentiating agents with bioactive compounds into the polymers resulted in conjugates with good water solubility, highly selective and non-toxic. In vitro cytotoxicity and in vitro antiplasmodial evaluation on the conjugates revealed that the conjugates were more effective when compared to the free drugs. The drug release studies further showed that the release profile of the drugs from the conjugates was sustained. The findings revealed the potential of polymer-drug conjugates to overcome drug toxicity and drug resistance, which is common with the currently used antimalarial and anticancer drugs.

Keywords: anticancer, antimalarials, combination therapy, polymer-drug conjugates

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2128 Assessment of Barriers to the Clinical Adoption of Cell-Based Therapeutics

Authors: David Pettitt, Benjamin Davies, Georg Holländer, David Brindley

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Cellular based therapies, whose origins can be traced from the intertwined concepts of tissue engineering and regenerative medicine, have the potential to transform the current medical landscape and offer an approach to managing what were once considered untreatable diseases. However, despite a large increase in basic science activity in the cell therapy arena alongside a growing portfolio of cell therapy trials, the number of industry products available for widespread clinical use correlates poorly with such a magnitude of activity, with the number of cell-based therapeutics in mainstream use remaining comparatively low. This research serves to quantitatively assess the barriers to the clinical adoption of cell-based therapeutics through identification of unique barriers, specific challenges and opportunities facing the development and adoption of such therapies.

Keywords: cell therapy, clinical adoption, commercialization, translation

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2127 Dynamic Modeling of the Impact of Chlorine on Aquatic Species in Urban Lake Ecosystem

Authors: Zhiqiang Yan, Chen Fan, Yafei Wang, Beicheng Xia

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Urban lakes play an invaluable role in urban water systems such as flood control, water supply, and public recreation. However, over 38% of the urban lakes have suffered from severe eutrophication in China. Chlorine that could remarkably inhibit the growth of phytoplankton in eutrophic, has been widely used in the agricultural, aquaculture and industry in the recent past. However, little information has been reported regarding the effects of chlorine on the lake ecosystem, especially on the main aquatic species.To investigate the ecological response of main aquatic species and system stability to chlorine interference in shallow urban lakes, a mini system dynamic model was developed based on the competition and predation of main aquatic species and total phosphorus circulation. The main species of submerged macrophyte, phytoplankton, zooplankton, benthos, spiroggra and total phosphorus in water and sediment were used as variables in the model,while the interference of chlorine on phytoplankton was represented by an exponential attenuation equation. Furthermore, the eco-exergy expressing the development degree of ecosystem was used to quantify the complexity of the shallow urban lake. The model was validated using the data collected in the Lotus Lake in Guangzhoufrom1 October 2015 to 31 January 2016.The correlation coefficient (R), root mean square error-observations standard deviation ratio (RSR) and index of agreement (IOA) were calculated to evaluate accuracy and reliability of the model.The simulated values showed good qualitative agreement with the measured values of all components. The model results showed that chlorine had a notable inhibitory effect on Microcystis aeruginos,Rachionus plicatilis, Diaphanosoma brachyurum Liévin and Mesocyclops leuckarti (Claus).The outbreak of Spiroggra.spp. inhibited the growth of Vallisneria natans (Lour.) Hara, leading to a gradual decrease of eco-exergy and the breakdown of ecosystem internal equilibria. This study gives important insight into using chlorine to achieve eutrophication control and understand mechanism process.

Keywords: system dynamic model, urban lake, chlorine, eco-exergy

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2126 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova

Authors: Balkibekova Venera Serikpaevna

Abstract:

Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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2125 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

Abstract:

Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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2124 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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2123 Wound Healing Dressing and Some Composites Such as Zeolite, TiO2, Chitosan and PLGA as New Alternative for Melanoma Therapy: A Review

Authors: L. B. Naves, L. Almeida

Abstract:

The development of Drugs Delivery System (DDS), has been wildly investigated in the last decades. In this paper, first a general overview of traditional and modern wound dressing is presented. This is followed by a review of what scientist have done in the medical environment, focusing the possibility to develop a new alternative for DDS through transdermal pathway, aiming to treat melanoma skin cancer.

Keywords: cancer therapy, dressing polymers, melanoma, wound healing

Procedia PDF Downloads 385
2122 Children of Syria: Using Drawings for Diagnosing and Treating Trauma

Authors: Fatten F. Elkomy

Abstract:

The Syrian refugees are the largest refugee population since World War II. Mostly, children, these individuals were exposed to intense traumatic events in their homeland, throughout their journey, and during settlement in foreign lands. Art is a universal language to express feelings and tough human experiences. It is also a medium for healing and promoting creativity and resilience. Literature review was conducted to examine the use of art to facilitate psychiatric interviews, diagnosis, and therapy with traumatized children. Results show a severe impact of childhood trauma on the increased risk for abuse, neglect, and psychiatric disorders. Clinicians must recognize, evaluated and provide help for these children. In conclusion, drawings are used to tell a story, reflect deep emotions, and create a meaningful self-recognition and determination. Participants will understand art therapy using the expressive therapies continuum framework to evaluate drawings and to promote healing for refugee children.

Keywords: art therapy, children drawings, Syrian refugees, trauma in childhood

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2121 Surface Sterilization of Aquatic Plant, Cryptopcoryne affinis by Using Clorox and Mercury Chloride

Authors: Sridevi Devadas

Abstract:

This study was aimed to examine the combination efficiency of Clorox (5.25% Sodium Hypochlorite) and mercury chloride (HgCl2) as reagent for surface sterilization process of aquatic plant, Cryptocoryne affinis (C. affinis). The treatment applied 10% of the Clorox and 0.1 ppm of mercury chloride. The maximum exposure time for Clorox and mercury chloride was 10 min and 60 sec respectively. After exposed to the treatments protocols (T1-T15) the explants were transferred to culture room under control temperature at 25°C ± 2°C and subjected to 16 hours fluorescence light (2000 lumens) for 30 days. The both sterilizing agents were not applied on control specimens. Upon analysis, the result indicates all of the treatments protocols produced sterile explants at range of minimum 1.5 ± 0.7 (30%) to maximum 5.0 ± 0.0 (100%). Meanwhile, maximum 1.0 ± 0.7 numbers of leaves and 1.4 ± 0.6 numbers of roots have been produced. The optimized exposure time was 0 to 15 min for Clorox and 30 sec for HgCl2 whereby 90% to 100% sterilization was archived at this condition.

Keywords: Cryptocoryne affinis, surface sterilization, tissue culture, clorox, mercury chloride

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2120 Sexual Cognitive Behavioral Therapy: Psychological Performance and Openness to Experience

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Amin Asadi Hieh, Majid Kazemnezhad

Abstract:

This research was conducted with the aim of determining the effectiveness of sexual cognitive behavioral therapy on psychological performance and openness to experience in women. The type of research was experimental in the form of pre-test-post-test. The statistical population of this research was made up of all working and married women with membership in the researcher's Instagram social network who had problems in marital-sexual relationships (N=900). From the statistical community, which includes working and married women who are members of the researcher's Instagram social network who have problems in marital-sexual relationships, there are 30 people including two groups (15 people in the experimental group and 15 people in the control group) as available sampling and selected randomly. They were placed in two experimental and control groups. The anxiety, stress, and depression scale (DASS) and the Costa and McCree personality questionnaire were used to collect data, and the cognitive behavioral therapy protocol of Dr. Mehrnaz Ali Akbari was used for the treatment sessions. To analyze the data, the covariance test was used in the SPSS22 software environment. The results showed that sexual cognitive behavioral therapy has a positive and significant effect on psychological performance and openness to experience in women. Conclusion: It can be concluded that interventions such as cognitive-behavioral sex can be used to treat marital problems.

Keywords: sexual cognitive behavioral therapy, psychological function, openness to experience, women

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2119 Enhancing VR Exposure Therapy for the Treatment of Phobias with the Use of Photorealistic VR Environments and Stimuli, and the Use of Tactile Feedback Suits and Responsive Systems

Authors: Vardan Melkonyan, Arman Azizyan, Astghik Boyajyan

Abstract:

Virtual reality (VR) exposure therapy is a form of cognitive-behavioral therapy that uses immersive virtual environments to expose individuals to the feared stimuli or situations that trigger their phobia. VR exposure therapy has become an increasingly popular treatment for phobias, including fear of heights, public speaking, and flying, due to its ability to provide a controlled and safe environment for individuals to confront their fears while also allowing therapists to tailor the virtual exposure to the specific needs and goals of each individual. It is also a cost-effective and accessible treatment option, as it can be delivered remotely and does not require the use of drugs. Overall, VR exposure therapy has the potential to be a valuable tool for therapists in the treatment of phobias. But current methods may be improved by incorporating advanced technology such as photorealistic VR environments, tactile feedback suits, and responsive systems. The aim of this study was to identify the most effective approach for enhancing VR exposure therapy for the treatment of phobias. Photorealistic VR environments and stimuli can greatly enhance the effectiveness of VR exposure therapy for the treatment of phobias. By creating immersive, realistic virtual environments that closely mimic the real-life situations that trigger phobia responses, patients are able to more fully engage in the therapeutic process and confront their fears in a controlled and safe manner. This can help to reduce the severity of phobia symptoms and increase treatment outcomes. The use of tactile feedback suits and responsive systems can further enhance the VR exposure therapy experience by adding a physical element to the virtual environment. These suits, which can mimic the sensations of touch, pressure, and movement, allow patients to fully immerse themselves in the virtual world and feel as if they are physically present in the situation. This can help to increase the realism of the virtual environment and make it more effective in reducing phobia symptoms. Additionally, responsive systems can be used to trigger specific events or responses within the virtual environment based on the patient's actions, providing a more interactive and personalized treatment experience. A comprehensive literature review was conducted, including studies on VR exposure therapy for phobias and the use of advanced technology to enhance the therapy. Results indicate that incorporating these enhancements may significantly increase the effectiveness of VR exposure therapy for phobias. Further research is needed to fully understand the potential of these enhancements and to determine the optimal combination and implementation.

Keywords: virtual reality, mental health, phobias, fears, treatment, photorealistic, immersive, phobia

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2118 Effectiveness of Exercise and TENS in the Treatment of Temporomandibular Joint Disorders

Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

Abstract:

Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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2117 Effect Of Sewage Treatment Plant's Effluent On Early Life Stages Development And Sex Determination Of Brown Trout (Salmo Trutta M. Fario)

Authors: Ning Zhang, Kateřina Grabicová, Pavel Horký, Zuzana Linhartová, Jan Turek, Martin Pšenička, Linan Gao, Roman Grabic, Tomáš Randák

Abstract:

Sewage treatment plant (STP) effluent is a significant source of pharmaceuticals and personal care products (PPCPs) in the aquatic environment. Exposure laboratory studies have a limited reporting capacity to capture the complex effect of actual pollution on exposed organisms in the aquatic environment. This study aimed to study the impact of contamination originating from the STP's effluent on early life stages development and sex determination of brown trout (Salmo trutta m. fario) – a native coldwater species with a long period of embryo-larval development – by using special floating egg incubators usually used to support native fish species within fisheries management. Brown trout eggs were placed upstream (the control group) and downstream (the exposure group) of the STP Prachatice situated on the Zivny stream. Up to 72 PPCPs were detected in at least one water sample with higher concentration downstream than upstream. Compared with the control group, the mortality of brown trout in the exposure group was significantly higher; after statistical correction of temperature, the size, growth rate, and metabolic rate of brown trout in the exposure group were significantly lower than those in the control group. After several months of natural growth in the stream, the male-to-female ratio of randomly caught brown trout in the exposure group was 1: 1.9, showing the imbalance of sex ratio. These results suggest that STP effluents can negatively affect the early growth and development of fish in watersheds, and these negative effects may further affect the population density of aquatic organisms and the balance of the whole aquatic ecosystem. The use of floating egg incubators proved to be a promising approach for studying the effect of pollution on the early developmental stages of fish in natural conditions.

Keywords: fish egg incubator, PPCPs, real exposure scenario, STP

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2116 Effects of Large Woody Debris on the Abundance and Diversity of Freshwater Invertebrates and Vertebrates

Authors: M. J. Matulino, Carissa Ganong, Mark Mills, Jazmine Harry

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Large Woody Debris (LWD), defined as wooden debris with a diameter of at least 10 cm and a length of 2 m, serves as a crucial resource and habitat for aquatic organisms. While research on the ecological impacts of LWD has been conducted in temperate streams, LWD's influence on tropical stream biodiversity remains understudied, making this investigation particularly valuable for future conservation efforts. The Sura River in La Selva Biological Station includes both LWD and open channel sites. We sampled paired LWD and open-channel sites using minnow traps, Promar traps, and dip nets. Vertebrates were identified as species, while macroinvertebrates were identified to order level. We quantified abundance, richness, and Shannon diversity at each. We captured a total of 467 individuals, including 2 turtles, 17 fishes, 1 freshwater crab, 39 shrimp, and 408 other macroinvertebrates. Total abundance was significantly higher in LWD sites. Species richness was marginally higher in LWD sites, but the Shannon diversity index did not differ significantly with habitat. Shrimp (Macrobrachium olfersi) length was significantly higher in LWD areas. Increased food resources and microhabitat availability could contribute to higher abundance, richness, and organismal size in LWD environments. This study fills a critical gap by investigating LWD effects in a tropical environment, providing valuable insights for conservation efforts and the preservation of aquatic biodiversity.

Keywords: large woody debris (LWD), aquatic organisms, ecological impacts, tropical stream biodiversity, conservation efforts

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2115 Diagnosis and Treatment of Sleep Disorders

Authors: Andrew Anis Fakhrey Mosaad

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Introduction: There are many different types of sleep disorders, each with serious implications for a person's health and a large financial burden on society. Method: This review offers a framework based on the International Classification of Sleep Disorders to aid in the diagnosis and treatment of sleep disorders. Differentiating between primary and secondary insomnia is covered, along with pharmacological and nonpharmacological therapy options. Common abnormalities of the circadian rhythm are mentioned along with their therapies, such as light therapy and chronotherapy. This article discusses the identification and management of periodic limb movement disorder and restless legs syndrome. The therapy of upper airway resistance syndrome and obstructive sleep apnea are the main topics of discussion. Conclusion: The range of narcolepsy symptoms and results, as well as diagnostic procedures and treatment, are discussed. The causes, outcomes, and treatments of many types of insomnias, such as sleep terrors, somnambulism, and rapid eye movement (REM) behavior sleep disorders, are discussed.

Keywords: diagnosis, treatment, sleep disorders, insomnia

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