Search results for: diagnosis and therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3636

Search results for: diagnosis and therapy

3516 Psychosocial Determinants of School Violent Behavior and the Efficacy of Covert Sensitization in Combination with Systematic approach Therapy among Male Students in Lagos Metropolis: Implications for Student Counselors

Authors: Fidel O. Okopi, Aminu Kazeem Ibrahim

Abstract:

The study investigated psychosocial determinants ‘attitudes and self-esteem’ of school violent behaviors and the efficacy of covert sensitization therapy in combination with systematic approach therapy among male students in Lagos metropolis. Ex-post facto experimental research design was adopted for the study. The samples consisted of 39 school violent behavior students identified through the School Disciplinary Record Books and another 39 non-school violent behavior students identified through randomization. The two groups were from four randomly selected Public Senior Secondary Schools. School Violent Behavior Attitudes Scale (SVBAS) and School Violent Behavior Self-Esteem Scale (SVBSES) were used to collect data for the study. Face and Content validity with the Reliability coefficient of 0.772 for SVBAS and 0.813 for SVBSES were obtained. The results showed that the attitude of school violent behavior students do not significantly differ from that of school non-violent behavior students; the self-esteem of school violent behavior students differs significantly from that of school non-violent behavior students and that Covert Sensitization therapy in combination with Systematic Approach therapy were effective in modifying the self-esteem and attitude of school violent behavior students as surf iced in the pre-test and post-test analysis of school violent behavior students’ responses. The School counselors can modify male school violent behaviors that are traced to attitude and self-esteem with Covert Sensitization therapy in combination with Systematic Approach therapy in metropolitan areas.

Keywords: psychosocial determinants, violent behavior, covert sensitization therapy, systematic approach therapy

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3515 Vital Pulp Therapy: A Paradigm Shift in Treating Irreversible Pulpitis

Authors: Fadwa Chtioui

Abstract:

Vital Pulp Therapy (VPT) is nowadays challenging the deep-rooted dogma of root canal treatment, being the only therapeutic option for permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure. Histologic and clinical research has shown that compromised dental pulp can be treated without the full removal or excavation of all healthy pulp, and the outcome of the partial or full pulpotomy followed by a Tricalcium-Silicate-based dressing seems to show promising results in maintaining pulp vitality and preserving affected teeth in the long term. By reviewing recent advances in the techniques of VPT and their clinical effectiveness and safety in permanent teeth with irreversible Pulpitis, this work provides a new understanding of pulp pathophysiology and defense mechanisms and will reform dental practitioners' decision-making in treating irreversible pulpits from root canal therapy to vital pulp therapy by taking advantage of the biological effects of Tricalcium Silicate materials.

Keywords: irreversible pulpitis, vital pulp therapy, pulpotomy, Tricalcium Silicate

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3514 Diagnosis and Management of Obesity Among South Asians: A Paradigm

Authors: Deepa Vasudevan, Thomas Northrup, Angela Stotts, Michelle Klawans

Abstract:

To date, we have conducted three studies on this subject. The research done to date is through three studies. The initial study was to document that modified criteria independently identified higher numbers of overweight/obese South Asian Indians. The second study was to document physician knowledge of appropriate diagnosis of obesity among South Asian Indians. The final study was an intervention to evaluate the efficacy of a training module on improving physician diagnosis and counseling of overweight/obese Asian patients.

Keywords: South Asian Indians, obesity, physicians, BMI and waist circumference

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3513 Potency Interaction using Simvastatin and Herbs Cholesterol Lowering Agent, Prevention of Unwanted Effect in Combination Hyperlipidemia Therapy

Authors: Agung A. Ginanjar, Lilitasari, Indra Prasetya, Rizal R. Hanif, Yusrina Rismandini, Atina Hussaana, Nurita P. Sari

Abstract:

Hyperlipidemia is an increase of lipids and cholesterol in the blood that causes the formation of atherosklerosis. The recent pharmacological therapy nowadays is statin. Many Indonesian people use of medicinal plants. There are several medical plants that people always use to cure hyperlipidemia such as bulbs onion sabrang, areca nuts, and seed of fenugreek. Most people often use a combination therapy of conventional medicine and herbs to achieve the desired therapeutic effect of combination therapy. The use of combination therapy might cause the interaction of pharmacodynamic from those medicines so that it influences the pharmacological effect of one of medicine. The aim of this study is to know the interaction of simvastatin and a cholesterol-lowering herb seen in rats pharmacodynamic simvastatin phase. This research used post-test only controlled group design. Analysis of statistical data normality and homogenity were tested by Kolmogorov Smirnov. The ANOVA test is used when the data is obtained homogeneous but if it is found that the data are not homogeneous then kruskal-wallis test is used. Normal (63.196 mg/dl), negative (70.604 mg/dl), positive (62.512 mg/dl), areca nuts (56.564 mg/dl), fenugreek seed (47.538 ,g/dl), onion sabrang (62.312 mg/dl). The results prove that the combination of herbs and simvastatin did not have a significant difference (P>0,05). The conclusion of this study is that the combination of simvastatin and a cholesterol-lowering herb can cause some pharmacodynamic interactions such as a synergistic effect, antagonist, and a powerful additive, so that combination therapy is not more effective than single simvastatin therapy. The use of the combination therapy is not given in the same time. It would be better if there are some period of time when the combination therapy is applied.

Keywords: onion bulb sabrang, areca nuts, seed of fenugreek, interaction medicine, hyperlipidemia

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3512 An Audit of the Diagnosis of Asthma in Children in Primary Care and the Emergency Department

Authors: Abhishek Oswal

Abstract:

Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

Procedia PDF Downloads 116
3511 The Impact of Solution-Focused Brief Therapy on the Improvement of the Psychological Wellbeing of Family Supervisor Women

Authors: Kaveh Qaderi Bagajan, Osman Khanahmadi, Ziba Mamaghani Chaharborj, Majid Chenaparchi

Abstract:

The purpose of this study is to investigate the efficacy of the solution-focused brief therapy on improving the psychological wellbeing of family supervisor woman. This study has been carried out by semi-experimental method and in the form of pre-test, post-test performance on two groups (experimental and control), so that one sample group of 30 individuals was randomly achieved and were randomly divided in two groups of experimental (n=15) and control (n=15). To collect data, Ryff scale psychological wellbeing was used. After conducting pre-test (RSPWB) for two experimental and control groups, Solution-focused brief therapy interference was conducted on the experimental group during five two-hour sessions. Finally, Ryff scale psychological wellbeing was reused for the two groups as post-test and achieved outcomes that were analyzed using covariance. The results indicated that the significant increase of average marks of the experimental group in psychological wellbeing had better function than that of the control group. Finally, solution-focused brief therapy for improving psychological well-being of family supervisor women has a suitable capability and could be used in this way.

Keywords: solution-focused brief therapy, short-term therapy, family supervisor women, psychological well-being

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3510 Development of a Delivery System for Statin Targeted Spray is a Breakthrough Therapy in Alzheimer’s Prevention

Authors: Fakhr Eddin Alnaal, Angela Dahdal, Duaa Aladib, Sabeen Ibrahim, Ibrahim Ghoraibi, Bissan Ahmed

Abstract:

Dementia is one of the diseases which had several stages and Alzheimer’s term was selected in respect for the first doctor Alzheimer who defined the first symptoms of this diseases in a woman whom was well treated by him. The fact that this is a type of a silent disease on which you have a long-term process of neurological degradation and suddenly gives symptoms which are most often irreversible, on clinical level likely we can consider it as a malignancy, one in terms of that it is sudden shocking irreversible and on the level of behavior and some mortality beside the lack of early detection tools for diagnosis. Therefore, the goal of our project is to test the concept of the ability of Statin in prevention of such disease and we investigated that both on experimental level and most importantly on clinical one, the clinical part was performed in a recognized house of aged people who had accidently a high cholesterol and were for years given Statin to treat that elevation, however after the symptoms of Alzheimer’s appeared and when diagnosed, they were well treated and rapidly recovered compared to Alzheimer’s patients in the same house who did not receive Statin had a mild improvement in their symptoms after the therapy, on the other hand we confirmed such observation by a well-organized experimental work.

Keywords: Alzheimer's, dementia, silent disease, statin

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3509 Observer-based Robust Diagnosis for Wind Turbine System

Authors: Sarah Odofin, Zhiwei Gao

Abstract:

Operations and maintenance of wind turbine have received much attention by researcher due to rapid expansion of wind farms. This paper explores a novel fault diagnosis that is designed and optimized to be very sensitive to faults and robust to disturbances. The faults considered are the sensor faults of which the augmented observer is considered to enlarge faults and to be robust to disturbance. A qualitative model based analysis is proposed for early fault diagnosis to minimize downtime mostly caused by components breakdown and exploit productivity. Simulation results are computed validating the models provided which demonstrates system performance using practical application of fault type examples. The results demonstrate the effectiveness of the developed techniques investigated in a Matlab/Simulink environment.

Keywords: wind turbine, condition monitoring, genetic algorithm, fault diagnosis, augmented observer, disturbance robustness, fault estimation, sensor monitoring

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3508 Fault Diagnosis in Induction Motors Using the Discrete Wavelet Transform

Authors: Khaled Yahia

Abstract:

This paper deals with the problem of stator faults diagnosis in induction motors. Using the discrete wavelet transform (DWT) for the current Park’s vector modulus (CPVM) analysis, the inter-turn short-circuit faults diagnosis can be achieved. This method is based on the decomposition of the CPVM signal, where wavelet approximation and detail coefficients of this signal have been extracted. The energy evaluation of a known bandwidth detail permits to define a fault severity factor (FSF). This method has been tested through the simulation of an induction motor using a mathematical model based on the winding-function approach. Simulation, as well as experimental, results show the effectiveness of the used method.

Keywords: induction motors (IMs), inter-turn short-circuits diagnosis, discrete wavelet transform (DWT), current park’s vector modulus (CPVM)

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3507 Fault Diagnosis of Squirrel-Cage Induction Motor by a Neural Network Multi-Models

Authors: Yahia. Kourd, N. Guersi D. Lefebvre

Abstract:

In this paper we propose to study the faults diagnosis in squirrel-cage induction motor using MLP neural networks. We use neural healthy and faulty models of the behavior in order to detect and isolate some faults in machine. In the first part of this work, we have created a neural model for the healthy state using Matlab and a motor located in LGEB by acquirins data inputs and outputs of this engine. Then we detected the faults in the machine by residual generation. These residuals are not sufficient to isolate the existing faults. For this reason, we proposed additive neural networks to represent the faulty behaviors. From the analysis of these residuals and the choice of a threshold we propose a method capable of performing the detection and diagnosis of some faults in asynchronous machines with squirrel cage rotor.

Keywords: faults diagnosis, neural networks, multi-models, squirrel-cage induction motor

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3506 MR Imaging Spectrum of Intracranial Infections: An Experience of 100 Cases in a Tertiary Hospital in Northern India

Authors: Avik Banerjee, Kavita Saggar

Abstract:

Infections of the nervous system and adjacent structures are often life-threatening conditions. Despite the recent advances in neuroimaging evaluation, the diagnosis of unclear infectious CNS disease remains a challenge. Our aim is to evaluate the typical and atypical neuro-imaging features of the various routinely encountered CNS infected patients so as to form guidelines for their imaging recognition and differentiation from tumoral, vascular and other entities that warrant a different line of therapy.

Keywords: central nervous system (CNS), Cerebro Spinal Fluid (Csf), Creutzfeldt Jakob Disease (CJD), progressive multifocal leukoencephalopathy (PML)

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3505 Mathematical Model of Cancer Growth under the Influence of Radiation Therapy

Authors: Beata Jackowska-Zduniak

Abstract:

We formulate and analyze a mathematical model describing dynamics of cancer growth under the influence of radiation therapy. The effect of this type of therapy is considered as an additional equation of discussed model. Numerical simulations show that delay, which is added to ordinary differential equations and represent time needed for transformation from one type of cells to the other one, affects the behavior of the system. The validation and verification of proposed model is based on medical data. Analytical results are illustrated by numerical examples of the model dynamics. The model is able to reconstruct dynamics of treatment of cancer and may be used to determine the most effective treatment regimen based on the study of the behavior of individual treatment protocols.

Keywords: mathematical modeling, numerical simulation, ordinary differential equations, radiation therapy

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3504 Teaching Health in an Online 3D Virtual Learning Environment

Authors: Nik Siti Hanifah Nik Ahmad

Abstract:

This research discuss about teaching cupping therapy or hijama by using an online 3D Virtual Learning Environment. The experimental platform was using of flash and Second Life as 2D and 3D comparison. 81 samples have been used in three experiments with 21 in the first and 30 in each second and third. The design of the presentation was tested in five categories such as effectiveness, ease of use, efficacy, aesthetic and users’ satisfaction. The results from three experiments had shown promising outcome for usage of the technique to be implement in teaching Cupping Therapy as well as other alternative or conventional medicine knowledge especially for training.

Keywords: medical and health, cupping therapy or hijama, second life, online 3D VLE, virtual worlds

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3503 Detection of Telomerase Activity as Cancer Biomarker Using Nanogap-Rich Au Nanowire SERS Sensor

Authors: G. Eom, H. Kim, A. Hwang, T. Kang, B. Kim

Abstract:

Telomerase activity is overexpressed in over 85% of human cancers while suppressed in normal somatic cells. Telomerase has been attracted as a universal cancer biomarker. Therefore, the development of effective telomerase activity detection methods is urgently demanded in cancer diagnosis and therapy. Herein, we report a nanogap-rich Au nanowire (NW) surface-enhanced Raman scattering (SERS) sensor for detection of human telomerase activity. The nanogap-rich Au NW SERS sensors were prepared simply by uniformly depositing nanoparticles (NPs) on single-crystalline Au NWs. We measured SERS spectra of methylene blue (MB) from 60 different nanogap-rich Au NWs and obtained the relative standard deviation (RSD) of 4.80%, confirming the superb reproducibility of nanogap-rich Au NW SERS sensors. The nanogap-rich Au NW SERS sensors enable us to detect telomerase activity in 0.2 cancer cells/mL. Furthermore, telomerase activity is detectable in 7 different cancer cell lines whereas undetectable in normal cell lines, which suggest the potential applicability of nanogap-rich Au NW SERS sensor in cancer diagnosis. We expect that the present nanogap-rich Au NW SERS sensor can be useful in biomedical applications including a diverse biomarker sensing.

Keywords: cancer biomarker, nanowires, surface-enhanced Raman scattering, telomerase

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3502 Fault Diagnosis in Induction Motors Using Discrete Wavelet Transform

Authors: K. Yahia, A. Titaouine, A. Ghoggal, S. E. Zouzou, F. Benchabane

Abstract:

This paper deals with the problem of stator faults diagnosis in induction motors. Using the discrete wavelet transform (DWT) for the current Park’s vector modulus (CPVM) analysis, the inter-turn short-circuit faults diagnosis can be achieved. This method is based on the decomposition of the CPVM signal, where wavelet approximation and detail coefficients of this signal have been extracted. The energy evaluation of a known bandwidth detail permits to define a fault severity factor (FSF). This method has been tested through the simulation of an induction motor using a mathematical model based on the winding-function approach. Simulation, as well as experimental, results show the effectiveness of the used method.

Keywords: Induction Motors (IMs), inter-turn short-circuits diagnosis, Discrete Wavelet Transform (DWT), Current Park’s Vector Modulus (CPVM)

Procedia PDF Downloads 524
3501 Prenatal Diagnosis of Beta Thalassemia Intermedia in Vietnamese Family: Case Report

Authors: Ha T. T. Ly, Truc B. Truc, Hai N. Truong, Mai P. T. Nguyen, Ngoc D. Ngo, Khanh V. Tran, Hai T. Le

Abstract:

Beta thalassemia is one of the most common inherited blood disorders, which is characterized by decreased or absent in beta globin expression. Patients with Beta thalassemia whose anemia is not so severe as to necessitate transfusions are said to have thalassemia intermedia. Objective: The goal of this study is prenatal diagnosis for pregnancy woman with Beta thalassemia intermedia and her husband with Beta thalassemia carrier at high risk of Beta thalassemia major in Northern of Vietnam. Material and method: The family has a 6 years-old compound heterozygous thalassemia major for CD71/72(+A) and Hbb:c. -78A>G/nt-28(A>G) male child. The father was heterozygous for CD71/72(+A) mutation which is Beta plus type and the mother was compound heterozygosity of two different variants, namely, Hbb: c. -78A>G/nt-28(A>G) and CD26(A-G) HbE. Prenatal Beta thalassemia mutation detection in fetal DNA was carried out using multiplex Amplification-refractory mutation system ARMS-PCR and confirmed by direct Sanger-sequencing Hbb gene. Prenatal diagnoses were perfomed by amniotic fluid sampling from pregnant woman in the 16-18th week of pregnancy after the genotypes of parents of the probands were identified. Result: When amniotic fluid sample was analyzed for Beta globin gene (Hbb), we found that the genotype is heterozygous for CD71/72(+A) and CD26(A-G) HbE. This genotype is different from the 1st child of this family. Conclusion: Prenatal diagnosis helps the parents to know the genotype and the thalassemia status of the fetus, so they can have early decision on their pregnancy. Genetic diagnosis provided a useful method in diagnosis for familial members in pedigree, genetic counseling and prenatal diagnosis.

Keywords: beta thalassemia intermedia, Hbb gene, pedigree, prenatal diagnosis

Procedia PDF Downloads 359
3500 Suggestion of Two-Step Traction Therapy for Safer and More Effective Conservative Treatment for Low Back Pain

Authors: Won Man Park, Dae Kyung Choi, Kyungsoo Kim, Yoon Hyuk Kim

Abstract:

Traction therapy has been used in the treatment of spinal pain for decades. However, a case study reported the occurrence of large disc protrusion during motorized traction therapy. In this study, we hypothesized that additional local decompression with a global axial traction could be helpful for risk reduction of intervertebral disc damage. A validated three dimensional finite element model of the lumbar spine was used. Two-step traction therapy using the axial global traction (the first step) with 1/3 body weight and the additional local decompression (the second step) with 7 mm translation of L4 spinal bone was determined for the traction therapy. During two-step traction therapy, the sacrum was constrained in all translational directions. Reduced lordosis angle by the global axial traction recovered with the additional local decompression. Stress on fibers of the annulus fibrosus by the axial global traction decreased with the local decompression by 17%~96% in the posterior region of intervertebral disc. Stresses on ligaments except anterior longitudinal ligaments in all motion segments decreased till 4.9 mm~5.6 mm translation of L4 spinal bone. The results of this study showed that the additional local decompression is very useful for reducing risk of damage in the intervertebral disc and ligaments caused by the global axial traction force. Moreover, the local decompression could be used to enhance reduction of intradiscal pressure.

Keywords: lumbar spine, traction-therapy, biomechanics, finite element analysis

Procedia PDF Downloads 465
3499 Stator Short-Circuits Fault Diagnosis in Induction Motors

Authors: K. Yahia, M. Sahraoui, A. Guettaf

Abstract:

This paper deals with the problem of stator faults diagnosis in induction motors. Using the discrete wavelet transform (DWT) for the current Park’s vector modulus (CPVM) analysis, the inter-turn short-circuit faults diagnosis can be achieved. This method is based on the decomposition of the CPVM signal, where wavelet approximation and detail coefficients of this signal have been extracted. The energy evaluation of a known bandwidth detail permits to define a fault severity factor (FSF). This method has been tested through the simulation of an induction motor using a mathematical model based on the winding-function approach. Simulation, as well as experimental results, show the effectiveness of the used method.

Keywords: induction motors (IMs), inter-turn short-circuits diagnosis, discrete wavelet transform (DWT), Current Park’s Vector Modulus (CPVM)

Procedia PDF Downloads 431
3498 Polypharmacy Overdose: Case Report on Mixed Overdose of Ramipril, Quetiapine, Lercanidipine and Duloxetine

Authors: Chui Ling Teng, R. Matsa

Abstract:

We report a case with combined overdose of Lercanidipine (non-dihydropyridine calcium channel blocker), Quetiapine (Atypical antipsychotic), Ramipril and Duloxetine. A 66-year old male presented to the Emergency Department 12-hours after the ingestion of 1.2g Lercanidipine, 3g Quetiapine, 280mg of Ramipril and 420mg of Duloxetine. He describes lethargic, drowsiness and was unable to pass any urine since overdosed. He was found to be bradycardic, hypotensive and anuric. He had refractory hypotension and anuric despite fluid resuscitation, glucagon therapy and intravenous naloxone. His care was escalated to Intensive care, requiring noradrenaline, adrenaline, vasopressin, and hyperinsulinaemic euglycaemia therapy. He achieved haemodynamic stability and kidney function improved gradually with the support received. The total length of therapy lasted for 30 horus in which individual therapy was weaned down based on the requirement. He was then transferred to medical ward for further psychiatric assessment. This is a the first repored case of mixed overdose with lercanidipine, Quetiapine, Rampmipril and Duloxetine.

Keywords: calcium channel blocker, hyperinsulinaemic Euglycaemia therapy, lercanidipine, overdose

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3497 Application of Topical Imiquimod for Treatment Cervical Intraepithelial Neoplasia in Young Women: A Preliminary Result of a Pilot Study

Authors: Phill-Seung Jung, Dae-Yeon Kim

Abstract:

Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

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3496 The Effectiveness of Sexual Cognitive Behavioral Therapy on Strategic Thinking and Communication Patterns of Couples in Colostomy Patients

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Seyedeh Somayeh Amiri, Mozhgan Shakhseniaei, Amin Asadi Hieh

Abstract:

The purpose of this research was to determine the effectiveness of sexual cognitive behavioral therapy on strategic thinking and communication patterns of couples in colostomy patients. In this study, experimental research was conducted with a pre-test and post-test design with a control group and a follow-up period. The statistical population studied were married female colostomy patients referring to the Iranian Ostomy Association. 30 qualified people were selected by voluntary sampling and randomly divided into two experimental and control groups (15 people in each group). Both groups responded to Goleman's strategic thinking (2007) and the communication patterns of Christensen and Sulawai questionnaires (1984). The results of covariance analysis showed that sexual cognitive behavioral therapy has an effect on improving strategic thinking. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving the strategic thinking of colostomy patients until the follow-up stage. Also, sexual cognitive behavioral therapy has an effect on improving the communication patterns of couples in colostomy patients. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving communication patterns of couples in patients with colostomy until the follow-up stage. Based on the results of this research, sexual cognitive behavioral therapy can be used to improve strategic thinking and communication patterns of couples of colostomy patients.

Keywords: sexual cognitive behavioral therapy, strategic thinking, communication patterns of couples, colostomy

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3495 Study of Early Diagnosis of Oral Cancer by Non-invasive Saliva-On-Chip Device: A Microfluidic Approach

Authors: Ragini Verma, J. Ponmozhi

Abstract:

The oral cavity is home to a wide variety of microorganisms that lead to various diseases and even oral cancer. Despite advancements in the diagnosis and detection at the initial phase, the situation hasn’t improved much. Saliva-on-a-chip is an innovative point-of-care platform for early diagnosis of oral cancer and other oral diseases in live and dead cells using a microfluidic device with a current perspective. Some of the major challenges, like real-time imaging of the oral cancer microbes, high throughput values, obtaining a high spatiotemporal resolution, etc. were faced by the scientific community. Integrated microfluidics and microscopy provide powerful approaches to studying the dynamics of oral pathology, microbe interaction, and the oral microenvironment. Here we have developed a saliva-on-chip (salivary microbes) device to monitor the effect on oral cancer. Adhesion of cancer-causing F. nucleatum; subsp. Nucleatum and Prevotella intermedia in the device was observed. We also observed a significant reduction in the oral cancer growth rate when mortality and morbidity were induced. These results show that this approach has the potential to transform the oral cancer and early diagnosis study.

Keywords: microfluidic device, oral cancer microbes, early diagnosis, saliva-on-chip

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3494 Analyzing Initial Efficacy of Animal Assisted Therapy for Autism Spectrum Disorders: A Case Study

Authors: Georgitta Joseph Valiyamattam

Abstract:

Autism spectrum disorders (ASD) are a growing phenomenon in India with over 10 million cases being recorded. Children with various levels and forms of ASD can be a major challenge both within the context of regular or special schooling. According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD) against a ratio of one in 110 few years back. The growing number of children with autism spectrum disorders places greater demands on health services and necessitates the roping in of non-traditional modes of treatment to complement or even substitute traditional health care methods when possible. Research evidence, particularly from Western countries, as also some parts of Asia, suggests that animal-assisted therapy, or zootherapy, may be used as an effective individual or complementary therapeutic tool for increasing overall wellbeing and quality of life among children with Autism spectrum disorders. The paper through a case-study format seeks to evaluate the efficacy (initial stage) of animal assisted therapy (canine-therapy with visiting dog: breed-Golden retriever), as a non-conventional treatment modality for improving cognitive functioning and managing the behavioral and psychological symptoms of Autism Spectrum Disorders. As a pilot study forming the basis for subsequent larger application of AAT, it analyses areas of efficacy as also the challenges faced, both with regard to the mode of therapy, as also particular to the Indian setting.

Keywords: animal assisted therapy, autism, canine therapy, analyzing initial efficacy

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3493 Bulbar Conjunctival Kaposi's Sarcoma Unmasked by Immune Reconstitution Syndrome

Authors: S. Mohd Afzal, R. O'Connell

Abstract:

Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.

Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus

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3492 Effectiveness of Short-Term Cognitive-Behavioral Group Therapy on Binge Eating Disorder in Females

Authors: Saeed Dehnavi, Ismail Asadallahi, Fatemeh Rahmatian, Elahe Rahimian

Abstract:

Purpose: Due to an increasing prevalence of over eating disorders, this paper aims to investigate the effectiveness of short-term group cognitive-behavioral therapy on reducing binge eating behavior and depression symptoms among females suffered from binge eating disorder (BED) in Qazvin, Iran. Methodology: This is aquasi-experimental study (pre-post testing plan with control group). Using a convenience sampling technique, binge eating scale (BES) and clinical interviews, 30 persons were selected among all clients who had referred to weight loss centers in Qazvin, these persons were randomly placed into two control and experimental groups. The experimental group participated in a seven-session plan on short-term cognitive-behavioral group therapy. Results: The results showed that the short term group cognitive-behavioral therapy results in a significant reduction in binge eating signs and depressive symptoms within the experimental group, compared to the control. Conclusion: Regarding the results, it is known that short-term group cognitive-behavioral therapy is effective in reducing overeating symptoms. Hence, it can be used as an economical and effective treatment method for individuals suffering from BED.

Keywords: cognitive-behavioral group therapy, binge eating disorder, depression

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3491 Analysis of the Development of Communicative Skills After Participating in the Equine-Assisted-Therapy Program Step-By-Step in Communication

Authors: Leticia Souza Guirra, Márcia Eduarda Vieira Ramos, Edlaine Souza Pereira, Leticia Correa Celeste

Abstract:

Introduction: Studies indicate that equine-assisted therapy enables improvements in several areas of functioning that are impaired in children with autism spectrum disorder (ASD), such as social interaction and communication. Objective: The study proposes to analyze the development of dialogic skills of a verbal child with ASD after participating in the equine-assisted therapy Step By Step in Communication. Method: This is quantitative and qualitative research through a case study. It refers to a 6 years old child diagnosed with ASD belonging to a group of practitioners of the Brazilian National Equine-Assited-Therapy Association. The Behavioral Observation Protocol (PROC) was used to evaluate communicative skills before and after the intervention, which consisted of 24 sessions once a week. Results: All conversational skills increased their frequency, with participation in dialogue and initiation of interaction. The child also increases the habit of waiting for his turn and answering the interlocutor. The emission of topics not related to conversation and echolalia showed a significant decrease after the intervention. Conclusion: The studied child showed improvement in communicative skills after participating in the equine-assisted therapy Step By Step in Communication. Contributions: This study contributes to a greater understanding of the impact of equine-assisted therapy on the communicative abilities of children with ASD.

Keywords: equine-assisted-therapy, autism spectrum disorder, language, communication, language and hearing sciences

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3490 An Extraction of Cancer Region from MR Images Using Fuzzy Clustering Means and Morphological Operations

Authors: Ramandeep Kaur, Gurjit Singh Bhathal

Abstract:

Cancer diagnosis is very difficult task. Magnetic resonance imaging (MRI) scan is used to produce image of any part of the body and provides an efficient way for diagnosis of cancer or tumor. In existing method, fuzzy clustering mean (FCM) is used for the diagnosis of the tumor. In the proposed method FCM is used to diagnose the cancer of the foot. FCM finds the centroids of the clusters of the foot cancer obtained from MRI images. FCM thresholding result shows the extract region of the cancer. Morphological operations are applied to get extracted region of cancer.

Keywords: magnetic resonance imaging (MRI), fuzzy C mean clustering, segmentation, morphological operations

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3489 Influence of Pretreatment Magnetic Resonance Imaging on Local Therapy Decisions in Intermediate-Risk Prostate Cancer Patients

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

Abstract:

Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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3488 An Accurate Computer-Aided Diagnosis: CAD System for Diagnosis of Aortic Enlargement by Using Convolutional Neural Networks

Authors: Mahdi Bazarganigilani

Abstract:

Aortic enlargement, also known as an aortic aneurysm, can occur when the walls of the aorta become weak. This disease can become deadly if overlooked and undiagnosed. In this paper, a computer-aided diagnosis (CAD) system was introduced to accurately diagnose aortic enlargement from chest x-ray images. An enhanced convolutional neural network (CNN) was employed and then trained by transfer learning by using three different main areas from the original images. The areas included the left lung, heart, and right lung. The accuracy of the system was then evaluated on 1001 samples by using 4-fold cross-validation. A promising accuracy of 90% was achieved in terms of the F-measure indicator. The results showed using different areas from the original image in the training phase of CNN could increase the accuracy of predictions. This encouraged the author to evaluate this method on a larger dataset and even on different CAD systems for further enhancement of this methodology.

Keywords: computer-aided diagnosis systems, aortic enlargement, chest X-ray, image processing, convolutional neural networks

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3487 Proof of Concept Design and Development of a Computer-Aided Medical Evaluation of Symptoms Web App: An Expert System for Medical Diagnosis in General Practice

Authors: Ananda Perera

Abstract:

Computer-Assisted Medical Evaluation of Symptoms (CAMEOS) is a medical expert system designed to help General Practices (GPs) make an accurate diagnosis. CAMEOS comprises a knowledge base, user input, inference engine, reasoning module, and output statement. The knowledge base was developed by the author. User input is an Html file. The physician user collects data in the consultation. Data is sent to the inference engine at servers. CAMEOS uses set theory to simulate diagnostic reasoning. The program output is a list of differential diagnoses, the most probable diagnosis, and the diagnostic reasoning.

Keywords: CDSS, computerized decision support systems, expert systems, general practice, diagnosis, diagnostic systems, primary care diagnostic system, artificial intelligence in medicine

Procedia PDF Downloads 129