Search results for: disease activity score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10807

Search results for: disease activity score

10357 Tele-Rehabilitation for Multiple Sclerosis: A Case Study

Authors: Sharon Harel, Rachel Kizony, Yoram Feldman, Gabi Zeilig, Mordechai Shani

Abstract:

Multiple Sclerosis (MS) is a neurological disease that may cause restriction in participation in daily activities of young adults. Main symptoms include fatigue, weakness and cognitive decline. The appearance of symptoms, their severity and deterioration rate, change between patients. The challenge of health services is to provide long-term rehabilitation services to people with MS. The objective of this presentation is to describe a course of tele-rehabilitation service of a woman with MS. Methods; R is a 48 years-old woman, diagnosed with MS when she was 22. She started to suffer from weakness of her non-dominant left upper extremity about ten years after the diagnosis. She was referred to the tele-rehabilitation service by her rehabilitation team, 16 years after diagnosis. Her goals were to improve ability to use her affected upper extremity in daily activities. On admission her score in the Mini-Mental State Exam was 30/30. Her Fugl-Meyer Assessment (FMA) score of the left upper extremity was 48/60, indicating mild weakness and she had a limitation of her shoulder abduction (90 degrees). In addition, she reported little use of her arm in daily activities as shown in her responses to the Motor Activity Log (MAL) that were equal to 1.25/5 in amount and 1.37 in quality of use. R. received two 30 minutes on-line sessions per week in the tele-rehabilitation service, with the CogniMotion system. These were complemented by self-practice with the system. The CogniMotion system provides a hybrid (synchronous-asynchronous), the home-based tele-rehabilitation program to improve the motor, cognitive and functional status of people with neurological deficits. The system consists of a computer, large monitor, and the Microsoft’s Kinect 3D sensor. This equipment is located in the client’s home and connected to a clinician’s computer setup in a remote clinic via WiFi. The client sits in front of the monitor and uses his body movements to interact with games and tasks presented on the monitor. The system provides feedback in the form of ‘knowledge of results’ (e.g., the success of a game) and ‘knowledge of performance’ (e.g., alerts for compensatory movements) to enhance motor learning. The games and tasks were adapted for R. motor abilities and level of difficulty was gradually increased according to her abilities. The results of her second assessment (after 35 on-line sessions) showed improvement in her FMA score to 52 and shoulder abduction to 140 degrees. Moreover, her responses to the MAL indicated an increased amount (2.4) and quality (2.2) of use of her left upper extremity in daily activities. She reported high level of enjoyment from the treatments (5/5), specifically the combination of cognitive challenges while moving her body. In addition, she found the system easy to use as reflected by her responses to the System Usability Scale (85/100). To-date, R. continues to receive treatments in the tele-rehabilitation service. To conclude, this case report shows the potential of using tele-rehabilitation for people with MS to provide strategies to enhance the use of the upper extremity in daily activities as well as for maintaining motor function.

Keywords: motor function, multiple-sclerosis, tele-rehabilitation, daily activities

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10356 The Association between Affective States and Sexual/Health-Related Status among Men Who Have Sex with Men in China: An Exploration Study Using Social Media Data

Authors: Zhi-Wei Zheng, Zhong-Qi Liu, Jia-Ling Qiu, Shan-Qing Guo, Zhong-Wei Jia, Chun Hao

Abstract:

Objectives: The purpose of this study was to understand and examine the association between diurnal mood variation and sexual/health-related status among men who have sex with men (MSM) using data from MSM Chinese Twitter messages. The study consists of 843,745 postings of 377,610 MSM users located in Guangdong that were culled from the MSM Chinese Twitter App. Positive affect, negative affect, sexual related behaviors, and health-related status were measured using the Simplified Chinese Linguistic Inquiry and Word Count. Emotions, including joy, sadness, anger, fear, and disgust were measured using the Weibo Basic Mood Lexicon. A positive sentiment score and a positive emotions score were also calculated. Linear regression models based on a permutation test were used to assess associations between affective states and sexual/health-related status. In the results, 5,871 active MSM users and their 477,374 postings were finally selected. MSM expressed positive affect and joy at 8 a.m. and expressed negative affect and negative emotions between 2 a.m. and 4 a.m. In addition, 25.1% of negative postings were directly related to health and 13.4% reported seeking social support during that sensitive period. MSM who were senior, educated, overweight or obese, self-identified as performing a versatile sex role, and with less followers, more followers, and less chat groups mainly expressed more negative affect and negative emotions. MSM who talked more about sexual-related behaviors had a higher positive sentiment score (β=0.29, p < 0.001) and a higher positive emotions score (β = 0.16, p < 0.001). MSM who reported more on their health status had a lower positive sentiment score (β = -0.83, p < 0.001) and a lower positive emotions score (β = -0.37, p < 0.001). The study concluded that psychological intervention based on an app for MSM should be conducted, as it may improve mental health.

Keywords: affect, men who have sex with men, sexual related behavior, health-related status, social media

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10355 Correlation between the Ratios of House Dust Mite-Specific IgE/Total IgE and Asthma Control Test Score as a Biomarker of Immunotherapy Response Effectiveness in Pediatric Allergic Asthma Patients

Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

Abstract:

Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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10354 Advanced Eales’ Disease with Neovascular Glaucoma at First Presentation: Case Report

Authors: Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Mahdi H. Almubarak

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Purpose: Eales’ disease is an idiopathic vasculitis that affects the peripheral retina. It is characterized by recurrent vitreous hemorrhage as a complication of retinal neovascularization. It is more prevalent in India and affects young males. Here we present a patient with neovascular glaucoma as a rare first presentation of Eales’ disease. Observations: This is a 24-year-old Indian gentleman, who complained of a sudden decrease in vision in the left eye over less than 24 hours, along with frontal headache and eye pain for the last three weeks. Ocular examination revealed peripheral retinal ischemia in the right eye, very high intraocular pressure, rubeosis iridis, vitreous hemorrhage and extensive retinal ischemia in the left eye, vascular sheathing and neovascularization in both eyes. Purified protein derivative skin test was positive. The patient was managed with anti-glaucoma, intravitreal anti-vascular endothelial growth factor and laser photocoagulation. Systemic steroids and anti-tuberculous therapy were also initiated. Conclusions: Neovascular glaucoma is an infrequent complication of Eales’ disease. However, the lack of early detection of the disease in the early stages might lead to such serious complication.

Keywords: case report, Eales’ disease, mycobacterium tuberculosis, neovascular glaucoma

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10353 Comparison of the Anthropometric Obesity Indices in Prediction of Cardiovascular Disease Risk: Systematic Review and Meta-analysis

Authors: Saeed Pourhassan, Nastaran Maghbouli

Abstract:

Statement of the problem: The relationship between obesity and cardiovascular diseases has been studied widely(1). The distribution of fat tissue gained attention in relation to cardiovascular risk factors during lang-time research (2). American College of Cardiology/American Heart Association (ACC/AHA) is widely and the most reliable tool to be used as a cardiovascular risk (CVR) assessment tool(3). This study aimed to determine which anthropometric index is better in discrimination of high CVR patients from low risks using ACC/AHA score in addition to finding the best index as a CVR predictor among both genders in different races and countries. Methodology & theoretical orientation: The literature in PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched by two independent investigators using the keywords "anthropometric indices," "cardiovascular risk," and "obesity." The search strategy was limited to studies published prior to Jan 2022 as full-texts in the English language. Studies using ACC/AHA risk assessment tool as CVR and those consisted at least 2 anthropometric indices (ancient ones and novel ones) are included. Study characteristics and data were extracted. The relative risks were pooled with the use of the random-effect model. Analysis was repeated in subgroups. Findings: Pooled relative risk for 7 studies with 16,348 participants were 1.56 (1.35-1.72) for BMI, 1.67(1.36-1.83) for WC [waist circumference], 1.72 (1.54-1.89) for WHR [waist-to-hip ratio], 1.60 (1.44-1.78) for WHtR [waist-to-height ratio], 1.61 (1.37-1.82) for ABSI [A body shape index] and 1.63 (1.32-1.89) for CI [Conicity index]. Considering gender, WC among females and WHR among men gained the highest RR. The heterogeneity of studies was moderate (α²: 56%), which was not decreased by subgroup analysis. Some indices such as VAI and LAP were evaluated just in one study. Conclusion & significance: This meta-analysis showed WHR could predict CVR better in comparison to BMI or WHtR. Some new indices like CI and ABSI are less accurate than WHR and WC. Among women, WC seems to be a better choice to predict cardiovascular disease risk.

Keywords: obesity, cardiovascular disease, risk assessment, anthropometric indices

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10352 Relationship between Strengths/Weaknesses of Studying and Subjective Well-Being among Japanese Working Adults

Authors: Katsumi Mera

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The purpose of this study was to clarify the relationship between strengths/weaknesses on studying and subjective well-being among Japanese working adults. We conducted an online questionnaire survey of Japanese working adults (aged 20-69) and obtained 1,063 valid responses. Subjective well-being was evaluated using the Cantril Self-Anchoring Striving Scale, the method used in the World Happiness Survey, in which the highest possible life is set at 10, and the lowest possible life is set at 0. The mean subjective well-being of all 1,063 respondents was 5.87, which is a very similar value that was obtained in the Japanese World Happiness Survey in 2023. First, we investigated the respondents' strengths/weaknesses in studying and their subjective well-being. The results showed that the subjective well-being of the group who answered that they were good at studying (6.62) was significantly higher than that of the group who answered that they were poor at studying (5.15). Next, we investigated the subjective well-being of students who answered that they were good at Japanese, Math, English, Social studies, and Science, the major subjects in Japan, and found that the subjective well-being of the group that answered that they were good at these subjects was higher than that of the group that answered that they were poor at these subjects. When the correlation between the score of "strengths/weaknesses on studying" and the score of "subjective well-being" was examined, those who answered that they were good at studying had higher subjective well-being (correlation coefficient r = 0.26, p < 0.001). The correlation between the subjective well-being score and the score of "strengths/weaknesses on studying each subject” was examined. Among the subjects, the subjective well-being score was the highest for those who answered that they were good at English (correlation coefficient r = 0.17, p < 0.001). These results indicate a relationship between strengths/weaknesses on studying and subjective well-being among workers in Japan. These findings may provide an important basis for considering what kind of education should be focused on in order to nurture working adults with high levels of well-being.

Keywords: subject well-being, strengths/weaknesses, studying, Japanese working adults

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10351 Design, Synthesis and In-Vitro Antibacterial and Antifungal Activities of Some Novel Spiro[Azetidine-2, 3’-Indole]-2, 4(1’H)-Dione

Authors: Ravi J. Shah

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The present study deals with the synthesis of novel spiro[azetidine-2, 3’-indole]-2’, 4(1’H)-dione derivative from the reactions of 3-(phenylimino)-1,3-dihydro-2H-indol-2-one derivatives with chloracetyl chloride in presence of triethyl amine (TEA). All the compounds were characterized using IR, 1H NMR, MS and elemental analysis. They were screened for their antibacterial and antifungal activities. Results revealed that, compounds (7a), (7b), (7c), (7d) and (7e) showed very good activity with MIC value of 6.25-12.5 μg/ml against three evaluated bacterial strains and the remaining compounds showed good to moderate activity comparable to standard drugs as antibacterial agents. Compounds (7c) and (7h) displayed equipotent antifungal activity in comparison to standard drugs. Structure-activity relationship study of the compounds showed that the presence of electron withdrawing group substitution at 5’ and 7’ positions of indoline ring and on ortho or para position of phenyl ring increases both antibacterial and antifungal activity of the compound. Henceforth, our findings will have a good impact on chemists and biochemists for further investigations in search of bromine containing spiro fused antimicrobial agents.

Keywords: antibacterial activity, antifungal activity, 2-Azetidinone, indoline

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10350 Insulin Resistance in Patients with Chronic Hepatitis C Virus Infection: Upper Egypt Experience

Authors: Ali Kassem

Abstract:

Background: In the last few years, factors such as insulin resistance (IR) and hepatic steatosis have been linked to progression of hepatic fibrosis.Patients with chronic liver disease, and cirrhosis in particular, are known to be prone to IR. However, chronic HCV (hepatitis C) infection may induce IR, regardless of the presence of liver cirrhosis. Our aims are to study insulin resistance (IR) assessed by HOMA-IR (Homeostatic Model Assessment Insulin Resistance) as a possible risk factor in disease progression in cirrhotic patients and to evaluate the role of IR in hepatic fibrosis progression. The correlations of HOMA-IR values to laboratory, virological and histopathological parameters of chronic HCV are also examined. Methods: The study included 50 people divided into 30 adult chronic hepatitis C patients diagnosed by PCR (polymerase chain reaction) within previous 6 months and 20 healthy controls. The functional and morphological status of the liver were evaluated by ultrasonography and laboratory investigations including liver function tests and by liver biopsy. Fasting blood glucose and fasting insulin levels were measured and body mass index and insulin resistance were calculated. Patients having HOMA-IR >2.5 were labeled as insulin resistant. Results: Chronic hepatitis C patients with IR showed significantly higher mean values of BMI (body mass index) and fasting insulin than those without IR (P < 0.000). Patients with IR were more likely to have steatosis (p = 0.006), higher necroinflammatory activity (p = 0.05). No significant differences were found between the two groups regarding hepatic fibrosis. Conclusion: HOMA-IR measurement could represent a novel marker to identify the cirrhotic patients at greater risk for the progression of liver disease. As IR is a potentially modifiable risk factor, these findings may have important prognostic and therapeutic implications. Assessment of IR by HOMA-IR and improving insulin sensitivity are recommended in patients with HCV and related chronic liver disease.

Keywords: hepatic fibrosis, hepatitis C virus infection, hepatic steatosis, insulin resistance

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10349 Antibacterial Activity of Bacillus thuringiensis Cristalline Parasporal Proteins

Authors: R. Gounina-Allouane, N. Ouali, F. Z. Berrabah, A. Bentaleb

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For a long time, the Gram-positive spore-forming bacteria Bacillus thuringiensis (Bt) has been widely used in biological control against devastating and disease vectors insects. This is due to the insecticidal activity of its crystalline parasporal inclusion (crystals) predominantly comprised of one or more proteins (Cry and Cyt proteins) also called δ-endotoxins, produced during sporulation. The shape and composition of Bt crystals vary among strains and crystalline proteins are extremely varied (more than 475 cry gene were discovered). The insecticidal activity of Bt crystals is very well studied, thus their insecticidal mode of action is well established, however, their antimicrobial effect is largely unknown. The lack of data on the antimicrobial effect of crystalline proteins of Bt and the need for searching new antimicrobial molecules encouraged us to carried out this study. The antibacterial effect of δ-endotoxines produced by two Bt stains; a strain isolated from soil at northern of Algeria (Bt 7.2.B), and a strain isolated from a bioinsecticide (Bacillus thuringiensis var aizawai), activated by proteolysis, was assayed on clinical bacterial strains and ATCC collection ones respectively. Gram positive and negative clinical bacterial strains (Escherichia coli, Klebsiella pneumonaie, Pseudomonas aeruginosa, Staphylococcus aureus) were sensitive to activated Bt 72B endotoxins. Similarly, bacterial strains from ATCC collection (Escherichia coli ATCC 25922, Pseudomonas aerugenosa ATCC 27853, Staphylococcus aureus ATCC 25923) were sensitive to activated B. thuringiensis var aizawai δ-endotoxines. The activated δ-endotoxins were separated by SDS-PAGE.

Keywords: Bacillus thuringiensis, crystals, cry proteins, δ-endotoxins, antibacterial activity

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10348 A Systematic Review on Measuring the Physical Activity Level and Pattern in Persons with Chronic Fatigue Syndrome

Authors: Kuni Vergauwen, Ivan P. J. Huijnen, Astrid Depuydt, Jasmine Van Regenmortel, Mira Meeus

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A lower activity level and imbalanced activity pattern are frequently observed in persons with chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME) due to debilitating fatigue and post-exertional malaise (PEM). Identification of measurement instruments to evaluate the activity level and pattern is therefore important. The objective is to identify measurement instruments suited to evaluate the activity level and/or pattern in patients with CFS/ME and review their psychometric properties. A systematic literature search was performed in the electronic databases PubMed and Web of Science until 12 October 2016. Articles including relevant measurement instruments were identified and included for further analysis. The psychometric properties of relevant measurement instruments were extracted from the included articles and rated based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 49 articles and 15 unique measurement instruments were found, but only three instruments were evaluated in patients with CFS/ME: the Chronic Fatigue Syndrome-Activity Questionnaire (CFS-AQ), Activity Pattern Interview (API) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), three self-report instruments measuring the physical activity level. The IPAQ-SF, CFS-AQ and API are all equally capable of evaluating the physical activity level, but none of the three measurement instruments are optimal to use. No studies about the psychometric properties of activity monitors in patients with CFS/ME were found, although they are often used as the gold standard to measure the physical activity pattern. More research is needed to evaluate the psychometric properties of existing instruments, including the use of activity monitors.

Keywords: chronic fatigue syndrome, data collection, physical activity, psychometrics

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10347 An Evaluation of Self-Esteem in Physically Disabled Adults Who Particapated in Sports

Authors: Ummuhan Bas Aslan, Sehmus Aslan

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Objective: Physical disability includes impairments, activity limitations, and participation restrictions. Individuals with physical disabilities have lower self-esteem compared non-disabled people. Self-esteem is widely accepted as a key indicator of emotional stability and adjustment to life demands. There is very limited study to investigate the effect of sports on self-esteem in physically disabled people. The aim of the present study was to evaluate of self-esteem in physically disabled adults who participated in sports. Methods: Fifty physically disabled adults who participated in sports aged between 18 to 35 years participated in the study. Self-esteem of the participants was assessed by Rosenberg Self-Esteem Scale. The scale is a 10-item measure of global self-esteem. The higher score on the scale indicates greater self-esteem. Scores between 15 and 25 are the normal range of and scores below 15 suggest low self-esteem. Results: Average age of participants was 25.18±6.20 years. 58% of the participants were 23 (46.0%) of the participants were wheelchair users, 8 (16.0%) were mobile with a walking aid and 19 (38.0%) were mobile without a walking aid. The length of physically disabled adults had been participating in their sports (basketball: 54%, athleticism: 32%, volleyball: 6%, cycling: 6%) was 4.94±3.86 years. The average Rosenberg Self-Esteem Scale score of the participants was 21.88 ±4.34. Conclusions: Our results suggest that physically disabled adults who participated in sports have the healthy level of self-esteem. Participating in sports could have positive effects on self-esteem in that physically, disabled people. There is needed future comparative studies on this topic.

Keywords: adult, physical disability, self-esteem, sport

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10346 Availability of Safety Measures and Knowledge Towards Hazardous Waste Management among Workers in Scientific Laboratories of Two Universities in Lebanon

Authors: Inaam Nasrallah, Pascale Salameh, Abbas El-Outa, Assem Alkak, Rihab Nasr, Wafa Toufic Bawab

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Background: Hazardous Waste Management(HWM). is critical to human health outcomes and environmental protection. This study evaluated the knowledge regarding safety measures to be applied when collecting and storing waste in scientific laboratories of two universities in Lebanon.Method: A survey-based observational study was conducted in scientific laboratories of the public university and that of a private university, where a total of 309 participants were recruited.Result: The mean total knowledge score on safety measures of HWM was 9.02±4.34 (maximum attainable score, 13). Significant association (p<0.05) was found between knowledge score and job function, years of experience, educational level, professional status, work schedule, and training on proper HWM. Participants had adequate perceptions regarding the impact of HWM on health and the environment. Linear regression modeling revealed that knowledge score was significantly higher among bachelor level lab workers compared to those with doctoral degrees (p=0.043), full-time schedule workers versus part-timers (p=0.03), and among public university participants as compared to those of the private university (p<0.001).Conclusion: This study showed good knowledge concerning HWM in the scientific laboratoriesof the studied universities in Lebanon and a good awareness of the HWM on health and the environment. It highlights the importance of culture, attitude, and practice on proper HWM in the academic scientific laboratory.

Keywords: hasardous waste, safety measures, waste management, knwoledge score, scientific laboratory workers

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10345 Finding the English Competency for Developing Public Health Village Volunteers at Ban Prasukchai in Chumpuang District, Nakhon Ratchasima Province in Thailand

Authors: Kittivate Boonyopakorn

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The purposes of this study were to find the English competence of the public health volunteers and to develop the use of their English. The samples for the study were 41 public health village volunteers at Ban Prasukchai, in Thailand. The findings showed that the sum of all scores for the pre-test was 452, while the score for the post-test was 1,080. Therefore, the results of the experiment confirm that the post-test scores (1,080) significantly are higher than the pre-test (452). The mean score (N=41) for the pre-test was 11.02 while the mean score (N=41) for the post-test was 18.10. The standard deviation for the pre-test was 2.734; however, for the post-test it was 1.934. In addition to the experts-evaluated research tools, the results of the evaluation for the structured interviews (IOC) were 1 in value. The evaluation of congruence for the content with learning objectives (IOC) were 0.66 to 1.00 in value. The evaluation of congruence for the pre and post-test with learning objectives (IOC) are 1 in value.

Keywords: finding the English competency, developing public health, village volunteers

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10344 In Vitro Assessment of Anti-microbial Properties of Murraya Koenigii Extract

Authors: Kinza Khan, Dad Muhmmad, Asif Saleem, Nadia Mukhtar, Tahir Yaqub

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Ethomedicines are more commonly used in underdeveloped and developing countries. These medicines are sometimes more potent in controlling microbial infections than conventional medicines. Medicinal plants have been common practice to cure many diseases for centuries. Murraya koenigii is one of these plants and is commonly used in South Asian countries as a flavoring agent in food. To evaluate its anti-microbial activity, six different bacterial strains (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella typhi, Bacillus cereus and Klebsiella pneumonia were used. N-hexane extract of Murraya koenigii leaves shows maximum activity against Bacillus cereus. Acetone extract of Murraya koenigii shoots showed more efficient activity against Pseudomonas aeruginosa Dichloromethane extracts showed maximum activity against Bacillus cereus. Ethanol extract exhibited maximum activity against Pseudomonas aeruginosa and Klebsiella pneumoniae. The methanol extract of Murraya koenigii shoots displayed maximum antibacterial activity against Bacillus cereus. Antifungal activity Ethanol extract was more effective against Candida albicans.

Keywords: ethnomedicines, bacteria, fungi, murraya koenigii, antimicrobial activity

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10343 Physical Activity Participation Levels as Correlates of Cardiorespiratory Fitness of Senior High School Teachers in the Dormaa East District

Authors: Isaac Yeboah, Emmanuel Osei Sarpong

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Physical activity (PA) is considered the best preventative tool for maintaining physical health and extending lifespan because it offers a range of benefits. However, for people to benefit from physical activity, it must be done at a level that can enhance fitness, health, and overall well-being. Therefore, this study aimed to determine the link between physical activity participation levels and cardiorespiratory fitness (CRF). The study employed the descriptive correlational design. The census sampling technique included all 190-teaching staff from the two senior high schools in the Dormaa East District. An adapted International Physical Activity Questionnaire (IPAQ) and standardized physical fitness tests were used for data collection. Descriptive statistics of frequency counts and percentages were used to answer the research questions while inferential statistics of Pearson Product Moment Correlation and the independent sample t-test were used to test hypotheses one and two respectively. A moderately negative (r = -.156) relationship existed between physical activity participation levels and CRF. Female teachers demonstrated a statistically significant value (p = .045) than males. The study concluded that the reported physical activity levels of the teachers did not reflect their CRF. The implication is that either the participants overestimated their physical activity participation levels, or the intensity of the activities was not high enough to affect physiological changes. For the teachers' CRF to improve, it was suggested, among other things, that regular physical activity sessions of the appropriate mixes of FITT be organized.

Keywords: physical activity, participation levels, cardiorespiratory fitness, sedentary lifestyle, teachers

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10342 Anti-Microbial Activity of Senna garrettiana Extract

Authors: Pun Jankrajangjaeng

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Senna garrettiana is a climatic tropical plant in Southeast Asia. Senna garrettiana (Craib) is used as a medicinal plant in Thailand, in which the experiment reported that the plant contains triterpenoids, ligans, phenolics, and fungal metabolites. Thus, it is also reported that the plant possesses interesting biological activity such as antioxidant activity. Therefore, Senna garrettiana is selected to examine the antimicrobial activity. The purpose of this study is to examine the antimicrobial activity of Senna garrettiana (crab) extract against Gram-positive Staphylococcus aureus and Gram-negative Salmonella typhi, and the fungus Candida albicans. This study performed the agar disk-diffusion method and broth microdilution by using five concentrations of plant extract to determine the minimum inhibitory concentration (MIC) of S. garrettiana extract. The result showed that S. garrettiana extract gave the maximum zone inhibition of 11.7 mm, 13.7 mm, and 14.0 mm against S. aureus, S. typhi, and C. albicans, respectively. The MIC value of S. garrettiana against S. aureus was 125 µg/mL while the MIC in S. typhi and C. albicans greater than 2000 µg/mL. To conclude, S. garrettiana extract showed higher sensitivity of antibacterial activity against gram-positive bacteria than gram-negative bacteria. In addition, the plant extracts also possessed antifungal activity. Therefore, further investigation to confirm the mechanism of action of antimicrobial activity in S. garrettiana extract should be performed to identify the target of the antimicrobial action.

Keywords: antimicrobial activity, Candida albicans, Salmonella typhi, Senna garrettiana, Staphylococcus aureus

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10341 The 10-year Risk of Major Osteoporotic and Hip Fractures Among Indonesian People Living with HIV

Authors: Iqbal Pramukti, Mamat Lukman, Hasniatisari Harun, Kusman Ibrahim

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Introduction: People living with HIV had a higher risk of osteoporotic fracture than the general population. The purpose of this study was to predict the 10-year risk of fracture among people living with HIV (PLWH) using FRAX™ and to identify characteristics related to the fracture risk. Methodology: This study consisted of 75 subjects. The ten-year probability of major osteoporotic fractures (MOF) and hip fractures was assessed using the FRAX™ algorithm. A cross-tabulation was used to identify the participant’s characteristics related to fracture risk. Results: The overall mean 10-year probability of fracture was 2.4% (1.7) for MOF and 0.4% (0.3) for hip fractures. For MOF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use showed a higher MOF score than those who were not (3.1 vs. 2.5; 4.6 vs 2.5; and 3.4 vs 2.5, respectively). For HF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use also showed a higher HF score than those who were not (0.5 vs. 0.3; 0.8 vs. 0.3; and 0.5 vs. 0.3, respectively). Conclusions: The 10-year risk of fracture was higher among PLWH with several factors, including the parent’s hip. Fracture history, smoking behavior and glucocorticoid used. Further analysis on determining factors using multivariate regression analysis with a larger sample size is required to confirm the factors associated with the high fracture risk.

Keywords: HIV, PLWH, osteoporotic fractures, hip fractures, 10-year risk of fracture, FRAX

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10340 Characterization and Correlation of Neurodegeneration and Biological Markers of Model Mice with Traumatic Brain Injury and Alzheimer's Disease

Authors: J. DeBoard, R. Dietrich, J. Hughes, K. Yurko, G. Harms

Abstract:

Alzheimer’s disease (AD) is a predominant type of dementia and is likely a major cause of neural network impairment. The pathogenesis of this neurodegenerative disorder has yet to be fully elucidated. There are currently no known cures for the disease, and the best hope is to be able to detect it early enough to impede its progress. Beyond age and genetics, another prevalent risk factor for AD might be traumatic brain injury (TBI), which has similar neurodegenerative hallmarks. Our research focuses on obtaining information and methods to be able to predict when neurodegenerative effects might occur at a clinical level by observation of events at a cellular and molecular level in model mice. First, we wish to introduce our evidence that brain damage can be observed via brain imaging prior to the noticeable loss of neuromuscular control in model mice of AD. We then show our evidence that some blood biomarkers might be able to be early predictors of AD in the same model mice. Thus, we were interested to see if we might be able to predict which mice might show long-term neurodegenerative effects due to differing degrees of TBI and what level of TBI causes further damage and earlier death to the AD model mice. Upon application of TBIs via an apparatus to effectively induce extremely mild to mild TBIs, wild-type (WT) mice and AD mouse models were tested for cognition, neuromuscular control, olfactory ability, blood biomarkers, and brain imaging. Experiments are currently still in process, and more results are therefore forthcoming. Preliminary data suggest that neuromotor control diminishes as well as olfactory function for both AD and WT mice after the administration of five consecutive mild TBIs. Also, seizure activity increases significantly for both AD and WT after the administration of the five TBI treatment. If future data supports these findings, important implications about the effect of TBI on those at risk for AD might be possible.

Keywords: Alzheimer's disease, blood biomarker, neurodegeneration, neuromuscular control, olfaction, traumatic brain injury

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10339 Antibacterial Activity of Northern Algerian Honey

Authors: Messaouda Belaid, Salima Kebbouche-Gana, Djamila Benaziza

Abstract:

Our study focuses on determining the antibacterial activity of some honeys from northern Algeria. To test this activity, the agar well diffusion methods was employed. The bacterial strains tested were Staphylococcus aureus, Bacillus subtilis, Streptococcus faecalis, Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeroginosae. The results showed that all the microbes tested were inhibited by all honey used in this study but Those bacteria that appear to be more sensitive to all honey tested are Staphylococcus aureus and Pseudomonas aeroginosae.

Keywords: honey, antibacterial activity, Northern Algeria, Staphylococcus aureus

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10338 Human Endogenous Retrovirus Link With Multiple Sclerosis Disease Progression

Authors: Sina Mahdavi

Abstract:

Background and Objective: Multiple sclerosis (MS) is an inflammatory autoimmune disease of the CNS that affects the myelination process in the central nervous system (CNS). Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially human endogenous retrovirus (HERV) and MS is one potential cause that is not well understood. This study aims to summarize the available data on HERV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", "Human endogenous retrovirus", and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2016 and 2022 were searched and 14 articles chosen, studied, and analyzed. Results: In the leptomeningeal cells of MS patients, a retrovirus-like element associated with reverse transcriptase (RT) activity called multiple sclerosis-associated retroviruses (MSRV) has been identified. HERVs are expressed in the human CNS despite mechanisms to suppress their expression. External factors, especially viral infections such as influenza virus, Epstein-Barr virus, and herpes simplex virus type 1, can activate HERV gene expression. The MSRV coat protein is activated by activating TLR4 at the brain surface, particularly in oligodendroglial progenitor cells and macrophages, leading to immune cascades followed by the downregulation of myelin protein expression. The HERV-K18 envelope gene (env) acts as a superantigen and induces inflammatory responses in patients with MS. Conclusion: There is a high expression of endogenous retroviruses during the course of MS, which indicates the relationship between HERV and MS, that this virus can play a role in the development of MS by creating an inflammatory state. Therefore, measures to modulate the expression of endogenous retroviruses may be effective in reducing inflammatory processes in demyelinated areas of MS patients.

Keywords: multiple sclerosis, human endogenous retrovirus, central nervous system, MSRV

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10337 Searching for Health-Related Information on the Internet: A Case Study on Young Adults

Authors: Dana Weimann Saks

Abstract:

This study aimed to examine the use of the internet as a source of health-related information (HRI), as well as the change in attitudes following the online search for HRI. The current study sample included 88 participants, randomly divided into two experimental groups. One was given the name of an unfamiliar disease and told to search for information about it using various search engines, and the second was given a text about the disease from a credible scientific source. The study findings show a large percentage of participants used the internet as a source of HRI. Likewise, no differences were found in the extent to which the internet was used as a source of HRI when demographics were compared. Those who searched for the HRI on the internet had more negative opinions and believed symptoms of the disease were worse than the average opinion among those who obtained the information about the disease from a credible scientific source. The Internet clearly influences the participants’ beliefs, regardless of demographic differences.

Keywords: health-related information, internet, young adults, HRI

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10336 Patterns of Libido, Sexual Activity and Sexual Performance in Female Migraineurs

Authors: John Farr Rothrock

Abstract:

Although migraine traditionally has been assumed to convey a relative decrease in libido, sexual activity and sexual performance, recent data have suggested that the female migraine population is far from homogenous in this regard. We sought to determine the levels of libido, sexual activity and sexual performance in the female migraine patient population both generally and according to clinical phenotype. In this single-blind study, a consecutive series of sexually active new female patients ages 25-55 initially presenting to a university-based headache clinic and having a >1 year history of migraine were asked to complete anonymously a survey assessing their sexual histories generally and as they related to their headache disorder and the 19-item Female Sexual Function Index (FSFI). To serve as 2 separate control groups, 100 sexually active females with no history of migraine and 100 female migraineurs from the general (non-clinic) population but matched for age, marital status, educational background and socioeconomic status completed a similar survey. Over a period of 3 months, 188 consecutive migraine patients were invited to participate. Twenty declined, and 28 of the remaining 160 potential subjects failed to meet the inclusion criterion utilized for “sexually active” (ie, heterosexual intercourse at a frequency of > once per month in each of the preceding 6 months). In all groups younger age (p<.005), higher educational level attained (p<.05) and higher socioeconomic status (p<.025) correlated with a higher monthly frequency of intercourse and a higher likelihood of intercourse resulting in orgasm. Relative to the 100 control subjects with no history of migraine, the two migraine groups (total n=232) reported a lower monthly frequency of intercourse and recorded a lower FSFI score (both p<.025), but the contribution to this difference came primarily from the chronic migraine (CM) subgroup (n=92). Patients with low frequency episodic migraine (LFEM) and mid frequency episodic migraine (MFEM) reported a higher FSFI score, higher monthly frequency of intercourse, higher likelihood of intercourse resulting in orgasm and higher likelihood of multiple active sex partners than controls. All migraine subgroups reported a decreased likelihood of engaging in intercourse during an active migraine attack, but relative to the CM subgroup (8/92=9%), a higher proportion of patients in the LFEM (12/49=25%), MFEM (14/67=21%) and high frequency episodic migraine (HFEM: 6/14=43%) subgroups reported utilizing intercourse - and orgasm specifically - as a means of potentially terminating a migraine attack. In the clinic vs no-clinic groups there were no significant differences in the dependent variables assessed. Research subjects with LFEM and MFEM may report a level of libido, frequency of intercourse and likelihood of orgasm-associated intercourse that exceeds what is reported by age-matched controls free of migraine. Many patients with LFEM, MFEM and HFEM appear to utilize intercourse/orgasm as a means to potentially terminate an acute migraine attack.

Keywords: migraine, female, libido, sexual activity, phenotype

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10335 The Effect of Modified Posterior Shoulder Stretching Exercises on Posterior Shoulder Tightness, Shoulder Pain, and Dysfunction in Patients with Subacromial Impingement

Authors: Ozge Tahran, Sevgi Sevi Yesilyaprak

Abstract:

Objective: The aim of the study was to investigate the effect of the Wilk’s modified two different stretching exercises on posterior shoulder tightness, pain, and dysfunction in patients with subacromial impingement syndrome (SIS). Method: This study was carried out on 67 patients who have more than 15° difference in shoulder internal rotation range of motion between two sides and had been diagnosed as SIS. Before treatment, all patients were randomly assigned into three groups. Standard physiotherapy programme was applied to the Group 3 (n=23), standard physiotherapy program with Wilk’s modified cross-body stretching exercises were applied to Group 1 (n=22), and standard physiotherapy program with Wilk’s modified sleeper stretching exercises were applied to Group 2 (n= 23). All the patients received 20 sessions of physiotherapy during 4 weeks, 5 days in a week by a physiotherapist. The patients continued their exercises at home at the weekends. Pain severity, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality with Constant and Murley Score (CMS) and disability level with The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) were evaluated before and after physiotherapy programme. Results: Before treatment, demographic and anthropometric characteristics were similar in groups and there was no statistical difference (p > 0.05). It was determined that pain severity decreased, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality, and disability were improved after physiotherapy in both groups (p < 0.05). Group 1 and 2 had better results in terms of reduction of pain severity during activity, increase in shoulder rotation range of motion, posterior shoulder mobility and upper extremity functionality and improvement in upper extremity disability, compared to Group 3 (p < 0.05). Conclusion: Modified posterior shoulder stretching exercises in addition to standard physiotherapy programme is more effective for reduction of pain during activity, to improve shoulder rotation range of motion, posterior shoulder mobility, and upper extremity functionality in patients with SIS compared to standard physiotherapy programme alone.

Keywords: modified posterior shoulder stretching exercises, posterior shoulder tightness, shoulder complex, subacromial impingement syndrome

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10334 Hunger and Health: The Acceptability and Development of Health Coaching in the Food Pantry Environment

Authors: Kelsey Fortin, Susan Harvey

Abstract:

The intersection between hunger and health outcomes is beginning to gain traction among the research community. With new interventions focusing on collaborations between the medical and social service sectors, this study aimed to understand the acceptability and approach of a health coaching intervention within a county-wide Midwest food pantry. Through formative research, the study used mixed methods to review secondary data and conduct surveys and semi-structured interviews with food pantry clients (n=30), staff (n=7), and volunteers (n=10). Supplemental secondary data collected and provided by pantry staff were reviewed to understand the broader pantry context of clientele health and health behaviors, annual food donations, and current pantry programming. Results from secondary data showed that the broader pantry client population reported high rates of chronic disease, low consumption of fruits and vegetables, and poor self-reported health, while annual donation data showed increases in produce availability on pantry shelves. This disconnect between produce availability, client health status, and behaviors was supported in the current study, with pantry staff and volunteers reporting lack of knowledge in produce selection and preparation being amongst the most common client inquiries and barriers to healthy food selection. Additional supports to secondary data came from pantry clients in the current study through self-reported high rates of both individual (60%, n=18) and household (43%, n=13 ) disease diagnosis, low consumption of fruits and vegetables averaging zero to one servings of vegetables (67%, n=20) and fruits (47%, n=14) per day, and low levels of physical activity averaging zero to 120 minutes per week (67%, n=20). Further, pantry clients provided health coaching programmatic recommendations through interviews with feedback such as non-judgmental coaching, accountability measures, and providing participant incentives as considerations for future program design and approach. Volunteers and staff reported the need for client education in food preparation, basic nutrition and physical activity, and the need for additional health expertise to educate and respond to diet related nutrition recommendations. All three stakeholder groups supported hosting a health coach within the pantry to focused on nutrition, physical activity, and health programming, with one client stating, 'I am hoping it really works out [the health coaching program]. I think it would be great for something like this to be offered for someone that isn’t knowledgeable like me.' In conclusion, high rates of chronic disease, partnered with low food, nutrition, and physical activity literacy among pantry clients, demonstrates the need to address health behaviors. With all three stakeholder groups showing acceptability of a health coaching program, partnered with existing literature showing health coaching success as a behavior change intervention, further research should be conducted to pilot the design and implementation of such a program in the pantry setting.

Keywords: food insecurity, formative research, food pantries, health coaching, hunger and health

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10333 The Patterns and Levels of Physical Activity and Sedentary Behavior of Primary School Learners in Eastern Cape Province, South Africa

Authors: Howard Gomwe, Eunice Seekoe, Philemon Lyoka, Chioneso Show Marange, Dennyford Mafa

Abstract:

Background: This study was designed to assess PA levels and sedentary behavior among primary school learners in the Eastern Cape province of South Africa. Methods: A cross-sectional study was adopted to assess the patterns and levels of PA and sedentary behavior using the Physical Activity Questionnaire for Older Children (PAQ-C). Results: Using complete case analysis, 870 randomly selected participants (boys = 351 and girls = 519) aged 9 to 14 years were retained. The sample comprised of primary school learners, both boys and girls; aged 9-14 years old, who were randomly selected from rural, urban and peri-urban areas in the Eastern Cape Province of South Africa. Overly, the sample had a mean PAQ-C score of 2.33 ± 0.43. The mean of PA in boys was significantly higher (p = 0.003) in comparison with the girls. The 13 to 14 age group had a significantly higher PA level (p = 0.014). Learners from urban areas (n = 136; 77.3%) engaged more in sedentary behaviour as compared to those from rural areas (n = 252; 54.9%). Conclusion: The findings demonstrated low levels of PA and high engagement of sedentary behavior, which have negative implications on the health, growth and development of children. The study, therefore, recommends relevant stakeholders to implement interventions aimed to promote the increase in PA and reduction in sedentary behaviors for primary school learners in the Eastern Cape province in South Africa.

Keywords: learners, physical activity, sedentary behavior, south Africa

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10332 Analgesic and Antipyretic Activity of Thunbergia laurifolia Lindl. Extract

Authors: Nantawan Soonklang, Linda Chularojanamontri, Urarat Nanna

Abstract:

Ethnopharmacological relevance: Thunbergia laurifolia Lindl. belongs to the family Acanthaceae commonly known as Rang jeud in Thailand. This plant is traditionally used in Thailand for centuries as an antidote for several poisons and drug overdose. Aim of the study: This research aimed to study the analgesic and antipyretic activities of T. laurifolia water extract by using animal models. Materials and Methods: The analgesic activity was studied using 2 methods of pain induction including acetic acid and heat induced pain. And the antipyretic activity study was performed by yeast-induced hyperthermia. Results: The results showed that the administration of T. laurifolia extract possessed analgesic activity by reducing acetic acid-induced writhing response and heat-induced pain as well as showed antipyretic activity by decreasing body temperature of hyperthermic rats induced by brewer’s yeast. Conclusion: The study indicates that the T. laurifolia extract possesses analgesic and antipyretic activities in animals.

Keywords: Thunbergia laurifolia extract, analgesic activity, antipyretic activity, hyperthermia

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10331 Risk of Disrupted Eating Attitudes in Disabled Athletes

Authors: Zehra Buyuktuncer, Aylin H. Büyükkaragöz, Tuğçe N. Balcı, Nevin Ergun

Abstract:

Background: Undergoing rigid dietary habits for enhancing athletic performance could lead to eating disorders. High prevalence of eating disorders among female athletes has been already reported. However, the risk of disordered eating among disabled athletes is not known. A better knowledge of the different eating behaviors and their prevalence in disabled athletes would be helpful to understand interactions between eating and health. This study aimed to examine the cognitive restraint, uncontrolled eating and emotional eating behaviors in a disabled athlete population. Method: A total of 70 disabled Turkish national athletes (33 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball) were involved in the study. The cognitive restraint, uncontrolled eating and emotional eating behaviors were assessed using the revised version of Three Factor Eating Questionnaire-R18 (TFEQ-R18). The questionnaires were conducted by dietitian during the preparation camps of athletes. Body weight, height and waist circumference (WC) were measured; and body composition was analyzed by bioelectrical impedance analysis method. Results: The TFEQ scales showed a cognitive dietary restraint score of 13.9±4.2, uncontrolled eating score of 17.7±5.8 and emotional eating score of 4.9±2.5. The mean score of total TFEQ-R18 was 36.5±8.62. Neither total TFEQ-R18 score nor subscale scores differed significantly by gender or sport branches (p>0.05, for each). The scores were also similar in BMI groups (n=63; p>0.05). Total TFEQ, uncontrolled eating and emotional eating scores were significantly higher among the athletes with congenital disabilities compared to the scores of the athletes with acquired disabilities (p<0.05, for each). Moreover, the cognitive dietary restraint score was significantly high in athletes who would like to lose weight (p=0.009). Conclusion: Disabled athletes might have a risk of disordered eating. The different eating behaviors among disabled athletes should be assessed using validated tools to develop personalized nutritional strategies for those athletes.

Keywords: disabled athletes, eating behaviour, three-factor eating questionnaire-r18, body composition

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10330 Antioxidant Activity and Microbiological Quality of Functional Bread Enriched with Morus Alba Leaf Extract during Storage

Authors: Joanna Kobus-Cisowska, Daria Szymanowska, Piotr Szulc, Oskar Szczepaniak, Marcin Dziedzinski, Szymon Byczkiewicz

Abstract:

A wide range of food products is offered on the market. However, increasing consumer awareness of the impact of food on health causes a growing interest in enriched products. Cereal products are an important element of the daily diet of man. In the literature, no data was found on the impact of Morus alba preparations on the content of active ingredients and properties of wholemeal bread. Mulberry leaves (Morus alba L) are a rich source of bioactive compounds with multidirectional antioxidant activity, which means that they can be a component of new foods that prevent disease or support therapy and improve the patient's health. The aim of the study was to assess the impact of the addition of white mulberry leaf extract on the antioxidant activity of bread. It has been shown that bread can be a carrier of biologically active substances from mulberry leaves, because the addition of mulberry at a sensory acceptable level and meeting microbiological requirements significantly influenced the increase in the content of bioactive ingredients and the antioxidant activity of bread. The addition of mulberry leaf water extract to bread increased the level of flavonols and phenolic acids, in particular protocatechic, chlorogenic gallic and caffeic acid and isoquercetin and rutine, and also increased the antioxidant potential, which were microbiological stable during 5 days storage. It has been shown also that the addition of Morus alba preparations has a statistically significant effect on anti-radical activity. In addition, there were no differences in activity in DPPH · and ABTS · + tests between post-storage samples. This means that the compounds responsible for the anti-radical activity present in the bread were not inactivated during storage. It was found that the tested bread was characterized by high microbiological purity, which is indicated by the obtained results of analyzes performed for the titers of indicator microorganisms and the absence of pathogens. In the tested products from the moment of production throughout the entire storage period, no undesirable microflora was found, which proves their safety and guarantees microbiological stability during the storage period.

Keywords: antioxidants, bread, extract, quality

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10329 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease

Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

Abstract:

Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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10328 Unpleasant Symptom Clusters Influencing Quality of Life among Patients with Chronic Kidney Disease

Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

Abstract:

This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

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