Search results for: mortality

Authors: Mochammad Indra Permana, Andhiani Sharfina Arnellya, Dika Pramita Destiani, Budhi Prihartanto

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Cardiovascular disease is the cause of the highest mortality rates in the world. The number of cardiovascular disease patients is increasing every year. Data obtained from World Health Organization (WHO) that 17,5 million people died from this disease. The condition of cardiovascular diseases such as atrial fibrillation, myocardial infarction, venous thromboembolism, and several other conditions need anticoagulant therapy. Results of the anticoagulant therapy are measured not only by the effectiveness of International Normalized Ratio (INR) value but also by the quality of life of the patients. The purpose of this study was to determine the quality of life of patients on oral anticoagulant therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This is a cross-sectional study with collecting data from the quality of life questionnaire and medical record of the patients. The results of this study showed that 28 patients (46,7%) had a good quality of life, 30 patients (50%) had a moderate quality of life, and 2 patients (3,3%) had a poor quality of life with no significant differences in quality of life based on age, gender, diagnosis, and duration of drug use.

Keywords: anticoagulant, cardiovascular diseases, INR, quality of life

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Authors: Faith-Michael E. Uzoka, Boluwaji A. Akinnuwesi, Taiwo Amoo, Flora Aladi, Stephen Fashoto, Moses Olaniyan, Joseph Osuji

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The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Keywords: medical diagnosis, tropical diseases, fuzzy cognitive map, decision support filters, malaria differential diagnosis

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Authors: Jacqueline Rose T. Alipo-on, Francesca Isabelle F. Escobar, Myles Joshua T. Tan, Hezerul Abdul Karim, Nouar Al Dahoul

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Electrocardiogram (ECG) signal analysis and processing are crucial in the diagnosis of cardiovascular diseases, which are considered one of the leading causes of mortality worldwide. However, the traditional rule-based analysis of large volumes of ECG data is time-consuming, labor-intensive, and prone to human errors. With the advancement of the programming paradigm, algorithms such as machine learning have been increasingly used to perform an analysis of ECG signals. In this paper, various deep learning algorithms were adapted to classify five classes of heartbeat types. The dataset used in this work is the synthetic MIT-BIH Arrhythmia dataset produced from generative adversarial networks (GANs). Various deep learning models such as ResNet-50 convolutional neural network (CNN), 1-D CNN, and long short-term memory (LSTM) were evaluated and compared. ResNet-50 was found to outperform other models in terms of recall and F1 score using a five-fold average score of 98.88% and 98.87%, respectively. 1-D CNN, on the other hand, was found to have the highest average precision of 98.93%.

Keywords: heartbeat classification, convolutional neural network, electrocardiogram signals, generative adversarial networks, long short-term memory, ResNet-50

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Authors: Abdulwahab Kammon, Tan Sheau Wei, Abdul Rahman Omar, Abdunaser Dayhum, Ibrahim Eldghayes, Monier Sharif

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Infectious bronchitis virus (IBV) is a very dynamic and evolving virus which causing major economic losses to the global poultry industry. Recently, the Libyan poultry industry faced severe outbreak of respiratory distress associated with high mortality and dramatic drop in egg production. Tracheal and cloacal swabs were analyzed for several poultry viruses. IBV was detected using SYBR Green I real-time PCR detection based on the nucleocapsid (N) gene. Sequence analysis of the partial N gene indicated high similarity (~ 94%) to IBV strain 3382/06 that was isolated from Taiwan. Even though the IBV strain 3382/06 is more similar to that of the Mass type H120, the isolate has been implicated associated with intertypic recombinant of 3 putative parental IBV strains namely H120, Taiwan strain 1171/92 and China strain CK/CH/LDL/97I. Complete sequencing and antigenicity studies of the Libya IBV strains are currently underway to determine the evolution of the virus and its importance in vaccine induced immunity. In this paper, we documented for the first time the presence of possibly variant IBV strain from Libya which required a dramatic change in the vaccination program.

Keywords: Libya, infectious bronchitis, molecular characterization, viruses, vaccine

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Authors: Marina Stramarkou, Sofia Papadaki, Maria Kaloupi, Ioannis Batzakas

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Biofouling is a complex problem of the aquaculture industry, as it reduces the efficiency of the equipment and causes significant losses of cultured organisms. Nowadays, the current antifouling methods are proved to be labor intensive, have limited lifetime and use toxic substances that result in fish mortality. Several species of marine algae produce a wide variety of biogenic compounds with antibacterial and antifouling properties, which are effective in the prevention and control of biofouling and can be incorporated in antifouling coatings. In the present work, Fucus spiralis, a species of macro algae, and Chlorella vulgaris, a well-known species of microalgae, were used for the isolation and recovery of bioactive compounds, belonging to groups of fatty acids, lipopeptides and amides. The recovery of the compounds was achieved through the application of the ultrasound- assisted extraction, an environmentally friendly method, using green, non-toxic solvents. Moreover, the coating of the antifouling agents was done by innovative encapsulation and coating methods, such as electro-hydrodynamic process. For the encapsulation of the bioactive compounds natural matrices were used, such as polysaccharides and proteins. Water extracts that were incorporated in protein matrices were considered the most efficient antifouling coating.

Keywords: algae, electrospinning, fatty acids, ultrasound-assisted extraction

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Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

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After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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Authors: Hamid Reza Ranjbar, Ali Reza Azmoude Ardalan, Hamid Dehghani, Mohammad Reza Sarajian

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Natural disasters are unexpected events which predicting them is difficult. Earthquake is one of the most devastating disasters among natural hazards with high rate of mortality and wide extent of damages. After the earthquake occurrence, managing the critical condition and allocating limited relief sources requiring a complete awareness of damaged area. The information for allocating relief teams should be precise and reliable as much as possible, and be presented in the appropriate time after the earthquake occurrence. This type of information was previously presented in the form of a damage map; conducting relief teams by using damage map mostly lead to waste of time for finding alive occupants under the rubble. In this research, a proposed standard for prioritizing damaged buildings in terms of requiring rescue and relief was presented. This standard prioritizes damaged buildings into four levels of priority including very high, high, moderate and low by considering key parameters such as type of land use, activity time, and inactivity time of each land use, time of earthquake occurrence and distinct index. The priority map by using the proposed standard could be a basis for guiding relief teams towards the areas with high relief priority.

Keywords: Damage map, GIS, priority map, USAR

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Authors: Afaf Benhouda, Mouloud Yahia, Hachani Khadraoui, Asma Meddour, Souhila Benbia, Abdelmoudjib Ghecham, Djahida Benhouda

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Umbilicus rupestris (UR) is an herbal medicine traditionally applied against the ignitions of the skin. The present paper aimed to study the acute and subacute toxicity with orally administered methanolic leaves extract of Umbilicus rupestris L (URMeOH). In acute toxicity tests, four groups of rats (n = 6/group/female) were orally treated with doses of 500, 1000, 1500 and 2000 mg/kg, and general behaviour, adverse effects, and mortality were recorded for up to 14 days. In subacute toxicity study, rats received URAMeOH by gavage at the doses of 100, 200 mg/kg/day (n = 6/group) for 28 days, and biochemical, hematological, and histopathological changes in tissues (liver, kidney) were determined. URMeOH did not produce any hazardous symptoms or death and in the acute toxicity test. Subacute treatment with URMeOH did not show any change in body weight, and hematological and biochemical profiles. In addition, no change was observed either in macroscopic or microscopic aspects of vital organs in rats. Our result showed that Umbilicus rupestris extract could be safe for human use.

Keywords: acute toxicity, biochemical parameters, hematological parameters, Umbilicus rupestris, subacute toxicity

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Authors: Dita Mayasari, Zahrina Mardina, Riki Siswanto, Agresta Ifada, Ova Oktavina, Prihartini Widiyanti

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Heart failure is a serious major health problem with high number of mortality per year. Bypass is one of the solutions that has often been taken. Natural vascular graft (xenograft) as the substitute in bypass is inconvenient due to ethic problems and the risk of infection transmission caused by the usage of another species transgenic vascular. Nowadays, synthetic materials have been fabricated from polymers. The aim of this research is to make a synthetic vascular graft with great physical strength, high biocompatibility, and good affordability. The method of this research was mixing PLGA and collagen by magnetic stirrer. This composite were shaped by spinneret with water as coagulant. Then it was coated by chitosan with 3 variations of weight (1 gram, 2 grams, and 3 grams) to increase hemo and cytocompatibility, proliferation, and cell attachment in order for the vascular graft candidates to be more biocompatible. Mechanical strength for each variation was 5,306 MPa (chitosan 1 gram), 3,433 MPa (chitosan 2 grams) and 3,745 MPa (chitosan 3 grams). All the tensile values were higher than human vascular tensile strength. Toxicity test showed that the living cells in all variations were more than 60% in number, thus the vascular graft is not toxic.

Keywords: chitosan, collagen, PLGA, spinneret

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Authors: Vimarshi Sandamali Godigamuwa

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Background: Breast cancer is the leading cause of cancer mortality in women worldwide. Its incidence is increasing and young women affected more than ever. Nursing students are the future nurses who will have the opportunity to encourage and influence women to be aware of breast cancers. Objectives: To determine the level of knowledge, awareness and practices concerning of breast cancer among Sri Lankan student nurses. Methods: A descriptive cross sectional study was conducted on 150 nursing students who are in their 2nd and 3rd year studies by distributing a standard self-administered questionnaire. The completed questionnaire were retrieved, graded and scored. Results: Mean age of the respondents was 24.27; (SD=1.66) years and ranged from 20-30 years. Most of the students were female which was 85%. 32% of nursing students scored below 55% for the questionnaire and only 7.3% had good overall knowledge and awareness of breast cancer. Out of 128 female students 89.9% were answered that they know how to perform Breast Self Examination (BSE), out of which 37% of them performed BSE regularly. Only 33% were aware of recommended age for BSE and 10% were knew the recommended age for mammography. 9.3% were aware of frequency for Clinical Breast Examination on 20-39 years of age group. Of the female participants, 11.7% reported positive family history of breast cancer. Conclusion: Nursing students should explore to health educational programs on regular basis on breast cancer and its screening methods. Further studies are needed to identify reasons for not practicing BSE.

Keywords: breast cancer, student nurses, knowledge, awareness, practice, BSE

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Authors: Shirin Jalili, Ramin Ghasemi Shayan

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Atrial fibrillation is the foremost common arrhythmia around the world, with expanding recurrence famous with age. Thromboembolic occasions and strokes are the number one cause of mortality and morbidity. For patients who don't react to restorative treatment for rate and beat control, the maze method offers an elective treatment mediation. pharmaco-medical treatment for atrial fibrillation is pointed at the control of rate or cadence, intrusive treatment for atrial fibrillation is pointed at cadence control. An obtrusive approach may comprise of percutaneous catheter treatment, surgery, or a crossover approach. Since the maze method is recognized as the foremost successful way to dispense with AF, combining the maze strategy amid major cardiac surgeries has been received in clinical hone. the maze strategy, moreover known as Cox¬maze iii or the ‘cut¬and¬sew’ method, involves making different incisions within the atria to make an arrangement of scars that dispose of each potential zone of re¬entry. The electrical drive is constrained through a maze of scars that coordinates the electrical drive from the sinus node to the av node. By settling the headstrong period between ranges of scar, re¬entry is disposed of. in this article, we evaluate the Maze surgery method that's the surgical method of choice for the treatment of restorative atrial fibrillation.

Keywords: atrial fibrillation, congenital heart disease, procedure, maze surgery, treatment

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Authors: Shriya Shukla, Lachin Fernando

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Pneumonia, a leading cause of mortality in young children globally, presents significant diagnostic challenges, particularly in resource-limited settings. This study presents an approach to diagnosing pediatric pneumonia using Chest X-Ray (CXR) images, employing a lightweight MobileNetV2 model enhanced with synthetic data augmentation. Addressing the challenge of dataset scarcity and imbalance, the study used a Variational Autoencoder-Generative Adversarial Network (VAE-GAN) to generate synthetic CXR images, improving the representation of normal cases in the pediatric dataset. This approach not only addresses the issues of data imbalance and scarcity prevalent in medical imaging but also provides a more accessible and reliable diagnostic tool for early pneumonia detection. The augmented data improved the model’s accuracy and generalization, achieving an overall accuracy of 95% in pneumonia detection. These findings highlight the efficacy of the MobileNetV2 model, offering a computationally efficient yet robust solution well-suited for resource-constrained environments such as mobile health applications. This study demonstrates the potential of synthetic data augmentation in enhancing medical image analysis for critical conditions like pediatric pneumonia.

Keywords: pneumonia, MobileNetV2, image classification, GAN, VAE, deep learning

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Authors: Joseph Carl Macalintal, Erlinda Armovit

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Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation.

Keywords: eclampsia, magnesium sulfate, preeclampsia, rocuronium bromide

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Authors: Reem Al-Shidhani, Isabelle S. R. Storer, Michael J. Bromley, Lydia Tabernero

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Invasive fungal diseases are an increasing global health concern that contributes to the high mortality rates in immunocompromised patients. The rising of antifungal resistance severely lowers the efficacy of the limited antifungal agents available. New antifungal drugs that target new mechanisms are necessary to tackle the current shortfalls. Amongst post- modifications, phosphorylation is a predominant and an outstanding protein alteration in all eukaryotes. In fungi, protein phosphorylation plays a vital role in many signal transduction pathways, including cell cycle, cell growth, metabolism, transcription, differentiation, proliferation, and virulence. The investigation of Aspergillus fumigatus phosphatases revealed seven genes essential for viability. Inhibiting one of these phosphatases is a new interesting route to develop novel antifungal drugs. In this study, we carried out an early drug discovery process targeting oneessential phosphatase, GlcA. Here, we report the identification of new GlcA inhibitors that show antifungal activity. These important finding open a new avenue to the development of novel antifungals to expand the current narrow arsenal of clinical candidates.

Keywords: invasive fungal diseases, phosphatases, GlcA, competitive inhibitors

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Authors: Sara Mouffouk, Fatma Belaid, Asma Hechani, Chaima Mouffouk

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Cancer of the cervix caused by HPV (human papillomavirus ) is for many years a real public health problem, it is ranked 2nd deadly female cancer kills more than 270 000 women each year worldwide. In Algeria, the mortality of cervical cancer decreases with the impact, but the prognosis of these cancers remains bleak: The 5-year relative survival is 60 %. The mode of transmission is usually sexuel. Our study was undertaken to show the link between HPV and cervical cancer and the importance of Pap smear screening in this type of pathology. On the total sample, 76.11 % showed abnormal cervical smears of which 13% have mild cases and hormonal reaction Change, and 44% represent inflammatory smears and normal cases 35%, while long seven years from 2005 to 2012. Thus, 43% of abnormal smear results between ASCUS, AGUS, low and high grade carcinoma and adenocarcinoma and 57 % of other cases of unknown origin. The average age of women at risk of developing adenocarcinoma is 45-50 with a 67% to 33% of the same risk in women of age group 41-45 years although the percentage of cases of HPV infected patients was 2% in the past seven years. We found that with increasing age, the risk is argued. Due to several factors such as multiparty can reduced the resistance of the uterine epithelium and even as the multi that promotes contamination HPV causes repeated infections with HPV.

Keywords: cervical cancer, human papillomavirus (HPV) screening, prevention, vaccines

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Authors: Rochelyn Dona, Mohamed F. Nur, Serdar Satar

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The biological response of Aphis gossypii Glover (Hom. Aphididae) was investigated on the effects of seven cucumber varieties (Cucumis sativus L.) such as Kitir, Muhika, Ayda, Beit, 14-F1, Ruzgar, and Ptk in the laboratory condition at 24±1°C, 65±5% relative humidity (RH) and a photoperiod of 16:8 (L:D) hour. The results were related that the developmental time of A. gossypii at the nymphal stages was presented a significant difference only on the first instar stage. From the lowest to the highest respectively, 0.98 days on ruzgar to 1.18 days on Kitir, the second nymphal stage 0.98 days to Beit alfa, 1.08 days on Muhika, the third from 0.94 days to Kitir, from 1.16 days to 14-F1, and the last instar 1.22 days on Ptk, 1.48 days on Kitir were investigated. The total development time was evaluated at 4.46 days Beit on alfa 4.72 days on Kitir. The offspring number was 60.42 aphids on ayda and 83.72 aphids on muhika, the significant differences between varieties were based on one-way ANOVA (Tukey test). The lifetime of A. gossypii was recorded 19.10 days on Kitir, 27.64 days on Ptk. The results showed that cucumber cultivars were affected by the biological life of A. gossypii. The combination of this study with the other methods of the IPM tactics can serve as the best strategy for controlling this pest on cucumber varieties into the greenhouse.

Keywords: cucumber cultivars, fecundity, intrinsic rate, mortality, resistance

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Authors: Manasvi Pinnaka, Brianna Chrisman

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Cystic fibrosis patients often develop lung infections that range anywhere in severity from mild to life-threatening due to the presence of thick and sticky mucus that fills their airways. Since many of these infections are chronic, they not only affect a patient’s ability to breathe but also increase the chances of mortality by respiratory failure. With a publicly available dataset of DNA sequences from bacterial species in the lung microbiome of cystic fibrosis patients, the correlations between different microbial species in the lung and the extent of deterioration of lung function were investigated. 16S sequencing technologies were used to determine the microbiome composition of the samples in the dataset. For the statistical analyses, referencing helped distinguish between taxonomies, and the proportions of certain taxa relative to another were determined. It was found that the Fusobacterium, Actinomyces, and Leptotrichia microbial types all had a positive correlation with the FEV1 score, indicating the potential displacement of these species by pathogens as the disease progresses. However, the dominant pathogens themselves, including Pseudomonas aeruginosa and Staphylococcus aureus, did not have statistically significant negative correlations with the FEV1 score as described by past literature. Examining the lung microbiology of cystic fibrosis patients can help with the prediction of the current condition of lung function, with the potential to guide doctors when designing personalized treatment plans for patients.

Keywords: bacterial infections, cystic fibrosis, lung microbiome, 16S sequencing

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Authors: Tery Nehemia Nugraha Joseph, J. D. P. Wisnubroto

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Thyroid cancer is a healthcare problem with high morbidity and mortality. Follicular adenoma and follicular carcinoma are thyroid tumors from the thyroid follicular cells differentiation with a microfollicular pattern that consists of follicular cuboidal cells. vascular endothelial growth factor (VEGF) is a potent and powerful mitogen for endothelial cells and increases vascular permeability. Therefore, due to an increase in thyroid-stimulating hormone (TSH), VEGF production is activated in the thyroid that leads to the end of mitogenic TSH stimulation and initiation of angiogenesis. The differences in VEGF levels in the follicular carcinoma of thyroid tissue with follicular adenoma thyroid can be used as a basis in differentiating the two types of neoplasms. This study aims to analyze VEGF in the serum so that it can be used to differentiate the types of thyroid carcinoma before surgery. This study uses a cross-sectional research design. Samples were carried out by taking serum samples, and the VEGF levels were calculated. Data were analyzed using the Mann-Whitney test. The results found a significant difference between VEGF levels in the follicular carcinoma thyroid group and VEGF levels in the follicular adenoma thyroid group with a value of p = 0.007 (p < 0.05). The results obtained are 560,427 ± 160,506 ng/mL in the type of follicular carcinoma thyroid and 320.943 ± 134.573 ng/mL in the type of follicular adenoma thyroid. VEGF levels between follicular adenoma and follicular carcinoma are different. VEGF levels are higher in follicular carcinoma thyroid than follicular adenoma thyroid.

Keywords: follicular adenoma thyroid, follicular carcinoma thyroid, thyroid, VEGF

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Authors: Jyoti Agrawal

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Introduction: Renal diseases in children and young adult can be difficult to diagnose early as it may present only with few symptoms, tends to have different course than adult and respond variously to different treatment. The pattern of renal disease in children is different from developing countries as compared to developed countries. Methods: This study was a hospital based prospective observational study carried from March, 2014 to February 2015 at BP Koirala institute of health sciences. Patients with renal disease, both inpatient and outpatient from birth to 14 years of age were enrolled in the study. The diagnosis of renal disease was be made on clinical and laboratory criteria. Results: Total of 120 patients were enrolled in our study which contributed to 3.74% % of total admission. The commonest feature of presentation was edema (75%), followed by fever (65%), hypertension (60%), decreased urine output (45%) and hematuria (25%). Most common diagnosis was acute glomerulonephritis (40%) followed by Nephrotic syndrome (25%) and urinary tract infection (25%). Renal biopsy was done for 10% of cases and most of them were steroid dependent nephrotic syndrome. 5% of our cases expired because of multiorgan dysfunction syndrome, sepsis and acute kidney injury. Conclusion: Renal disease contributes to a large part of hospital pediatric admission as well as mortality and morbidity to the children.

Keywords: glomerulonephritis, nephrotic syndrome, renal disease, urinary tract infection

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Authors: Sarita Kumari, Ranjit Kumar Upadhyay

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This paper deals with plankton-fish dynamics where the fish population is growing logistically and nonlinearly harvested. The interaction between phytoplankton and zooplankton population is considered to be Crowley-Martin type functional response. It has been assumed that phytoplankton grows logistically and is affected by a space-dependent growth rate. Conditions for the existence of a positive equilibrium point and their stability analysis (both local and global) have been discussed for the non-spatial system. We have discussed maximum sustainable yields as well as optimal harvesting policy for maximizing the economic gain. The stability and existence of Hopf –bifurcation analysis have been discussed for the spatial system. Different conditions for turning pattern formation have been established through diffusion-driven instability analysis. Numerical simulations have been carried out for both non-spatial and spatial models. Phase plane analysis, the largest Lyapunov exponent, and bifurcation theory are used to numerically analyzed the non-spatial system. Our study shows that spatial heterogeneity, the mortality rate of phytoplankton, and constant harvesting of the fish population each play an important role in the dynamical behavior of the marine system.

Keywords: optimal harvesting, pattern formation, spatial heterogeneity, Crowley-Martin functional response

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Authors: Funmilola O. Omoya

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Muscid flies are known to be vectors of disease agents and species that annoy humans and domesticated animals. An example of these flies is Musca domestica (house fly) whose adult and immature stages occur in a variety of filthy organic substances including household garbage and animal manures. They contribute to microbial contamination of foods. It is therefore imperative to control these flies as a result of their role in Public health. The second and third instars of Musca domestica (Linn) were infected with varying cell loads of Bacillus subtilis in vitro for a period of 48 hours to evaluate its larvicidal activities. Mortality of the larvae increased with incubation period after treatment with the varying cell loads. Investigation revealed that the second instars larvae were more susceptible to treatment than the third instars treatments. Values obtained from the third instar group were significantly different (P0.05) from those obtained from the second instars group in all the treatments. Lethal concentration (LC50) at 24 hours for 2nd instars was 2.35 while LC50 at 48 hours was 4.31.This study revealed that Bacillus subtilis possess good larvicidal potential for use in the control of Musca domestica in poultry farms.

Keywords: Bacillus subtilis, Musca domestica, larvicidal activities, poultry farms

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Authors: M. J. Pourvaghar, M. E. Bahram, Sh. Khoshemehry

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Hyperlipidemia or an increase in blood lipids is a condition that has been rising, especially during the last decade, with the advancement of the life-span of the car, as an important disease. In fact, it is one of the complications of industrial life and semi-industrial. Hyperlipidemia alone is not a disease, but it is recognized as an important risk factor for coronary artery disease. The methodology of this review article is the use of research to provide the best solution for physical activity and exercise in relation to lowering blood lipids and lowering blood pressure. Also, factors that contribute to improving the health status of humans should be introduced. Research findings in this article show that physical activity with a specific duration and severity can keep a person away from the cardiovascular disease. The result shows that regular physical activity with low intensity and long periods of time is essential for human health. Physical mobility reduces blood pressure, reduces the harmful fats and does not cause cardiovascular disease. More than half of the patients suffering from cardiovascular problems are afflicted with blood lipids. On the other hand, high blood pressure is one of the serious health hazards in the world today, which causes a large number of cardiovascular problems and mortality in the world. Undoubtedly, the second most common risk factor for heart disease is high blood pressure after cigarette smoking.

Keywords: blood pressure, cardiovascular, hyperlipidemia, risk factor

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Authors: Ankush Kalra, Mirza Masroor, Usha Manaktala, B. C. Koner, T. K. Mishra

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Introduction: Pre-eclampsia affects 3-5% of pregnancies worldwide and increases maternal-fetal morbidity and mortality. Reduced placental perfusion induces the release of biomolecules by the placenta into maternal circulation causing endothelial dysfunction. Zinc dependent matrix metalloproteinase-2 (MMP-2) may be up-regulated and interact with circulating factors of oxidative stress and inflammation to produce endothelial dysfunction in pre-eclampsia. Aim: To study the functional genetic polymorphism of MMP-2 gene (g-1306 C>T) in pre-eclampsia and its effect on serum MMP-2 levels in these patients. Method: Hundred pre-eclampsia patients and hundred age and gestation period matched healthy pregnant women with their consent were recruited in the study. Serum MMP-2 levels in all subjects were estimated using standard ELISA kits. MMP-2 gene (g.- 1306 C>T) SNPs were genotyped using whole blood by ASO-PCR. Result: The pre-eclampsia patients had higher serum levels of MMP-2 compared to the healthy pregnant (p < 0.05). Also the MMP-2 genotype was associated with significant alteration in the serum MMP-2 concentration in these patients (p < 0.05). Conclusion: This study results suggest an association of MMP-2 genetic polymorphism and serum levels of MMP-2 to the path physiology of hypertensive disorder of pregnancy.

Keywords: allele specific oligonucleotide polymerase chain reaction (ASO-PCR), enzyme linked immunosorbent assay (ELISA), matrix metalloproteinase-2 (MMP-2), pre-eclampsia

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Authors: Zahra Tolou-Ghamari

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Objective: Health care associated with multiresistant pathogens is rising globally. It is well known that nosocomial infections increase hospital stay, morbidity, mortality, and disability. Therefore, the aim of this study was to define the occurrence of nosocomial infections in a tertiary hospital in Isfahan/Iran. Materials and Methods: The data were extracted from the official database of hospital nosocomial infections records that included 9152 vertical rows. For each patient, the reported infections were coded by number as UTI-SUTI; Code 55, VAE-PVAP; Code 56, BSI-LCBI Code 19, SSI-DIP; Code 14, and so on. For continuous variables, mean ± standard deviation and for categorical variables, the frequency was used. Results: The study population was 5542 patients, comprised of males (n=3282) and females (n=2260). With a minimum of 15 and a maximum of 99, the mean age in 5313 patients was 58.5 ± 19.1 years old. The highest reported nosocomial infections (n= 77%) were associated with the ages 30-80 years old. Sites of nosocomial infections in 87% were as: VAE-PVAP; 27.3%, VAE-IVAC; 7.7, UTI-SUTI; 29.5%, BSI-LCBI; 12.9%, SSI-DIP; 9.5% and other individual infection (13%) with the main pathogens klebsiella pneumonia, acinetobacter baumannii and staphylococcus. Conclusions: For an efficient surveillance system, adopting pharmacotherapy used antibiotics in terms of monotherapy or polypharmacy control policy, in addition to advanced infection control programs at regional and national levels in Iran recommended.

Keywords: infection, nosocomial, ventilator, blood stream, Isfahan, Iran

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Authors: Shirin Sarejloo

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Background: Electrophysiological-related manifestation of COVID-19 is a matter of debate in the literature nowadays. A wide spectrum of arrhythmias was observed among patients who have been infected with COVID-19. Objectives: This study discussed the prevalence of arrhythmias and conduction system disease in patients with COVID-19. Method: In this retrospective study, demographic and electrocardiographic data of 432 expired COVID-19 patients who had been admitted to Faghihi Hospital of Shiraz University of Medical Sciences from August2020 until December 2020 were reviewed. Results: Atrioventricular nodal block (AVB) was found in 40(9.3%) patients. Furthermore, 28(6.5%) of them suffered from the first degree of AVB, and 12(2.8%) suffered from complete heart block (CHB). Among 189 cases (59.0%), ST-T changes agreed with myocardial infarction or localized myocarditis. Findings of myocardial injury, including fragmented QRS and prolonged QTc were observed among 91 (21.1%) and 28 (6.5%), respectively. In victims of COVID-19, conduction disease was not related to any comorbidities. Fragmented QRS, axis deviation, presence of S1Q3T3, and poor R wave progression were significantly related to conduction system abnormalities in victims of COVID-19 (P-value > 0.05). Conclusion: Our findings can serve in future studies that aim to develop a risk stratification method for susceptible COVID-19 patients. The myocardial injury appears to role significantly in COVID-19 morbidity and mortality. Consequently, we recommend health policymakers consider separate catheterization laboratories that provide service only to COVID-19 patients.

Keywords: COVID-19, conduction system, ECG, atrioventricular block

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Authors: Öykü Barutçu, Mehmet Özgür Kuzdan

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Aim: Laparoscopy is very risky in patients undergoing, multiple open abdominal surgeries. The aim of this study, to define a safe method for the first trocar placement in children with a history of multiple open abdominal surgeries. Methods: Children who underwent laparoscopic surgery between March 2019 and April 2020 with a history of three or more open abdominal surgeries were included in the retrospective study. Patient information was obtained from the hospital automation system. Ultrasonography was used to determine the location of adhesions preoperatively. The first trocar was placed according to ultrasonography findings, using the Hasson technique to create an air pocket with finger dissection. The patient's preoperative, perioperative, and postoperative findings are reported. Results: A total of 10 patients were included in the study. The median number of operations before laparoscopy was three. The most common site for the first trocar entry was Palmer's point (40%). No mortality or morbidity was observed amongst any patients. The average number of adhesions detected by USG and observed on laparoscopy were significantly positively correlated. Conclusion: In children with a history of multiple abdominal surgeries, abdominal wall ultrasonography for visualization of adhesions and finger dissection for the formation of an air pocket appears to be a safe method for the first trocar insertion.

Keywords: abdominal wall, child, laparoscopy, ultrasonography

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Authors: Ajay Agrawal, Pravin Shah, Shailaja Chhetri, Pappu Rijal

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Background and Objectives: Postpartum hemorrhage (PPH) is a common and occasionally life-threatening complication of labour. Cesarean section (CS) is associated with more blood loss than vaginal delivery. There is a trend for increasing CS rates in both developed and developing countries. This could increase the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of Intravenous Tranexamic Acid (TA) on blood loss during and after elective CS delivery. Materials and Methods: It is a prospective, randomized controlled study. 160 eligible pregnant women of 37 or more POG planned for CS were randomized into two groups either to receive 10ml(1gm) of tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation. Results: The mean estimated blood loss was significantly lower in women treated with TA compared with women in the placebo group (392.13 ml ± 10.06 versus 498.69 ml ± 15.87, respectively; p < 0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the tranexamic acid group than in the control group (0.31 ± 0.18 versus 0.79 ± 0.23, respectively; p < 0.001). Conclusion: Pre-operative use of tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where PPH is a major threat to the life of the mothers, it seems to be a promising option.

Keywords: blood loss, cesarean section, postpartum hemorrhage, tranexamic acid

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Authors: Maedeh Gharazi

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Adults with age 50 and older will include more than 70% of the diabetic populace by the year 2025. More established patients with diabetes are more inclined to have concurrent ceaseless conditions like hypertension, dyslipidemia, and cardiovascular sickness that may affect their nutritious necessities. The issue of achievement and support of an ideal body weight in elderly diabetic persons may not be as direct as in other age gatherings, and the risk-benefit ratio may be diverse too. Albeit expanded predominance of overweight and weight in the elderly adds to insulin resistance and hyperglycemia, more seasoned tenants of long haul care offices who experience the ill effects of diabetes have a tendency to be underweight. Both may mean insufficient nutritional status and lead to expanded grimness and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may influence the sort and amount of food devoured by elderly persons. Organized screening devices may recognize nutrition related issues that warrant proof based mediations. Despite the fact that glucose control and health concerns are essential calculates diet change in the more established populace, different contemplations incorporate personal satisfaction and individual inclinations. Redoing of nutritious rules to the needs of the more seasoned diabetic patient bodes well.

Keywords: diabetes, nutritious necessities, insulin resistance, glucose control

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Authors: Shital Patil, Surendra Bhosale

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Cardiac diseases are the leading causes of mortality and morbidity in the world, from recent few decades accounting for a large number of deaths have emerged as the most life-threatening disorder globally. Machine learning and Artificial intelligence have been playing key role in predicting the heart diseases. A relevant set of feature can be very helpful in predicting the disease accurately. In this study, we proposed a comparative analysis of 4 different features selection methods and evaluated their performance with both raw (Unbalanced dataset) and sampled (Balanced) dataset. The publicly available Z-Alizadeh Sani dataset have been used for this study. Four feature selection methods: Data Analysis, minimum Redundancy maximum Relevance (mRMR), Recursive Feature Elimination (RFE), Chi-squared are used in this study. These methods are tested with 8 different classification models to get the best accuracy possible. Using balanced and unbalanced dataset, the study shows promising results in terms of various performance metrics in accurately predicting heart disease. Experimental results obtained by the proposed method with the raw data obtains maximum AUC of 100%, maximum F1 score of 94%, maximum Recall of 98%, maximum Precision of 93%. While with the balanced dataset obtained results are, maximum AUC of 100%, F1-score 95%, maximum Recall of 95%, maximum Precision of 97%.

Keywords: cardio vascular diseases, machine learning, feature selection, SMOTE

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Authors: Pei Yi Lin

Abstract:

Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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