Publications | Medical and Health Sciences
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 680

World Academy of Science, Engineering and Technology

[Medical and Health Sciences]

Online ISSN : 1307-6892

680 Side Effects of Dental Tooth Whitening: Data from Literature

Authors: Saimir Heta, Ilma Robo, Emela Dalloshi, Nevila Alliu, Vera Ostreni

Abstract:

The dental whitening process, beyond the fact that it is a mini-invasive dental treatment, has effects on the dental structure or on the pulp of the tooth where it is applied. The electronic search was performed using keywords to find articles published within the last 10 years about side effects, assessed as such, of the minimally invasive dental bleaching treatment. The aim of the study was to evaluate the side effects of bleaching based on the percentage and type of solution used, where the latter was evaluated on the basic solution used for bleaching. The side effects of bleaching are evaluated in selected articles depending on the method of bleaching application, which means it is carried out with recommended solutions, or with mixtures of alternative solutions or substances based on Internet information. The dental bleaching process has side effects which have not yet been definitively evaluated, experimentally in large samples of individuals or animals (mice or cattle) to arrive at accurate numerical conclusions. The trend of publications about this topic is increasing in recent years, as long as the trend for aesthetic facial treatments, including dental ones, is increasing.

Keywords: Teeth whitening, side effects, permanent teeth, formed dental apex.

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679 The Physiological Impacts of Genital Weightlifting Conditioning: Exploring Iron Crotch Practice for Enhanced Sexual Function, Premature Ejaculation, Penile Dysfunction, Impotence, Hormonal Balance, and Prostate Health

Authors: C. Ardil

Abstract:

This study explores "Iron Crotch Kung Fu," a unique practice involving genital weightlifting. While the practice has historical significance, its potential health benefits, particularly in sexual function and overall well-being, remain largely anecdotal. To bridge the gap between tradition and modern science, this study proposes a modified Iron Crotch training program integrating principles from Pelvic Floor Muscle Training (PFMT). This integrated approach offers a safer and more effective pathway to harness the potential benefits of Iron Crotch, including enhanced sexual function, improved pelvic floor health, and increased core strength. The study delves into the historical context, technical methodologies, and potential physiological impacts of Iron Crotch, while highlighting the importance of careful practice under expert guidance. By integrating historical context, practical techniques, and scientific insights, this study aims to provide a balanced perspective on Iron Crotch and its potential role in modern health and wellness practices.

Keywords: Iron Crotch, iron crotch kung fu, Diao Gung, genital weightlifting, back pain, erectile dysfunction, exercise, exercise therapy, female athletes, hormonal balance, hypertonicity, martial arts, meta-analysis, overactivity, pelvic floor, pelvic floor disorders, pelvic floor muscle dysfunction, pelvic floor muscle training, pelvic floor physical therapy, penile dysfunction, physical health, physical medicine, physiotherapy, premature ejaculation, prostate health, provoked vestibulodynia, resistance training, sexual dysfunction, sexual health, sexual medicine, sexual orientation, systematic review, traditional health practices, urinary incontinence, urodynamics, vaginismus, vestibulodynia, women’s health, PFMT

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678 Necrotising Anterior Scleritis and Scleroderma: A Rare Association

Authors: A. Vassila, D. Kalogeropoulos, R. Rawashdeh, N. Hall, N. Rahman, M. Fabian, S. Thulasidharan, H. Parwez

Abstract:

Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. This is a retrospective analysis, which examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750 mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: Scleritis, necrotizing scleritis, scleroderma, autoimmune disease.

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677 Visual Preferences of Elementary School Children with Autism Spectrum Disorder: An Experimental Study

Authors: Larissa Pliska, Isabel Neitzel, Michael Buschermöhle, Olga Kunina-Habenicht, Ute Ritterfeld

Abstract:

Visual preferences, which can be assessed using eye tracking technologies, are considered one of the defining hallmarks of autism spectrum disorder (ASD). Specifically, children with ASD show a decreased preference for social images rather than geometric images compared to typically developed (TD) children. Such differences are already prevalent at a very early age and indicate the severity of the disorder: toddlers with ASD who preferred geometric images when confronted with social and geometric images showed higher ASD symptom severity than toddlers with ASD who showed higher social attention. Furthermore, the complexity of social images (one child playing vs. two children playing together) as well as the mode of stimulus presentation (video or image), are not decisive for the marker. The average age of diagnosis for ASD in Germany is 6.5 years, and visual preference data on this age group are missing. In the present study, we therefore investigated whether visual preferences persist into school age. We examined the visual preferences of 16 boys aged 6 to 11 years with ASD and unimpaired cognition as well as TD children (1:1 matching based on children's age and the parent's level of education) within an experimental setting. Different stimulus presentation formats (images vs. videos) and different levels of stimulus complexity were included. Children with and without ASD received pairs of social and non-social images and video stimuli on a screen while eye movements (i.e., eye position and gaze direction) were recorded. For this specific use case, KIZMO GmbH developed a customized, native iOS app (KIZMO Face-Analyzer) for use on iPads. Neither the format of stimulus presentation nor the complexity of the social images had a significant effect on the visual preference of children with and without ASD in this study. Despite the tendency for a difference between the groups for the video stimuli, there were no significant differences. Overall, no statistical differences in visual preference occurred between boys with and without ASD, suggesting that gaze preference in these groups is similar at elementary school age. One limitation is that the children with ASD were already receiving ASD-specific intervention. The potential of a visual preference task as an indicator of ASD can be emphasized. The article discusses the clinical relevance of this marker in elementary school children.

Keywords: Autism spectrum disorder, eye tracking, hallmark, visual preference.

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676 Probe-Assisted Axillary Lymph Node Biopsy Compared with Axillary Dissection in Breast Cancer: A Retrospective Study from the West of Iran

Authors: Morteza Alizadeh Foroutan, Hassan Moayeri, Keivan Sabooni, Motahareh Rouhi Ardeshiri

Abstract:

Breast cancer incidence is annually increasing in various parts of the world, and sentinel lymph node biopsy (SLNB) has turned into a new standard for care as a staging process in this regard. In the present study, the gamma probe technique was used for SLNB as a safe method with more accuracy and less complications. The study sought to compare the results of two surgical techniques, namely, axillary lymph node dissection (ALND) and SLNB, including epidemiological results and clinicopathological features of BC patients from the western provinces of Iran. In general, 420 BC women were identified who referred to the breast clinic in Sanandaj, Kurdistan province during 2017-2021. Of whom, 318 patients underwent breast surgery, and from these patients, 277 cases participated in the current study. Patients were divided into those undergoing ALND and SLNB. The criteria for complete dissection or axillary biopsy using the gamma probe were based on the results of clinical examinations and the presence of palpable lymph nodes. Overall complications after surgery belonged to 58 (18.9%) cases, including 15 (25.9%) and 43 (74.1%) patients in the SLNB and ALND groups, respectively (P = 0.74). Based on the findings, Seroma (60.3%) was the most reported complication in each group. Most patients had tumors in the upper-outer quadrant of their left breast. The mean of the tumor dimension in the SLNB and ALND groups was 2.1 ± 1.3 cm and 3.2 ± 1.8 cm, respectively, (P = 0.003). The benefits of breast-conserving surgery (BCS) with the SLNB technique are clearly undeniable and can be considered a method with less complications and a better prognosis. Accordingly, SLNB and BCS are favorable methods that can be performed, along with gamma probe technique, which is safe and accurate.

Keywords: Breast cancer, Sentinel lymph node biopsy, Axillary lymph node dissection, Gamma probe.

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675 Assessing the Competence of Junior Paediatric Doctors in Managing Paediatric Diabetic Ketoacidosis: An Exploration Across Paediatric Care Units in UK

Authors: Mai Ali

Abstract:

Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they will encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in paediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing DKA emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: DKA management, junior paediatricians, level of competence, standardized protocols.

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674 Evaluation of Surgical Site Infection in Bile Spillage Cases Compared to Non-Bile Spillage Cases Following Laparoscopic Cholecystectomy

Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

Abstract:

Bile spillage occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visit, with subsequent readmission and additional procedures. Thus, this study sought to examine whether bile spillage is indeed associated with increased risk of postoperative wound infections after laparoscopic cholecystectomy. We hypothesize that patients who experience bile spillage (BS) during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per Center for disease control and prevention (CDC) defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and absent in the rest i.e., 92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in non-bile spillage cases SSI was found in 8 cases (8.7%). However, it was statistically not significant (p value > 0.05). 11 (92%) cases were superficial SSI and one was organ-space infection. No mortality or 30-day readmission was found in our study period. Spillage of gallbladder content does not lead to an increase in SSIs. However, as the rate of SSI is still higher, surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage, thorough peritoneal irrigation with normal saline should be done.

Keywords: Biliary spillage, organ space infection, Laparoscopic cholecystectomy, surgical site infection.

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673 Relationship between Behavioral Inhibition/Approach System and Perceived Stress: With White Blood Cell in Multiple Sclerosis Patients

Authors: Amin Alvani

Abstract:

Multiple sclerosis (MS) is a chronic, often disabling disease in which the immune system attacks the myelin sheath of neurons in the central nervous system. The purpose of this study was to explore the correlation between the Behavioral Inhibition/Approach System (BIS-BAS) and Perceived Stress (PS), while controlling for White Blood Cell (WBC) count. 60 MS patients (36.7% male, 63.3% female; aged 15-65 years) participated in this study. They completed a demographic questionnaire, underwent a complete blood cell (CBC) test, filled out the Behavioral Activation and Behavioral Inhibition Scale (BIS-BAS), and responded to the Perceived Stress Questionnaire (PSS-14). The results indicated a significant relationship between the BAS-Reward Responsiveness (BAS-RR) subscale and PS, particularly in a subset of MS patients with increased WBC counts.

Keywords: Behavioral inhibition/approach system, multiple sclerosis, perceived stress, white blood cell.

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672 The Relationship between Body Fat Percentage and Metabolic Syndrome Indices in Childhood Morbid Obesity

Authors: Mustafa M. Donma

Abstract:

Metabolic syndrome (MetS) is characterized by a series of biochemical, physiological and anthropometric indicators and is a life-threatening health problem due to its close association with chronic diseases such as obesity, diabetes mellitus, hypertension, cancer and cardiovascular diseases. The syndrome deserves great interest both in adults and children. Particularly, children with morbid obesity have a great tendency to develop the disease. The diagnostic decision is not so easy and may not be complete particularly in the pediatric population. Therefore, preventive measures should be considered at this stage. The aim of the study was to develop a MetS index capable of predicting MetS, while children are at the morbid obesity stage. This study was performed on morbid obese (MO) children, which were divided into two groups. MO children, who do not possess MetS criteria comprised the first group (n = 44). The second group was composed of children with MetS diagnosis (n = 42). Anthropometric measurements including weight, height, waist circumference (WC), hip C, head C, neck C, biochemical tests including fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) and blood pressure measurements (systolic (SBP) and diastolic (DBP)) were performed. Body fat percentage (BFP) values were determined by TANITA’s Bioelectrical Impedance Analysis technology. Body mass index and MetS indices were calculated. Descriptive statistics including median values, t-test, Mann Whitney U test, correlation-regression analysis were performed within the scope of data evaluation using the statistical package program, SPSS. Statistically significant mean differences were determined by a p value smaller than 0.05. Median values for MetSI and ADMI in MO (MetS-) and MO (MetS+) groups were calculated as 25.9 and 36.5 and 74.0 and 106.1, respectively. Corresponding mean ± SD values for BFPs were 35.9 ± 7.1 and 38.2 ± 7.7 in groups. Correlation analysis of these two indices with corresponding general BFP values exhibited significant association with ADMI, close to significance with MetSI in MO group. Any significant correlation was found with neither of the indices in MetS group. In conclusion, important associations observed with MetS indices in MO group were quite meaningful. The presence of these associations in MO group was important for showing the tendency towards the development of MetS in MO (MetS-) participants. The other index, ADMI, was more helpful for predictive purpose.

Keywords: Body fat percentage, child obesity, metabolic syndrome index, morbid obesity.

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671 An Anthropometric Index Capable of Differentiating Morbid Obesity from Obesity and Metabolic Syndrome in Children

Authors: Mustafa M. Donma

Abstract:

Circumference measurements may give meaningful information about the varying stages of obesity. Some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements for the differential diagnosis of morbid obesity with and without metabolic syndrome (MetS), MOMetS+ and MOMetS-, respectively. 187 children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University, Faculty of Medicine. Signed informed consent forms were taken from the participants. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee of Tekirdag Namik Kemal University Medical Faculty. The study population was divided into four groups as normal-body mass index (N-BMI) (n = 35), obese (OB) (n = 44), morbid obese (MO) (n = 75) and MetS (n = 33). Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. BMI values were calculated. A circumference index, advanced Donma circumference index (ADCI) was presented as WC*HC/NC. The statistical significance degree was chosen as p < 0.05. BMI values were 17.7 ± 2.8, 24.5 ± 3.3, 28.8 ± 5.7, 31.4 ± 8.0 kg/m2, for N-BMI, OB, MO, MetS groups (p = 0.001), respectively. An increasing trend from N-BMI to MetS was observed. However, the increase in MetS group compared to MO group was not significant. For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p = 0.001). A significant difference between MO and MetS groups was detected (p = 0.043). A significant correlation was found between BMI and ADCI. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: Anthropometry, body mass index, childhood obesity, body circumference, metabolic syndrome.

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670 Waist Circumference-Related Performance of Tense Indices during Varying Pediatric Obesity States and Metabolic Syndrome

Authors: Mustafa M. Donma

Abstract:

Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. 194 children, aged 6-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight + obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender-dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements as well as blood pressure values were taken. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and ADTI, which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: Blood pressure, metabolic syndrome, waist circumference.

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669 The Evaluation of a Cardiac Index Derived from Anthropometric and Biochemical Parameters in Pediatric Morbid Obesity and Metabolic Syndrome

Authors: Mustafa M. Donma

Abstract:

Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity, because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index, which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems was used. 124 children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. 43 children with normal body mass index, 41 and 40 morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip circumference (HC), head circumference (HdC), neck circumference (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanine transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p < 0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: Aspartate transaminase, cardiac index, metabolic syndrome, obesity.

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668 Proportion and Factors Associated with Presumptive Tuberculosis among Suspected Pediatric TB Patients

Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

Abstract:

The study addresses the increasing challenge of pediatric presumptive tuberculosis, emphasizing the need to understand the factors associated with it. The research aims to determine the proportion of presumptive TB and factors associated with it among suspected pediatric tuberculosis patients. A cross-sectional study was conducted at ICDDR-Bangladesh, collecting specimens from suspected pediatric patients and using logistic regression for data analysis. The study found a high proportion of presumptive TB (85.7%) but no statistically significant differences between presumptive and non-presumptive TB. Theoretical importance of the study highlights the importance of identifying factors associated with presumptive TB for better control and management strategies. Specimens were collected from 84 suspected pediatric patients diagnosed with TB based on clinical symptoms/radiological findings. Microbiological tests like smear-microscopy, culture, and GeneXpert were used to isolate presumptive TB and confirmed TB. The proportion of presumptive TB was 85.7% among suspected pediatric TB patients. Among various factors that were not found to be associated with the presumptive TB. The study concludes that despite a high proportion of presumptive TB, no significant differences were found between presumptive and non-presumptive TB cases.

Keywords: Presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis.

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667 Different Ergonomic Exposure Risk and Infrared Thermal Temperature on Low Back

Authors: Sihao Lin, Bo Shen, Xuexiang Dai, Xuyan Xu, Zhenyi Wu, Xianzhe Zeng

Abstract:

Infrared Thermography (IRT) has been little documented in the objective measurement of ergonomic exposure. We aimed to examine the association between different ergonomic exposures and low back skin temperature measured by IRT. A total of 114 subjects among sedentary students, sports students and cleaning workers were selected as different ergonomic exposure levels. Low back skin temperature was measured by IRT before and post ergonomic exposure. Ergonomic exposure was assessed by Quick Exposure Check (QEC) and quantitative scores were calculated on the low back. Multiple regressions were constructed to examine the possible associations between ergonomic risk exposures and the skin temperature over the low back. Compared to the two student groups, clean workers had significantly higher ergonomic exposure scores on the low back. The low back temperature variations were different among the three groups. The temperature decreased significantly among students with ergonomic exposure (P < 0.01), while it increased among cleaning workers. With adjustment of confounding, the post-exposure temperature and the temperature changes after exposure showed a significantly negative association with ergonomic exposure scores. For maximum temperature, one increasing ergonomic score decreased -0.23 °C (95% CI -0.37, -0.10) of temperature after ergonomic exposure over the low back. There was a significant association between ergonomic exposures and infrared thermal temperature over low back. IRT could be used as an objective assessment of ergonomic exposure on the low back.

Keywords: Ergonomic exposure, infrared thermography, musculoskeletal disorders, skin temperature, low back.

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666 Characteristics of Neonates and Child Health Outcomes after the Mamuju Earthquake Disaster

Authors: Dimas T. Anantyo, Zsa-Zsa A. Laksmi, Adhie N. Radityo, Arsita E. Rini, Gatot I. Sarosa

Abstract:

A six-point-two-magnitude earthquake rocked Mamuju District, West Sulawesi Province, Indonesia, on 15 January 2021, causing significant health issues for the affected community, particularly among vulnerable populations such as neonates and children. The aim of this study is to examine and describe the diseases diagnosed in the pediatric population in Mamuju 14 days after the earthquake. This study uses a prospective observational study of the pediatric population presenting at West Sulawesi Regional Hospital, Mamuju Regional Public Hospital, and Bhayangkara Hospital for the period of 14 days after the earthquake. Demographic and clinical information was recorded. 153 children were admitted to the health center. Children younger than six years old were the highest proportion (78%). Out of 153 children, 82 of them were male (54%). The most frequently diagnosed disease during the first and second weeks after the earthquake was respiratory problems, followed by gastrointestinal problems that showed an increase in incidence in the second week. This study found that age has a correlation with common disease in children after an earthquake. Respiratory and gastrointestinal problems were found to be the most common diseases among the pediatric population in Mamuju after the earthquake.

Keywords: Health outcomes, pediatric population, earthquake, Mamuju.

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665 Relationship between Mental Health and Food Access among Healthcare College Students in a Snowy Area in Japan

Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

Abstract:

Dropout rates in higher educational institutions pose significant challenges for both students and institutions, with poor mental health (MH) emerging as a key risk factor. Healthcare college students, including medical students, are particularly vulnerable to MH issues due to the demanding academic schedules they face. Poor mental health (MH) would be considered as a key risk factor for dropout from higher educational institutions that pose significant challenges for both students and institutions. And, inadequate food access (FA) has been related to poor MH. Given that targeted students may experience multiple risk factors for poor MH and vulnerable FA, the study aims to clarify the relationship between MH and FA to enhance student well-being. A cross-sectional design was used to explore the association between MH status and FA among 421 students (147 male, 274 female). Participants completed two questionnaires assessing MH and FA during winter 2022. The mean MH score was 6.7 ± 4.6, with higher scores indicating worse MH (max. score 27). While year-round FA showed no significant association with MH, FA during winter was significantly associated with MH (p = 0.01). Although car ownership did not directly impact MH, it was significantly associated with FA (p < 0.01), thus indirectly influencing MH. Our findings underscore the importance of FA in promoting MH, particularly during winter. Adopting a lifestyle that facilitates easier FA may be beneficial for MH, given its indirect association with MH outcomes. These insights emphasize the significance of addressing FA-related challenges to enhance student’s mental well-being.

Keywords: Mental health, food access, co-medical students, lifestyle.

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664 Attention Multiple Instance Learning for Cancer Tissue Classification in Digital Histopathology Images

Authors: Afaf Alharbi, Qianni Zhang

Abstract:

The identification of malignant tissue in histopathological slides holds significant importance in both clinical settings and pathology research. This paper presents a methodology aimed at automatically categorizing cancerous tissue through the utilization of a multiple instance learning framework. This framework is specifically developed to acquire knowledge of the Bernoulli distribution of the bag label probability by employing neural networks. Furthermore, we put forward a neural network-based permutation-invariant aggregation operator, equivalent to attention mechanisms, which is applied to the multi-instance learning network. Through empirical evaluation on an openly available colon cancer histopathology dataset, we provide evidence that our approach surpasses various conventional deep learning methods.

Keywords: Attention Multiple Instance Learning, Multiple Instance Learning, transfer learning, histopathological slides, cancer tissue classification.

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663 Design of a Computer Vision Based Exercise Video Game for Senior Citizens

Authors: June Tay, Ivy Chia

Abstract:

There are numerous changes, both mental and physical, taking place when people age. We need to understand the different aspects required for healthy living, including meeting nutritional needs, regular physical activities to keep agility, sufficient rest and sleep to have physical and mental well-being, social engagement to avoid the risk of social isolation and depression, and access to healthcare to detect and manage chronic conditions. Promoting physical activities for an ageing population is necessary as many may have enjoyed sedentary lifestyles for some time. In our study, we evaluate the considerations when designing a computer vision video game for the elderly. We need to design some low-impact activities, such as stretching and gentle movements, because some elderly individuals may have joint pains or mobility issues. The exercise game should consist of simple movements that are easy to follow and remember. It should be fun and enjoyable so that they can be motivated to do some exercise. Social engagement can keep the elderly motivated and competitive, and they are more willing to engage in game exercises. Elderly citizens can compare their game scores and try to improve them. We propose a computer vision-based video game for the elderly that will capture and track the movement of the elderly hand pushing a ball on the screen into a circle. It can be easily set up using a PC laptop with a webcam. Our video game adhered to the design framework we employed, and it encompassed ease of use, a simple graphical interface, easy-to-play game exercise, and fun gameplay.

Keywords: Computer vision, video games, gerontology technology, caregiving.

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662 When Scientific Laws and Findings Encounter Life: A Traditional Chinese Medicine Perspective

Authors: Eric Y. Zhang, L. Acu

Abstract:

This paper is to point out the limitations of modern medical research and why the Traditional Chinese Medicine (TCM) can help address the limitations. Many of the modern medical research results are based on the findings in fundamental research disciplines, such as physics, and chemistry. However, this foundation is not as solid as it seems. The theory proposed in this paper, the Law of Chasm, or the Chasm Theory, states that there are two categories of objects to be studied. One is non-life objects, or lifeless objects; the other is living beings, or the objects that are alive. The laws and findings obtained by studying non-life objects may not all be extended to living beings, and vice versa. TCM is the study of medicine based on living beings. Therefore, TCM findings may not exist in the body of the knowledge obtained from studying non-life objects.

Keywords: TCM, Traditional Chinese Medicine, Law of Chasm, Chasm Theory, living-beings, non-life.

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661 Arteriosclerosis and Periodontitis: Correlation Expressed in the Amount of Fibrinogen in Blood

Authors: Nevila Alliu, Saimir Heta, Ilma Robo, Vera Ostreni

Abstract:

Periodontitis as an oral pathology caused by specific bacterial flora functions as a focal infection for the onset and aggravation of arteriosclerosis. These two distant pathologies, since they affect organs at a distance from each other, communicate with each other with correlation at the level of markers of inflammation in the blood. Fluctuations in the level of fibrinogen in the blood, depending on the active or passive phase of the existing periodontitis, affect the promotion of arteriosclerosis. The study is of the brief communication article type with the aim to analyze the effect of non-surgical periodontal treatment on fluctuations in the level of fibrinogen in the blood. The reduction of fibrinogen's level in blood after non-surgical periodontal treatment of periodontitis in the patient's oral cavity, is a common consequence supported by literature sources. Also, the influence of a high amount of fibrinogen in blood on the occurrence of arteriosclerosis at the same patient, is also another important data that again rely on many sources of literature. Thromboembolism and arteriosclerosis, as risk factors expressed in clinical data, have temporary bacteremia in the blood, which can occur significantly and often between phases of non-surgical periodontal treatment of periodontitis, treatments performed with treatment phases and protocols of predetermined treatment. Arterial thromboembolism has a significant factor, such as high levels of fibrinogen in the blood, which are significantly reduced during the period of non-surgical periodontal treatment.

Keywords: Fibrinogen, refractory periodontitis, atherosclerosis, non-surgical, periodontal treatment.

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660 Dental Ethics versus Malpractice, as Phenomenon with a Growing Trend

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

Abstract:

Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. Let this article serve as a short communication between readers and interested parties about the problems that dental malpractice can bring to the community. Malpractice should not be seen only as a professional wrong approach, but also as a phenomenon that can occur during dental practice. The aim of this article is presentation of the latest data published in the literature about malpractice. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed that the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited amount of data on the same topic. Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: Dental ethics, malpractice, professional protocol, random deviation, dental tourism.

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659 Indications and Characteristics of Clinical Application of Periodontal Suturing

Authors: Saimir Heta, Ilma Robo, Vera Ostreni, Glorja Demika, Sonila Kapaj

Abstract:

Suturing, as a procedure of joining the lips of the lembo or wound, is important at the beginning of the healing process. This procedure helps to pass the healing process from the procedure per secundam to the stages of healing per primam, thus logically reducing the healing time of the wound. The purpose of this article is to publish some data on the clinical characteristics of periodontal suturing, presenting the advantages and disadvantages of different types of suture threads. The article is a mini-review type of articles selected from the application of keywords on the PubMed page. The number of articles extracted from this article publication page is in accordance with the 10-year publication time limit. The element that remains in the individual selection of the dentist applying the suture is the selection of the suture material. At a moment when some types of sutures are offered for use, some elements should be considered in the selection of the suture depending on the constituent material, the cross-section of the suture elements, and whether it collects bacteria in the "pits" created by the material. The presence of bacteria is a source of infection and possible delay in the healing of the sutured wound. The marketing of suture types offers a variety of materials, from which the selection of the most suitable suture type for specific application cases is a personal indication of the dental surgeon based on professional experiences and knowledge in this field.

Keywords: Suture, suture material, types of sutures, clinical application.

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658 Temperature Related Alterations to Mineral Levels and Crystalline Structure in Porcine Long Bone: Intense Heat vs. Open Flame

Authors: Caighley Logan, Suzzanne McColl

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The outcome of fire related fatalities, along with other research, has found fires can have a detrimental effect to the mineral and crystalline structures within bone. This study focused on the mineral and crystalline structures within porcine bone samples to analyse the changes caused, with the intent of effectively ‘reverse engineering’ the data collected from burned bone samples to discover what may have happened. Using Fourier Transform Infrared (FTIR), and X-Ray Fluorescence (XRF), the data were collected from a controlled source of intense heat (muffle furnace) and an open fire, based in a living room setting in a standard size shipping container (2.5 m x 2.4 m) of a similar temperature with a known ignition source, a gasoline lighter. This approach is to analyse the changes to the samples and how the changes differ depending on the heat source. Results have found significant differences in the levels of remaining minerals for each type of heat/burning (p =< 0.001), particularly Phosphorus and Calcium, this also includes notable additions of absorbed elements and minerals from the surrounding materials, i.e., Cerium (Ce), Bromine (Br) and Neodymium (Ne). The analysis techniques included provide validated results in conjunction with previous studies.

Keywords: Forensic anthropology, thermal alterations, porcine bone, FTIR, XRF.

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657 Physicochemical Activities of Blood Biomarkers Due to Ingestible Radon-222 in Drinking Water and Its Associated Health Consequences

Authors: I. M. Yusuff, A. M. Arogunjo, S. B. Ibikunle, O. M. Oni, P. O. Osho

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Generally, water contamination is a serious health concern, affecting millions of people worldwide every year. Among the water contaminants, radon is a radioactive contaminant understudied and under-regulated. It produces many adverse health effects, including cancer. It is a natural gas that cannot be seen, tasted, or smelled. It develops from the radioactive decay of radium found in the rock of soil and has been considered a health hazard due to its radioactivity in nature. To examine its effects and physicochemical characteristics on the blood biomarkers due to its ingestion in drinking water, its concentrations were monitored and measured in treated and untreated water using Electronic Radon Active Detector (RAD7), while human blood samples were collected using the required laboratory tools. The blood samples were collected and examined physicochemically using semi-automated chemistry analyzer to evaluate the chemistry parameters of the blood. Statistically, results obtained were analyzed using T-test of variables at 95% confidence interval. The outcome of results revealed 112.03 Bq/m3, 561.67 Bq/m3 and 2,753.00 Bq/m3 of radon-222 concentrations in the three water samples used respectively. Demographically, chemistry parameters biomarkers of the blood determined displayed some levels of variations due to radon-222 contaminants ingested from untreated water. Also, analyzed results of blood revealed the associations between the physicochemical parameters of the blood biomarkers and volunteers’ health consequences. The consequences observed were more severed with group B volunteers than group A, due to high level of radon contaminants in borehole water consumed by group B than in well water consumed by group A. The percentages of elevated and depressed biomarkers observed differ from initial reference values and, were the dysfunction indicators. They are directly or indirectly associated to human’s state of health. Most significant biomarkers affected were; HCO3, Cl, K, Cr and Na, they are relevant biomarkers in medicine to determine human’s state of health at any point in time.

Keywords: Radioactive, radon, biomarker, ingestion, dysfunction.

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656 The Contribution of Diet and Lifestyle Factors in the Prevalence of Irritable Bowel Syndrome

Authors: Alexander Dao, Oscar Wambuguh

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Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.

Keywords: Irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder.

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655 Artificial Intelligence-Based Detection of Individuals Suffering from Vestibular Disorder

Authors: D. Hişam, S. İkizoğlu

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Identifying the problem behind balance disorder is one of the most interesting topics in medical literature. This study has considerably enhanced the development of artificial intelligence (AI) algorithms applying multiple machine learning (ML) models to sensory data on gait collected from humans to classify between normal people and those suffering from Vestibular System (VS) problems. Although AI is widely utilized as a diagnostic tool in medicine, AI models have not been used to perform feature extraction and identify VS disorders through training on raw data. In this study, three ML models, the Random Forest Classifier (RF), Extreme Gradient Boosting (XGB), and K-Nearest Neighbor (KNN), have been trained to detect VS disorder, and the performance comparison of the algorithms has been made using accuracy, recall, precision, and f1-score. With an accuracy of 95.28 %, Random Forest (RF) Classifier was the most accurate model.

Keywords: Vestibular disorder, machine learning, random forest classifier, k-nearest neighbor, extreme gradient boosting.

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654 Preventive Interventions for Central Venous Catheter Infections in Intensive Care Units: A Systematic Literature Review

Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: Central venous access, critically ill patients, hospital-acquired complications, prevention.

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653 Traumatic Ankle Pain: Adequacy of Clinical Information in X-Ray Request with Reference to the Ottawa Ankle Rule

Authors: Rania Mustafa

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This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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652 Development of an Omaha System-Based Remote Intervention Program for Work-Related Musculoskeletal Disorders among Front-Line Nurses

Authors: Tianqiao Zhang, Ye Tian, Yanliang Yin, Yichao Tian, Suzhai Tian, Weige Sun, Ruoliang Tang

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Heavy biomechanical loads at workplaces may lead to high risks of work-related musculoskeletal disorders (WMSDs). However, there is a lack of investigations on the efficacy of the ergonomic interventions with theoretical frameworks. This study aimed to formulate an Omaha System based remote intervention program on the WMSDs among nurses by systematic literature review, interviews, expert consultation. After screening title and abstract, 11 articles out of the initial search results (i.e., n=1,418) were included, 12 nurses were interviewed, and 10 experts were consulted to review the initial intervention program. Modification to the draft included (1) supplementing traditional Chinese medicine practices, (2) adding the use of assistive patient handling equipment, (3) revising the on-line training method, (4) editing and proofreading the main text of the initial program, (5) adding quizzes and exercise scales, (6) it was determined that the associated coursework should be announced promptly with multiple follow-up reminders, and (7) removing bodyweight superman exercise, and peaceful/calm meditation. In the end, the final intervention program was developed.

Keywords: Omaha System, nurses, remote intervention, musculoskeletal disease.

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651 Impact of Standardized Therapeutic Hypothermia Protocol on Neurological Performance after Resuscitation from Cardiac Arrest

Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

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We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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