World Academy of Science, Engineering and Technology

Authors: Mohammad Zavid Parvez, Manoranjan Paul

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A seizure prediction method is proposed by extracting global features using phase correlation between adjacent epochs for detecting relative changes and local features using fluctuation/ deviation within an epoch for determining fine changes of different EEG signals. A classifier and a regularization technique are applied for the reduction of false alarms and improvement of the overall prediction accuracy. The experiments show that the proposed method outperforms the state-of-the-art methods and provides high prediction accuracy (i.e., 97.70%) with low false alarm using EEG signals in different brain locations from a benchmark data set.

Keywords: Epilepsy, Seizure, Phase Correlation, Fluctuation, Deviation.

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Authors: Tanwarat Kajsongkram, Saowalux Rotamporn, Sirinat Limbunruang, Sirinan Thubthimthed

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High Performance Liquid Chromatography (HPLC) method was developed and validated for simultaneous estimation of 6-Gingerol(6G) and 6-Shogaol(6S) in joint pain relief gel containing ginger extract. The chromatographic separation was achieved by using C18 column, 150 x 4.6mm i.d., 5μ Luna, mobile phase containing acetonitrile and water (gradient elution). The flow rate was 1.0 ml/min and the absorbance was monitored at 282 nm. The proposed method was validated in terms of the analytical parameters such as specificity, accuracy, precision, linearity, range, limit of detection (LOD), limit of quantification (LOQ), and determined based on the International Conference on Harmonization (ICH) guidelines. The linearity ranges of 6G and 6S were obtained over 20- 60 and 6-18 μg/ml respectively. Good linearity was observed over the above-mentioned range with linear regression equation Y= 11016x- 23778 for 6G and Y = 19276x-19604 for 6S (x is concentration of analytes in μg/ml and Y is peak area). The value of correlation coefficient was found to be 0.9994 for both markers. The limit of detection (LOD) and limit of quantification (LOQ) for 6G were 0.8567 and 2.8555 μg/ml and for 6S were 0.3672 and 1.2238 μg/ml respectively. The recovery range for 6G and 6S were found to be 91.57 to 102.36 % and 84.73 to 92.85 % for all three spiked levels. The RSD values from repeated extractions for 6G and 6S were 3.43 and 3.09% respectively. The validation of developed method on precision, accuracy, specificity, linearity, and range were also performed with well-accepted results.

Keywords: Ginger, 6-gingerol, HPLC, 6-shogaol.

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Authors: Aurela Saliaj, Majlinda Zahaj, Bruna Pura

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Background: Breast milk may impact early brain development, with potentially important biological, medical and social implications. There is an important discussion on which is the adequate breastfeeding extension to the development consolidation and how the children breastfeeding affects their psychomotor development, in the first year of life, and in following periods as well. Some special fats (LC PUFA) contained in breast milk play a key role in the brain’s maturation and cognitive development or social skills. These capacities created during breastfeeding time would be unfolded throughout all lifespan. Aim of the study: In our research, we have studied the effect of breastfeeding in preschooler's psychomotor assessment. Method: This study was conducted in a sample of 158 preschool children in Vlorë, Albania. We have measured the psychometric parameters of preschoolers with ASQ-3 (Age&Stage Questionnaires- 3). The studied sample was divided in three groups according to their breastfeeding duration (3, 6 and 12 months). Results: Children breastfed for only 3 months have definitely lower psychometric scores compared to the ones with 6 or more months of breastfeeding (respectively 217 to 239 ASQ-3 scores). Six and twelvemonth breastfed children have progressively more odds to have high levels of psychomotor development comparing to those with only 3 months of breastfeeding. The most affected psychometric domains by shortness of breastfeeding are Communication and Global motor. Conclusion: This leads to conclusion that to ensure high psychomotor parameters during childhood is necessary breastfeeding for at least 6 months.

Keywords: Breastfeeding, preschoolers, psycho-motor development, psycho-motor domains.

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Authors: Asit K Sikary, O. P. Murty

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In this study, we have collected cases with adipocere formation, which were from the South Delhi region (average room temperature 27-390C) and autopsied at our centre. Details of the circumstances of the death, cause and time of death, surrounding environment and demographic profile of the deceased were taken into account. Total 16 cases were included in this study. Adipocere formation was predominantly present over cheeks, shoulder, breast, flanks, buttocks, and thighs. Out of 16, 11 cases were found in a dry atmosphere, 5 cases were brought from the water. There were 5 cases in which adipocere formation was seen in less than 2 days, and among them, in 1 case, as early as one day. This study showed that adipocere formation can be seen as early as 1 day in a hot and humid environment.

Keywords: Adipocere, drowning, hanging, humid environment, strangulation, subtropical climate.

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Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris

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Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and aware ness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval; seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides.

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Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic Blood Pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2., and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: Hypertension, age, exercise, obesity, gender.

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Authors: Amer A. Hasan, Mehri Igci, Ersin Borazan, Rozhgar A. Khailany, Emine Bayraktar, Ahmet Arslan

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Gastric Cancer (GC) has high morbidity and fatality rate in various countries. It is still one of the most frequent and deadly diseases. Gastrokine1 (GKN1) and gastrokine2 (GKN2) genes are highly expressed in the normal stomach epithelium and play important roles in maintaining the integrity and homeostasis of stomach mucosal epithelial cells. In this study, 47 paired samples that were grouped according to the types of gastric cancer and the clinical characteristics of the patients, including gender and average of age. They were investigated with gene expression analysis and mutation screening by monitoring RT-PCR, SSCP and nucleotide sequencing techniques. Both GKN1 and GKN2 genes were observed significantly reduced found by (Wilcoxon signed rank test; p<0.05). As a result of gene screening, no mutation (no different genotype) was detected. It is considered that gene mutations are not the cause of gastrokines inactivation. In conclusion, the mRNA expression level of GKN1 and GKN2 genes statistically was decreased regardless the gender, age, or cancer type of patients. Reduced of gastrokine genes seem to occur at the initial steps of gastric cancer development.

Keywords: Diagnostic biomarker, gastric cancer, nucleotide sequencing, semi-quantitative RT-PCR.

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Authors: Faris Tarlochan, Siva Mahesh Tangutooru

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Lateral Geniculate Nucleus (LGN) is the relay center in the visual pathway as it receives most of the input information from retinal ganglion cells (RGC) and sends to visual cortex. Low threshold calcium currents (IT) at the membrane are the unique indicator to characterize this firing functionality of the LGN neurons gained by the RGC input. According to the LGN functional requirements such as functional mapping of RGC to LGN, the morphologies of the LGN neurons were developed. During the neurological disorders like glaucoma, the mapping between RGC and LGN is disconnected and hence stimulating LGN electrically using deep brain electrodes can restore the functionalities of LGN. A computational model was developed for simulating the LGN neurons with three predominant morphologies each representing different functional mapping of RGC to LGN. The firings of action potentials at LGN neuron due to IT were characterized by varying the stimulation parameters, morphological parameters and orientation. A wide range of stimulation parameters (stimulus amplitude, duration and frequency) represents the various strengths of the electrical stimulation with different morphological parameters (soma size, dendrites size and structure). The orientation (0-1800) of LGN neuron with respect to the stimulating electrode represents the angle at which the extracellular deep brain stimulation towards LGN neuron is performed. A reduced dendrite structure was used in the model using Bush–Sejnowski algorithm to decrease the computational time while conserving its input resistance and total surface area. The major finding is that an input potential of 0.4 V is required to produce the action potential in the LGN neuron which is placed at 100 μm distance from the electrode. From this study, it can be concluded that the neuroprostheses under design would need to consider the capability of inducing at least 0.4V to produce action potentials in LGN.

Keywords: Lateral geniculate nucleus, visual cortex, finite element, glaucoma, neuroprostheses.

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: Clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula.

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Authors: Obinna K. Ihesiulor, Krishna Shankar, Paul Smith, Alan Fien

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Excessive fretting wear at the taper-trunnion junction (trunnionosis) apparently contributes to the high failure rates of hip implants. Implant wear and corrosion lead to the release of metal particulate debris and subsequent release of metal ions at the tapertrunnion surface. This results in a type of metal poisoning referred to as metallosis. The consequences of metal poisoning include; osteolysis (bone loss), osteoarthritis (pain), aseptic loosening of the prosthesis and revision surgery. Follow up after revision surgery, metal debris particles are commonly found in numerous locations. Background: A stable connection between the femoral ball head (taper) and stem (trunnion) is necessary to prevent relative motions and corrosion at the taper junction. Hence, the importance of component assembly cannot be over-emphasized. Therefore, the aim of this study is to determine the influence of head-stem junction assembly by press fitting and the subsequent disengagement/disassembly on the connection strength between the taper ball head and stem. Methods: CoCr femoral heads were assembled with High stainless hydrogen steel stem (trunnion) by Push-in i.e. press fit; and disengaged by pull-out test. The strength and stability of the two connections were evaluated by measuring the head pull-out forces according to ISO 7206-10 standards. Findings: The head-stem junction strength linearly increases with assembly forces.

Keywords: Wear, modular hip prosthesis, taper head-stem, force assembly, force disassembly.

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Authors: Hye-Young Shin, Chan Kee Park

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Background: To compare the thinning patterns of the ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) as measured using Cirrus high-definition optical coherence tomography (HD-OCT) in patients with visual field (VF) defects that respect the vertical meridian. Methods: Twenty eyes of eleven patients with VF defects that respect the vertical meridian were enrolled retrospectively. The thicknesses of the macular GCIPL and pRNFL were measured using Cirrus HD-OCT. The 5% and 1% thinning area index (TAI) was calculated as the proportion of abnormally thin sectors at the 5% and 1% probability level within the area corresponding to the affected VF. The 5% and 1% TAI were compared between the GCIPL and pRNFL measurements. Results: The color-coded GCIPL deviation map showed a characteristic vertical thinning pattern of the GCIPL, which is also seen in the VF of patients with brain lesions. The 5% and 1% TAI were significantly higher in the GCIPL measurements than in the pRNFL measurements (all P < 0.01). Conclusions: Macular GCIPL analysis clearly visualized a characteristic topographic pattern of retinal ganglion cell (RGC) loss in patients with VF defects that respect the vertical meridian, unlike pRNFL measurements. Macular GCIPL measurements provide more valuable information than pRNFL measurements for detecting the loss of RGCs in patients with retrograde degeneration of the optic nerve fibers.

Keywords: Brain lesion, Macular ganglion cell-Inner plexiform layer, Spectral-domain optical coherence tomography.

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Authors: Lise P. Labéjof, Krisnayne S. Ribeiro, Jackson A. Santos, Nicolle P. dos Santos

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An unrecorded experiment of use of the smartphone as a tool for practical classes of histology is presented in this paper. Behavior and learning of students of science courses at the University were analyzed and compared as well as the mode of teaching of this discipline and the appreciation of the students, using either digital photographs taken by phone or drawings for record microscopic observations, analyze and interpret histological sections of human or animal tissues.

Keywords: Cell phone, digital micrographs, learning of sciences, teaching practices.

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people as shown in the Thompson Cortisol Hypothesis. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and poststimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: Cortisol, Electromyography, Neurology, Yawning.

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Authors: Rupinder Bakshi, Geeta Walia, Anita Gupta

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Urinary Tract Infections are considered as one of the most common bacterial infections with an estimated annual global incidence of 150 million. Antimicrobial drug resistance is one of the major threats due to wide spread usage of uncontrolled antibiotics. In this study, a total number of 9149 urine samples were collected from R.H Patiala and processed in the Department of Microbiology G. M. C Patiala (January 2013 to December 2013). Urine samples were inoculated on MacConkey’s and blood agar plates and incubated at 370C for 24 hrs. The organisms were identified by colony characters, Gram’s staining, and biochemical reactions. Antimicrobial susceptibility of the isolates was determined against various antimicrobial agents (Hi – Media Mumbai India) by Kirby Bauer DISK diffusion method on Muller Hinton agar plates. Maximum patients were in the age group of 21-30 yrs followed by 31-40 yrs. Males (34%) are less prone to urinary tract infections than females (66%). Culture was positive in 25% of the samples. Escherichia coli was the most common isolate 60.3% followed by Klebsiella pneumoniae 13.5%, Proteus spp. 9% and Staphylococcus aureus 7.6%. Most of the urinary isolates were sensitive to, carbepenems, Aztreonam, Amikacin, and Piperacillin + Tazobactum. All the isolates showed a good sensitivity towards Nitrofurantoin (82%). ESBL production was found to be 70.6% in Escherichia coli and 29.4% in Klebsiella pneumonia. Susceptibility of ESBL producers to Imipenem, Nitrofurantoin and Amikacin were found to be 100%, 76%, and 75% respectively. Uropathogens are increasingly showing resistance to many antibiotics making empiric management of outpatient UTIs challenging. Ampicillin, Cotrimoxazole and Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin could be used in lower urinary tract infection. Knowledge of uropathogens and their antimicrobial susceptibility pattern in a geographical region will help in appropriate and judicious antibiotic usage in a health care setup.

Keywords: Urinary Tract Infection, UTI, antibiotic susceptibility pattern, ESBL.

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Authors: Abeer A. Abdelhamed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common microvascular complications of type 2 diabetes. Loss of sensation is thought to contribute to a lack of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low-level laser (LLL) and monochromatic near-infrared photo energy (MIRE) on pain, cutaneous sensation, static stability, and index of lower limb blood flow in diabetic patients with peripheral neuropathy. Methods: Forty diabetic patients with peripheral neuropathy were recruited for participation in this study. They were divided into two groups: The MIRE group, which contained 20 patients, and the LLL group, which contained 20 patients. All patients who participated in the study had been subjected to various physical assessment procedures, including pain, cutaneous sensation, Doppler flow meter, and static stability assessments. The baseline measurements were followed by treatment sessions that were conducted twice a week for six successive weeks. Results: The statistical analysis of the data revealed significant improvement of pain in both groups, with significant improvement in cutaneous sensation and static balance in the MIRE group compared to the LLL group; on the other hand, the results showed no significant differences in lower limb blood flow between the groups. Conclusion: LLL and MIRE can improve painful symptoms in patients with diabetic neuropathy. On the other hand, MIRE is also useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: Diabetic neuropathy, Doppler flow meter, –Lowlevel laser, Monochromatic near-infrared photo energy.

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Authors: Sajjad Seifi Mofarah, S. K. Sadrnezhaad, Shokooh Moghadam, Javad Tavakoli

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In recent years a new method of combination treatment for cancer has been developed and studied that has led to significant advancements in the field of cancer therapy. Hyperthermia is a traditional therapy that, along with a creation of a medically approved level of heat with the help of an alternating magnetic AC current, results in the destruction of cancer cells by heat. This paper gives details regarding the production of the spherical nanocomposite PVA/γ-Fe2O3 in order to be used for medical purposes such as tumor treatment by hyperthermia. To reach a suitable and evenly distributed temperature, the nanocomposite with core-shell morphology and spherical form within a 100 to 200 nanometer size was created using phase separation emulsion, in which the magnetic nano-particles γ- Fe2O3 with an average particle size of 20 nano-meters and with different percentages of 0.2, 0.4, 0.5 and 0.6 were covered by polyvinyl alcohol. The main concern in hyperthermia and heat treatment is achieving desirable specific absorption rate (SAR) and one of the most critical factors in SAR is particle size. In this project all attempts has been done to reach minimal size and consequently maximum SAR. The morphological analysis of the spherical structure of the nanocomposite PVA/γ-Fe2O3 was achieved by SEM analyses and the study of the chemical bonds created was made possible by FTIR analysis. To investigate the manner of magnetic nanocomposite particle size distribution a DLS experiment was conducted. Moreover, to determine the magnetic behavior of the γ- Fe2O3 particle and the nanocomposite PVA/γ-Fe2O3 in different concentrations a VSM test was conducted. To sum up, creating magnetic nanocomposites with a spherical morphology that would be employed for drug loading opens doors to new approaches in developing nanocomposites that provide efficient heat and a controlled release of drug simultaneously inside the magnetic field, which are among their positive characteristics that could significantly improve the recovery process in patients.

Keywords: Nanocomposite, hyperthermia, cancer therapy, drug release.

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Authors: Sanchita B. Sarma, M. P. Nath

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Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing caesarean section. Sixty women with mild preeclampsia undergoing elective caesarean section were included in a prospective, double blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg) (group M) with 0.15ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anaesthesia and postoperative analgesic requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher’s exact tests and Independent Student’s t-test where appropriate. The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anaesthesia (246 vs. 284) and motor block (186.3 vs. 210) were significantly longer in the magnesium group. Total analgesic top up requirement was less in group M. Hemodynamic parameters were similar in both the groups. Intrathecal magnesium caused minimal side effects. Since Fentanyl and other opioid congeners are not available throughout the country easily, magnesium with its easy availability and less side effect profile can be a cost effective alternative to fentanyl in managing pregnancy induced hypertension (PIH) patients given along with Bupivacaine intrathecally in caesarean section.

Keywords: Analgesia, magnesium, preeclampsia, spinal anaesthesia.

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Authors: Hiroaki Hirose, Hiroshi Ikeda, Isao Takeda

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The Japanese version of the SF-36 has been employed to assess individuals’ health-related QOL (HRQOL). This study aimed to clarify the HRQOL of motorists with a spinal cord injury, in order to compare these individuals' SF-36 scores and national standard values. A total of 100 motorists with a spinal cord injury participated in this study. Participants’ HRQOL was evaluated using the Japanese version of the SF-36 (second edition). The score for each subscale was standardized based on data on the Japanese population. The average scores for NPF, NRP, NBP, NGH, NVT, NSF, NRE, and NMH were 10.9, 41.8, 45.9, 47.1, 46.1, 46.7, 46.0, and 47.4 points, respectively. Subjects showed significantly lower scores for NPF and NRP compared with national standard values, which were both ≤ 45.0 points, but relatively normal scores for the other items: NBP, NGH, NVT, NSF, NRE and NMH (> 45.0 points). The average scores for PCS, MCS and RCS were 21.9, 56.0, and 50.0 points, respectively. Subjects showed a significantly lower PCS score (≤ 20.0 points); however, the MCS score was higher (> 55.0 points) along with a relatively normal RCS score in these individuals (= 50.0 points).

Keywords: Health-related QOL (HRQOL), SF-36, motorist, spinal cord injury, Japan.

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Authors: L. Dixon, D. Gavani

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Objective: Sharing devastating news with patients is often considered the most difficult task of doctors. This study aimed to explore patients’ perceptions of receiving bad news including which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the SPIKES model for breaking bad new. 20 patients receiving treatment for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised their consultation. ‘Poor’ was more commonly rated by women and participants aged 45-64. The main differences between the ‘excellent’ and ‘poor’ consultations include the doctor’s sensitivity and checking the patients’ understanding. Only 35% of patients were asked their existing knowledge and 85% of consultations failed to discuss the impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing literature. The commended aspects include consultation set-up and information given. Areas patients felt needed improvement include doctors determining the patient’s existing knowledge and checking new information has been understood. Doctors should also explore how the diagnosis will affect the patient’s life. With a poorer prognosis, doctors should work on conveying appropriate hope. The study was limited by a small sample size and potential recall bias.

Keywords: Communication, diagnosis, hematology, patients.

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Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

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Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, however a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures, in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: Trouble prevention, knowledge structure, structured knowledge, reusable knowledge.

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Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

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Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: Chronic inflammatory diseases, intravenous infusion, mesenchymal stem cells (MSCs), umbilical cord blood.

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Authors: Enas Elsayed Abutaleb, Mohamed Taher Eldesoky, Shahenda Abd El Rasol

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Background: Muscle Energy Techniques (MET) have been widely used by manual therapists over the past years, but still limited research validated its use and there was limited evidence to substantiate the theories used to explain its effects. Objective: To investigate the effect of Muscle Energy Technique (MET) on anterior pelvic tilt in patients with lumbar spondylosis. Design: Randomized controlled trial. Subjects: Thirty patients with anterior pelvic tilt from both sexes were involved, aged between 35 to 50 years old and they were divided into MET and control groups with 15 patients in each. Methods: All patients received 3sessions/week for 4 weeks where the study group received MET, Ultrasound and Infrared, and the control group received U.S and I.R only. Pelvic angle was measured by palpation meter, pain severity by the visual analogue scale and functional disabilities by the Oswestry disability index. Results: Both groups showed significant improvement in all measured variables. The MET group was significantly better than the control group in pelvic angle, pain severity, and functional disability as p-value were (0.001, 0.0001, 0.0001) respectively. Conclusion and implication: the study group fulfilled greater improvement in all measured variables than the control group which implies that application of MET in combination with U.S and I.R were more effective in improving pelvic tilting angle, pain severity and functional disabilities than using electrotherapy only.

Keywords: Anterior pelvic tilt, lumbar spondylosis, muscle energy technique exercise, palpation meter.

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Authors: Marina Nosik, Irina Rymanova, Sergei Sevostyanihin, Natalya Sergeeva, Alexander Sobkin

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This paper presents results of the survey regarding the awareness about HIV/AIDS among HIV-infected individuals. A questionnaire covering various aspects of HIV-infection was conducted among 110 HIV-infected individuals who attended the G.A. Zaharyan Moscow Tuberculosis Clinic, Department for treatment of TB patients with HIV. The questionnaire included questions about modes of HIV transmission and preventive measures against HIV/AIDS, as well as questions about age, gender, education and employment status. The survey revealed that the respondents in the whole had a good knowledge regarding modes of HIV transmission and preventive measures against HIV/AIDS: about 83,6% male respondents and 85,7% female respondents gave an accurate answers regarding the HIV-infection. However, the overwhelming majority of the study participants, that is, 88,5% men and 98% women, was quite ignorant about the risk of acquiring HIV through saliva and toothbrush of HIV-infected individual. Though that risk is rather insignificant, it is still biologically possible. And this gap in knowledge needs to be filled. As the study showed another point of concern was the fact, that despite the knowledge of HIV transmission risk through unprotected sex about 40% percent of HIVpositive men and 25% of HIV-positive women did not insist on using condoms with their sexual partners. These findings indicate that there are still some aspects about HIV-infection which needed to be clarified and explained through more detailed and specific educational programs.

Keywords: AIDS, HIV transmission risks, HIV misconceptions, risk behavior.

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Authors: Malinee Pongsavee

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Sodium formate is the chemical substance used for food additive. Catalase is the important antioxidative enzyme in protecting the cell from oxidative damage by reactive oxygen species (ROS). The resultant level of oxidative stress in sodium formatetreated lymphocytes was investigated. The sodium formate concentrations of 0.05, 0.1, 0.2, 0.4 and 0.6 mg/mL were treated in human lymphocytes for 12 hours. After 12 treated hours, catalase activity change was measured in sodium formate-treated lymphocytes. The results showed that the sodium formate concentrations of 0.4 and 0.6 mg/mL significantly decreased catalase activities in lymphocytes (P < 0.05). The change of catalase activity in sodium formate-treated lymphocytes may be the oxidative damage marker for detect sodium formate exposure in human.

Keywords: Sodium formate, catalase activity, oxidative damage marker, toxicity.

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Authors: Amir Ghasemlouei, Alireza Khalaj

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Breast cancer is in the top rate of cancer. We analyzed the prevalence of obesity and its association with breast cancer and finally we reviewed 25 article that 320 patient and 320 control which enrolled to our study. The distribution of breast cancer patients and controls with respect to their anthropometric indices in patients with higher weight, which was statistically significant (60.2 ± 10.2 kg) compared with control group (56.1 ± 11.3 kg). The body mass index of patients was (26.06+/-3.42) and significantly higher than the control group (24.1+/-1.7). Obesity leads to increased levels of adipose tissue in the body that can be stored toxins and carcinogens to produce a continuous supply. Due to the high level of fat and the role of estrogen in a woman which is endogenous estrogen of the tumor and regulates the activities of growth steroids, obesity has confirmed as a risk factor for breast cancer. Our study and other studies have shown that obesity is a risk factor for breast cancer. And it can be prevented with a weight loss intervention for breast cancer in the future.

Keywords: Breast cancer, review study, obesity, overweight.

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Authors: Rauno Pääkkönen, Fabriziomaria Gobba, Leena Korpinen

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The objective of the study is to assess the implementation of LED lighting into forest machine work in the dark. In addition, the paper includes a wide variety of important and relevant safety and health parameters. In modern, computerized work in the cab of forest machines, artificial illumination is a demanding task when performing duties, such as the visual inspections of wood and computer calculations. We interviewed entrepreneurs and gathered the following as the most pertinent themes: (1) safety, (2) practical problems, and (3) work with LED lighting. The most important comments were in regards to the practical problems of LED lighting. We found indications of technical problems in implementing LED lighting, like snow and dirt on the surfaces of lamps that dim the emission of light. Moreover, service work in the dark forest is dangerous and increases the risks of on-site accidents. We also concluded that the amount of blue light to the eyes should be assessed, especially, when the drivers are working in a semi-dark cab.

Keywords: Forest machines, health, LED, safety.

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Authors: Sanaa Ali Ahmed Alrashid

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The present study aimed to investigate the effect of synchronous music in Gymnastics' motor skill performance among undergraduate female students in physical education college at Basra University. The researcher used experimental design. 20 female students of physical education divided equally into two groups, (10) experimental group with music, (10) control group without music. All participants complete 6 weeks in testing. Data analysis based on T-test shows significant difference at (α = 0.05) in all skills level between experimental and control groups in favor of experimental group. Results of this study contribute to developing the role of synchronous music in improving gymnastic skills performance.

Keywords: Performance, motor skill, music, synchronous.

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Authors: Mohamed M. Ragab, Neveen A. Abdel Raoof, Reham H. Diab

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Background: Delayed onset muscle soreness (DOMS) is the most common symptom when ordinary individuals and athletes are exposed to unaccustomed physical activity, especially eccentric contraction which impairs athletic performance, ordinary people work ability and physical functioning. Multitudes of methods have been investigated to reduce DOMS. One of the valuable methods to control DOMS is repeated bout effect (RBE) as a prophylactic method. Purpose: To compare the repeated bout effect of submaximal eccentric with maximal isometric contraction on induced DOMS. Methods: Sixty normal male volunteers were assigned randomly into three equal groups: Group A (first study group): 20 subjects received submaximal eccentric contraction on non-dominant elbow flexors as a prophylactic exercise. Group B (second study group): 20 subjects received maximal isometric contraction on nondominant elbow flexors as a prophylactic exercise. Group C (control group): 20 subjects did not receive any prophylactic exercises. Maximal isometric peak torque of elbow flexors and patient related elbow evaluation (PREE) scale were measured for each subject 3 times before, immediately after, and 48 hours after induction of DOMS. Results: Post-hoc test for maximal isometric peak torque and PREE scale immediately and 48 hours after induction of DOMS revealed that group (A) and group (B) resulted in significant decrease in maximal isometric strength loss and elbow pain and disability rather than control group (C), but submaximal eccentric group (A) was more effective than maximal isometric group (B) as it showed more rapid recovery of functional strength and less degrees of elbow pain and disability. Conclusion: Both submaximal eccentric contraction and maximal isometric contraction were effective in prevention of DOMS but submaximal eccentric contraction produced a greater protective effect against muscle damage induced by maximal eccentric exercise performed 2 days later.

Keywords: Delayed onset muscle soreness, maximal isometric peak torque, patient related elbow evaluation scale, repeated bout effect.

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Authors: Maya S. Rathod, Bahadur Singh Hathan

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Mustard leaves are rich in folates, vitamin A, K and B-complex. Mustard greens are low in calories and fats and rich in dietary fiber. They are rich in potassium, manganese, iron, copper, calcium, magnesium and low in sodium. It is very rich in antioxidants and Phytonutrients. For the optimization of process variables (moisture content and mustard leave powder), the experiments were conducted according to central composite Face Centered Composite design of RSM. The mustard leaves powder was replaced with composite flour (a combination of rice, chickpea and corn in the ratio of 70:15:15). The extrudate was extruded in a twin screw extruder at a barrel temperature of 120°C. The independent variables were mustard leaves powder (2-10 %) and moisture content (12-20 %). Responses analyzed were bulk density, water solubility index, water absorption index, lateral expansion, antioxidant activity, total phenolic content, and overall acceptability. The optimum conditions obtained were 7.19 g mustard leaves powder in 100g premix having 16.8% moisture content (w.b).

Keywords: Extrusion, mustard leaves powder, optimization, response surface methodology.

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Authors: S. M. M. Syairah, M. H. Rajikin, A-R. Sharaniza

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Several embryonic cellular mechanism including cell cycle, growth and apoptosis are regulated by phosphatidylinositol-3- kinase (PI3K)/Akt signaling pathway. The goal of present study is to determine the effects of annatto (Bixa orellana)-derived δ-tocotrienol (δ-TCT) on the regulations of PI3K/Akt genes in murine morula. Twenty four 6-8 week old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) received tocopherol stripped corn oil, G2 was given 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers), G3 was given 60 mg/kg/day of pure δ-TCT (>98% purity) and G4 received 60 mg/kg/day α-TOC. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. About fifty morulas from each group were used in the gene expression analyses using Affymetrix QuantiGene Plex 2.0 Assay. Present data showed a significant increase (p<0.05) in the average number (mean + SEM) of morula produced in G2 (27.32 + 0.23), G3 (25.42 + 0.21) and G4 (27.21 + 0.34) compared to control group (G1 – 14.61 + 0.25). This is parallel with the high expression of PDK1 gene with increase of 2.75-fold (G2), 3.07-fold (G3) and 3.59-fold (G4) compared to G1. From the present data, it can be concluded that supplementation with δ-TCT(s) and α-TOC induced high expression of PDK1 in G2-G4 which enhanced the PI3K/Akt signaling activity, resulting in the increased number of morula.

Keywords: Embryonic development, morula, nicotine, vitamin E.

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