World Academy of Science, Engineering and Technology

Authors: A. Yavar, S. Sarmani, K. S. Khoo

Abstract:

The analysis of trace elements in human hair provides crucial insights into an individual's nutritional status and environmental exposure. This research aimed to examine the levels of toxic and essential elements in the scalp hair of school children aged 12-17 from three villages (Anglong Romiot (AR), Svay Romiot (SR), and Kampong Kong (KK)) in Cambodia's Kandal province, a region where residents are especially vulnerable to toxic elements, notably arsenic (As), due to their dietary habits, lifestyle, and environmental conditions. The scalp hair samples were analyzed using the k0-Instrumental Neutron Activation method (k0-INAA), with a six-hour irradiation period in the Malaysian Nuclear Agency (MNA) research reactor followed by High Purity Germanium (HPGe) detector use to identify the gamma peaks of radionuclides. The analysis identified 31 elements in the human hair from the study area, including As, Au, Br, Ca, Ce, Co, Dy, Eu-152m, Hg-197, Hg-203, Ho, Ir, K, La, Lu, Mn, Na, Pa, Pt-195m, Pt-197, Sb, Sc-46, Sc-47, Sm, Sn-117m, W-181, W-187, Yb-169, Yb-175, Zn, and Zn-69m. The accuracy of the method was verified through the analysis of ERM-DB001-human hair as a Certified Reference Material (CRM), with the results demonstrating consistency with the certified values. Given the prevalent arsenic pollution in the research area, the study also examined the relationship between the concentration of As and other elements using Pearson's correlation test. The outcomes offer a comprehensive resource for future investigations into toxic and essential element presence in the region. In the main body of the paper, a more extensive discussion on the implications of arsenic pollution and the correlations observed is provided to enhance understanding and inform future research directions.

Keywords: Human scalp hair, toxic and essential elements, Kandal Province, Cambodia, k0-Instrumental Neutron Activation Method.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

The number of indices developed for the evaluation of obesity and metabolic syndrome (MetS) both in adults and pediatric population is ever increasing. These indices can be weight-dependent or weight–independent. Some are extremely sophisticated equations and their clinical utility is questionable in routine clinical practice. The aim of this study was to compare presently available obesity indices and find the most practical one. Their associations with MetS components were also investigated to determine their capacities in differential diagnosis of morbid obesity with and without MetS. Children with normal body mass index (N-BMI) and morbid obesity were recruited for this study. Three groups were constituted. Age- and sex-dependent BMI percentiles for morbid obese (MO) children were above 99 according to World Health Organization tables. Of them, those with MetS findings were evaluated as MetS group. Children, whose values were between 85 and 15, were included in N-BMI group. The study protocol was approved by the Ethics Committee of Tekirdag Namik Kemal University, Faculty of Medicine. Parents filled out informed consent forms to participate in the study. Anthropometric measurements and blood pressure values were recorded. BMI, hip index (HI), conicity index (CI), triponderal mass index (TPMI), body adiposity index (BAI), body shape index (BSI), body roundness index (BRI), abdominal volume index (AVI), waist-to-hip ratio (WHR) and [waist circumference (WC) + hip circumference (HC)]/2 were the formulas examined in this study. Routine biochemical tests including fasting blood glucose (FBG), insulin (INS), blood lipids were performed. Statistical program SPSS was used for the evaluation of study data; p < 0.05 was accepted as the statistical significance degree. HI did not differ among the groups. A statistically significant difference was noted between N-BMI and MetS groups in terms of ABSI. All the other indices were capable of making discrimination between N-BMI-MO, N-BMI- MetS and MO-MetS groups. No correlation was found between FBG and any obesity indices in any groups. The same was true for INS in N-BMI group. Insulin was correlated with BAI, TPMI, CI, BRI, AVI and (WC+HC)/2 in MO group without MetS findings. In the MetS group, the only index, which was correlated with INS, was (WC+HC)/2. These findings have pointed out that complicated formulas may not be required for the evaluation of the alterations among N-BMI and various obesity groups including MetS. The simple easily computable weight-independent index, (WC+HC)/2, was unique, because it was the only index, which exhibits a valuable association with INS in MetS group. It did not exhibit any correlation with other obesity indices showing associations with INS in MO group. It was concluded that (WC+HC)/2 was pretty valuable practicable index for the discrimination of MO children with and without MetS findings.

Keywords: Fasting blood glucose, insulin, metabolic syndrome, obesity indices.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Metabolic syndrome (MetS) is a severe health problem caused by morbid obesity, the severest form of obesity. The components of MetS are rather stable in adults. However, the diagnosis of MetS in morbid obese (MO) children still constitutes a matter of discussion. The aim of this study was to develop a formula, which facilitated the diagnosis of MetS in MO children and was capable of discriminating MO children with and without MetS findings. The study population comprised MO children. Age and sex-dependent body mass index (BMI) percentiles of the children were above 99. Increased blood pressure, elevated fasting blood glucose (FBG), elevated triglycerides (TRG) and/or decreased high density lipoprotein cholesterol (HDL-C) in addition to central obesity were listed as MetS components for each child. Two groups were constituted. In the first group, there were 42 MO children without MetS components. Second group was composed of 44 MO children with at least two MetS components. Anthropometric measurements including weight, height, waist and hip circumferences were performed during physical examination. BMI and homeostatic model assessment of insulin resistance (HOMA-IR) values were calculated. Informed consent forms were obtained from the parents of the children. Institutional Non-Interventional Clinical Studies Ethics Committee approved the study design. Routine biochemical analyses including FBG, insulin (INS), TRG, HDL-C were performed. The performance and the clinical utility of Diagnostic Obesity Notation Model Assessment Metabolic Syndrome Index (DONMA MetS index) [(INS/FBG)/(HDL-C/TRG)*100] was tested. Appropriate statistical tests were applied to the study data. p value smaller than 0.05 was defined as significant. MetS index values were 41.6 ± 5.1 in MO group and 104.4 ± 12.8 in MetS group. Corresponding values for HDL-C values were 54.5 ± 13.2 mg/dl and 44.2 ± 11.5 mg/dl. There was a statistically significant difference between the groups (p < 0.001). Upon evaluation of the correlations between MetS index and HDL-C values, a much stronger negative correlation was found in MetS group (r = -0.515; p = 0.001) in comparison with the correlation detected in MO group (r = -0.371; p = 0.016). From these findings, it was concluded that the statistical significance degree of the difference between MO and MetS groups was highly acceptable for this recently introduced MetS index. This was due to the involvement of all of the biochemically defined MetS components into the index. This is particularly important because each of these four parameters used in the formula is a cardiac risk factor. Aside from discriminating MO children with and without MetS findings, MetS index introduced in this study is important from the cardiovascular risk point of view in MetS group of children.

Keywords: Fasting blood glucose, high density lipoprotein cholesterol, insulin, metabolic syndrome, morbid obesity, triglycerides.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity (MO) is the most severe clinical form of obesity and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate MO children with MetS (MOMetS+) from MO children without MetS (MOMetS-). Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. The aim of this study was to find out the clinical availability of (waist circumference + hip circumference)/2 ((WC+HC)/2) for the differential diagnosis of MOMetS+ and MOMetS- and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. 45 MOMetS+ and 45 MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Clinical Studies Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. BMI, waist-to-hip circumference (WHR), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data were analyzed statistically and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for WHR, TLFR, TAFR, D2I and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r = 0.961; p < 0.001) and MOMetS+ (r = 0.936; p < 0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r = 0.726; p < 0.001 in MOMetS- group and r = 0.932; p < 0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as WHR, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: Hip circumference, metabolic syndrome, morbid obesity, waist circumference.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Cardiovascular (CV) pathology is one of the expected consequences of excessive fat gain. The role of zinc (Zn) in thyroid hormone metabolism (THM) is a matter of debate. Both thyroid stimulating hormone (TSH) and Zn levels are subject to variation in obese individuals. Zn participates in THM. It is closely related to TSH. Since thyroid hormones are required for Zn absorption, hypothyroidism can lead to Zn deficiency and vice versa. Zn exhibits protective effects on CV health and it is inversely correlated with CV markers in childhood obesity. The association between subclinical hypothyroidism (SCHT) and metabolic disorders is under investigation due to its clinical importance. SCHT is defined as the elevated serum TSH levels in the presence of normal free thyroxin (T4) concentrations. The aim of this study is to evaluate the associations between TSH levels and Zn concentrations in SCHT cases detected in morbid obese (MO) children with and without metabolic syndrome (MetS) [(MOMetS+ and MOMetS-)], respectively. 42 children were present in each study group. Informed consent forms were obtained. Tekrdag Namik Kemal University Faculty of Medicine Non-Interventional Clinical Investigations Ethical Committee approved the study protocol. World Health Organization criteria were used for obesity classification. Children with age and sex-dependent body mass index percentile values above 99 were defined as MO. Children exhibiting at least two of MetS criteria were included in MOMetS+ group. Elevated fasting blood glucose, elevated triglycerides (TRG)/decreased high density lipoprotein-cholesterol (HDL-C) concentrations, elevated blood pressure values in addition to central obesity were listed as MetS criteria. Anthropometric measures were recorded. Routine biochemical analyses were performed. In MOMetS- group 13, in MOMetS+ group 15 children were with SCHT. Statistical analyses were performed. p < 0.05 was accepted as statistically significant. In MOMetS- and MOMetS+ groups, TSH levels were 4.1 ± 2.9 mU/L and 4.6 ± 3.1 mU/L, respectively. Corresponding values for SCHT cases were 7.3 ± 3.1 mU/L and 8.0 ± 2.7 mU/L. Free T4 levels were within normal limits. Zn concentrations were negatively correlated with TSH levels in both groups. Significant negative correlation calculated in MOMetS+ group (r = -0.909; p < 0.001) was much stronger than that found in MOMetS- group (r = -0.706; p < 0.05). This strong correlation (r = -0.909; p < 0.001) calculated for cases with SCHT in MOMetS+ group was much lower in the same group (r = -0.793; p < 0.001) when all cases were considered. In conclusion, the presence of strong correlations between TSH and Zn in SCHT in both MOMetS- and MOMetS+ groups have pointed out that MO children were under the threat of CV pathologies. The detection of the much stronger correlation in MOMetS+ group in comparison with the correlation found in MOMetS- group was the indicator of greater CV risk due to the presence of MetS. In MOMetS+ group, correlation in SCHT cases found higher than correlation calculated for all cases confirmed much higher CV risk due to the contribution of SCHT.

Keywords: Cardiovascular risk, child morbid obesity, subclinical hypothyroidism, zinc.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. However, to the best of our knowledge, their status in children is not clear. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of 68 children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, 35 children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised 33 OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p < 0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r = 0.336 and p = 0.065 in the N-BMI group. On the other hand, they were r = 0.707 and p = 0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p < 0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. TRG are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. TRG are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs. FIB-4 correlations in N-BMI and OB groups (no correlation vs. high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, FIB-4, obesity, triglycerides.

Authors: N. Tsvetkova, R. Harizanov A. Ivanova, I. Rainova, N. Yancheva-Petrova, D. Strashimirov, R. Enikova, M. Videnova, E. Kaneva, I. Kaftandjiev, V. Levterova, I. Simeonovski, N. Yanev, G. Hinkov

Abstract:

The Pneumocystis jirovecii (P. jirovecii) and protozoan of the genera Acanthamoeba, Cryptosporidium, and Toxoplasma gondii are opportunistic pathogens that can cause life-threatening infections in immunocompromised patients. Aim of the study was to evaluate the coinfection rate with opportunistic protozoal agents among Bulgarian patients diagnosed with P. jirovecii pneumonia. 38 pulmonary samples were collected from 38 patients (28 HIV-infected) with P. jirovecii infection. P. jirovecii DNA was detected by real-time PCR targeting the large mitochondrial subunit ribosomal RNA gene. Acanthamoeba was determined by genus-specific conventional PCR assay. Real-time PCR for the detection of a Toxoplasma gondii and Cryptosporidium DNA fragment was used. Pneumocystis DNA was detected in all 38 specimens; 28 (73.7%) were from HIV-infected patients. Three (10,7%) of them were coinfected with T. gondii and 1 (3.6%) with Cryptosporidium. In the group of non-HIV-infected (n = 10), Cryptosporidium DNA was detected in an infant (10%). Acanthamoeba DNA was not found in the tested samples. The current study showed a relatively low rate of coinfections of Cryptosporidium spp./T. gondii and P. jirovecii in the Bulgarian patients studied.

Keywords: Coinfection, opportunistic protozoal agents, Pneumocystis jirovecii, pulmonary infections.

Authors: Domenica Tambasco, Riina Bray

Abstract:

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in various musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recognized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two physiotherapists knowledgeable in this physical treatment modality. The main outcome measure was an overall impact score for function and symptoms based on the validated assessment tool for fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre- and post-intervention. Both descriptive and analytical methods were applied and reported. We analyzed results using a paired t-test to determine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Our pilot study showed that SMR appeared to be a safe and effective intervention for our fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an randomized control trial (RCT) are recommended.

Keywords: Fibromyalgia, myofascial release, fibromyalgia impact questionnaire, fibromyalgia assessment status.

Authors: Alena Dadova, Katarina Holla, Anna Cidlinova, Linda Makovicka Osvaldova, Jiri Vala, Samuel Kockar

Abstract:

Occupational health and safety (OHS) is an area in which procedures and applications are constantly evolving and changing through legislation and new directives and guidelines. In this way, the relevant organizations strive to ensure continuous progress and the advantage of up-to-date information to ensure safety and prevent occupational accidents. Three ESENER surveys have been carried out in the European Union, led by the Agency for Safety and Health at Work (EU-OSHA). On the basis of surveys, it was determined how European workplaces manage risks and how they manage the field of safety and health protection at work. Thousands of companies and organizations in the European Union were involved in the surveys. Organizations and businesses were presented with a questionnaire that focused on the following topics: the impact of general risks on the field of OSH and the possibility of their management, psychosocial risks and other factors such as stress, harassment and bullying, and employee participation in OSH procedures. The article is dedicated to the fundamental conclusions from these surveys and their subsequent connection with the strategic intent of the Strategic Framework of European Union for the years 2021-2027. In the conclusion, emerging risks are identified and the EU will soon have to deal with them.

Keywords: ESENER, emerging risks, strategic framework in OSH, EU.

Authors: P. Murphy, D. Vasic, A. W. Gunaratne, T. Tugonon, M. Ison, C. Pagonis, E. T. Sitchon, A. Le Busque, T. J. Borody

Abstract:

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by an alteration in bowel movements. There are three different types of IBS: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). Antimicrobials are increasingly being used as treatment for all types of IBS. Due to this increased use and subsequent success, the gut microbiome as a factor in the etiology of IBS is becoming more apparent. Accepted standard treatment has focused on IBS-C and involves either vancomycin or rifaximin. Here, we report on a cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients were aged between 24-74 years (mean 44 years) and nine were female. At baseline all patients had diarrhea, four with mucus and one with blood. Other reported symptoms include abdominal pain (n = 11) bloating (n = 9), flatulence (n = 7), fatigue (n = 4) and nausea (n = 3). Patient’s treatments were personalized according to their symptom severity and tolerability and were treated with a combination of rifaximin (500-3000 mg/d) and vancomycin (500 mg-1500 mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks. Of all patients, 89% reported improvement of at least 1 symptom, one reported no change and one patient’s symptoms got worse. The success of this combination treatment could be due to the different mechanisms of action undertaken by each medication. Vancomycin works by inhibiting the cell wall of the bacteria and rifaximin by inhibiting protein synthesis. This success in treatment validates the idea that IBS-D may be driven by a bacterial infection of the gastrointestinal microbiome. As IBS-D presents similarly to Clostridium difficile and symptom improvement can occur with the same treatment as Clostridium difficile of rifaximin and vancomycin, there is reason to suggest that the infectious agent could be an unidentified strain of Clostridium. Although these results offer some validity to the theory, more research is required.

Keywords: Clostridium difficile infection, diarrhea predominant irritable bowel syndrome, microbiome, vancomycin/rifaximin combination.

Authors: Alireza Barari, Maryam Firoozi, Maryam Ebrahimzadeh, Romina Roohani Ardeshiri, Maryam Kamarloeei

Abstract:

Background: The purpose of this study was to analyze the effect of six-week aerobic training and taxol consumption on interleukin-8 and Plasminogen Activator Inhibitor-1 (PAI-1) in mice with cervical cancer. Materials and Methods: In this experimental study, 40 female C57 mice with cervical cancer, eight weeks old, were randomly divided into 4 groups including: control, taxol supplement, training, and training-taxol supplement. The implantation of cancerous tumors was performed under the skin at the upper of the pelvis. The program training was included: endurance training for six weeks, 3 sessions per week and 50 minutes per session, at the speed of 14-18 m/s. Taxol supplement at a dose of 60 mg/kg per day was injected intraperitoneally. Data analysis was performed using t-test and one-way ANOVA and if statistically significant, Bonferroni post hoc was used at the significance level p < .05. Results: The results showed that there was a significant difference between the levels of interleukin 8 (P < 0.05, F = 12.25) and the PAI-1 (P < 0.05, P = 0.10737 between the 4 groups. The results of this study showed a significant difference between the control group and the training - complementary group. Six weeks of aerobic training and taxol consumption have a significant effect on the level of PAI-1 and interleukin-8 mice with cervical cancer. Conclusion: Considering the effect of training on these variables, this type of exercise can be used as a complementary therapeutic approach with other therapies for cervical cancer.

Keywords: Cervical cancer, taxol, endurance training, interleukin 8, plasminogen activator inhibitor-1.

Authors: Ilma Robo, Saimir Heta, Edona Hasanaj, Vera Ostreni

Abstract:

The hybrid layer (HL), the way it is created and how it is protected against degradation over time, is the key to the clinical success of a composite restoration. The composite supports the dentinal structure exactly with the realized surface of micro-retention. Thus, this surface is in direct proportion to its size versus the duration of clinical use of composite dental restoration. Micro-retention occurs between dentin or acidified enamel and adhesive resin extensions versus pre-prepared spaces, such as hollow dentinal tubules. The way the adhesive resin binds to the acidified dentinal structure depends on the physical or chemical factors of this interrelationship between two structures with very different characteristics. During the acidification process, a precursor to the placement of the adhesive resin layer, activation of metalloproteinases of dental origin occurs, enzymes which are responsible for the degradation of the HL. These enzymes have expressed activity depending on the presence of Zn2+ or Ca2+ ions. There are several ways to inhibit these enzymes, and consequently, there are several ways to inhibit the degradation process of the HL. The study aim is to evaluate chlorhexidine (CHX) as a solution element, inhibitor of dentin activated metalloproteinases, as a result of the application of acidification. This study aims to look at this solution in advantage or contraindication theories, already published in the literature.

Keywords: Hybrid layer, chlorhexidine, degradation, smear layer.

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

Frozen shoulder (FS) is an insidious, painful condition caused by an inflammatory condition that causes fibrosis of the glenohumeral joint capsule, which causes progressive stiffness and restriction of the active and passive range of motion (ROM) of the shoulder. The studies of FS are still limited. This single-blinded randomized controlled trial involved participants with FS. The study participants were divided into two groups. The Prolotherapy group was the study group, and the Normal Saline (NS) group was the control group. Both groups were given injections at weeks 0, 2, 4, and 6. Matrix Metalloproteinase-1 (MMP-1) and Tissue Inhibitor Metalloproteinase-1 (TIMP-1) were measured at week six and week 12 after the last injection. The Disabilities of The Arm, Shoulder, and Hand (DASH) Score and ROM were measured at weeks 0, 2, 4, and 6 before and after injection and week 12. Comparative analysis was performed using repeated measures Paired T-Test, and data processing to assess correlation was using ANOVA. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolotherapy injection patients in each measurement week (p < 0.05). While the measurement of ROM, each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p < 0.05). Dextrose prolotherapy injection results significantly improved the functional outcome of the shoulder joint and ROM. They did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1, in tissue repair. This study suggests an alternative to injection prolotherapy in FS patients; it has minimal adverse effects and is efficient in time and cost.

Keywords: Frozen Shoulder, ROM, DASH Score, prolotherapy, MMP-1, TIMP-1.

Authors: Kasra Afsahi, Maryam Soheilifar

Abstract:

Cerebrovascular accident (CVA) is a neurological side effect of COVID-19 disease wit high rate in pandemics. Effect of COVID-19 disease on disorder is unclear. In this cohort, patients with COVID-19 disease were assessed. 60 CVA cases were assessed in a referral hospital in 2020. The major factor was mortality and the cases were those with and without death. The groups were compared for all features about mortality in the patients with COVID-19 and CVA. Totally 23 out of 60 cases (38.3%) were expired. In univariate analysis there was significant association for death by ischemic heart disease (P = 0.015), high-severity stroke (P = 0.012), high C-reactive protein (CRP) (P = 0.001), high ESR (P = 0.009), pleural effusion (P = 0.005), pericardial effusion (P = 0.027), cardiomegaly (P = 0.005), ground glass opacity (P = 0.001), and consolidation (P = 0.001). Among these factors, there was significant association only for CRP (P = 0.001) and consolidation (P = 0.003) in multivariate analysis. Mortality in the cases with COVID-19-related CVA is one-third and it has relationship to elevated CRP and finding the consolidation in the computerized tomography scan of the lungs.

Keywords: COVID-19, stroke, prognosis, C-reactive protein, CRP.

Authors: Muhammad Waqar, Touqir Ahmad Afridi, Quratulain Soomro

Abstract:

Radiation is a ghost causing unimaginable physical damage, but its harm is not inevitable. The panic created by previously reported worst-case scenarios i.e., Three Mile Island, Fukushima, Chernobyl, has adversely affected the attitude of radiation workers towards the profession. The psychological effect of radiation-related catastrophes creates an invisible barrier that reduces the efficiency of radiation workers. Careful handling and proper monitoring of radiation decreases the hazards of radiation and proves that the psychological impairment of radiation is myriad fold adverse than its physiological damage. Thermoluminescent Dosimeter (TLD) badges with unique identity numbers were provided to 36 radiation workers for a period of one year (2021). TLDs were read quarterly, and doses were recorded for every radiation worker. Annual doses were recorded and compared with national and international standards. Moreover, the period for which an individual worker is expected to reach one year limit of 20 mSv was also calculated. The highest radiation dose for the radiation worker in 2021 was found at 3.2 mSv, which was 16% of the permissible annual dose limit. The average occupational radiation doses ranged from 1.0 mSv to 3.20 mSv. 64% of the employees did not exceed the 10% of the annual limit, receiving less than 2 mSv. The least time for 20 mSv completion was found 6.25 years for the hot-lab technician. As a whole, the 20 mSv completion period ranged from 6.25 to 20 years. We concluded that the annual professional radiation doses were well within the permissible limits of Pakistan Nuclear Regulatory Authority (PNRA) and International Commission on Radiological Protection (ICRP). The fear of radiation is unnecessary and it creates reluctance towards performing their assigned duties and it is also not favorable for the institute. It must be abolished through education and training sessions.

Keywords: TLD, thermoluminescent dosimeter, psychological impact, radiation dose, annual dose limit, PNRA, ICRP, IAEA.

Authors: M. Umar Farooq, T. Ahmad Afridi, M. Zia-Ul-Islam Arsalan, U. Hussain Haider, S. Ullah

Abstract:

Cancer, a leading fatal disease worldwide, can be treated with various techniques including radiation therapy. It involves the use of ionizing radiation to target cancer cells. On basis of source placement, radiation therapy is of two types i.e., Brachytherapy and External Beam Radiotherapy (EBRT). EBRT has evolved from 2-D conventional therapy to 3-D Conformal radiotherapy (3D-CRT) and then Intensity-Modulated Radiotherapy (IMRT). IMRT improves dose conformity and sparing of organs at risk. Volumetric Modulated Arc Therapy (VMAT) is a modern technique that uses treatment delivery in arcs with rotation of the gantry. In this report, a dosimetry comparison was performed between IMRT and VMAT. This study was conducted in the Radiotherapy Department of the Institute of Nuclear Medicine and Oncology Lahore (INMOL). Ten patients with Prostate Carcinoma were selected for this study to compare the methods. Simulation of these patients was done with help of a CT Simulator. All target volumes and organs were delineated by the oncologists. Then suitable fields/arcs were applied which cover volumes effectively. This was followed by the optimization of plans for both techniques for every patient. Finally, a comparison of evaluating parameters e.g., Conformity Index (CI), Volume Coverage, Homogeneity Index (HI), Organ Doses, and MUs (Monitor Units) was performed. We obtained better results of target conformity indices from VMAT (CI = 1.16) than IMRT (CI = 1.24). VMAT was better in organ sparing too. Also, VMAT shows fewer MUs (733 MUs) as compared to IMRT (2149 MUs). From this study, it is concluded that VMAT is a better treatment technique than IMRT. This technique will enhance treatment efficiency as it takes less time in obtaining the required results. Also, a very less scatter dose will be delivered to the patient.

Keywords: 2-D Conventional Radiotherapy, 3-D Conformal Radiotherapy, Intensity Modulated Radiotherapy, Prostate Carcinoma, Radiotherapy, Volumetric Modulated Arc Therapy.

Authors: Tsvetomira Braynova, Miglena Simonska

Abstract:

The article presents the results of a research of phonological processes in three- and four-year-old children. A test, created for the purpose of the study, was developed and conducted among 120 children. The study included three areas of research - at the level of words (96 words), at the level of sentence repetition (10 sentences) and at the level of generating own speech from a picture (15 pictures). The test also gives us additional information about the articulation errors of the assessed children. The main purpose of the research is to analyze all phonological processes that occur at this age in Bulgarian children and to identify which are typical and atypical for this age. The results show that the most common phonology errors that children make are: sound substitution, elision of sound, metathesis of sound, elision of syllable, elision of consonants clustered in a syllable. Measuring the correlation between average length of repeated speech and average length of generated speech, the analysis does not prove that the more words a child can repeat in part “repeated speech”, the more words they can be expected to generate in part “generating sentence”. The results of this study show that the task of naming a word provides sufficient and representative information to assess the child's phonology.

Keywords: Articulation, phonology, speech, language development.

Authors: A. C. B. C. J. Fernandes, V. C. de Jesus, S. Noruziaan, O. F. G. G. Vilela, K. K. Somarin, R. França, F. H. S. L. Pinheiro

Abstract:

Objective: This in vitro study aimed to evaluate the shear bond strength (SBS) of orthodontic tubes after different enamel pre-treatments. Materials and Methods: A total of 39 crown halves were randomly divided into 3 groups (n = 13). Group I (control group) was exposed to prophy paste (PP), 37% phosphoric acid (PA), and a self-etching primer (SEP). Group II received no prophylaxis, but only PA and SEP. Group III was exposed to PP and SEP. The SBS was used to evaluate the bond strength of the orthodontic tubes one year after bonding. One-way ANOVA and Tukey’s post-hoc test were used to compare SBS values between the three groups. The statistical significance was set to 5%. Results: The difference in SBS values of groups I (36.672 ± 9.315 Mpa), II (34.242 ± 9.986 Mpa), and III (39.055 ± 5.565 Mpa) were not statistically significant (P < 0.05). Conclusion: This study suggests that chairside time can be significantly reduced with the use of PP and a SEP without compromising adhesion. Further evidence is needed by means of a split-mouth design trial.

Keywords: Shear bond strength, orthodontic tubes, self-etching primer, pumice, prophy.

Authors: Luan Mavriqi, Ilma Robo, Emin Kuzimi, Egresa Baca

Abstract:

The process of skeletal growth in an adolescent significantly affects the displacement of implants placed in the palatine suture. The problems caused by this process have an impact on the dental function and aesthetics of the affected data. If fixed prostheses are placed based on implants, the whole structure would impede maxillary growth. This is the significant difference between the maxilla and the mandible, as the lower jaw has no growth process that affects the movement of the implants or the latter to inhibit the growth of the jaw. In a teenager patient an accident occurred accompanied by loss of maxillary central incisors. The main complaint of patients is aesthetics and phonetics. Dental history of patients refers to the presence of a Maryland bridge that was accompanied by dissatisfaction on the part of the patient. Implant placement is not indicated as jaw augmentation may lead to displacement of the implant. The treatment plan includes the placement of implants in the palatum where this bone thickness allows as a procedure.in this article only the first stage of treatment is presented. Implant treatment is ongoing, will be followed by the second phase of treatment when the patient has reached the age of 18 years.

Keywords: Implants, palatum, adolescent, primary incisor teeth.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention particularly in pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. 28, 29, 34 and 34 children were involved in Group 1 (healthy), Group 2 (obese), Group 3 (morbid obese) and Group 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the parents of the participants. The classification of obese groups was performed based upon the recommendations of World Health Organization. MetS components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: Children, fat mass, fat-free mass, macrominerals, obesity.

Authors: Novita Verayanti Manalu, Alvin Salim, Esti Yunitasari

Abstract:

Background: Palliative care is caring holistically for patients and families to improve their quality of life. The approach by a multidisciplinary team requires integrated collaboration based on sufficient knowledge of the principles of palliative care as a whole, especially for nurses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along the relationship with attitude and performance. Method: This study applies cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0.05 by SPSS. Results: The majority of respondents were females, age above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are in adequate level. Knowledge may affect attitude, but it does not happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as reference to conduct further study in improving knowledge of palliative care.

Keywords: Knowledge, attitude, work performance, palliative care.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Zinc (Zn) is a vital element required for growth and development particularly in children. It exhibits some protective effects against cardiovascular diseases (CVDs). Zn may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis and prognosis of CVDs. The aim of this study is to determine Zn as well as new generation cardiac markers’ profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. 45 MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99 and above 99 for N-BMI, OB and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses including Zn were performed. hs-cTnT and cMyBP-C concentrations were measured by enzyme-linked immunosorbent assay. Data were analyzed by using SPSS software. p < 0.05 was accepted as significant. Four groups were matched for age and gender. Decreased Zn concentrations were measured in Groups 2, 3 and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between Zn and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between Zn and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of Zn accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both Zn and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: Cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Alterations in lipid parameters as well as in the fat distribution of the body are noteworthy during the evaluation of obesity stages. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information. Ratios such as trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are derived from distinct fat distribution in these areas. In this study, lipid fractions and TLFR as well as TAFR were evaluated and the distinctions among healthy, obese (OB) and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were recorded during the physical examination. BMI values were calculated. Total, trunk, leg and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including lipid fractions were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR as well as TAFR values in MO group. When adjusted for SBP and DBP, partial correlations were calculated for LDL-TLFR as well as LDL-TAFR. Much stronger partial correlations were obtained for the same couples upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: Children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio.

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Indices derived from anthropometric measurements [waist-to-hip ratio (WHR)] or body fat mass compositions [trunk-to-leg fat ratio (TLFR)] are used for the evaluation of obesity. The best for clinical practices is still being investigated. The aim of this study is to derive an index, which best suits the purpose for the discrimination of children with normal body mass index (N-BMI) from obese (OB) children. 83 children participated in the study. Groups 1 and 2 comprised 42 children with N-BMI and 41 OB children, whose age- and sex-adjusted BMI percentile values vary between 15-85 and 95-99, respectively. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements (weight, height (Ht), waist circumference (WC), hip circumference (HC), neck circumference (NC) values) were taken. BMI, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. TLFR, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2), fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis was performed. Significantly higher values of (WC+HC)/2, (TF+LF)/2, D2I and FMI were observed in OB group than N-BMI group. Significant correlations were found between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I, FMI in both groups. Similar correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR as well as TAFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I, FMI in N-BMI group. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. In conclusion, the only correlation valid in both groups was that exists between (TF+LF)/2 and (WC+HC)/2, which was suggested as a link between fat-based and anthropometric indices. (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index.

Keywords: Children, hip circumference, obesity, waist circumference.

Authors: Areej R. Banjar, Abraham G. Campbell

Abstract:

The use of Mixed Reality (MR) in teaching and training is growing popular and can improve students’ ability to perform technical procedures. This paper outlines the creation of an interactive educational MR 3D application that aims to improve the quality of instruction for dentistry students. This application is called ”MR-Implantology” and aims to teach and train dentistry students on single dental implant placement. MR-Implantology uses cone-beam computed tomography (CBCT) images as the source for 3D dental models that dentistry students will be able to freely manipulate within a 3D MR world to aid their learning process.

Keywords: Cone-Beam Computed Tomography, dentistry education, implantology, Mixed Reality, MR.

Authors: Rachel Hurdley, Jane Hopkinson

Abstract:

This article is based on observation of a cross-disciplinary, cross-institutional team that worked on an intervention called ‘Memory Mate’ for use in a UK Cancer Centre. This aimed to improve treatment outcomes for patients who had comorbid dementia or other memory impairment. Comorbid patients present ambiguous, spoiled identities, problematising the boundaries of health specialisms and frames of understanding. Memory Mate is theorised as a boundary object facilitating service transformation by changing relations between oncology and mental health care practice. It crosses the boundaries between oncology and mental health. Its introduction signifies an important step in reconfiguring relations between the specialisms. As a boundary object, it contains parallel, even contesting worlds, with potential to enable an eventual synthesis of the double stigma of cancer and dementia. Memory Mate comprises physical things, such as an animation, but its principal value is in the interaction it initiates across disciplines and services. It supports evolution of practices to address a newly emergent challenge for health service provision, namely the cancer patient with comorbid dementia/cognitive impairment. Getting clinicians from different disciplines working together on a practical solution generates a dialogue that can shift professional identity and change the culture of practice.

Keywords: Boundary object, cancer, dementia, interdisciplinary teams.

Authors: Ilma Robo, Saimir Heta, Merilda Tarja, Sonila Kapaj, Eduart Kapaj, Geriona Lasku

Abstract:

The classification of periodontal diseases has changed significantly in favor of simplifying the protocol of diagnosis and periodontal treatment. This review study aims to highlight the latest publications in the new periodontal disease classification, talking about the most significant differences versus the old classification with the tendency to express the advantages or disadvantages of clinical application. The aim of the study also includes the growing tendency to link the way of classification of periodontal diseases with predetermined protocols of periodontal treatment of the diagnoses included in the classification. The new classification of periodontal diseases is rather comprehensive in its subdivisions, as the disease is viewed in its entirety, with the biological dimensions of the disease, the degree of aggravation and progression of the disease, in relation to risk factors, predisposition to patient susceptibility and impact of periodontal disease to the general health status of the patient.

Keywords: Periodontal diseases, clinical application, periodontal treatment, oral diagnosis.

Authors: Tahir Majeed, Michael Handschuh, René Meier

Abstract:

Rheumatoid Arthritis patients have swelling and pain in joints of the hand. The regions where the patient feels pain also show increased body temperature. Thermal cameras can be used to detect the rise in temperature of the affected regions. To monitor the progression of Rheumatoid Arthritis, patients must visit the clinic regularly for scanning and examination. After scanning and evaluation, the dosage of the medicine is regulated accordingly. To monitor the disease progression over time, the correlation of the images between different visits must be established. It has been observed that the thermal measurements do not remain the same over time, even within a single scanning, when low-cost thermal cameras are used. In some situations, temperatures can vary as much as 2◦C within the same scanning sequence. In this paper, it has been shown that although the absolute temperature varies over time, the relative difference between different regions remains similar. Results have been computed over four scanning sequences and are presented.

Keywords: Relative thermal difference, rheumatoid arthritis, thermal imaging, thermal sensors.

Authors: Mustafa M. Donma, Orkide Donma, Savas Guzel

Abstract:

Iron is physiologically essential. However, it also participates in the catalysis of free radical formation reactions. Its deficiency is associated with amplified health risks. This trace element establishes some links with another physiological process related to cell death, apoptosis. Both iron deficiency and iron overload are closely associated with apoptosis. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) has the ability to trigger apoptosis and plays a dual role in the physiological versus pathological inflammatory responses of tissues. The aim of this study was to investigate the status of these parameters as well as the associations among them in children with obesity, a low-grade inflammatory state. The study was performed on groups of children with normal body mass index (N-BMI) and obesity. 43 children were included in each group. Based upon age- and sex-adjusted BMI percentile tables prepared by the World Health Organization, children whose values varied between 85 and 15 were included in N-BMI group. Children, whose BMI percentile values were between 99 and 95, comprised obese (OB) group. Institutional ethical committee approval and informed consent forms were taken prior to the study. Anthropometric measurements (weight, height, waist circumference, hip circumference, head circumference, neck circumference) and blood pressure values (systolic blood pressure and diastolic blood pressure) were recorded. Routine biochemical analyses, including serum iron, total iron binding capacity (TIBC), transferrin saturation percent (Tf Sat %) and ferritin, were performed. sTWEAK levels were determined by enzyme-linked immunosorbent assay. study data were evaluated using appropriate statistical tests performed by the statistical program SPSS. Serum iron levels were 91 ± 34 mcrg/dl and 75 ± 31 mcrg/dl in N-BMI and OB children, respectively. The corresponding values for TIBC, Tf Sat %, ferritin were 265 mcrg/dl vs. 299 mcrg/dl, 37.2 ± 19.1% vs. 26.7 ± 14.6%, and 41 ± 25 ng/ml vs 44 ± 26 ng/ml. In N-BMI and OB groups, sTWEAK concentrations were measured as 351 ng/L and 325 ng/L, respectively (p > 0.05). Correlation analysis revealed significant associations between sTWEAK levels and iron related parameters (p < 0.05) except ferritin. In conclusion, iron contributes to apoptosis. Children with iron deficiency have decreased apoptosis rate in comparison with that of healthy children. sTWEAK is an inducer of apoptosis. OB children had lower levels of both iron and sTWEAK. Low levels of sTWEAK are associated with several types of cancers and poor survival. Although iron deficiency state was not observed in this study, the correlations detected between decreased sTWEAK and decreased iron as well as Tf Sat % values were valuable findings, which point out decreased apoptosis. This may induce a proinflammatory state, potentially leading to malignancies in the future lives of OB children.

Keywords: Apoptosis, children, iron-related parameters, obesity, soluble tumor necrosis factor-like weak inducer of apoptosis.

Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

Abstract:

A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical student, physical therapy student, and biomedical science student cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stain as histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54 and median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes were present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) of death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: Atherosclerosis, cardiovascular, histology, pathology.