Search results for: PTB+ patients

Authors: Domenica Tambasco, Riina Bray

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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.

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Authors: W. Astiata, A. Wasif

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In this paper, an overview is made on the educational and research activities in the field of physical medicine and rehabilitation in Libya, including development in rehabilitation science, research, training, occupational therapy, physiotherapy and physiatrist, which are mainly concerned with the patients in Libya[3] [13].

Keywords: Physiotherapy, Rehabilitation, Libya, Graduates, Institutions, Universities, Research, Education, Courses.

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Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: Awareness, knowledge, osteoporosis, practices.

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Authors: Yujun Zheng, Qin Song, Haihe Shi, and Jinyun Xue

Abstract:

There are a number of different cars for transferring hundreds of close contacts of swine influenza patients to hospital, and we need to carefully assign the passengers to those cars in order to minimize the risk of influenza spreading during transportation. The paper presents an approach to straightforward obtain the optimal solution of the relaxed problems, and develops two iterative improvement algorithms to effectively tackle the general problem.

Keywords: Influenza spread, discrete optimization, stationary point, iterative improvement

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

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Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialized software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarize and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, re-evaluate their perceptions about hospitalization, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalized peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective-taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimize escapism and feelings of exclusion and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: Hospitalized children, interactive games, long-term illness, cognitive enhancement, socioemotional development.

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Authors: Yi-Yun Ko, Der-Ming Liou

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The Electronic Health Record (EHR) system is very general and we should pay more attention to a patient-s privacy. The patient-s consent is one of the elements when dealing with privacy topics. This study focuses on the creating and managing of patient consent. The integration of the HL7 standards and the IHE BPPC profile provides a base for the creation of patient consent. Establishing the platform offers the patients a way to create, revoke or update their consents. Through this platform, they can manage their consents in an easier manner.

Keywords: consent, EHR, HL7, IHE

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Authors: Kulaya Wimolwat, Panlop Chakravitthamrong, Neti Waranuch

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Background: Seborrheic dermatitis is a common chronic skin condition affecting the face, scalp, chest, and trunk. The cause of seborrheic dermatitis is still unknown. Sebum production, lipid composition, hormone levels, and Malassezia species have been suggested as important factors in the development of seborrheic dermatitis. Curcuma aeruginosa Roxb. extract-containing cream with anti-inflammatory and anti-androgenic properties may be beneficial for treating mild to moderate facial seborrheic dermatitis. Objectives: We evaluated the efficacy and safety of 2% C. aeruginosa Roxb. extract-containing cream in the treatment of mild to moderate seborrheic dermatitis. Methods: This was a prospective, open-label, and non-comparative study. Ten adult patients clinically diagnosed with mild to moderate seborrheic dermatitis were enrolled in a four-week study. The 2% C. aeruginosa Roxb. cream was applied twice daily to a lesional area on the face for four weeks. The Scoring Index (SI) ranking system on days 14 and 28 was compared with that at baseline to determine the efficacy of treatment. The adverse events (burning sensation and erythema) were evaluated on days 14 and 28 to determine the safety of the treatment. Results: Significant improvement was observed in the reduction of the mean SI at day 14 (2.9) and 28 (1.4) compared to that at baseline (4.9). An adverse reaction was observed on day 14 (mild erythema 20% and mild burning sensation 10%) and was resolved by the end of the study. Conclusion: This open-label pilot study has shown that there was a significant improvement in the severity in these seborrheic patients and most reported they were satisfied with it. Reported adverse events were all mild.

Keywords: Anti-androgenic, antifungals, anti-inflammatory, Curcuma aeruginosa, seborrheic dermatitis, efficacy, safety.

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Authors: Ogunduyile O. Oluwgbenga

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Recent advancements in sensor technologies and Wireless Body Area Networks (WBANs) have led to the development of cost-effective healthcare devices which can be used to monitor and analyse a person-s physiological parameters from remote locations. These advancements provides a unique opportunity to overcome current healthcare challenges of low quality service provisioning, lack of easy accessibility to service varieties, high costs of services and increasing population of the elderly experienced globally. This paper reports on a prototype implementation of an architecture that seamlessly integrates Wireless Body Area Network (WBAN) with Web services (WS) to proactively collect physiological data of remote patients to recommend diagnostic services. Technologies based upon WBAN and WS can provide ubiquitous accessibility to a variety of services by allowing distributed healthcare resources to be massively reused to provide cost-effective services without individuals physically moving to the locations of those resources. In addition, these technologies can reduce costs of healthcare services by allowing individuals to access services to support their healthcare. The prototype uses WBAN body sensors implemented on arduino fio platforms to be worn by the patient and an android smart phone as a personal server. The physiological data are collected and uploaded through GPRS/internet to the Medical Health Server (MHS) to be analysed. The prototype monitors the activities, location and physiological parameters such as SpO2 and Heart Rate of the elderly and patients in rehabilitation. Medical practitioners would have real time access to the uploaded information through a web application.

Keywords: Android Smart phone, Arduino Fio, Web application server, Wireless Body Area Networks.

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Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

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Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: Colorectal cancer, Hail Region, changing pattern, distal shift.

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal breast cancer, hormone sensitivity, Iraq, risk factors.

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Authors: Ahmed R. Z. Baghdadi, Amira A. A. Abdallah

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.

Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.

Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m² for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1^st week), home-based (2^nd-4^th weeks), and outpatient clinic (5^th-8^th weeks) programs.

Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.

Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Pain.

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Authors: Susannah G. Fleming Lionel Tarassenko

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The photoplethysmogram (PPG) is the pulsatile waveform produced by the pulse oximeter, which is widely used for monitoring arterial oxygen saturation in patients. Various methods for extracting the breathing rate from the PPG waveform have been compared using a consistent data set, and a novel technique using autoregressive modelling is presented. This novel technique is shown to outperform the existing techniques, with a mean error in breathing rate of 0.04 breaths per minute.

Keywords: Autoregressive modelling, breathing rate, photoplethysmogram, pulse oximetry.

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Authors: Eduardo da Silva, Tânia Caetano, Jessica B. Lopes

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Emotion dysregulation has been linked to psychopathology in general and, in particular, to substance abuse and other addiction-related disorders, such as eating disorders, impulsive disorder, and gambling. It has been proposed that a lessening of the difficulties in emotion regulation can have a significant positive impact on the treatment of these disorders. The present study explores the association between the progress in the Change & Grow^® therapeutic model (5 stages of treatment), and the decrease in the difficulties related to emotion regulation. The Change & Grow^® model has five stages of treatment according to the model’s five principles (Truth, Acceptance, Gratitude, Love and Responsibility) and incorporates different therapeutic approaches such as positive psychology, cognitive and behavioral therapy and third generation therapies. The main objective is to understand the impact of the presented therapeutic model on difficulties in emotion regulation in patients with addiction-related disorders. The exploratory study has a cross-sectional design. Participants were 44 (15 women and 29 men) Portuguese patients in the residential Villa Ramadas International Treatment Centre. The instrument used was the Portuguese version of the Difficulties in Emotion Regulation Scale (DERS), which measures six dimensions of emotion regulation (Strategies, Non-acceptance, Awareness, Impulse, Goals, and Clarity). The mean rank scores for both the DERS total score and the Impulse subscale showed statistically significant differences according to Stage of Treatment/Principles. Furthermore, Stage of Treatment/Principles held a negative correlation with the scores of the Non-acceptance and Impulse subscales, as well as the DERS total score. The results indicate that the Change & Grow^® model seems to have an impact in lessening the patient’s difficulties in emotion regulation. The Impulse dimension suffered the greater impact, which supports the well-known relevance of impulse control, or related difficulties, in addiction-related disorders.

Keywords: Addiction, Change & Grow®, emotion regulation, psychopathology.

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Authors: S. Karthikeyan, Naveen Bindra

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Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore, this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organization. The clinicians are the main users of the technology and manage us to “go paperless”. The fact is that day today changing technologically is very sound and up to date. Basically, the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: Medical records, digital records, health information, electronic record system.

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

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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.

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Authors: O. Sotolongo-Grau, D. Rodriguez-Perez, J. A. Santos-Miranda, M. M. Desco, O. Sotolongo-Costa, J. C. Antoranz

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The use of the oncologic index ISTER allows for a more effective planning of the radiotherapic facilities in the hospitals. Any change in the radiotherapy treatment, due to unexpected stops, may be adapted by recalculating the doses to the new treatment duration while keeping the optimal prognosis. The results obtained in a simulation model on millions of patients allow the definition of optimal success probability algorithms.

Keywords: Mathematical model, radiation oncology, dynamical systems applications.

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Authors: Eric Jacob Bacon, Chaoyang Jin, Dianning He, Shuaishuai Hu, Lanbo Wang, Han Li, Shouliang Qi

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Refractory epilepsy is a complicated type of epilepsy that can be difficult to diagnose. Recent technological advancements have made resting-state functional magnetic resonance (rsfMRI) a vital technique for studying brain activity. However, there is still much to learn about rsfMRI. Investigating rsfMRI connectivity may aid in the detection of abnormal activities. In this paper, we propose studying the functional connectivity of rsfMRI candidates to diagnose epilepsy. 45 rsfMRI candidates, comprising 26 with refractory epilepsy and 19 healthy controls, were enrolled in this study. A data-driven approach known as Independent Component Analysis (ICA) was used to achieve our goal. First, rsfMRI data from both patients and healthy controls were analyzed using group ICA. The components that were obtained were then spatially sorted to find and select meaningful ones. A two-sample t-test was also used to identify abnormal networks in patients and healthy controls. Finally, based on the fractional amplitude of low-frequency fluctuations (fALFF), a chi-square statistic test was used to distinguish the network properties of the patient and healthy control groups. The two-sample t-test analysis yielded abnormal in the default mode network, including the left superior temporal lobe and the left supramarginal. The right precuneus was found to be abnormal in the dorsal attention network. In addition, the frontal cortex showed an abnormal cluster in the medial temporal gyrus. In contrast, the temporal cortex showed an abnormal cluster in the right middle temporal gyrus and the right fronto-operculum gyrus. Finally, the chi-square statistic test was significant, producing a p-value of 0.001 for the analysis. This study offers evidence that investigating rsfMRI connectivity provides an excellent diagnosis option for refractory epilepsy.

Keywords: Independent Component Analysis, Resting State Network, refractory epilepsy, rsfMRI.

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Authors: P. Phenpun, S. Wareewan

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This qualitative study aimed to describe the opinions in relation to humanized care emerging from the volunteer activities of nursing students at Boromarajonani College of Nursing, Chonburi, Thailand. One hundred and twenty-seven second-year nursing students participated in this study. The volunteer activity model was composed of preparation, implementation, and evaluation through a learning log, in which students were encouraged to write their daily activities after completing practical training at the healthcare center. The preparation content included three main categories: service minded, analytical thinking, and client participation. The preparation process took over three days that accumulates up to 20 hours only. The implementation process was held over 10 days, but with a total of 70 hours only, with participants taking part in volunteer work activities at a healthcare center. A learning log was used for evaluation and data were analyzed using content analysis. The findings were as follows. With service minded, there were two subcategories that emerged from volunteer activities, which were service minded towards patients and within themselves. There were three categories under service minded towards patients, which were rapport, compassion, and empathy service behaviors, and there were four categories under service minded within themselves, which were self-esteem, self-value, management potential, and preparedness in providing good healthcare services. In line with analytical thinking, there were two components of analytical thinking, which were analytical skill for their works and analytical thinking for themselves. There were four subcategories under analytical thinking for their works, which were evidence based thinking, real situational thinking, cause analysis thinking, and systematic thinking, respectively. There were four subcategories under analytical thinking for themselves, which were comparative between themselves, towards their clients that leads to the changing of their service behaviors, open-minded thinking, modernized thinking, and verifying both verbal and non-verbal cues. Lastly, there were three categories under participation, which were mutual rapport relationship; reconsidering client’s needs services and providing useful health care information.

Keywords: Humanized care service, volunteer activity, nursing student, and learning log.

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Authors: J. A. López, C.I. López, J.E. Olguín, C. Camargo, J. M. López

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The institutions seek to improve their performance and quality of service, so that their patients are satisfied. This research project aims, conduct a time study program in the area of gynecological surgery, to determine the current level of capacity and optimize the programming time in order to adequately respond to demand. The system is analyzed by waiting lines and uses the simulation using ARENA to evaluate proposals for improvement and optimization programming time each of the surgeries.

Keywords: Time study, waiting lines, reducing time, simulation.

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Authors: Achitphol Chookaew, Paramee Thongsukhsai, Patamarerk Engsontia, Narongwit Nakwan, Pritsana Raugrut

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Lung cancer is one of the most common malignancies and primary cause of death due to cancer worldwide. Non-small cell lung cancer (NSCLC) is the main subtype in which majority of patients present with advanced-stage disease. Herein, we analyzed differentially expressed genes to find potential biomarkers for lung cancer diagnosis as well as prognostic markers. We used transcriptome data from our 2 NSCLC patients and public data (GSE81089) composing of 8 NSCLC and 10 normal lung tissues. Differentially expressed genes (DEGs) between NSCLC and normal tissue and between early-stage and late-stage NSCLC were analyzed by the DESeq2. Pairwise correlation was used to find the DEGs with false discovery rate (FDR) adjusted p-value £ 0.05 and |log2 fold change| ³ 4 for NSCLC versus normal and FDR adjusted p-value £ 0.05 with |log2 fold change| ³ 2 for early versus late-stage NSCLC. Bioinformatic tools were used for functional and pathway analysis. Moreover, the top ten genes in each comparison group were verified the expression and survival analysis via GEPIA. We found 150 up-regulated and 45 down-regulated genes in NSCLC compared to normal tissues. Many immnunoglobulin-related genes e.g., IGHV4-4, IGHV5-10-1, IGHV4-31, IGHV4-61, and IGHV1-69D were significantly up-regulated. 22 genes were up-regulated, and five genes were down-regulated in late-stage compared to early-stage NSCLC. The top five DEGs genes were KRT6B, SPRR1A, KRT13, KRT6A and KRT5. Keratin 6B (KRT6B) was the most significantly increased gene in the late-stage NSCLC. From GEPIA analysis, we concluded that IGHV4-31 and IGKV1-9 might be used as diagnostic biomarkers, while KRT6B and KRT6A might be used as prognostic biomarkers. However, further clinical validation is needed.

Keywords: Bioinformatics, differentially expressed genes, non-small cell lung cancer, transcriptomics.

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Authors: Ahmed R. Z. Baghdadi, Mona H. Gamal Eldein

Abstract:

Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for groups I, II and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks preand post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months postoperatively in groups I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months postoperatively in groups I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Long-Term.

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Authors: Marina Gorunescu, Florin Gorunescu, Kenneth Revett

Abstract:

Hepatocellular carcinoma, also called hepatoma, most commonly appears in a patient with chronic viral hepatitis. In patients with a higher suspicion of HCC, such as small or subtle rising of serum enzymes levels, the best method of diagnosis involves a CT scan of the abdomen, but only at high cost. The aim of this study was to increase the ability of the physician to early detect HCC, using a probabilistic neural network-based approach, in order to save time and hospital resources.

Keywords: Early HCC diagnosis, probabilistic neural network.

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Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson

Abstract:

Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.

Keywords: Accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance.

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Authors: R. Kongnuy, P. Pongsumpun

Abstract:

We used mathematical model to study the transmission of dengue disease. The model is developed in which the human population is separated into two populations, pregnant and non-pregnant humans. The dynamical analysis method is used for analyzing this modified model. Two equilibrium states are found and the conditions for stability of theses two equilibrium states are established. Numerical results are shown for each equilibrium state. The basic reproduction numbers are found and they are compared by using numerical simulations.

Keywords: Basic reproductive number, dengue disease, equilibrium states, pregnancy.

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Authors: N. Namviriyachote, N. Bang, P. Aramwit

Abstract:

Silk sericin (SS) is a glue-like protein from silkworm cocoon. With its outstanding moisturization and activation collagen synthesis properties, silk protein is applied for wound healing. Since wound dressing in film preparation can facilitate patients- convenience and reduce risk of wound contraction, SS and polyvinyl alcohol (PVA) films were prepared with various concentrations of SS. Their physical properties such as surface density, light transmission, protein dissolution and tensile modulus were investigated. The results presented that 3% SS with 2% PVA is the best ingredient for SS film forming.

Keywords: Sericin, silk protein, film, wound healing.

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Authors: I. Oloyede

Abstract:

The COVID-19 dataset is obtained by extracting weather, longitude, latitude, ISO3666, cases and death of coronavirus patients across the globe. The data were extracted for a period of eight day choosing uniform time within the specified period. Then mapping of cases and deaths with reverence to continents were obtained. Bayesian Geostastical modelling was carried out on the dataset. The study found out that countries in the tropical region suffered less deaths/attacks compared to countries in the temperate region, this is due to high temperature in the tropical region.

Keywords: COVID-19, Bayesian, geostastical modelling, prior, posterior.

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Authors: M. D. Prokhorov, V. I. Ponomarenko, A. S. Karavaev, A. R. Kiselev, V. I. Gridnev

Abstract:

Synchronization between the slow oscillations of heart rate and blood pressure having in humans a basic frequency close to 0.1 Hz is investigated. A method is proposed for quantitative estimation of synchronization between these oscillating processes based on calculation of relative time of phase synchronization of oscillations. It is shown that healthy subjects exhibit in average substantially longer epochs of synchronization between the slow oscillations in heart rate and blood pressure than patients after acute myocardial infarction

Keywords: Cardiovascular system, slow oscillating processes, synchronization.

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Authors: Fahad Shahbaz Khan, Rao Muhammad Anwer, Olof Torgersson, Göran Falkman

Abstract:

Data mining has been used very frequently to extract hidden information from large databases. This paper suggests the use of decision trees for continuously extracting the clinical reasoning in the form of medical expert-s actions that is inherent in large number of EMRs (Electronic Medical records). In this way the extracted data could be used to teach students of oral medicine a number of orderly processes for dealing with patients who represent with different problems within the practice context over time.

Keywords: Data mining, Oral Medicine, Decision Trees, WEKA.

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Authors: R. Inkum, A. Teerawutgulrag, P. Puangsombat, N. Rakariyatham

Abstract:

Propranolol is worldwide hypertension drug that is active in S-isomer. Patients must use this drug throughout their lives, and this action employsa significant level of expenditure. A simpler synthesis and lower cost can reduce the price for the patient. A sis pathway of S-propranolol starting from protection of (R,S)-propranolol with di-t-butyldicarbonate and then the product is oxidized with pyridiniumchlorochromate. The selective reduction of ketone occurrs with sodiumborohydride in the presence of metal chloride provided S-propranolol.

Keywords: S-propranolol, selective reduction, sodium borohydride, metal chloride

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