Search results for: Cancer Patients

Authors: T. Sungkaworn, W. Triampo, P. Nalakarn, D. Triampo, I. M. Tang, Y. Lenbury, P. Picha

Abstract:

Semiconductor nanomaterials like TiO2 nanoparticles (TiO2-NPs) approximately less than 100 nm in diameter have become a new generation of advanced materials due to their novel and interesting optical, dielectric, and photo-catalytic properties. With the increasing use of NPs in commerce, to date few studies have investigated the toxicological and environmental effects of NPs. Motivated by the importance of TiO2-NPs that may contribute to the cancer research field especially from the treatment prospective together with the fractal analysis technique, we have investigated the effect of TiO2-NPs on colony morphology in the dark condition using fractal dimension as a key morphological characterization parameter. The aim of this work is mainly to investigate the cytotoxic effects of TiO2-NPs in the dark on the growth of human cervical carcinoma (HeLa) cell colonies from morphological aspect. The in vitro studies were carried out together with the image processing technique and fractal analysis. It was found that, these colonies were abnormal in shape and size. Moreover, the size of the control colonies appeared to be larger than those of the treated group. The mean Df +/- SEM of the colonies in untreated cultures was 1.085±0.019, N= 25, while that of the cultures treated with TiO2-NPs was 1.287±0.045. It was found that the circularity of the control group (0.401±0.071) is higher than that of the treated group (0.103±0.042). The same tendency was found in the diameter parameters which are 1161.30±219.56 μm and 852.28±206.50 μm for the control and treated group respectively. Possible explanation of the results was discussed, though more works need to be done in terms of the for mechanism aspects. Finally, our results indicate that fractal dimension can serve as a useful feature, by itself or in conjunction with other shape features, in the classification of cancer colonies.

Keywords: Tumor growth, Cell colonies, TiO2, Nanoparticles, Fractal, Morphology, Aggregation.

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Authors: O. O. Obe, V. Balanica, E. Neagoe

Abstract:

The effects of hypertension are often lethal thus its early detection and prevention is very important for everybody. In this paper, a neural network (NN) model was developed and trained based on a dataset of hypertension causative parameters in order to forecast the likelihood of occurrence of hypertension in patients. Our research goal was to analyze the potential of the presented NN to predict, for a period of time, the risk of hypertension or the risk of developing this disease for patients that are or not currently hypertensive. The results of the analysis for a given patient can support doctors in taking pro-active measures for averting the occurrence of hypertension such as recommendations regarding the patient behavior in order to lower his hypertension risk. Moreover, the paper envisages a set of three example scenarios in order to determine the age when the patient becomes hypertensive, i.e. determine the threshold for hypertensive age, to analyze what happens if the threshold hypertensive age is set to a certain age and the weight of the patient if being varied, and, to set the ideal weight for the patient and analyze what happens with the threshold of hypertensive age.

Keywords: Neural Network, hypertension, data set, training set, supervised learning.

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Authors: Cornelia-Eugenia Munteanu

Abstract:

The goal of this paper is to present the diagnostic contribution that the screening instrument, Mini-Mental State Examination-2: Expanded Version (MMSE-2:EV), brings in detecting the cognitive impairment or in monitoring the progress of degenerative disorders. The diagnostic signification is underlined by the interpretation of the MMSE-2:EV scores, resulted from the test application to patients with mild and major neurocognitive disorders. The cases were selected from current practice, in order to cover vast and significant neurocognitive pathology: mild cognitive impairment, Alzheimer’s disease, vascular dementia, mixed dementia, Parkinson’s disease, conversion of the mild cognitive impairment into Alzheimer’s disease. The MMSE-2:EV version was used: it was applied one month after the initial assessment, three months after the first reevaluation and then every six months, alternating the blue and red forms. Correlated with age and educational level, the raw scores were converted in T scores and then, with the mean and the standard deviation, the z scores were calculated. The differences of raw scores between the evaluations were analyzed from the point of view of statistic signification, in order to establish the progression in time of the disease. The results indicated that the psycho-diagnostic approach for the evaluation of the cognitive impairment with MMSE-2:EV is safe and the application interval is optimal. In clinical settings with a large flux of patients, the application of the MMSE-2:EV is a safe and fast psychodiagnostic solution. The clinicians can draw objective decisions and for the patients: it does not take too much time and energy, it does not bother them and it doesn’t force them to travel frequently.

Keywords: MMSE-2, dementia, cognitive impairment, neuropsychology.

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Authors: A. T. Nakysh, A. S. Idrisov, S. A. Baidurin

Abstract:

This work presents the results of a study the incidence of metabolic syndrome (MetS) in women with impaired reproductive function (IRF) according to the data of Astana, Kazakhstan. The anthropometric, biochemical and instrumental studies were conducted among 515 women, of which 53 patients with MetS according to IDF criteria, 2006, were selected. The frequency of occurrence of the IRF, due to MetS is 10.3% of cases according to the data of Astana. In women of childbearing age with IRF and the MetS, blood pressure (BP), indicators of carbohydrate and lipid metabolism were significantly higher and the level of high density lipoprotein (HDL) significantly lower compared to the same in women with the IRF without MetS. The hyperandrogenism, the hyperestrogenemia, the hyperprolactinemia and the hypoprogesteronemia were found in the patients with MetS and IRF, indicating the impact of MetS on the development of the polycystic ovary syndrome in 28% of cases and hyperplastic processes of the myometrium in 20% of cases.

Keywords: Dyslipidemia, insulin resistance, metabolic syndrome, reproductive disorders, obesity.

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Authors: N. Khatiashvili, Ch. Pirumova, V. Akhobadze

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In the paper the mathematical model of tumor growth is considered. New capillary network formation, which supply cancer cells with the nutrients, is taken into the account. A formula estimating a tumor growth in connection with the number of capillaries is obtained.

Keywords: Differential Equations, Mathematical Models, Vascular Endothelial, Tumor

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Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

Abstract:

Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, hypertension, Iraq, risk factors.

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Authors: M. Sadeghi, A.H. Jafari, S.M.P. Firoozabadi

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Deep Brain Stimulation or DBS is the second solution for Parkinson's Disease. Its three parameters are: frequency, pulse width and voltage. They must be optimized to achieve successful treatment. Nowadays it is done clinically by neurologists and there is not certain numerical method to detect them. The aim of this research is to introduce simulation and modeling of Parkinson's Disease treatment as a computational procedure to select optimum voltage. We recorded finger tremor signals of some Parkinsonian patients under DBS treatment at constant frequency and pulse width but variable voltages; then, we adapted a new model to fit these data. The optimum voltages obtained by data fitting results were the same as neurologists- commented voltages, which means modeling can be used as an engineering method to select optimum stimulation voltages.

Keywords: modeling, Deep Brain Stimulation, Parkinson'sdisease, tremor.

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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.

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Authors: Sadaf Moeez, Madiha Khalid, Zoya Khalid, Sania Shaheen, Sumbul Khalid

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Background: Inter-individual variation in response to metformin, which has been considered as a first line therapy for T2DM treatment is considerable. In the current study, it was aimed to investigate the impact of two genetic variants Leu125Phe (rs77474263) and Gly64Asp (rs77630697) in gene SLC47A1 on the clinical efficacy of metformin in T2DM Pakistani patients. Methods: The study included 800 T2DM patients (400 metformin responders and 400 metformin non-responders) along with 400 ethnically matched healthy individuals. The genotypes were determined by allele-specific polymerase chain reaction. In-silico analysis was done to confirm the effect of the two SNPs on the structure of genes. Association was statistically determined using SPSS software. Results: Minor allele frequency for rs77474263 and rs77630697 was 0.13 and 0.12. For SLC47A1 rs77474263 the homozygotes of one mutant allele ‘T’ (CT) of rs77474263 variant were fewer in metformin responders than metformin non-responders (29.2% vs. 35.5 %). Likewise, the efficacy was further reduced (7.2% vs. 4.0 %) in homozygotes of two copies of ‘T’ allele (TT). Remarkably, T2DM cases with two copies of allele ‘C’ (CC) had 2.11 times more probability to respond towards metformin monotherapy. For SLC47A1 rs77630697 the homozygotes of one mutant allele ‘A’ (GA) of rs77630697 variant were fewer in metformin responders than metformin non-responders (33.5% vs. 43.0 %). Likewise, the efficacy was further reduced (8.5% vs. 4.5%) in homozygotes of two copies of ‘A’ allele (AA). Remarkably, T2DM cases with two copies of allele ‘G’ (GG) had 2.41 times more probability to respond towards metformin monotherapy. In-silico analysis revealed that these two variants affect the structure and stability of their corresponding proteins. Conclusion: The present data suggest that SLC47A1 Leu125Phe (rs77474263) and Gly64Asp (rs77630697) polymorphisms were associated with the therapeutic response of metformin in T2DM patients of Pakistan.

Keywords: Diabetes, T2DM, SLC47A1, Pakistan, polymorphism.

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Authors: N. Nelasov, D. Safonov, M. Babaev, E. Mirzojan, O. Eroshenko, M. Morgunov, A. Erofeeva

Abstract:

We have shown previously that reflected high intensity motion signals (RIMS) can be used for detection of left ventricular (LV) diastolic dysfunction (DD). It is also well known, that left atrial (LA) dimension can be used as a marker of DD. In this study we decided to analyze the diagnostic role of new echocardiographic morphofunctional diastolic index (MFDI) in differentiation of normal filling of LV from pseudonormal and restrictive. MFDI includes LA dimension and velocity of early diastolic component ea of RIMS (MFDI = LA/ea).  

343 healthy subjects and patients with various cardiac pathology underwent dopplerechocardiographic exam. According to the criteria of "Don" classification scheme 155 subjects had signs of normal LV filling (N) and 55 - of pseudonormal and restrictive filling (PN + R). LA dimension was performed in standard manner. RIMS were registered by conventional pulsed wave Doppler from apical 4-chamber view, when the sample volume was positioned between the tips of mitral leaflets. The velocity of early diastolic component of RIMS was measured. After calculation of MFDI mean values of this index in two groups (N and PN + R) were compared. The cutoff value of MFDI for differentiation of patients with N and PN + R was determined.

Mean value of MFDI in subjects with normal filling was 1.38+0.33 and in patients with pseudonormal and restrictive filling 2.43+0.43; p<0.0001. The cutoff value of MFDI > 2.0 separated subjects with normal LV filling from subjects with pseudonormal and restrictive filling with sensitivity 89.1% and specificity 97.4%.

Keywords: Dopplerechocardiography, diastolic dysfunction, left atrium, reflected high intensity motion signals.

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Authors: Gulten Yilmaz, A. Beril Tugrul, Mustafa Demir, Dogan Yasar, Bayram Demir, Bulent Buyuk

Abstract:

A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.

Keywords: PET/CT, TLD, MIRD, Dose measurement, Patient doses.

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Authors: Suken Nayak, Aditya Kambli, Bharati Ingale, Gauri Shukla

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The technological concepts such as wireless hospital and portable cardiac telemetry system require the development of physiological signal acquisition devices to be easily integrated into the hospital database. In this paper we present the low cost, portable wireless ECG acquisition hardware that transmits ECG signals to a dedicated computer.The front end of the system obtains and processes incoming signals, which are then transmitted via a microcontroller and wireless Bluetooth module. A monitoring purpose Bluetooth based end user application integrated with patient database management module is developed for the computers. The system will act as a continuous event recorder, which can be used to follow up patients who have been resuscitatedfrom cardiac arrest, ventricular tachycardia but also for diagnostic purposes for patients with arrhythmia symptoms. In addition, cardiac information can be saved into the patient-s database of the hospital.

Keywords: ECG, Bluetooth communication, monitoring application, patient database

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Authors: Amir Moslemi, Amir Movafeghi, Shahab Moradi

Abstract:

One of the most important challenging factors in medical images is nominated as noise. Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjects to low quality due to the noise. Quality of CT images is dependent on absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete Wavelet Transform (DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: Computed Tomography (CT), noise reduction, curve-let, contour-let, Signal to Noise Peak-Peak Ratio (PSNR), Structure Similarity (Ssim), Absorbed Dose to Patient (ADP).

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Authors: I. Omerhodzic, S. Avdakovic, A. Nuhanovic, K. Dizdarevic

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In this paper, a wavelet-based neural network (WNN) classifier for recognizing EEG signals is implemented and tested under three sets EEG signals (healthy subjects, patients with epilepsy and patients with epileptic syndrome during the seizure). First, the Discrete Wavelet Transform (DWT) with the Multi-Resolution Analysis (MRA) is applied to decompose EEG signal at resolution levels of the components of the EEG signal (δ, θ, α, β and γ) and the Parseval-s theorem are employed to extract the percentage distribution of energy features of the EEG signal at different resolution levels. Second, the neural network (NN) classifies these extracted features to identify the EEGs type according to the percentage distribution of energy features. The performance of the proposed algorithm has been evaluated using in total 300 EEG signals. The results showed that the proposed classifier has the ability of recognizing and classifying EEG signals efficiently.

Keywords: Epilepsy, EEG, Wavelet transform, Energydistribution, Neural Network, Classification.

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Authors: Neila Mezghani, Philippe Phan, Hubert Labelle, Carl Eric Aubin, Jacques de Guise

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The identification and classification of the spine deformity play an important role when considering surgical planning for adolescent patients with idiopathic scoliosis. The subject of this article is the Lenke classification of scoliotic spines using Cobb angle measurements. The purpose is two-fold: (1) design a rulebased diagram to assist clinicians in the classification process and (2) investigate a computer classifier which improves the classification time and accuracy. The rule-based diagram efficiency was evaluated in a series of scoliotic classifications by 10 clinicians. The computer classifier was tested on a radiographic measurement database of 603 patients. Classification accuracy was 93% using the rule-based diagram and 99% for the computer classifier. Both the computer classifier and the rule based diagram can efficiently assist clinicians in their Lenke classification of spine scoliosis.

Keywords: Scoliosis, Lenke model, decision-rules, computer aided classifier.

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Authors: Hui-Min Ting, Tsair-Fwu Lee, Ming-Yuan Cho, Pei-Ju Chao, Chun-Ming Chang, Long-Chang Chen, Fu-Min Fang

Abstract:

To evaluate the ability to predict xerostomia after radiotherapy, we constructed and compared neural network and logistic regression models. In this study, 61 patients who completed a questionnaire about their quality of life (QoL) before and after a full course of radiation therapy were included. Based on this questionnaire, some statistical data about the condition of the patients’ salivary glands were obtained, and these subjects were included as the inputs of the neural network and logistic regression models in order to predict the probability of xerostomia. Seven variables were then selected from the statistical data according to Cramer’s V and point-biserial correlation values and were trained by each model to obtain the respective outputs which were 0.88 and 0.89 for AUC, 9.20 and 7.65 for SSE, and 13.7% and 19.0% for MAPE, respectively. These parameters demonstrate that both neural network and logistic regression methods are effective for predicting conditions of parotid glands.

Keywords: NPC, ANN, logistic regression, xerostomia.

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Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

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Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: Age incidence, breast carcinoma, fine needle aspiration, Hail Region.

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Authors: V. I. Thajudin Ahamed, P. Dhanasekaran, A. Naseem, N. G. Karthick, T. K. Abdul Jaleel, Paul K.Joseph

Abstract:

It is established that the instantaneous heart rate (HR) of healthy humans keeps on changing. Analysis of heart rate variability (HRV) has become a popular non invasive tool for assessing the activities of autonomic nervous system. Depressed HRV has been found in several disorders, like diabetes mellitus (DM) and coronary artery disease, characterised by autonomic nervous dysfunction. A new technique, which searches for pattern repeatability in a time series, is proposed specifically for the analysis of heart rate data. These set of indices, which are termed as pattern repeatability measure and pattern repeatability ratio are compared with approximate entropy and sample entropy. In our analysis, based on the method developed, it is observed that heart rate variability is significantly different for DM patients, particularly for patients with diabetic foot ulcer.

Keywords: Autonomic nervous system, diabetes mellitus, heart rate variability, pattern identification, sample entropy

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Authors: Magda M. Mohsen, Manal E. Fareed

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Background: Widespread use of chemotherapeutic drugs in the treatment of cancer has lead to higher health hazards among employee who handle and administer such drugs, so nurses should know how to protect themselves, their patients and their work environment against toxic effects of chemotherapy. Aim of this study was carried out to examine the effect of chemotherapy safety protocol for oncology nurses on their protective measure practices. Design: A quasi experimental research design was utilized. Setting: The study was carried out in oncology department of Menoufia university hospital and Tanta oncology treatment center. Sample: A convenience sample of forty five nurses in Tanta oncology treatment center and eighteen nurses in Menoufiya oncology department. Tools: 1. an interviewing questionnaire that covering sociodemographic data, assessment of unit and nurses' knowledge about chemotherapy. II: Obeservational check list to assess nurses' actual practices of handling and adminestration of chemotherapy. A base line data were assessed before implementing Chemotherapy Safety protocol, then Chemotherapy Safety protocol was implemented, and after 2 monthes they were assessed again. Results: reveled that 88.9% of study group I and 55.6% of study group II improved to good total knowledge scores after educating on the safety protocol, also 95.6% of study group I and 88.9% of study group II had good total practice score after educating on the safety protocol. Moreover less than half of group I (44.4%) reported that heavy workload is the most barriers for them, while the majority of group II (94.4%) had many barriers for adhering to the safety protocol such as they didn’t know the protocol, the heavy work load and inadequate equipment. Conclusions: Safety protocol for Oncology Nurses seemed to have positive effect on improving nurses' knowledge and practice. Recommendation: chemotherapy safety protocol should be instituted for all oncology nurses who are working in any oncology unit and/ or center to enhance compliance, and this protocol should be done at frequent intervals.

Keywords: Chemotherapy Safety protocol, Effect, protective measure practice.

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Authors: Kasra Afsahi, Maryam Soheilifar

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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.

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Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

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Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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

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

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

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Authors: Raissa A. Muzychkina, Irina M. Korulkina, Dmitriy Yu. Korulkin

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In article the data of acute toxicity for pre-clinical researches of Ramon preparation is described. Ramon effects to clinical characteristics of blood, cardio-vascular system, hepatotoxic and diuretic effects were studied.

Keywords: Cancer, toxicity, antitumor activity, pre-clinical testing, anthraquinones, phytopreparation, Ramon.

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

Abstract:

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

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

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Authors: Rania Mustafa

Abstract:

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

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

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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.

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

Abstract:

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

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

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Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

Abstract:

Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: Chronic periodontitis, atherosclerosis, risk factor, inflammatory markers.

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Authors: Dwitya Elvira, Eryati Darwin

Abstract:

Background: Graves’ disease (GD) is an autoimmune thyroid disease. Imbalance of Th1/Th2 cells and T-regulatory (Treg)/Th17 cells was thought to play pivotal role in the pathogenesis of GD. Treg FoxP3 produced TGF-β to maintain regulatory function, and Th17 cells produced IL-17 as cytokines that were thought in mediating several autoimmune diseases. The aim of this study is to assess the role of IL-17 and TGF-β in the pathogenesis of GD and to investigate its correlation with Thyroid Stimulating Hormone Receptor Antibody (TRAb) and Treg FoxP3 expression. Method: 30 GD patients and 27 age and sex-matched controls were enrolled in this study. Diagnosis of GD was based on clinical and biochemical of GD. Serum IL-17, TGF-β, TRAb, and FoxP3 were measured by enzyme-linked immunosorbent assay (ELISA). Data were analyzed by using SPSS 21.0 (SPSS Inc.). Spearman rank correlation test was used for assessment of correlation. The statistical significance was accepted as P<0.05. Result: There was no significant correlation between IL-17 and TGF-β serum with expression of FoxP3 level in GD, but there was significant correlation between TGF-β and TRAb serum level (P<0.05). Serum levels of IL-17 and TGF-β were found to be elevated in patient group compared to control, where mean values of IL-17 were 14.43±2.15 pg/mL and TGF-β were 10.44±3.19 pg/mL in patients group; and in control group, level of IL-17 were 7.1±1.45 pg/mL and TGF-β were 4.95±1.35 pg/mL. Conclusion: Serum Il-17 and TGF-β were elevated in GD patients that reflect the role of inflammatory and regulatory cytokines activation in pathogenesis of GD. There was significant correlation between TGF-β and TRAb, revealing that Treg cytokines may play a role in pathogenesis of GD.

Keywords: IL-17, TGF-β, FoxP3, Graves’ disease.

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Authors: L. Bikulciene, E. Venskaityte, G. Jarusevicius

Abstract:

Nonstationary and nonlinear signals generated by living complex systems defy traditional mechanistic approaches, which are based on homeostasis. Previous our studies have shown that the evaluation of the interactions of physiological signals by using special analysis methods is suitable for observation of physiological processes. It is demonstrated the possibility of using deep physiological model, based on the interpretation of the changes of the human body’s functional states combined with an application of the analytical method based on matrix theory for the physiological signals analysis, which was applied on high risk cardiac patients. It is shown that evaluation of cardiac signals interactions show peculiar for each individual functional changes at the onset of hemodynamic restoration procedure. Therefore, we suggest that the alterations of functional state of the body, after patients overcome surgery can be complemented by the data received from the suggested approach of the evaluation of functional variables’ interactions.

Keywords: Cardiac diseases, Complex systems theory, ECG analysis, matrix analysis.

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