Search results for: digestive disease
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 491

Search results for: digestive disease

371 Predictors of Non-Alcoholic Fatty Liver Disease in Egyptian Obese Adolescents

Authors: Moushira Zaki, Wafaa Ezzat, Yasser Elhosary, Omnia Saleh

Abstract:

Nonalcoholic fatty liver disease (NAFLD) has increased in conjunction with obesity. The accuracy of risk factors for detecting NAFLD in obese adolescents has not undergone a formal evaluation. The aim of this study was to evaluate predictors of NAFLD among Egyptian female obese adolescents. The study included 162 obese female adolescents. All were subjected to anthropometry, biochemical analysis and abdominal ultrasongraphic assessment. Metabolic syndrome (MS) was diagnosed according to the IDF criteria. Significant association between presence of MS and NAFLD was observed. Obese adolescents with NAFLD had significantly higher levels of ALT, triglycerides, fasting glucose, insulin, blood pressure and HOMA-IR, whereas decreased HDL-C levels as compared with obese cases without NAFLD. Receiver– operating characteristic (ROC) curve analysis shows that ALT is a sensitive predictor for NAFLD, confirming that ALT can be used as a marker of NAFLD.

Keywords: Adolescents, Egyptians, obesity.

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370 Analysis of the Long-term Effect of Office Lighting Environment on Human Reponses

Authors: D.Y. Su, C.C. Liu, C.M. Chiang, W. Wang

Abstract:

This study aims to discuss the effect of illumination and the color temperature of the lighting source under the office lighting environment on human psychological and physiological responses. In this study, 21 healthy participants were selected, and the Ryodoraku measurement system was utilized to measure their skin resistance change.The findings indicated that the effect of the color temperature of the lighting source on human physiological responses is significant within 90 min after turning the lights on; while after 90 min the effect of illumination on human physiological responses is higher than that of the color temperature. Moreover, the cardiovascular, digestive and endocrine systems are prone to be affected by the indoor lighting environment. During the long-term exposure to high intensity of illumination and high color temperature (2000Lux -6500K), the effect on the psychological responses turned moderate after the human visual system adopted to the lighting environment. However, the effect of the Ryodoraku value on human physiological responses was more significant with the increase of perceptive time. The effect of long time exposure to a lighting environment on the physiological responses is greater than its effect on the psychological responses. This conclusion is different from the traditional public viewpoint that the effect on the psychological responses is greater.

Keywords: Autonomic nervous system, Human responses, Office Lighting Environment, Ryodoraku, Meridian

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369 Association of Selected Biochemical Markers and Body Mass Index in Women with Endocrine Disorders

Authors: M. Mydlárová Blaščáková, J. Bernasovská, J. Poráčová, I. Boroňová

Abstract:

Obesity is frequent attendant phenomenon of patients with endocrinological disease. Between BMI and endocrinological diseases is close correlation. In thesis we focused on the allocation of hormone concentration – PTH and TSH, CHOL a mineral element Ca in a blood serum. The examined group was formed by 100 respondents (women) aged 36 – 83 years, who were divided into two groups – control group (CG), group with diagnosed endocrine disease (DED). The concentration of PTH and TSH, Ca and CHOL was measured through the medium of analyzers Cobas e411 (Japan); Cobas Integra 400 (Switzerland). At individuals was measured body weight as well as stature and thereupon from those data we enumerated BMI. On the basis of Student T-test in biochemical parameter of PTH and Ca we found out significantly meaningful difference (p<0,05) between CG and DED. In CG we made a founding the association between BMI and PTH by means of correlation analysis.

Keywords: Biochemical markers, hormones, obesity, women.

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368 MITAutomatic ECG Beat Tachycardia Detection Using Artificial Neural Network

Authors: R. Amandi, A. Shahbazi, A. Mohebi, M. Bazargan, Y. Jaberi, P. Emadi, A. Valizade

Abstract:

The application of Neural Network for disease diagnosis has made great progress and is widely used by physicians. An Electrocardiogram carries vital information about heart activity and physicians use this signal for cardiac disease diagnosis which was the great motivation towards our study. In our work, tachycardia features obtained are used for the training and testing of a Neural Network. In this study we are using Fuzzy Probabilistic Neural Networks as an automatic technique for ECG signal analysis. As every real signal recorded by the equipment can have different artifacts, we needed to do some preprocessing steps before feeding it to our system. Wavelet transform is used for extracting the morphological parameters of the ECG signal. The outcome of the approach for the variety of arrhythmias shows the represented approach is superior than prior presented algorithms with an average accuracy of about %95 for more than 7 tachy arrhythmias.

Keywords: Fuzzy Logic, Probabilistic Neural Network, Tachycardia, Wavelet Transform.

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367 Effect of a Probiotic Compound in Rumen Development, Diarrhea Incidence and Weight Gain in Young Holstein Calves

Authors: Camilo Aldana, Sara Cabra, Carlos A. Ospina, Fredy Carvajal, Fernando Rodríguez

Abstract:

It has been proven that early establishment of microbial flora in digestive tract of ruminants, has a beneficial effect on their health condition and productivity. A probiotic compound, made from five bacteria isolated from adult bovine cattle, was dosed to 15 Holstein newborn calves in order to measure its capacity of improving body weight gain and reduce diarrhea incidence. The test was performed in the municipality of Cajicá (Colombia), at 2580 m.a.s.l., throughout rainy season, with environmental temperature that oscillated between 4 to 25 °C. Five calves were allotted to control (no addition of probiotic). Treatments 1, and 2 (5 calves per group) received 10 ml Probiotic mix 1 and 2, respectively. Probiotic mixes 1 and 2 where similar in microbial composition but different in production process. Probiotics were added to the morning milk and dosed on a daily basis by a month and then on a weekly basis for three additional months. Diarrhea incidence was measured by observance of number of animals affected in each group; each animal was weighed up on a daily basis for obtaining weight gain and rumen fluid samples were extracted with oro-esophageal catheter for determining level of fiber and grain consumption.

Keywords: Calve, diarrhea, probiotic, rumen microorganisms.

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366 Wavelet Feature Selection Approach for Heart Murmur Classification

Authors: G. Venkata Hari Prasad, P. Rajesh Kumar

Abstract:

Phonocardiography is important in appraisal of congenital heart disease and pulmonary hypertension as it reflects the duration of right ventricular systoles. The systolic murmur in patients with intra-cardiac shunt decreases as pulmonary hypertension develops and may eventually disappear completely as the pulmonary pressure reaches systemic level. Phonocardiography and auscultation are non-invasive, low-cost, and accurate methods to assess heart disease. In this work an objective signal processing tool to extract information from phonocardiography signal using Wavelet is proposed to classify the murmur as normal or abnormal. Since the feature vector is large, a Binary Particle Swarm Optimization (PSO) with mutation for feature selection is proposed. The extracted features improve the classification accuracy and were tested across various classifiers including Naïve Bayes, kNN, C4.5, and SVM.

Keywords: Phonocardiography, Coiflet, Feature selection, Particle Swarm Optimization.

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365 Optimizing Voltage Parameter of Deep Brain Stimulation for Parkinsonian Patients by Modeling

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

Abstract:

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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364 Integrating Geographic Information into Diabetes Disease Management

Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

Abstract:

Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: Geocoding, chronic disease management, quality of diabetes care, rate ratio.

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363 Logic Programming and Artificial Neural Networks in Pharmacological Screening of Schinus Essential Oils

Authors: José Neves, M. Rosário Martins, Fátima Candeias, Diana Ferreira, Sílvia Arantes, Júlio Cruz-Morais, Guida Gomes, Joaquim Macedo, António Abelha, Henrique Vicente

Abstract:

Some plants of genus Schinus have been used in the folk medicine as topical antiseptic, digestive, purgative, diuretic, analgesic or antidepressant, and also for respiratory and urinary infections. Chemical composition of essential oils of S. molle and S. terebinthifolius had been evaluated and presented high variability according with the part of the plant studied and with the geographic and climatic regions. The pharmacological properties, namely antimicrobial, anti-tumoural and anti-inflammatory activities are conditioned by chemical composition of essential oils. Taking into account the difficulty to infer the pharmacological properties of Schinus essential oils without hard experimental approach, this work will focus on the development of a decision support system, in terms of its knowledge representation and reasoning procedures, under a formal framework based on Logic Programming, complemented with an approach to computing centered on Artificial Neural Networks and the respective Degree-of-Confidence that one has on such an occurrence.

Keywords: Artificial neuronal networks, essential oils, knowledge representation and reasoning, logic programming, Schinus molle L, Schinus terebinthifolius raddi.

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362 Overview of CARDIOSENSOR Project on the Development of a Nanosensor for Assessing the Risk of Cardiovascular Disease

Authors: A.C. Duarte, C.I.L. Justino, K. Duarte, A.C. Freitas, R. Pereira, P. Chaves, P. Bettencourt, S. Cardoso, T.A.P. Rocha-Santos

Abstract:

This paper aims at overviewing the topics of a research project (CARDIOSENSOR) on the field of health sciences (biomaterials and biomedical engineering). The project has focused on the development of a nanosensor for the assessment of the risk of cardiovascular diseases by the monitoring of C-reactive protein (CRP), which has been currently considered as the best validated inflammatory biomarker associated to cardiovascular diseases. The project involves tasks such as: 1) the development of sensor devices based on field effect transistors (FET): assembly, optimization and validation; 2) application of sensors to the detection of CRP in standard solutions and comparison with enzyme-linked immunosorbent assay (ELISA); and 3) application of sensors to real samples such as blood and saliva and evaluation of their ability to predict the risk of cardiovascular disease.

Keywords: Carbon nanotubes field effect transistors, cardiovascular diseases, C-reactive protein, sensor.

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361 Medical Advances in Diagnosing Neurological and Genetic Disorders

Authors: Simon B. N. Thompson

Abstract:

Retinoblastoma is a rare type of childhood genetic cancer that affects children worldwide. The diagnosis is often missed due to lack of education and difficulty in presentation of the tumor. Frequently, the tumor on the retina is noticed by photography when the red-eye flash, commonly seen in normal eyes, is not produced. Instead, a yellow or white colored patch is seen or the child has a noticeable strabismus. Early detection can be life-saving though often results in removal of the affected eye. Remaining functioning in the healthy eye when the child is young has resulted in super-vision and high or above-average intelligence. Technological advancement of cameras has helped in early detection. Brain imaging has also made possible early detection of neurological diseases and, together with the monitoring of cortisol levels and yawning frequency, promises to be the next new early diagnostic tool for the detection of neurological diseases where cortisol insufficiency is particularly salient, such as multiple sclerosis and Cushing’s disease.

Keywords: Cortisol, Neurological Disease, Retinoblastoma, Thompson Cortisol Hypothesis, Yawning.

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360 An Evaluation of Sputum Smear Conversion and Haematological Parameter Alteration in Early Detection Period of New Pulmonary Tuberculosis (PTB) Patients

Authors: Tasnuva Tamanna, Sanjida Halim Topa

Abstract:

Sputum smear conversion after one month of antituberculosis therapy in new smear positive pulmonary tuberculosis patients (PTB+) is a vital indicator towards treatment success. The objective of this study is to determine the rate of sputum smear conversion in new PTB+ patients after one month under treatment of National Institute of Diseases of the Chest and Hospital (NIDCH). Analysis of sputum smear conversion was done by re-clinical examination with sputum smear microscopic test after one month. Socio-demographic and hematological parameters were evaluated to perceive the correlation with the disease status. Among all enrolled patients only 33.33% were available for follow up diagnosis and of them only 42.86% patients turned to smear negative. Probably this consequence is due to non-coherence to the proper disease management. 66.67% and 78.78% patients reported low haemoglobin and packed cell volume level respectively whereas 80% and 93.33% patients accounted accelerated platelet count and erythrocyte sedimentation rate correspondingly.

Keywords: Followed up patients, PTB+ patients, sputum smear conversion, and sputum smear microscopic test.

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359 Molluscicidal Effects of Ageratum conyzoides and Datura stramonium on Bulinus globosus and Lymnea natalensis

Authors: Olofintoye Lawrence Kayode, Olorunniyi Omojola Felix

Abstract:

Schistosomiasis is a vector-borne water-based disease transmitted by Bulinus globosus, causing haematuria in the urine of man, while fascioliasis is a trematode zoonosis infectious transmitted by Lymnaea natalensis causing liver disease in man and animals. Adult Bulinus globosus and Lymnaea natalensis were used for the experiment. Aqueous leaf extract of Ageratum conyzoides and Datura stramonium were prepared into 25, 50, 75, 100, 200 and 400 ppm concentrations. Ten snails of each species were exposed to different concentrations in triplicates, and dechlorinated water was used as control at 24h, 48h, and 72h exposure. The results revealed that 100 ppm of both plants leaves extracts indicated mortality rates between 76.7% and 100% at 24h, 48h, and 72h for both snail species. (P < 0.05). In conclusion, the extract exercised molluscicidal activity to control the snail vector at lethal doses LC50 (66.611-72.021 ppm), CI = 63.083-77.90 ppm and LC90 (92.623-102.350), CI = 87.715-110.12 ppm.

Keywords: Snail, plant leaf, aqueous extract, mortality.

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358 Utilization Juice Wastes as Corn Replacement in the Broiler Diet

Authors: Yose Rizal, Maria Endo Mahata, Mira Andriani, Guoyao Wu

Abstract:

An experiment was conducted with 80 unsexed broilers of the Arbor Acress strain to determine the capability of a carrot and fruit juice wastes mixture (carrot, apple, manggo, avocado, orange, melon and Dutch egg plant) in the same proportion for replacing corn in broiler diet. This study involved a completely randomized design (CRD) with 5 treatments (0, 5, 10, 15, and 20% of juice wastes mixture in diets) and 4 replicates per treatment. Diets were isonitrogenous (22% crude protein) and isocaloric (3000 kcal/kg diet). Measured variables were feed consumption, average daily gain, feed conversion, as well as percentages of abdominal fat pad, carcass, digestive organs (liver, pancreas and gizzard), and heart. Data were analyzed by analysis of variance for CRD. Increasing juice wastes mixture levels in diets increased feed consumption (P<0.05) and average daily gain (P<0.01), while improving feed utilization efficiency (P<0.05). These treatments also affected (P<0.05) abdominal fat pad percentage but had no effect (P>0.05) on carcass, liver, pancreas, gizzard or heart percentages. In conclusion, up to 20% of juice wastes mixture could be included for the broiler diet to effectively replace up to 40% corn in the diet.

Keywords: average daily gain, feed consumption, feedconversion, juice waste mixture

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357 Impact of Urbanization Growth on Disease Spread and Outbreak Response: Exploring Strategies for Enhancing Resilience

Authors: Raquel Vianna Duarte Cardoso, Eduarda Lobato Faria, José Jorge Boueri

Abstract:

Rapid urbanization has transformed the global landscape, presenting significant challenges to public health. This article delves into the impact of urbanization on the spread of infectious diseases in cities and identifies crucial strategies to enhance urban community resilience. Massive urbanization over recent decades has created conducive environments for the rapid spread of diseases due to population density, mobility, and unequal living conditions. Urbanization has been observed to increase exposure to pathogens and foster conditions conducive to disease outbreaks, including seasonal flu, vector-borne diseases, and respiratory infections. In order to tackle these issues, a range of cross-disciplinary approaches are suggested. These encompass the enhancement of urban healthcare infrastructure, emphasizing the need for robust investments in hospitals, clinics, and healthcare systems to keep pace with the burgeoning healthcare requirements in urban environments. Moreover, the establishment of disease monitoring and surveillance mechanisms is indispensable, as it allows for the timely detection of outbreaks, enabling swift responses. Additionally, community engagement and education play a pivotal role in advocating for personal hygiene, vaccination, and preventive measures, thus playing a pivotal role in diminishing disease transmission. Lastly, the promotion of sustainable urban planning, which includes the creation of cities with green spaces, access to clean water, and proper sanitation, can significantly mitigate the risks associated with waterborne and vector-borne diseases. The article is based on the analysis of scientific literature, and it offers a comprehensive insight into the complexities of the relationship between urbanization and health. It places a strong emphasis on the urgent need for integrated approaches to improve urban resilience in the face of health challenges.

Keywords: Infectious diseases dissemination, public health, urbanization impacts, urban resilience.

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356 Evolved Disease Avoidance Mechanisms, Generalized Prejudice, Modern Attitudes towards Individuals with Intellectual Disability

Authors: Campbell Townsend, David Hamilton

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Previous research has demonstrated that negative attitudes towards people with physical disabilities and obesity are predicted by a component of perceived vulnerability to disease; germ aversion. These findings have been suggested as illustrations of an evolved but over-active mechanism which promotes the avoidance of pathogen-carrying individuals. To date, this interpretation of attitude formation has not been explored with regard to people with intellectual disability, and no attempts have been made to examine possible mediating factors. This study examined attitudes in 333 adults and demonstrated that the moderate positive relationship between germ aversion and negative attitudes toward people with intellectual disability is fully mediated by social dominance orientation, a general preference for hierarchies and inequalities among social groups. These findings have implications for the design of programs which attempt to promote community acceptance and inclusion of people with disabilities.

Keywords: avoidance, evolutionary psychology, intellectual disability, prejudice

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355 Identification of Healthy and BSR-Infected Oil Palm Trees Using Color Indices

Authors: Siti Khairunniza-Bejo, Yusnida Yusoff, Nik Salwani Nik Yusoff, Idris Abu Seman, Mohamad Izzuddin Anuar

Abstract:

Most of the oil palm plantations have been threatened by Basal Stem Rot (BSR) disease which causes serious economic impact. This study was conducted to identify the healthy and BSRinfected oil palm tree using thirteen color indices. Multispectral and thermal camera was used to capture 216 images of the leaves taken from frond number 1, 9 and 17. Indices of normalized difference vegetation index (NDVI), red (R), green (G), blue (B), near infrared (NIR), green – blue (GB), green/blue (G/B), green – red (GR), green/red (G/R), hue (H), saturation (S), intensity (I) and thermal index (T) were used. From this study, it can be concluded that G index taken from frond number 9 is the best index to differentiate between the healthy and BSR-infected oil palm trees. It not only gave high value of correlation coefficient (R=-0.962), but also high value of separation between healthy and BSR-infected oil palm tree. Furthermore, power and S model developed using G index gave the highest R2 value which is 0.985.

Keywords: Oil palm, image processing, disease, leaves.

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354 Motion Analysis for Duplicate Frame Removal in Wireless Capsule Endoscope Video

Authors: Min Kook Choi, Hyun Gyu Lee, Ryan You, Byeong-Seok Shin, Sang-Chul Lee

Abstract:

Wireless capsule Endoscopy (WCE) has rapidly shown its wide applications in medical domain last ten years thanks to its noninvasiveness for patients and support for thorough inspection through a patient-s entire digestive system including small intestine. However, one of the main barriers to efficient clinical inspection procedure is that it requires large amount of effort for clinicians to inspect huge data collected during the examination, i.e., over 55,000 frames in video. In this paper, we propose a method to compute meaningful motion changes of WCE by analyzing the obtained video frames based on regional optical flow estimations. The computed motion vectors are used to remove duplicate video frames caused by WCE-s imaging nature, such as repetitive forward-backward motions from peristaltic movements. The motion vectors are derived by calculating directional component vectors in four local regions. Our experiments are performed on small intestine area, which is of main interest to clinical experts when using WCEs, and our experimental results show significant frame reductions comparing with a simple frame-to-frame similarity-based image reduction method.

Keywords: Wireless capsule endoscopy, optical flow, duplicated image, duplicated frame.

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353 Application of Intuitionistic Fuzzy Cross Entropy Measure in Decision Making for Medical Diagnosis

Authors: Shikha Maheshwari, Amit Srivastava

Abstract:

In medical investigations, uncertainty is a major challenging problem in making decision for doctors/experts to identify the diseases with a common set of symptoms and also has been extensively increasing in medical diagnosis problems. The theory of cross entropy for intuitionistic fuzzy sets (IFS) is an effective approach in coping uncertainty in decision making for medical diagnosis problem. The main focus of this paper is to propose a new intuitionistic fuzzy cross entropy measure (IFCEM), which aid in reducing the uncertainty and doctors/experts will take their decision easily in context of patient’s disease. It is shown that the proposed measure has some elegant properties, which demonstrates its potency. Further, it is also exemplified in detail the efficiency and utility of the proposed measure by using a real life case study of diagnosis the disease in medical science.

Keywords: Intuitionistic fuzzy cross entropy (IFCEM), intuitionistic fuzzy set (IFS), medical diagnosis, uncertainty.

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352 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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351 Segmenting Ultrasound B-Mode Images Using RiIG Distributions and Stochastic Optimization

Authors: N. Mpofu, M. Sears

Abstract:

In this paper, we propose a novel algorithm for delineating the endocardial wall from a human heart ultrasound scan. We assume that the gray levels in the ultrasound images are independent and identically distributed random variables with different Rician Inverse Gaussian (RiIG) distributions. Both synthetic and real clinical data will be used for testing the algorithm. Algorithm performance will be evaluated using the expert radiologist evaluation of a soft copy of an ultrasound scan during the scanning process and secondly, doctor’s conclusion after going through a printed copy of the same scan. Successful implementation of this algorithm should make it possible to differentiate normal from abnormal soft tissue and help disease identification, what stage the disease is in and how best to treat the patient. We hope that an automated system that uses this algorithm will be useful in public hospitals especially in Third World countries where problems such as shortage of skilled radiologists and shortage of ultrasound machines are common. These public hospitals are usually the first and last stop for most patients in these countries.

Keywords: Endorcardial Wall, Rician Inverse Distributions, Segmentation, Ultrasound Images.

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350 The Integrated Management of Health Care Strategies and Differential Diagnosis by Expert System Technology: A Single-Dimensional Approach

Authors: A. B. Adehor, P. R. Burrell

Abstract:

The Integrated Management of Child illnesses (IMCI) and the surveillance Health Information Systems (HIS) are related strategies that are designed to manage child illnesses and community practices of diseases. However, both strategies do not function well together because of classification incompatibilities and, as such, are difficult to use by health care personnel in rural areas where a majority of people lack the basic knowledge of interpreting disease classification from these methods. This paper discusses a single approach on how a stand-alone expert system can be used as a prompt diagnostic tool for all cases of illnesses presented. The system combines the action-oriented IMCI and the disease-oriented HIS approaches to diagnose malaria and typhoid fever in the rural areas of the Niger-delta region.

Keywords: Differential diagnosis, Health Information System(HIS), Integrated Management of Child Illnesses (IMCI), Malaria andTyphoid fever.

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349 Socio-Demographic Characteristics and Psychosocial Consequences of Sickle Cell Disease: The Case of Patients in a Public Hospital in Ghana

Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

Abstract:

Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: Sickle cell disease, quality of life, anxiety, depression, socio-demographic characteristics, Ghana.

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348 The Impact of HIV/AIDS on Micro-enterprise Development in Kenya: A Study of Obunga Slum in Kisumu

Authors: C. A. Oloo, C. Ojwang

Abstract:

The performances of small and medium enterprises have stagnated in the last two decades. This has mainly been due to the emergence of HIV / Aids. The disease has had a detrimental effect on the general economy of the country leading to morbidity and mortality of the Kenyan workforce in their primary age. The present study sought to establish the economic impact of HIV / Aids on the micro-enterprise development in Obunga slum – Kisumu, in terms of production loss, increasing labor related cost and to establish possible strategies to address the impact of HIV / Aids on microenterprises. The study was necessitated by the observation that most micro-enterprises in the slum are facing severe economic and social crisis due to the impact of HIV / Aids, they get depleted and close down within a short time due to death of skilled and experience workforce. The study was carried out between June 2008 and June 2009 in Obunga slum. Data was subjected to computer aided statistical analysis that included descriptive statistic, chi-squared and ANOVA techniques. Chi-squared analysis on the micro-enterprise owners opinion on the impact of HIV / Aids on depletion of microenterprise compared to other diseases indicated high levels of the negative effects of the disease at significance levels of P<0.01. Analysis of variance on the impact of HIV / Aids on the performance and productivity of micro-enterprises also indicated a negative effect on the general performance of micro-enterprise at significance levels of P<0.01. Therefore reducing the negative impacts of HIV/Aids on micro-enterprise development, there is need to improve the socioeconomic environment, mobilize donors and stake holders in training and funding, and review the current strategies for addressing the disease. Further conclusive research should also be conducted on a bigger scale.

Keywords: Entrepreneurship, HIV-AIDS, Micro-enterprise, Poverty.

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347 Design of a Pneumonia Ontology for Diagnosis Decision Support System

Authors: Sabrina Azzi, Michal Iglewski, Véronique Nabelsi

Abstract:

Diagnosis error problem is frequent and one of the most important safety problems today. One of the main objectives of our work is to propose an ontological representation that takes into account the diagnostic criteria in order to improve the diagnostic. We choose pneumonia disease since it is one of the frequent diseases affected by diagnosis errors and have harmful effects on patients. To achieve our aim, we use a semi-automated method to integrate diverse knowledge sources that include publically available pneumonia disease guidelines from international repositories, biomedical ontologies and electronic health records. We follow the principles of the Open Biomedical Ontologies (OBO) Foundry. The resulting ontology covers symptoms and signs, all the types of pneumonia, antecedents, pathogens, and diagnostic testing. The first evaluation results show that most of the terms are covered by the ontology. This work is still in progress and represents a first and major step toward a development of a diagnosis decision support system for pneumonia.

Keywords: Clinical decision support system, diagnostic errors, ontology, pneumonia.

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346 Mutational Analysis of CTLA4 Gene in Pakistani SLE Patients

Authors: N. Hussain, G. Jaffery, A.N. Sabri, S. Hasnain

Abstract:

The main aim is to perform mutational analysis of CTLA4 gene Exon 1 in SLE patients. A total of 61 SLE patients fulfilling “American College of Rheumatology (ACR) criteria" and 61 controls were enrolled in this study. The region of CTLA4 gene exon 1 was amplified by using Step-down PCR technique. Extracted DNA of band 354 bp was sequenced to analyze mutations in the exon-1 of CTLA-4 gene. Further, protein sequences were identified from nucleotide sequences of CTLA4 Exon 1 by using Expasy software and through Blast P software it was found that CTLA4 protein sequences of Pakistani SLE patients were similar to that of Chinese SLE population. No variations were found after patients sequences were compared with that of the control sequence. Furthermore it was found that CTLA4 protein sequences of Pakistani SLE patients were similar to that of Chinese SLE population. Thus CTLA4 gene may not be responsible for an autoimmune disease SLE.

Keywords: American College of Rheumatology criteria, autoimmune disease, Cytotoxic T Lymphocyte Antigen-4, Polymerase Chain Reaction, Systemic Lupus Erythematosus

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345 Impact of Tuberculosis Co-infection on Cytokine Expression in HIV-Infected Individuals

Authors: M. Nosik, I. Rymanova, N. Adamovich, S. Sevostyanihin, K. Ryzhov, Y. Kuimova, A. Kravtchenko, N. Sergeeva, A. Sobkin

Abstract:

HIV and Tuberculosis (TB) infections each speed the other's progress. HIV-infection increases the risk of TB disease. At the same time, TB infection is associated with clinical progression of HIV-infection. HIV+TB co-infected patients are also at higher risk of acquiring new opportunistic infections. An important feature of disease progression and clinical outcome is the innate and acquired immune responses. HIV and TB, however, have a spectrum of dysfunctions of the immune response. As cytokines play a crucial role in the immunopathology of both infections, it is important to study immune interactions in patients with dual infection HIV+TB. Plasma levels of proinflammatory cytokines IL-2, IFN-γ and immunoregulating cytokines IL-4, IL-10 were evaluated in 75 patients with dual infection HIV+TB, 58 patients with HIV monoinfection and 50 patients with TB monoinfection who were previously naïve for HAART. The decreased levels of IL-2, IFN-γ, IL-4 and IL-10 were observed in patients with dual infection HIV+TB in comparison with patients who had only HIV or TB which means the profound suppression of Th1 and Th2 cytokine secretion. Thus, those cytokines could possibly serve as immunological markers of progression of HIV-infection in patients with TB.

Keywords: HIV, Tuberculosis, TB, HIV associated with TB, Th1/ Th2 cytokine expression.

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344 A Chaotic Study on Tremor Behavior of Parkinsonian Patients under Deep Brain Stimulation

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

Abstract:

Deep Brain Stimulation or DBS is a surgical treatment for Parkinson-s Disease with three stimulation parameters: frequency, pulse width, and voltage. The parameters should be selected appropriately to achieve effective treatment. This selection now, performs clinically. The aim of this research is to study chaotic behavior of recorded tremor of patients under DBS in order to present a computational method to recognize stimulation optimum voltage. We obtained some chaotic features of tremor signal, and discovered embedding space of it has an attractor, and its largest Lyapunov exponent is positive, which show tremor signal has chaotic behavior, also we found out, in optimal voltage, entropy and embedding space variance of tremor signal have minimum values in comparison with other voltages. These differences can help neurologists recognize optimal voltage numerically, which leads to reduce patients' role and discomfort in optimizing stimulation parameters and to do treatment with high accuracy.

Keywords: Chaos, Deep Brain Stimulation, Parkinson's Disease, Stimulation Parameters, tremor.

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343 Principle Knowledge of Integrated Pest Management Adopting Cotton Cultivators in Irrigated and Rainfed Conditions: A Critical Analysis

Authors: B. Sudhakar, K. A. Ponnusamy

Abstract:

In India cotton was the major commercial crop and cultivating all the states. In recent years, area of cotton declined due to pest and disease attack, drought, lower price for the produces etc. The first reason as pest and disease attack will be the challenges and it is of utmost importance that in future the insect problems would have to be tackled through Integrated Pest Management (IPM). The present study deals with principle knowledge of IPM adopting cotton cultivators in irrigated and rainfed conditions. Under irrigated conditions, among cultural practices, all respondents had principle knowledge about growing high yielding and pest resistant hybrids, sowing quality and certified seeds and avoiding cotton ratoon cropping. Regarding mechanical practices all respondents had principle knowledge about collecting and destroying egg, larvae and pupae of pests and removing and destroying pest and disease infected cotton squares, flowers and other shed materials. With regard to biological practices, 93% of them had principle knowledge about spraying neem oil, followed by 82% about tying Trichogramma eggcard. Among chemical practices, more than 90% of the respondents had principle knowledge about of spraying herbicide (96%), identifying ETL (Economic Threshold Level) for cotton pests (94%), and applying safe insecticides (90%). Under rainfed condition, among cultural practices, all respondents had principle knowledge about sowing quality and certified seeds and growing high yielding and pest resistant hybrids seeds. Regarding mechanical practices hundred percentage of the respondents had principle knowledge on the mechanical practices viz., collecting and destroying egg, larvae and pupae of pests and removing and destroying pest and disease infected cotton squares, flowers and other shed materials. With regard to biological practices, 96% of the respondents had correct in principle knowledge about spraying neem oil, followed by 89% about tying Trichogramma eggcard. With regard to chemical practices, more than 90% of the respondents had principle knowledge of applying safe insecticides (95%), avoiding repeated use of the same insecticides (95%), identifying ETL for cotton pests (94%) and applying granular insecticides (90%).

Keywords: Biological practices, chemical practices, cultural practices, mechanical practices, integrated pest management.

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342 Genetic Polymorphism of the Acute Lymphoblastic Leukaemia and Hyperhomocysteinemia its Relation with the for a Group of Children in the East of Algeria

Authors: Yahia Massinissa, Kalla A, Yahia M, Benbia S

Abstract:

A lot of recent research have spoken on the relation between the increase of the homocysteinemia and some kinds of cancer . For that, our study was based on the research of a possible relation between the increase of the concentration of this amino-acid in the plasma and the appearance of the disease of the Acute Lymphoblastic Leukaemia in a part of Algerian children with Berber origin in the East of Algeria . The study has done on 47 ill persons with an average age of (09±06 ) years , with whom the disease has diagnosed by blood and marrow examination in the hospital of blood diseases in the CHU of Batna, and on 194 healthy witnesses of the same age. The two groups were benefited by a dosage of the concentration of the homocysteine vitamin B9 ,vitamin B12 , and also of the study of special polymorphisms of indispensable enzymes in the metabolism of this acid , and that by the use of the method ( Light cycler ) Real time PCR , on the following enzymes : MS ( C2756G ), MSR ( A66G ) ,MTHFR1 ( C677T ) and MTHFR2 (A1298C). The obtained results have revealed that the rate of the homozygote muted genotype is the less frequent in the two groups , and that exist at list one genotype of each enzyme in the ill group and in which the percentage exceed with remarkable way the same genotype in the healthy group and we notice specially the muted genotype GG of -the methionine synthetase-and the form TT of the enzyme – methyline tetra hydrofolate reductase – We notice the existence of considerable number of genotypes in the ill group lied with characteristic increase of this Amino-acid ,and that for the reduction of the biologic activity of these enzymes which become inefficient in the transfer of the homocysteine into the methionine and cause the diminution of the biologic activity of these enzymes and with consequence the reduction of the percentage of methylic radicals in the DNA of studied genes and that lead to the increase of the activity and the capacity of transcription , and it-s so probably that this last one is one of the factors of this disease especially if we know that the specific check-up of vitamins is normal and similar in the two groups , which ovoid the hypothesis of the reduction of vitamins . We notice also that the heterozygote genotype is the less in the sick category except the MTHFR2. Wild genotype is more frequent in the witness group except MSR. Even these results are partials; they open a new way in the genetic diagnosis of this malicious disease which allow a precocious diagnosis and the use of an effective and appropriated treatment in the same time.

Keywords: Genetic polymorphism, Acute Lymphoblastic Leukaemia, Biomarkers, Metabolism of homocystein

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