Search results for: critically ill patients

Authors: Alexander V. Libin, Manon Schladen, Assya Pascalev, Nawar Shara, Miriam Philmon, Yuri Millo, Joseph Verbalis

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Chronic conditions carry with them strong emotions and often lead to charged relationships between patients and their health providers and, by extension, patients and health researchers. Persons are both autonomous and relational and a purely cognitive model of autonomy neglects the social and relational basis of chronic illness. Ensuring genuine informed consent in research requires a thorough understanding of how participants perceive a study and their reasons for participation. Surveys may not capture the complexities of reasoning that underlies study participation. Contradictory reasons for participation, for instance an initial claim of altruism as rationale and a subsequent claim of personal benefit (therapeutic misconception), affect the quality of informed consent. Individuals apply principles through the filter of personal values and lived experience. Authentic autonomy, and hence authentic consent to research, occurs within the context of patients- unique life narratives and illness experiences.

Keywords: ethical dilemmas, open source technology, patient education, psychology of decision making

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Authors: Ahmed Abdi Hassan, Mustapha Muhammad Aliyu

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Turmeric (Curcuma longa) belongs to the ginger family and is used for food coloring mostly in Asian countries. It has long traditional medicinal value for the treatment of inflammations with excellent antioxidant properties. The purpose of this study is to investigate the efficiency of turmeric powder in the treatment of hyperthyroidism when combined with carbimazole antithyroid drug. The trial was conducted on 20 hyperthyroid patients but only 16 of them were successfully enrolled for the study. The 16 patients were divided into two equal groups where one group was treated with the only carbimazole while the other group was treated with a combined approach of carbimazole plus turmeric for 6 months consecutively. The result obtained is promising showing an average improvement of 99% in Thyroid-stimulating hormone (TSH) and 88%Thyroid Autoantibodies (TPOAb) in patients treated with the combined approach compared to those treated with the only carbimazole with an average of 3% and 18% of TSH and TPOAb improvement respectively. However, no major difference has been observed in both T4 and T3. Therefore, turmeric powder is a promising treatment if carefully and consistently combined with carbimazole antithyroid drug at very low amounts of 1.5 to 2 grams for at least 2 to 3 times a week.

Keywords: Thyroid, curcuminoids, turmeric, thyroxine, triiodothyronine, thyroid stimulating hormone, TPOAb.

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Authors: Anchana Khemphila, Veera Boonjing

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In this study, the Multi-Layer Perceptron (MLP)with Back-Propagation learning algorithm are used to classify to effective diagnosis Parkinsons disease(PD).It-s a challenging problem for medical community.Typically characterized by tremor, PD occurs due to the loss of dopamine in the brains thalamic region that results in involuntary or oscillatory movement in the body. A feature selection algorithm along with biomedical test values to diagnose Parkinson disease.Clinical diagnosis is done mostly by doctor-s expertise and experience.But still cases are reported of wrong diagnosis and treatment. Patients are asked to take number of tests for diagnosis.In many cases,not all the tests contribute towards effective diagnosis of a disease.Our work is to classify the presence of Parkinson disease with reduced number of attributes.Original,22 attributes are involved in classify.We use Information Gain to determine the attributes which reduced the number of attributes which is need to be taken from patients.The Artificial neural networks is used to classify the diagnosis of patients.Twenty-Two attributes are reduced to sixteen attributes.The accuracy is in training data set is 82.051% and in the validation data set is 83.333%.

Keywords: Data mining, classification, Parkinson disease, artificial neural networks, feature selection, information gain.

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: Hypertension, dietary intake, weight, waist circumference, North of Iran.

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Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb

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Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.

Keywords: Stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback.

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Authors: Arturo Aquino, Manuel Emilio Gegundez, Diego Marin

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In this paper, a new automated methodology to detect the optic disc (OD) automatically in retinal images from patients with risk of being affected by Diabetic Retinopathy (DR) and Macular Edema (ME) is presented. The detection procedure comprises two independent methodologies. On one hand, a location methodology obtains a pixel that belongs to the OD using image contrast analysis and structure filtering techniques and, on the other hand, a boundary segmentation methodology estimates a circular approximation of the OD boundary by applying mathematical morphology, edge detection techniques and the Circular Hough Transform. The methodologies were tested on a set of 1200 images composed of 229 retinographies from patients affected by DR with risk of ME, 431 with DR and no risk of ME and 540 images of healthy retinas. The location methodology obtained 98.83% success rate, whereas the OD boundary segmentation methodology obtained good circular OD boundary approximation in 94.58% of cases. The average computational time measured over the total set was 1.67 seconds for OD location and 5.78 seconds for OD boundary segmentation.

Keywords: Diabetic retinopathy, macular edema, optic disc, automated detection, automated segmentation.

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Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: Adverse reactions, contrast media, computed tomography, iodinated contrast agents.

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Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G.M. Petrakis

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Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called affective disorders, which is characterized by great mood swings. We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s nonresponse to treatment. We propose an architecture as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: Bipolar disorder, intelligent systems patient monitoring, semantic web technologies, IoT.

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Authors: Vimala Balakrishnan, Mohammad R. Shakouri, Hooman Hoodeh, Loo, Huck-Soo

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Diabetes is one of the high prevalence diseases worldwide with increased number of complications, with retinopathy as one of the most common one. This paper describes how data mining and case-based reasoning were integrated to predict retinopathy prevalence among diabetes patients in Malaysia. The knowledge base required was built after literature reviews and interviews with medical experts. A total of 140 diabetes patients- data were used to train the prediction system. A voting mechanism selects the best prediction results from the two techniques used. It has been successfully proven that both data mining and case-based reasoning can be used for retinopathy prediction with an improved accuracy of 85%.

Keywords: Case-Based Reasoning, Data Mining, Prediction, Retinopathy.

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Authors: S. Vijayakumar, M. Sasikala, T. S. Mohammed Saleem, Gurusharan, K. Gauthaman

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The main objective of our study is to collect data about the profile of the asthmatic patients in Assam and thereby have a comprehensive knowledge of the factors influencing the asthmatic patients of the state and their medication pattern. We developed a search strategy to find any publication about the community based survey asthma related and used. These to search the MEDLINE (1996 to current literature) CINAHL DOAJ pubmed databases using the key phrases, Asthma, Respiratory disorders, Drug therapy of Asthma, database decision support system and asthma. The appropriate literature was printed out from the online source and library (Journal) source. The study was conducted through a set of structured and non-structured questionnaires targeted on the asthmatic patients belonging to the rural and urban areas of Assam, during the month of Dec 2006 to July 2007, 138 cases were studied in Gauwathi Medical College & Hospital located in Bhangagarh, Assam in India. The demographic characteristics a factor in 138 patients with asthma with allergic rhinitis (cases) gives the detail profile of asthmatic patient-s distribution of Assam as classified on the basis of age and sex. It is evident from the study that male populations (66%) are more prone to asthma as compared to the females (34%).Another striking features that emerged from this survey is the maximum prevalence of asthma in the age group of 20- 30 years followed by infants belonging to the age group of 7 (0.05%) 0-10years among both male and female populations of Assam. The high incidence of asthma in the age group of 20-30 years may probably be due to the allergy arising out of sudden exposure to dust and pollen which the children face while playing and going to the school. The rural females in the age group of 30-40 years are more prone to asthma than urban females in the same age group may be due to sex differentiation among the tribal population of the state. Pharmacists should educate the asthmatics how to use inhalers considering growing menace of asthma in the state. Safer drugs should be produced in the form of aerosol so that easy administration by the asthmatic patients and physicians of the state is possible for curing asthma. The health centers should be more equipped with the medicines to cure asthma in the state like Assam.

Keywords: Asthma, Respiratory disease, Smoker.

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Authors: Atay A, Suer BT

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The aim of this retrospective study was to evaluate the parameters of dental implants such as patient gender, number of implant, failed implant before prosthetic restorations and failed implant after implantation and failed implant after prosthetic restorations. 135 male and 99 female patients, total 234 implant patients which have been treated with 450 implant between 2005- 2009 years in GATA Haydarpasa Training Hospital Dental Service. Twelve implants were failed before prosthetic restorations. Four implant were failed after fixed prosthetic restorations. Cumulative survival rate after prostheses were 97.56 % during 6 years period.

Keywords: Dental implants, implant supported prostheses, single implants, single crown

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Authors: Olga V. Lebedinskaya, Irina N. Kabanovskaya, Anna S. Lasareva, Nelly K. Akhmatova, Anatoliy P. Godovalov, Andrey V. Horinko, Mikhail V. Kiselevsky

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The nature, prevalence, cellular composition of leukocyte infiltrates and immunohistochemical characteristics of their constituent cells in the liver of patients with chronic viral hepatitis B and C were investigated. It was found that the area of distribution and cellular composition of infiltrates depended on the virus type and process activity. The expediency of immunohistochemical study using leukocyte infiltrates from liver biopsies of patients with viral hepatitis aimed at clarifying diagnosis, making prognosis, and choice of optimal treatment with elements of immune correction is emphasized.

Keywords: Viral hepatitis, leukocyte infiltration, immunohistochemical characteristics, immunosupression.

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: Cervical cancer, Manipuri women, RIIMS, Socio-demographic risk factors.

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Authors: Wayne Goodridge, Alexander Nikov, Ashok Sahai

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Multi criteria decision making (MCDM) methods like analytic hierarchy process, ELECTRE and multi-attribute utility theory are critically studied. They have irregularities in terms of the reliability of ranking of the best alternatives. The Routing Decision Support (RDS) algorithm is trying to improve some of their deficiencies. This paper gives a mathematical verification that the RDS algorithm conforms to the test criteria for an effective MCDM method when a linear preference function is considered.

Keywords: Decision support systems, linear preference function, multi-criteria decision-making algorithm, analytic hierarchy process.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: P. T. Ahamed Seyd, V. I. Thajudin Ahamed, Jeevamma Jacob, Paul Joseph K

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Diabetes mellitus (DM) is frequently characterized by autonomic nervous dysfunction. Analysis of heart rate variability (HRV) has become a popular noninvasive tool for assessing the activities of autonomic nervous system (ANS). In this paper, changes in ANS activity are quantified by means of frequency and time domain analysis of R-R interval variability. Electrocardiograms (ECG) of 16 patients suffering from DM and of 16 healthy volunteers were recorded. Frequency domain analysis of extracted normal to normal interval (NN interval) data indicates significant difference in very low frequency (VLF) power, low frequency (LF) power and high frequency (HF) power, between the DM patients and control group. Time domain measures, standard deviation of NN interval (SDNN), root mean square of successive NN interval differences (RMSSD), successive NN intervals differing more than 50 ms (NN50 Count), percentage value of NN50 count (pNN50), HRV triangular index and triangular interpolation of NN intervals (TINN) also show significant difference between the DM patients and control group.

Keywords: Autonomic nervous system, diabetes mellitus, frequency domain and time domain analysis, heart rate variability.

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Authors: Feng-Chuan Pan, Fang-Yue Liu

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Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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Authors: D. Farsi, Gh. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

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Background and aim: It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FT versus fentanyl-midazolam (FM) in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods: In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccessful rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: Procedural Sedation and Analgesia, Thiopental, Fentanyl, Midazolam, Orthopedic Procedure, Emergency Department, Pain.

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Authors: Om Pal, Amit Kumar Gupta, R. K. Garg

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An effective supplier selection process is very important to the success of any manufacturing organization. The main objective of supplier selection process is to reduce purchase risk, maximize overall value to the purchaser, and develop closeness and long-term relationships between buyers and suppliers in today’s competitive industrial scenario. The literature on supplier selection criteria and methods is full of various analytical and heuristic approaches. Some researchers have developed hybrid models by combining more than one type of selection methods. It is felt that supplier selection criteria and method is still a critical issue for the manufacturing industries therefore in the present paper the literature has been thoroughly reviewed and critically analyzed to address the issue.

Keywords: Supplier selection, AHP, ANP, TOPSIS, Mathematical Programming

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: Skeletal scintigraphy, SPECT/CT, imaging.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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Authors: K. Kalaiselvan, A. Elango, N.M. Nagarajan

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Laser beam welding is an important joining technique for Titanium/Aluminum thin sheet alloys with their increasing applications in aerospace, aircraft, automotive, electronics and other industries. In this paper the research and progress in laser welding of Ti/Al thin sheets are critically reviewed from different perspectives. Some important aspects such as microstructure, metallurgical defects and mechanical properties in weldments are discussed. Also the recent progress in laser welding of Ti/Al dissimilar thin sheets to provide a basis for further research work is reported.

Keywords: Laser welding, Titanium/Aluminium sheets, microstructure, metallurgical defects and mechanical properties.

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: Dilator, sexually active, vaginal dilation, vaginal stenosis.

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Authors: Kwok Tak Kit

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The trend of autonomous vehicles is the future solution to road networks congestion in terms of their advanced ability to drive closer together and at higher speeds than humans can do safely. Infrastructure sector can drive the economic prosperity and provide a balance and inclusive growth of sustainable economy development. In this paper, the road infrastructure and the future development of electric car, self-driving of autonomous vehicles and the increasing demand of automated car parking system are critically revised and this paper aims to provide the insight and achieve better sustainable infrastructure and community in smart city.

Keywords: Autonomous vehicles, sustainable infrastructure, real time parking, automated car parking.

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Authors: Komwit Surachat, Supasit Kajkamhaeng, Kasikrit Damkliang, Watanyoo Tiprat, Taninnuch Wacharanimit

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An accident is an unexpected and unplanned situation that happens and affects human in a negative outcome. The accident can cause an injury to a human biological organism. Thus, the provision of initial care for an illness or injury is very important move to prepare the patients/victims before sending to the doctor. In this paper, a First Aid Application is developed to give some directions for preliminary taking care of patient/victim via Android mobile device. Also, the navigation function using Google Maps API is implemented in this paper for searching a suitable path to the nearest hospital. Therefore, in the emergency case, this function can be activated and navigate patients/victims to the hospital with the shortest path.

Keywords: First Aid Application, Android, Google Maps API, Navigation System.

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Authors: Hai-Ying Liu, Yi-Hao Chen, Shu-Yin Pang, Feng-Hua Wang, Xiao-Fang Peng, Li-Yuan Yang, Zheng-Rong Chen, Yi Chen, Bing Zhu

Abstract:

Objective: Biliary atresia (BA) is characterized by progressive liver fibrosis. Epithelial-mesenchymal transition (EMT) has been implicated as a key mechanism in the pathogenesis of organ fibrosis. MiR-200a has been shown to repress EMT. We aim to explore the role of miR-200a in the fibrogenesis of BA. Methods: We obtained the plasma samples and liver samples from patients with BA or controls to examine the role of miR-200a. Histological liver fibrosis was assessed using the Ishak fibrosis scores. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was performed to detect the expression of miR-200a in plasma. We also evaluated the expression of miR-200a in liver tissues using tyramide signal amplification fluorescence in situ hybridization (TSA-FISH). The expression of EMT related proteins zinc finger E-box-binding homeobox 1 (ZEB1), E-cadherin and α-smooth muscle actin (α-SMA) in the liver sections were detected by immunohistochemical staining. Results: We found that the expression of miR-200a was both elevated in the plasma and liver tissues from BA patients compared with the controls. The hepatic expression of ZEB1 and α-SMA were markedly increased in the liver sections from BA patients compared to the controls, whereas E-cadherin was downregulated in the BA group. Simultaneously, we noted that the hepatic expression of miR-200a, E-cadherin and α-SMA were upregulated with the progression of liver fibrosis in the BA group, while ZEB1 was downregulated with the progression of liver fibrosis in BA patients. Conclusion: These findings suggest EMT has a critical effect on the fibrotic process of BA, and the interaction between miR-200a and ZEB1 may regulate EMT and eventually influence liver fibrogenesis of BA.

Keywords: Biliary atresia, liver fibrosis, MicroRNA, epithelial-mesenchymal transition, zinc finger e-box-binding homeobox 1.

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Authors: Sharan Badiger, Prema T. Akkasaligar, Sandeep HM, Biradar MS

Abstract:

Essential hypertension (HTN) usually clusters with other cardiovascular risk factors such as age, overweight, diabetes, insulin resistance and dyslipidemia. The target organ damage (TOD) such as left ventricular hypertrophy, microalbuminuria (MA), acute coronary syndrome (ACS), stroke and cognitive dysfunction takes place early in course of hypertension. Though the prevalence of hypertension is high in India, the relationship between microalbuminuria and target organ damage in hypertension is not well studied. This study aim at detecting MA in essential hypertension and its relation to severity of HTN, duration of HTN, body mass index (BMI), age and TOD such as HTN retinopathy and acute coronary syndrome The present study was done in 100 patients of essential hypertension non diabetics admitted to B.L.D.E.University-s Sri B.M.Patil Medical College, Bijapur, from October 2008 to April 2011. The patients underwent detailed history and clinical examination. Early morning 5 ml of urine sample was collected & MA was estimated by immunoturbidometry method. The relationship of MA with the duration & severity of HTN, BMI, age, sex and TOD's like hypertensive retinopathy, ACS was assessed by univariate analysis. The prevalence of MA in this study was found to be 63 %. In that 42% were male & 21% were female. In this study a significant association between MA and the duration of hypertension (p = 0.036) & (OR =0.438). Longer the duration of hypertension, more possibility of microalbumin in urine. Also there was a significant association between severity of hypertension and MA (p=0.045) and (OR=0.093). MA was positive in 50 (79.4%) patients out of 63, whose blood pressure was >160/100 mm Hg. In this study a significant association between MA and the grades of hypertensive retinopathy (p =0.011) and acute coronary syndrome (p = 0.041) (OR =2.805). Gender and BMI did not pose high risk for MA in this study.The prevalence of MA in essential hypertension is high in this part of the community and MA will increase the risk of developing target organ damage.Early screening of patients with essential hypertension for MA and aggressive management of positive cases might reduce the burden of chronic kidney diseases and cardiovascular diseases in the community.

Keywords: Acute coronary syndrome, Essential hypertension, Microalbuminuria, Target organ damage

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Authors: Ling-Lih Shen, Feng-Chuan Pan

Abstract:

Chronic diseases prevailed along with economic growth as well as life style changed in recent years in Taiwan. According to the governmental statistics, hypertension related disease is the tenth of death causes with 1,816 died directly from hypertension in 2010. There were more death causes amongst the top ten had been proofed that having strong association with the hypertension, such as heart diseases, cardiovascular diseases, and diabetes. Hypertension or High blood pressure is one of the major indicators for chronic diseases, and was generally perceived as the major causes of mortality. The literature generally suggested that regular physical exercise was helpful to prevent the occurrence or to ease the progress of a hypertension. This paper reported the process and outcomes in detailed of an improvement project of physical exercise intervention specific for hypertension patients. Physical information were measured before and after the project to obtain information such as weight, waistline, cholesterol (HD & LD), blood examination, as well as self-perceived health status. The intervention project involved a six-week exercise program, of which contained three times a week, 30 minutes of tutored physical exercise intervention. The project had achieved several gains in changing the subjects- behavior in terms of many important biophysical indexes. Around 20% of the participants had significantly improved their cholesterols, BMI, and changed unhealthy behaviors. Results from the project were encouraging, and would be good reference for other samples.

Keywords: Intervention, biological information, hypertension patients, behavioral changes, chronic disease

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Authors: K. Venclova, H. Urbancova, H. Vostra Vydrova

Abstract:

In current global economics the application of Business Continuity Management is the prerequisite for sustainable competitive advantage in an organization. Business Continuity Management is a managerial which identifies the potential impact of losses in an organization. The aim of this paper is to identify and critically evaluate the relative advantages and disadvantages of deploying Business Continuity Management in an organization on the basis of seven criteria. The strongest advantage of Business Continuity Management is in its capacity to identify a crisis situation and help the organization to flexibly and also to keep the critical knowledge within the organization. By contrast the main disadvantage is that establishing Business Continuity Management in an organization is time-consuming and its implementation as an integral part of the organizational culture present significant difficulties.

Keywords: Business continuity management, criteria, advantages, disadvantages, organisations, survey.

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Authors: Paria Soleimani, Arezoo Neshati

Abstract:

Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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