Search results for: Patient doses.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 439

Search results for: Patient doses.

259 Effect of Gamma Irradiation on the Crystalline Structure of Poly(Vinylidene Fluoride)

Authors: Adriana Souza M. Batista, Cláubia Pereira, Luiz O. Faria

Abstract:

The irradiation of polymeric materials has received much attention because it can produce diverse changes in chemical structure and physical properties. Thus, studying the chemical and structural changes of polymers is important in practice to achieve optimal conditions for the modification of polymers. The effect of gamma irradiation on the crystalline structure of poly(vinylidene fluoride) (PVDF) has been investigated using differential scanning calorimetry (DSC) and X-ray diffraction techniques (XRD). Gamma irradiation was carried out in atmosphere air with doses between 100 kGy at 3,000 kGy with a Co-60 source. In the melting thermogram of the samples irradiated can be seen a bimodal melting endotherm is detected with two melting temperature. The lower melting temperature is attributed to melting of crystals originally present and the higher melting peak due to melting of crystals reorganized upon heat treatment. These results are consistent with those obtained by XRD technique showing increasing crystallinity with increasing irradiation dose, although the melting latent heat is decreasing.

Keywords: Differential scanning calorimetry, gamma irradiation, PVDF, X-ray diffraction technique.

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258 Biochemical Changes in the Liver of Mice after Exposure to Different Doses of Diclofenac Sodium

Authors: Deepak Mohan, Sushma Sharma

Abstract:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a group of widely used drugs for the treatment of rheumatoid diseases and to relieve pain and inflammation due to their analgesic anti-pyretic and anti-inflammatory properties. The therapeutic and many of the toxic effects of NSAIDs result from reversible inhibition of enzymes in the cyclooxygenase (COX) group. In the present investigation the effect of the drug on the concentration of lipids, and on the activity of the enzymes i.e. acid and alkaline phosphatase, GOT, GPT and lipid peroxidase were studied. There was a significant enhancement in the activities of both acid and alkaline phosphatase after 21 days of treatment. Proportionate increase in the MDA contents was observed after different days of diclofenac treatment. Cellular damage in the liver resulted in decrease in the activity of both GOT (Glutamate oxaloacetate transaminase) and GPT (Glutamate pyruvate transaminase) in both low and high dose groups. Significant decrease in the liver contents was also observed in both dose groups.

Keywords: Anti-inflammatory, cyclooxygenase, glutamate oxaloacetate transaminase, malondialdehyde.

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257 Absorbed Dose Estimation of 177Lu-DOTATOC in Adenocarcinoma Breast Cancer Bearing Mice

Authors: S. Zolghadri, M. Mousavi-Daramoroudi, H. Yousefnia, F. Abbasi-Davani

Abstract:

In this study, the absorbed dose of human organs after injection of 177Lu-DOTATOC was studied based on the biodistribution of the complex in adenocarcinoma breast cancer bearing mice. For this purpose, the biodistribution of the radiolabelled complex was studied and compartmental modeling was applied to calculate the absorbed dose with high precision. As expected, 177Lu-DOTATOC illustrated a notable specific uptake in tumor and pancreas, organs with high level of somatostatin receptor on their surface and the effectiveness of the radio-conjugate for targeting of the breast adenocarcinoma tumors was indicated. The elicited results of modeling were the exponential equations, and those are utilized for obtaining the cumulated activity data by taking their integral. The results also exemplified that non-target absorbed-doses such as the liver, spleen and pancreas were approximately 0.008, 0.004, and 0.039, respectively. While these values were so much lower than target (tumor) absorbed-dose, it seems due to this low toxicity, this complex is a good agent for therapy.

Keywords: Breast cancer, compartmental modeling, 177Lu, dosimetry.

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256 Forensic Implications of Blowfly Chrysomya rufifacies (Calliphoridae: Diptera) Development Rates Affected by Ketum Extract

Authors: A. R. Rashid, A. S. Siti, F. R. Siti, A. R. Reena, H. S. S. Sharifah, F. Z. Nurul, W. A. Nazni

Abstract:

This study was conducted to examine the effects of ketum extract on development of Chrysomya rufifacies and to analyze the presence of mitragynine in the larvae samples. 110 newly emerged first instar larvae of C. rufifacies were introduced on ketum extract-mixed cow liver at doses of 0, 20, 40 and 60g. Blowfly development rate was determined with 12 hour intervals and mitragynine in larvae was extracted and quantitated. C. rufifacies in control group took about 192 hours to complete their development from first instar larvae to adult blowfly; meanwhile blowfly form from the highest dose of ketum was 264 hours. Mitragynine was detected in all groups of treatment, except for control. In conclusion, the presence of mitragynine in C. rufifacies is affected in delaying development rates of the blowfly for up to 62 hours or 3 days. Chemical analysis of mitragynine from larvae samples showed that this alkaloid present in all specimens analyzed. 

Keywords: Chrysomya rufifacies, Ketum, Mitragynine, Postmortem Interval (PMI).

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255 Effect of Bio-Nitrogen as a Partial Alternative to Mineral-Nitrogen Fertiliser on Growth, Nitrate and Nitrite Contents, and Yield Quality in Brassica oleracea L.

Authors: Saad M. Howladar, Mostafa M. Rady, Ashraf Sh. Osman

Abstract:

Effects of bio-nitrogen fertilizer (bio-N), as a partial alternative to mineral-nitrogen fertilizer (mineral-N), on growth, yield and yield quality of broccoli plants were investigated. Bio-N was applied at 1, 2 or 3 doses in combination with 65% of the recommended dose of mineral-N (bio-N1, bio-N2 or bio-N3 + ⅔mineral-N). However, 100% of the recommended dose of mineral- N was applied as a control. Significant positive influences of the bio- N3 + ⅔mineral-N treatment were observed on growth traits, leaf contents of nitrogen, phosphorus, potassium, nitrate and nitrite, and yield quality when compared to the other two combined treatments. In contrast, there were no significant differences in these parameters between the bio-N3 + ⅔mineral-N and the control treatments, except for leaf contents of nitrate and nitrite. They showed lower contents in the bio-N3 + ⅔mineral-N treatment than the control. Therefore, we recommend using bio-N as a partial alternative to mineral-N for healthy nutrition.

Keywords: Bio-fertilization, broccoli, growth, nitrate, nitrite, yield quality.

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254 Traumatic Ankle Pain: Adequacy of Clinical Information in X-Ray Request with Reference to the Ottawa Ankle Rule

Authors: Rania Mustafa

Abstract:

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

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

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253 Physicians’ Knowledge and Perception of Gene Profiling in Malaysia

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

Abstract:

Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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252 Characterization of Gamma Irradiated PVDF and PVDF/Graphene Oxide Composites by Spectroscopic Techniques

Authors: Juliana V. Pereira, Adriana S. M. Batista, Jefferson P. Nascimento, Clascídia A. Furtado, Luiz O. Faria

Abstract:

The combination of the properties of graphene oxide (OG) and PVDF homopolymer makes their combined composite materials as multifunctional systems with great potential. Knowledge of the molecular structure is essential for better use. In this work, the degradation of PVDF polymer exposed to gamma irradiation in oxygen atmosphere in high dose rate has been studied and compared to degradation of PVDF/OG composites. The samples were irradiated with a Co-60 source at constant dose rate, with doses ranging from 100 kGy to 1,000 kGy. In FTIR data shown that the formation of oxidation products was at the both samples with formation of carbonyl and hydroxyl groups amongst the most prevalent products in the pure PVDF samples. In the other hand, the composites samples exhibit less presence of degradation products with predominant formation of carbonyl groups, these results also seen in the UV-Vis analysis. The results show that the samples of composites may have greater resistance to the irradiation process, since they have less degradation products than pure PVDF samples seen by spectroscopic techniques.

Keywords: Gamma irradiation, PVDF, PVDF/OG composites, spectroscopic techniques.

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251 Assessment of the Efficacy of Oral Vaccination of Wild Canids and Stray Dogs against Rabies in Azerbaijan

Authors: E. N. Hasanov, K. Y. Yusifova, M. A. Ali

Abstract:

Rabies is a zoonotic disease that causes acute encephalitis in domestic and wild carnivores. The goal of this investigation was to analyze the data on oral vaccination of wild canids and stray dogs in Azerbaijan. Before the start of vaccination campaign conducted by the IDEA (International Dialogue for Environmental Action) Animal Care Center (IACC), all rabies cases in Azerbaijan for the period of 2017-2020 were analyzed. So, 30 regions for oral immunization with the Rabadrop vaccine were selected. In total, 95.9 thousand doses of baits were scattered in 30 regions, 970 (0.97%) remained intact. In addition, a campaign to sterilize and vaccinate stray dogs and cats undoubtedly had a positive impact on reducing the dynamics of rabies incidence. During the period 2017-2020, 2,339 dogs and 2,962 cats were sterilized and vaccinated under this program. It can be noted that the risk of rabies infection can be reduced through special preventive measures against disease reservoirs, which include oral immunization of wild and stray animals.

Keywords: Rabies, vaccination, oral immunization, wild canids, stray dogs, vaccine, disease reservoirs.

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250 Electron Beam Processing of Ethylene-Propylene-Terpolymer-Based Rubber Mixtures

Authors: M. D. Stelescu, E. Manaila, G. Craciun, D. Ighigeanu

Abstract:

The goal of the paper is to present the results regarding the influence of the irradiation dose and amount of multifunctional monomer trimethylol-propane trimethacrylate (TMPT) on ethylene-propylene-diene terpolymer rubber (EPDM) mixtures irradiated in electron beam. Blends, molded on an electrically heated laboratory roller mill and compressed in an electrically heated hydraulic press, were irradiated using the ALID 7 of 5.5 MeV linear accelerator in the dose range of 22.6 kGy to 56.5 kGy in atmospheric conditions and at room temperature of 25 °C. The share of cross-linking and degradation reactions was evaluated by means of sol-gel analysis, cross-linking density measurements, FTIR studies and Charlesby-Pinner parameter (p0/q0) calculations. The blends containing different concentrations of TMPT (3 phr and 9 phr) and irradiated with doses in the mentioned range have present the increasing of gel content and cross-linking density. Modified and new bands in FTIR spectra have appeared, because of both cross-linking and chain scission reactions.

Keywords: Electron beam irradiation, EPDM rubber, crosslinking density, gel fraction.

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249 Dental Ethics versus Malpractice, as Phenomenon with a Growing Trend

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

Abstract:

Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. Let this article serve as a short communication between readers and interested parties about the problems that dental malpractice can bring to the community. Malpractice should not be seen only as a professional wrong approach, but also as a phenomenon that can occur during dental practice. The aim of this article is presentation of the latest data published in the literature about malpractice. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed that the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited amount of data on the same topic. Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: Dental ethics, malpractice, professional protocol, random deviation, dental tourism.

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248 Breeding Biology and Induced Breeding Status of Freshwater Mud Eel, Monopterus cuchia

Authors: M. F. Miah, H. Ali, E. Zannath, T. M. Shuvra, M. N. Naser, M. K. Ahmed

Abstract:

In this study, breeding biology and induced breeding of freshwater mud eel, Monopterus cuchia was observed during the experimental period from February to June, 2013. Breeding biology of freshwater mud eel, Monopterus cuchia was considered in terms of gonadosomatic index, length-weight relationship of gonad, ova diameter and fecundity. The ova diameter was recorded from 0.3 mm to 4.30 mm and the individual fecundity was recorded from 155 to 1495 while relative fecundity was found from 2.64 to 12.45. The fecundity related to body weight and length of fish was also discussed. A peak of GSI was observed 2.14±0.2 in male and 5.1 ±1.09 in female. Induced breeding of freshwater mud eel, Monopterus cuchia was also practiced with different doses of different inducing agents like pituitary gland (PG), human chorionic gonadotropin (HCG), Gonadotropin releasing hormone (GnRH) and Ovuline-a synthetic hormone in different environmental conditions. However, it was observed that the artificial breeding of freshwater mud eel, Monopterus cuchia was not yet succeeded through inducing agents in captive conditions, rather the inducing agent showed negative impacts on fecundity and ovarian tissues. It was seen that mature eggs in the oviduct were reduced, absorbed and some eggs were found in spoiled condition.

Keywords: Breeding biology, induced breeding, Monopterus cuchia.

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247 A Retrospective Cross-Sectional Study on the Prevalence and Factors Associated with Virological Non-Suppression among HIV-Positive Adult Patients on Antiretroviral Therapy in Woliso Town, Oromia, Ethiopia

Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

Abstract:

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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246 CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

Abstract:

The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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245 Dexamethasone: Impact on Testicular Activity

Authors: H. Sadi-Guettaf, F. Hadj Bekkouche

Abstract:

Dexamethasone (Dex) is a synthetic glucocorticoid that is used in therapy. However prolonged treatments with high doses are often required. This causes side effects that interfere with the activity of several endocrine systems, including the gonadotropic axis. The aim of our study is to determine the effect of Dex on testicular function in prepubertal Wistar rats. Newborn Wistar rats are submitted to intraperitoneal injection of Dex (1μg of Dex dissolved in NaCl 0.9% / 5g bw) for 20 days and then sacrificed at the age of 40days. A control group received NaCl 0.9%. The rat is weighed daily. The plasmatic levels of testosterone, LH and FSH were measured by radioimmunoassay. A histomorphometric study was performed on sections of testis. Treated groups showed a significant decrease in body weight (p < 0.05), testis weight (p < 0.05) and plasma levels of testosterone (p < 0.05), of LH (P < .05) and FSH (p> 0.05). There is a reduction of seminiferous tubules average diameter and also of the seminiferous epithelium thickness with an increasing of lumen tubular. The diameter of the Leydig cells and Sertoli cell nucleus is also significantly reduced. Spermatogenesis is blocked at the stage round spermatid unlike witnesses or elongated spermatid stage is found. These results suggest that Dex administered during neonatal life influences testicular activity in the long term.

Keywords: Dexamethasone, FSH, LH, rat, testis, testosterone.

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244 Software Architecture and Support for Patient Tracking Systems in Critical Scenarios

Authors: Gianluca Cornetta, Abdellah Touhafi, David J. Santos, Jose Manuel Vazquez

Abstract:

In this work a new platform for mobile-health systems is presented. System target application is providing decision support to rescue corps or military medical personnel in combat areas. Software architecture relies on a distributed client-server system that manages a wireless ad-hoc networks hierarchy in which several different types of client operate. Each client is characterized for different hardware and software requirements. Lower hierarchy levels rely in a network of completely custom devices that store clinical information and patient status and are designed to form an ad-hoc network operating in the 2.4 GHz ISM band and complying with the IEEE 802.15.4 standard (ZigBee). Medical personnel may interact with such devices, that are called MICs (Medical Information Carriers), by means of a PDA (Personal Digital Assistant) or a MDA (Medical Digital Assistant), and transmit the information stored in their local databases as well as issue a service request to the upper hierarchy levels by using IEEE 802.11 a/b/g standard (WiFi). The server acts as a repository that stores both medical evacuation forms and associated events (e.g., a teleconsulting request). All the actors participating in the diagnostic or evacuation process may access asynchronously to such repository and update its content or generate new events. The designed system pretends to optimise and improve information spreading and flow among all the system components with the aim of improving both diagnostic quality and evacuation process.

Keywords: IEEE 802.15.4 (ZigBee), IEEE 802.11 a/b/g (WiFi), distributed client-server systems, embedded databases, issue trackers, ad-hoc networks.

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243 Comparison of Statins Dose Intensity on HbA1c Control in Outpatients with Type 2 Diabetes: A Prospective Cohort Study

Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Ahmed A. Khamis, Abeer Kharshid, Nor Azizah Aziz

Abstract:

The effect of statins dose intensity (SDI) on glycemic control in patients with existing diabetes is unclear. Also, there are many contradictory findings were reported in the literature; thus, it is limiting the possibility to draw conclusions. This project was designed to compare the effect of SDI on glycated hemoglobin (HbA1c%) control in outpatients with Type 2 diabetes in the endocrine clinic at Hospital Pulau Pinang, Malaysia, between July 2015 and August 2016. A prospective cohort study was conducted, where records of 345 patients with Type 2 diabetes (Moderate-SDI group 289 patients and high-SDI cohort 56 patients) were reviewed to identify demographics and laboratory tests. The target of glycemic control (HbA1c < 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, and the results were presented as descriptive statistics. From 289 moderate-SDI cohorts with a mean age of 57.3 ± 12.4 years, only 86 (29.8%) cases were shown to have controlled glycemia, while there were 203 (70.2%) cases with uncontrolled glycemia with confidence interval (CI) of 95% (6.2–10.8). On the other hand, the high-SDI group of 56 patients with Type 2 diabetes with a mean age 57.7±12.4 years is distributed among 11 (19.6%) patients with controlled diabetes, and 45 (80.4%) of them had uncontrolled glycemia, CI: 95% (7.1–11.9). The study has demonstrated that the relative risk (RR) of uncontrolled glycemia in patients with Type 2 diabetes that used high-SDI is 1.15, and the excessive relative risk (ERR) is 15%. The absolute risk (AR) is 10.2%, and the number needed to harm (NNH) is 10. Outpatients with Type 2 diabetes who use high-SDI of statin have a higher risk of uncontrolled glycemia than outpatients who had been treated with a moderate-SDI.

Keywords: Cohort study, diabetes control, dose intensity, HbA1c, Malaysia, statin, Type 2 diabetes mellitus, uncontrolled glycemia.

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242 In vitro Cytotoxic and Genotoxic Effects of Arsenic Trioxide on Human Keratinocytes

Authors: H. Bouaziz, M. Sefi, J. de Lapuente, M. Borras, N. Zeghal

Abstract:

Although, arsenic trioxide has been the subject of toxicological research, in vitro cytotoxicity and genotoxicity studies using relevant cell models and uniform methodology are not well elucidated. Hence, the aim of the present study was to evaluate the cytotoxicity and genotoxicity induced by arsenic trioxide in human keratinocytes (HaCaT) using the MTT [3-(4, 5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide] and alkaline single cell gel electrophoresis (Comet) assays, respectively. Human keratinocytes were treated with different doses of arsenic trioxide for 4 h prior to cytogenetic assessment. Data obtained from the MTT assay indicated that arsenic trioxide significantly reduced the viability of HaCaT cells in a dose-dependent manner, showing an IC50 value of 34.18 ± 0.6 μM. Data generated from the comet assay also indicated a significant dose-dependent increase in DNA damage in HaCaT cells associated with arsenic trioxide exposure. We observed a significant increase in comet tail length and tail moment, showing an evidence of arsenic trioxide -induced genotoxic damage in HaCaT cells. This study confirms that the comet assay is a sensitive and effective method to detect DNA damage caused by arsenic.

Keywords: Arsenic trioxide, cytotoxixity, genotoxicity, HaCaT.

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241 Using Data Clustering in Oral Medicine

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

Abstract:

The vast amount of information hidden in huge databases has created tremendous interests in the field of data mining. This paper examines the possibility of using data clustering techniques in oral medicine to identify functional relationships between different attributes and classification of similar patient examinations. Commonly used data clustering algorithms have been reviewed and as a result several interesting results have been gathered.

Keywords: Oral Medicine, Cluto, Data Clustering, Data Mining.

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240 Pre and Post Mordant Effect of Alum on Gamma Rays Assisted Cotton Fabric by Using Ipomoea indica Leaves Extract

Authors: Abdul Hafeez, Shahid Adeel, Ayesha Hussain

Abstract:

There are number of plants species in the universe which give the protections from different diseases and give colour for the foods and textiles. The environmental condition of the universe suggested toward the ecofriendly textiles. The aim of the paper is to analyze the influence of pre & post mordanting of alum on radiated cotton fabric with Gamma Radiation of different doses by using Ipomoea indica leaves extract. Alum used as mordant with the concentration of 2, 4, 6, 8 and 10% as pre and post mordanting to observe the effect of light and colour fastness of radiated cotton. 6% of alum concentration in pre mordanting gave good colour strength 117.82 with darker in shade toward the greenish tone and in post mordanting 6% concentration gave good colour strength 102.19. The lab values show that the colour is darker in tone and gave bluish effect. Further results showed that alum gave good light and rubbing fastness on gamma radiated cotton fabric.

Keywords: Ipomoea indica, gamma radiation, alum, light fastness.

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239 Vancomycin and Rifaximin Combination Therapy for Diarrhoea Predominant Irritable Bowel Syndrome: An Observational Study

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

Abstract:

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

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

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238 Effect of Zeolite on the Decomposition Resistance of Organic Matter in Tropical Soils under Global Warming

Authors: Mai Thanh Truc, Masao Yoshida

Abstract:

Global temperature had increased by about 0.5oC over the past century, increasing temperature leads to a loss or a decrease of soil organic matter (SOM). Whereas soil organic matter in many tropical soils is less stable than that of temperate soils, and it will be easily affected by climate change. Therefore, conservation of soil organic matter is urgent issue nowadays. This paper presents the effect of different doses (5%, 15%) of Ca-type zeolite in conjunction with organic manure, applied to soil samples from Philippines, Paraguay and Japan, on the decomposition resistance of soil organic matter under high temperature. Results showed that a remain or slightly increase the C/N ratio of soil. There are an increase in percent of humic acid (PQ) that extracted with Na4P2O7. A decrease of percent of free humus (fH) after incubation was determined. A larger the relative color intensity (RF) value and a lower the color coefficient (6logK) value following increasing zeolite rates leading to a higher degrees of humification. The increase in the aromatic condensation of humic acid (HA) after incubation, as indicates by the decrease of H/C and O/C ratios of HA. This finding indicates that the use of zeolite could be beneficial with respect to SOM conservation under global warming condition.

Keywords: Global warming, Humic substances, Soil organicmatter, Zeolite.

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237 The implementation of IHE ATNA for the EHR system

Authors: Sheng-Chi Tseng, Der-Ming Liou

Abstract:

The health record in the Electronic Health Record (EHR) system is more sensitive than demographic. It raises the important issue for the EHR requirement in privacy, security, audit trail, patient access, and archiving and data retention. The studies about the EHR system security are deficient. The aim of this study is to build a security environment for the EHR system by Integrating the Healthcare Enterprise (IHE) Audit Trail and Node Authentication Security (ATNA) profile. The CDAs can be access in a secure EHR environment.

Keywords: IHE ATNA, EHR security.

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236 Heart Rate Variability Analysis for Early Stage Prediction of Sudden Cardiac Death

Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

Abstract:

In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: Early stage prediction, heart rate variability, linear and non linear analysis, sudden cardiac death.

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235 In vitro Effects of Amygdalin on the Functional Competence of Rabbit Spermatozoa

Authors: Marek Halenár, Eva Tvrdá, Tomáš Slanina, Ľubomír Ondruška, Eduard Kolesár, Peter Massányi, Adriana Kolesárová

Abstract:

The present in vitro study was designed to reveal whether amygdalin (AMG) is able to cause changes to the motility, viability and mitochondrial activity of rabbit spermatozoa. New Zealand White rabbits (n = 10) aged four months were used in the study. Semen samples were collected from each animal and used for the in vitro incubation. The samples were divided into five equal parts and diluted with saline supplemented with 0, 0.5, 1, 2.5 and 5 mg/mL AMG. At times 0h, 3h and 5h spermatozoa motion parameters were assessed using the SpermVision™ computer-aided sperm analysis (CASA) system, cell viability was examined with the metabolic activity (MTT) assay, and the eosin-nigrosin staining technique was used to evaluate the viability of rabbit spermatozoa. All AMG concentrations exhibited stimulating effects on the spermatozoa activity, as shown by a significant preservation of the motility (P<0.05 with respect to 0.5 mg/mL and 1 mg/mL AMG; Time 5 h) and mitochondrial activity (P< 0.05 in case of 0.5 mg/mL AMG; P< 0.01 in case of 1 mg/mL AMG; P < 0.001 with respect to 2.5 mg/mL and 5 mg/mL AMG; Time 5 h). None of the AMG doses supplemented had any significant impact of the spermatozoa viability. In conclusion, the data revealed that short-term co-incubation of spermatozoa with AMG may result in a higher preservation of the sperm structural integrity and functional activity.

Keywords: Amygdalin, CASA, mitochondrial activity, motility, rabbits, spermatozoa, viability.

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234 Transforming Health Information from Manual to Digital (Electronic) World–Reference and Guide

Authors: S. Karthikeyan, Naveen Bindra

Abstract:

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

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

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233 Clinical Benefits of an Embedded Decision Support System in Anticoagulant Control

Authors: Tony Austin, Shanghua Sun, Nathan Lea, Steve Iliffe, Dipak Kalra, David Ingram, David Patterson

Abstract:

Computer-based decision support (CDSS) systems can deliver real patient care and increase chances of long-term survival in areas of chronic disease management prone to poor control. One such CDSS, for the management of warfarin, is described in this paper and the outcomes shown. Data is derived from the running system and show a performance consistently around 20% better than the applicable guidelines.

Keywords: "Decision Support", "Anticoagulant Control"

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232 A Neural Computing-Based Approach for the Early Detection of Hepatocellular Carcinoma

Authors: Marina Gorunescu, Florin Gorunescu, Kenneth Revett

Abstract:

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

Keywords: Early HCC diagnosis, probabilistic neural network.

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231 Risk Management Approach for a Secure and Performant Integration of Automated Drug Dispensing Systems in Hospitals

Authors: Hind Bouami, Patrick Millot

Abstract:

Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, hospitals, human-centered automated system, risk management.

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230 Status of Thyroid Function and Iron Overload in Adolescents and Young Adults with Beta- Thalassemia Major Treated with Deferoxamine in Jordan

Authors: Fawzi Irshaid, Kamal Mansi

Abstract:

Thyroid dysfunction is one of the most frequently reported complications of chronic blood transfusion therapy in patients with beta-thalassemia major (BTM). However, the occurrence of thyroid dysfunction and its possible association with iron overload in BTM patients is still under debate. Therefore, this study aimed to investigate the status of thyroid functions and iron overload in adolescent and young adult patients with BTM in Jordan population. Thirty six BTM patients aged 12-28 years and matched controls were included in this study. All patients have been receiving frequent blood transfusion to maintain pretransfusion hemoglobin concentration above 10 g dl-1 and deferoxamine at a dose of 45 mg kg-1 day-1 (8 h, 5-7 days/week) by subcutaneous infusion. Blood samples were drawn from patients and controls. The status of thyroid functions and iron overload was evaluated by measurements of serum free thyroxine (FT4), triiodothyronine (FT3), thyrotropin (TSH) and serum ferritin level. A number of some hematological and biochemical parameters were also measured. It was found that hematocrit, serum ferritin, hemoglobin, FT3 and zinc, copper mean values were significantly higher in the patients than in the controls (P< 0.05). On other hand, leukocyte, FT4 and TSH mean values were similar to that of the controls. In addition, our data also indicated that all of the above examined parameters were not significantly affected by the patient-s age and gender. Deferoxamine approach for removing excess iron from our BTM patient did not normalize the values of serum ferritin, copper and zinc, suggesting poor compliance with deferoxamine chelation therapy. Thus, we recommend the use of a combination of deferoxamine and deferiprone to reduce the risk of excess of iron in our patients. Furthermore, thyroid dysfunction appears to be a rare complication, because our patients showed normal mean levels for serum TSH and FT4. However, high mean levels of serum ferritin, zinc, copper might be seen as potential risk factors for initiation and development of thyroid dysfunctions and other diseases. Therefore, further studies must be carried out at yearly intervals with large sample number, to detect subclinical thyroid dysfunction cases.

Keywords: beta-thalassemia major, deferoxamine, iron overload, triiodothyronine, zinc.

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