Search results for: patients with chronic disease

Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: Cancer Patients, E-Learning, Nursing, Web Based Education.

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Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

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Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: Hemodialysis units, hospital, renal dialysis, renal insufficiency chronic, resilience psychological.

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Authors: Leslie Beale

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Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: Health promotion, emotional health, patients with chronic disease, patient-centered care.

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Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL), its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know how to cope with having a family member with hepatitis C and more importantly to know what should you say and what shouldn’t you say as a positive hopeful attitude is essential for combating HCV chronic infection.

Keywords: Hepatitis C virus chronic infection, physical health component and mental health component of QoL, total quality of life.

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Authors: A. Seham A. Elgamal, Reham H. Saleh

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Chronic kidney disease became a global health problem worldwide. Therefore, in order to maintain a patient’s life and improve the survival rate, hemodialysis is essential to replace the function of their kidneys. However, those patients may complain about multiple physical and psychological stressors due to the nature of the disease and the need for frequent hemodialysis sessions. So, those patients use various strategies to cope with the stressors related to their disease and the treatment procedures. Cross-sectional, descriptive study was carried out to achieve the aim of the study. A convenient sample including all adult patients was recruited for this study. Hemodialysis Stressors Scale (HSS) and Jalowiec Coping Scale (JCS) were used to investigate the stressors and coping strategies of 89 hemodialysis patients, at a governmental hospital (King Khalid Hospital-Jeddah). Results of the study revealed that 50.7% experienced physiological stressors and 38% experienced psychosocial stressors. Also, optimistic, fatalistic, and supportive coping strategies were the most common coping strategies used by the patients with mean scores (2.88 + 0.75, 2.87 + 0.75, and 1.82 + 0.71), respectively. In conclusion, being familiar with the types of stressors and the effective coping strategies of hemodialysis patients and their families are important in order to enhance their adaptation with chronic kidney diseases.

Keywords: Coping strategies, hemodialysis, physiological stressors, psychological stressors.

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Authors: Stela Papa, Klementina Puto, Migena Pllaha

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HCV is a hepatotropic RNA virus, transmitted primarily via the blood route, which causes progressive disease such as chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma. HCV nowadays is a global healthcare problem. A variety of immunoassays including old and new technologies are being applied to detect HCV in our country. These methods include Immunochromatography assays (ICA), Fluorescence immunoassay (FIA), Enzyme linked fluorescent assay (ELFA), and Enzyme linked immunosorbent assay (ELISA) to detect HCV antibodies in blood serum, which lately is being slowly replaced by more sensitive methods such as rapid automated analyzer chemiluminescence immunoassay (CLIA). The aim of this study is to estimate HCV infection in carriers and chronic acute patients and to evaluate the use of new diagnostic methods. This study was realized from September 2016 to May 2018. During this study period, 2913 patients were analyzed for the presence of HCV by taking samples from their blood serum. The immunoassays performed were ICA, FIA, ELFA, ELISA, and CLIA assays. Concluding, 82% of patients taken in this study, resulted infected with HCV. Diagnostic methods in clinical laboratories are crucial in the early stages of infection, in the management of chronic hepatitis and in the treatment of patients during their disease.

Keywords: CLIA, ELISA, hepatitis C virus, immunoassay.

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Authors: Christopher C. Anyadubalu

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Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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Authors: Reza Ariaeinejad, Norm Archer

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Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Keywords: M-health, e-health, self-management, disease.

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Authors: P. Ghasemi Dehkordi, A. Doosti, M. R. Hajimirzaei

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TTV is an unenveloped circular single-stranded DNA virus with a diameter of 30-32 nm that first was described in 1997 in Japan. TTV was detected in various populations without proven pathology, including blood donors and in patients with chronic HBV and HCV hepatitis. The aim of this study was to determine the prevalence of TTV DNA in Iranian patients with chronic hepatitis B and C. Viral TTV-DNA was studied in 442 samples (202 with HBV, 138 with HCV and 102 controls) collected from west south of Iran. All extracted serum DNA was amplified by TTV ORF1 gene specific primers using the semi nested PCR technique. TTV DNA was detected in the serum of 8.9% and 10.8% patients with chronic hepatitis B and C, respectively. Prevalence of TTV-DNA in the serum of 102 controls was 2.9%. Results showed significant relation of TTV with HBV and HCV in patients by using T test examination (P<0.01). The prevalence of TTV-DNA in Iranian hepatitis B and C patients is rather high, and compare with other countries. To control and prevention of the distribution of TT-virus, examination of the blood and blood products it seems to be necessary.

Keywords: Transfusion-transmitted virus (TTV), Hepatitis Cvirus (HCV), Hepatitis B virus (HBV), ORF1 gene, Semi nested PCR, Iran.

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Authors: Ling-Lih Shen, Feng-Chuan Pan

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

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

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

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Authors: Elya S. Pepoyan, Astghik Z. Pepoyan

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The Zung self-depression scale and Beck Anxiety Inventory were used both to study the depression and anxiety levels of Armenian Crohn’s disease patients, and to reveal the relation between emotional status and placebo effect of these patients. On the other hand, the blood cell analyses and gut bacteria investigations were used to assess the placebo effect on ESR, and haemoglobin-s and leukocyte-s levels as well as gut commensal E. coli quantities of these patients. Despite of registered high levels of depression and anxiety, the high placebo effect on psychoemotional status for investigated patients during the investigations was described. On the other hand, no positive effect of placebo on measurements of ESP and hemoglobin-s levels of Crohn’s disease patients was revealed. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn’s disease is discussed.

Keywords: Crohn's disease, emotional disorders, placebo, gut microflora and blood composition.

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Authors: Astghik Z. Pepoyan, Elya S. Pepoyan

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The Zung self-depression scale and Beck Anxiety Inventory were used to study the depression and anxiety levels of Armenian Crohn's disease patients, as well as to reveal the relation between emotional status and placebo effect of these patients. Despite of registered high levels of depression and anxiety, the high placebo rate during investigations was described. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn's disease is obvious.

Keywords: Crohn's disease, emotional disorders, placebo, psychotherapy.

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Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

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Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: Chronic inflammatory diseases, intravenous infusion, mesenchymal stem cells (MSCs), umbilical cord blood.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: A. Zidani, M. Yahia K. Belhadi, S. Benbia

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Hepatitis C is an infectious disease transmitted by blood and due to hepatitis C virus (HCV), which attacks the liver. The infection is characterized by liver inflammation (hepatitis) that is often asymptomatic but can progress to chronic hepatitis and later cirrhosis and liver cancer. Our problem tends to highlight on the one hand the prevalence of infectious disease in the population of the region of Batna and on other hand the biological characteristics of this disease by a screening and a specific diagnosis based on serological tests, liver checkup (measurement of haematological and biochemical parameters). The results showed: The serology of hepatitis C establishes the diagnosis of infection with hepatitis C. In this study and with the serological test, 24 cases of the disease of hepatitis C were found in 1000 suspected cases (7 cases with normal transaminases and 17 cases with elevated transaminases). The prevalence of this disease in this study population was 2.4%. The presence of hepatitis C disrupts liver function including the onset of cytolysis, cholestasis, jaundice, thrombocytopenia, and coagulation disorders.

Keywords: Disease hepatitis C, serology, liver checkup

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

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

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

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Authors: Alexandru George Floares

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Chronic hepatitis B can evolve to cirrhosis and liver cancer. Interferon is the only effective treatment, for carefully selected patients, but it is very expensive. Some of the selection criteria are based on liver biopsy, an invasive, costly and painful medical procedure. Therefore, developing efficient non-invasive selection systems, could be in the patients benefit and also save money. We investigated the possibility to create intelligent systems to assist the Interferon therapeutical decision, mainly by predicting with acceptable accuracy the results of the biopsy. We used a knowledge discovery in integrated medical data - imaging, clinical, and laboratory data. The resulted intelligent systems, tested on 500 patients with chronic hepatitis B, based on C5.0 decision trees and boosting, predict with 100% accuracy the results of the liver biopsy. Also, by integrating the other patients selection criteria, they offer a non-invasive support for the correct Interferon therapeutic decision. To our best knowledge, these decision systems outperformed all similar systems published in the literature, and offer a realistic opportunity to replace liver biopsy in this medical context.

Keywords: Interferon, chronic hepatitis B, intelligent virtualbiopsy.

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Authors: Ghias ul Hassan, Bilal Nasir, Israr ul Haque, ShafiqAwan, Ghias Un NabiTayyab, S. Hassan Akhtar Bokhari, Khawar Saeed, Qazi Masroor

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Introduction: Pegylated Interferon and Ribavirin combination is standard of care in the management of chronic HCV infected patients. Efficacy of the therapy is judged by the ability to achieve biochemical and virological response as judged by RVR, EVR, ETR and SVR.Objective: To evaluate the efficacy of newly marketed biosimilar Pegylated Interferon Alpha 40KD (Peg INF) in chronic HCV patients. Materials and methods: This was observational, prospective multicentre study to evaluate the ability of biosimilar pegylated interferon alfa 2a (40KD) along with Ribavirin (weight based) to achieve SVR. The enrolled patients were separated into Naïve (A), Relapsers (B) and Non Responders(C) based on the previous history of interferon exposure and its response. The RGT was followed on ALT and RVR, EVR, ETR and SVR.Results:As per protocol analysis estimated SVR for three groups is 86.6% for naïve, 89.4% for relapsers and 52.4% for non-responders to standard interferon. Conclusion: It is concluded that Bio-similar pegylated interferon alfa-2a (40kD) along with Ribavirin has good anti-viral efficacy in Naïve, Relapsers and Non-responders to standard IFN of chronic HCV infected patients requiring treatment.

Keywords: SVR (Sustained virological response), NR (Nonresponders), Pegylated Interferon.

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Authors: Hassan M. Abo Salem, Xiaolin Huang

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Background: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantar flexor muscle tone by Modified Ashworth Scale. Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05).Conclusion: Mirror therapy combined with a conventional stroke rehabilitation program enhances lowerextremity motor recovery and walking speed in chronic stroke patients.

Keywords: Mirror therapy, stroke, MAS, walking speed.

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Authors: Tasnuva Tamanna, Sanjida Halim Topa

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

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

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Authors: Ching - Yi Lee, I-Hsiung Tseng, Feng-Chuan Pan

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Environment today is featured with aging population, increasing prevalence of chronic disease and complex of medical treatment. Safe use of pharmaceutics relied very much on the efforts made by both the health- related organizations and as well as the government agencies. As far as the specialization concern in providing health services to the patients, the government actively issued and implemented the divisions of medical treatment and pharmaceutical to improve the quality of care and to reduce medication errors and ensure public health. Pharmaceutical sub-sector policy has been implemented for 13 years. This study attempts to explore the factors that affect the patients- behavior intention of refilling a prescription from a NHIB pharmacy. Samples were those patients refilling their prescriptions with the case NHIB pharmacies. A self-administered questionnaire was used to collect respondents- information while the patients or family members visit the pharmacy for the refilling. 1,200 questionnaires were dispatched in 37 pharmacies that randomly selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas. 732 responses were gained with 604 valid samples for further analyses. Results of data analyses indicated that respondents- attitude, subjective norm, perceived behavior control and behavior intentions toward refilling behavior varied from some demographic variables to another. This research also suggested adding actual behavior, either by a self-report or observed, into the research.

Keywords: Separation of dispensing and prescribing, prescriptions refill slip, NHIB contracted pharmacy, drug safety, theory of planned behavior.

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

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

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

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Authors: Farhan Ismaeel Dakheel, Raoof Smko, K. Negrat, Abdelsalam Almarimi

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In this paper we used data mining techniques to identify outlier patients who are using large amount of drugs over a long period of time. Any healthcare or health insurance system should deal with the quantities of drugs utilized by chronic diseases patients. In Kingdom of Bahrain, about 20% of health budget is spent on medications. For the managers of healthcare systems, there is no enough information about the ways of drug utilization by chronic diseases patients, is there any misuse or is there outliers patients. In this work, which has been done in cooperation with information department in the Bahrain Defence Force hospital; we select the data for Cardiac patients in the period starting from 1/1/2008 to December 31/12/2008 to be the data for the model in this paper. We used three techniques for finding the drug utilization for cardiac patients. First we applied a clustering technique, followed by measuring of clustering validity, and finally we applied a decision tree as classification algorithm. The clustering results is divided into three clusters according to the drug utilization, for 1603 patients, who received 15,806 prescriptions during this period can be partitioned into three groups, where 23 patients (2.59%) who received 1316 prescriptions (8.32%) are classified to be outliers. The classification algorithm shows that the use of average drug utilization and the age, and the gender of the patient can be considered to be the main predictive factors in the induced model.

Keywords: Data Mining, Clustering, Classification, Drug Utilization..

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Authors: P. Pongsumpun

Abstract:

Malaria is transmitted to the human by biting of infected Anopheles mosquitoes. This disease is a serious, acute and chronic relapsing infection to humans. Fever, nausea, vomiting, back pain, increased sweating anemia and splenomegaly (enlargement of the spleen) are the symptoms of the patients who infected with this disease. It is caused by the multiplication of protozoa parasite of the genus Plasmodium. Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale are the four types of Plasmodium malaria. A mathematical model for the transmission of Plasmodium Malaria is developed in which the human and vector population are divided into two classes, the susceptible and the infectious classes. In this paper, we formulate the dynamical model of Plasmodium falciparum and Plasmodium vivax malaria. The standard dynamical analysis is used for analyzing the behavior for the transmission of this disease. The Threshold condition is found and numerical results are shown to confirm the analytical results.

Keywords: Dynamical analysis, Malaria, mathematical model, threshold condition.

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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: Zarita Zainuddin, Ong Pauline, C. Ardil

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Diabetes Mellitus is a chronic metabolic disorder, where the improper management of the blood glucose level in the diabetic patients will lead to the risk of heart attack, kidney disease and renal failure. This paper attempts to enhance the diagnostic accuracy of the advancing blood glucose levels of the diabetic patients, by combining principal component analysis and wavelet neural network. The proposed system makes separate blood glucose prediction in the morning, afternoon, evening and night intervals, using dataset from one patient covering a period of 77 days. Comparisons of the diagnostic accuracy with other neural network models, which use the same dataset are made. The comparison results showed overall improved accuracy, which indicates the effectiveness of this proposed system.

Keywords: Diabetes Mellitus, principal component analysis, time-series, wavelet neural network.

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Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le, Chi V. Phan

Abstract:

Wilson’s disease (WD) is an autosomal recessive disorder of the copper metabolism, which is caused by a mutation in the copper-transporting P-type ATPase (ATP7B). The mechanism of this disease is the failure of hepatic excretion of copper to bile, and leads to copper deposits in the liver and other organs. The ATP7B gene is located on the long arm of chromosome 13 (13q14.3). This study aimed to investigate the gene mutation in the Vietnamese patients with WD, and make a presymptomatic diagnosis for their familial members. Forty-three WD patients and their 65 siblings were identified as having ATP7B gene mutations. Genomic DNA was extracted from peripheral blood samples; 21 exons and exon-intron boundaries of the ATP7B gene were analyzed by direct sequencing. We recognized four mutations ([R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G) in the sum of 20 detectable mutations, accounting for 87.2% of the total. Mutation S105* was determined to have a high rate (32.6%) in this study. The hotspot regions of ATP7B were found at exons 2, 16, and 8, and intron 14, in 39.6 %, 11.6 %, 9.3%, and 7 % of patients, respectively. Among nine homozygote/compound heterozygote siblings of the patients with WD, three individuals were determined as asymptomatic by screening mutations of the probands. They would begin treatment after diagnosis. In conclusion, 20 different mutations were detected in 43 WD patients. Of this number, four novel mutations were explored, including [R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G. The mutation S105* is the most prevalent and has been considered as a biomarker that can be used in a rapid detection assay for diagnosis of WD patients. Exons 2, 8, and 16, and intron 14 should be screened initially for WD patients in Vietnam. Based on risk profile for WD, genetic testing for presymptomatic patients is also useful in diagnosis and treatment.

Keywords: ATP7B gene, mutation detection, presymptomatic diagnosis, Vietnamese Wilson’s disease.

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Authors: Yuthapoom Thanakijborisut

Abstract:

This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.

Keywords: Consumption insurance, chronic illness, health care, Thailand.

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Authors: Zoltán Szabó, Blanka Štorková

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We analyze hand dexterity in Parkinson-s disease patients (PD) and control subjects using a natural manual transport task (moving an object from one place to another). Eight PD patients and ten control subjects performed the task repeatedly at maximum speed both in OFF and ON medicated status. The movement parameters and the grip and load forces were recorded by a single optoelectronic camera and force transducers built in the especially designed object. Using the force and velocity signals, ten subsequent phases of the transport movement were defined and their durations were measured. The outline of 3D optical measurement is presented to obtain more precise movement trajectory.

Keywords: Manual transport, movement phases, Parkinson's disease.

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