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Apr 2025 DOI 10.14302/issn.2379-7835.ijn-25-5463
Fokou ElieCorresponding author
Iron deficiency is a major public health problem worldwide. It affects a significant proportion of the population, and is responsible for around 50% of anemia cases worldwide. Cameroon in general and Lekie Division in particular, is very highlyaffected by this problem. However, early detection of the problem can prevent the fatalities associated to it. The objective of this study was to provide up-to-date, detailed data on the markers of iron status in these populations, so that treatment can be better targeted. A two-month cross-sectional study was conducted in the Lekie Division in collaboration with local health centres in both urban and rural areas. The study sample consisted of 361 participants of all age groups and sexes. A questionnaire was issued to obtain information of the participants socio-demographic status, then 3 to 5ml of blood were collected and a number of markers of the participants iron status were studied. Of all the hematological markers studied, hemoglobin concentration in the study population was below normal in both men and women. Biochemical markers were good for all socio-demographic parameters. The mean values of biochemical and hematological markers in the population of the Lekie Division were good for all socio-demographic parameters, with the exception of hemoglobin concentration, which remains critical, requiring particular attention in this locality, but above all urgent intervention lest the situation aggravates further.
Mar 2023 DOI 10.14302/issn.2470-0436.jos-23-4444
A. Byrd WilliamCorresponding author
A 27-year-old male presented one week after surgical repair of his fractured left zygomatic arch, 5 weeks post-assault, complaining of persistent blurred vision in the left eye and worsening migraine headaches. Magnetic resonance images (MRI) revealed no intra-orbital pathologies or optic neuropathy but demonstrated a clearly delineated air-filled space of the left anterior clinoid process (ACP). No vision threatening pathologies were identified and surgical treatment was not recommended. His blurred vision remained at 6-month follow up. We report a case of delayed vision loss and headache post zygomatic fracture repair surgery in patient with a confirmed ipsilateral ACP pneumatization.
Sep 2021
J. Kavana NicholasCorresponding author
Department of Microbiology and Parasitology, St. Francis University College of Health and Allied Sciences P.O Box 175 Ifakara, Tanzania
Background This study was done to assess knowledge, attitude and preventive practices towards sexually transmitted infections among secondary school students in Mlimba Division, Ifakara, Tanzania. Method A descriptive cross-sectional study was conducted in March 2021. A total of 365 secondary school students (193 male; 172 female) aged between 12 and 23 years were surveyed by using a pretested self-administered questionnaire. Results The study found the majority 95.9% had heard of STDs, 77.8% knew symptoms of STDs, 86.8% knew mode of transmission, 94.0% knew the importance of use of condom during sexual intercourse. Among the sexually-active students, 70.7% had practiced sexual intercourse and 42.2% used condom during sexual intercourse. Conclusion The risky behavior practiced by the sexually-active students in this study is alarming. There is a need to introduce STD education curriculum in secondary schools so that appropriate intervention on STDs can be implemented.
Apr 2019 DOI 10.14302/issn.2470-0436.jos-19-2693
E. Moroi SayokoCorresponding author
Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, Michigan, 48105 USA.
Given limited knowledge regarding validity of the Titmus vision screener, we sought to compare visual acuity measurements obtained from the Titmus with that from the Snellen chart and assess the validity properties of the Titmus as a screening instrument to detect vision impairment. Visual acuity was measured in 150 participants recruited from an academic ophthalmology practice, using the Snellen chart as well as the Titmus vision screener. Visual acuities from the Titmus and Snellen were compared and validity of the Titmus vision screener was assessed by computing sensitivity and specificity. Using Snellen visual acuity as the reference standard, the sensitivity of the Titmus vision screener to detect vision impairment, defined as visual acuity worse than 20/40, was 92% (95% CI (72.5, 98.6)) and the specificity was 64% (95% CI (57.9, 70.1)). Comparisons of the precise visual acuity level revealed poor agreement between the two methods (weighted Kappa: 0.15, 95% CI (0.08, 0.21)). Visual acuities obtained from the Titmus were, on average, two lines worse than Snellen visual acuities. ((logMAR Snellen – logMAR Titmus) = - 0.19 ± 0.29, 95% confidence interval (CI) (-0.23, -0.16)). Titmus vision screener is a sensitive tool to detect visual impairment. However high false positive results and poor agreement with Snellen limits its widespread use in clinical applications.
Feb 2019 DOI 10.14302/issn.2831-8846.j3dpa-19-2603
L. Buresh DonaldCorresponding author
3115 Enoch Avenue, Zion, IL 60099, USA.
This paper addresses the topic of whether, and to what extent, copyrights should govern the distribution of 3D printing plans which are used in creating 3D printed, tangible objects. The essay discusses the various 3D printing technologies, describes how 3D printing is accomplished, defines copyright, and then briefly outlines the Digital Millennium Copyright Act (“DMCA”) of 1998. In particular, the paper lists the conditions that a firm publishing 3D printing plans must satisfy to invoke Section 512(c) safe harbor provision of the DMCA. Finally, the essay discusses when a distributor of 3D printing plans would be protected under the safe harbor provisions, arguing that when a 3D printing plan is released not-for-profit, the organization is protected under Section 512(c).
Nov 2018 DOI 10.14302/issn.2691-6622.ijar-18-2463
Miégoué EmileCorresponding author
University of Dschang, Faculty of Agronomy and Agricultural Sciences, Department of Animal Production Animal Nutrition and production Research Unit B.P. 222 Dschang, Cameroun
This study was conducted to evaluate the effect of the substitution of fishmeal by Lima bean flouron the growth performance, survival rate and feed cost of Clariasgariepinusbetween March and May 2018 within the AIO ICG of the Batié District. It also aimed to contribute to the development of alternative sources of animal protein on a global scale. For this purpose, 300 fry of Clariasgariepinuswith an average weight of 3 ± 1.41g were divided into five batches and fed three times a day with rations corresponding to 5% of their ichthyobiomass. The rations R0, R25 R50, R75 and R100 respectively corresponded to the substitution rates of 0, 25, 50, 75 and 100% of fish meal by that of Lima bean. The physic-chemical characteristics of the water (pH, temperature, dissolved oxygen, nitrites and nitrates) were measured daily. The following results were obtained: The highest weight gains were obtained with the rations R25 (20.56 ± 0.40 g), R50 (20.64 ± 0.32 g), R75 (20.98 ± 0.46 g) and the lowest with the rations of R100 (16.21 ± 0.28 g). The highest average daily gain were 0.36 ± 0.02 g; 0.37 ± 0.01 g ; 0.38 ± 0.01 g respectively for the R0, R50 and R75 rations and the lowest with R100 (0.29 ± 0.01 g). The highest value of the specific growth rate (2.47 ± 0.07%) was obtained with the ration R0 and the lowest (1.61%) with the ration R100. The consumption index reached its highest and lowest values with the rations R100 (4.74 ± 0.42) and R50 (3.57 ± 0.43) respectively, compared to the value of the ration R0 (3.31 ± 0.37) for this parameter. Concerning the condition factor K, the highest value was recorded with the R50 diet (1.11 ± 0.49) while the lowest value was obtained with the R75 diet (0.95 ± 0.45). The cost of producing one kilogram of food was higher with the R25 ration (504.59 FCFA) and lower with the R100 ration (443.20 FCFA). Our results revealed that incorporating 75% Lima bean flour into the feed increases the growth performance of Clariasgariepinus fry and reduces the cost of food production.
Jul 2016 DOI 10.14302/issn.2470-0436.jos-16-940
Ofeibea Amedo AngelaCorresponding author
Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, Kumasi, Ghana
Our aim was to evaluate the influence of visual impairment on the quality of life of patients reporting at the low vision centre of the Eastern Regional Hospital in Koforidua. The World Health Organization Quality Of Life (WHOQOL-Bref) which assesses quality of life in four main domains was administered to two hundred and ninety four (294) patients who visited the low vision centre of the Eastern Regional Hospital, for various eye services. Additional information on patient demographics and their visual acuities were obtained. The mean quality of life scores were determined for the visually and non-visually impaired. 86(29.3%) of the participants were visually impaired (presenting vision worse than 6/18). A significant difference in mean age was realized between subjects who were visually impaired (53.7 ± 18.4) (mean ± SD) and subjects who were not visually impaired (34.3 ± 13.1) (p = 0.001). The visually impaired participants had a lower quality of life scores in all four domains of quality of life naming, environmental, physical, social and psychological with 7.5% unadjusted reduction in overall quality of life. Visual impairment is associated with significant reduction in different quality of life domains for this population. Quality of life is poorer with increasing severity of visual impairment.
Jul 2026 DOI 10.14302/issn.2470-0436.jos-26-6357
Awan MuhammadCorresponding author
Herpes zoster ophthalmicus (HZO) is a manifestation of varicella-zoster virus (VZV) reactivation involving the ophthalmic division of the trigeminal nerve, carrying significant risk of vision-threatening complications. Diplopia in HZO is often attributed to cranial nerve palsy, although orbital myositis remains a rare and underrecognized cause. We present a 79-year-old male who developed right-sided headache, binocular diplopia, and a V1 vesicular rash two weeks after receiving the recombinant zoster vaccine. Examination revealed restriction of extraocular movements without a localizing cranial nerve pattern, raising suspicion for orbital myositis. Neuroimaging was unremarkable, and VZV polymerase chain reaction confirmed the diagnosis of HZO. The patient received antiviral therapy and was discharged in stable condition after three days. This case highlights HZO presenting with suspected orbital myositis in temporal association with vaccination and underscores the need for vigilance for uncommon neuro-ophthalmic manifestations, as early recognition and treatment are essential to prevent vision-threatening complications. Given the patient's advanced age, this case also emphasizes the possibility that age-related immunosenescence may contribute to VZV reactivation and the development of HZO-related ocular complications. Potential therapeutic approaches targeting age-related immune dysfunction are also considered.
Jun 2026 DOI 10.14302/issn.2474-7785.jarh-26-6358
Marks RayCorresponding author
Hip fractures, which remain an immense public health concern, have been subject to study and prevention efforts for many decades, but with limited success in averting either incident, second or subsequent hip fractures, commonly attributed to a combination of age related proclivity to fall, low bone and muscle mass. This review examines second hip fracture incidence rates and determinants of this serious functionally debilitating injury as observed over time remains a current 2026 public health concern. It specifically explores if more preventive efforts are currently warranted in this regard, and in what respect, if indeed, more frail older adults are living longer, but may be in excessively poor health, fearful of moving or falling, malnourished, weak with poor balance, or depressed. Based on what is published, it is concluded 1) second hip fracture incidence rates remain considerable, especially among those who are frail with osteoporotic bone disease, poor vision, heart/or cognitive conditions, plus those with muscle deficits of the lower limb, live alone and have a falls history; 2) studies to identify possible mitigation approaches appear promising in this regard, along with more routine efforts to minimize falls risk and bone attrition.
Feb 2026
DeRoche ChristinaCorresponding author
The current research assessed gaps and barriers related to perinatal mental health service access by parents during COVID-19, as well as service providers’ knowledge and provision of PMAD services, in one Northern community, where rural and remote healthcare is a daily reality, and recruitment and retention of qualified professionals is a significant issue. Two mixed-methods surveys were designed, one to assess PMAD knowledge and service provision via a volunteer sample of service providers, and another to assess PMAD service need and access among a volunteer sample of new parents. Results indicated that many parents waited too long for services, and some parents in need of PMAD services didn’t receive them. Interestingly, higher-income parents were more likely than lower-income respondents to desire services and support for PMADs. Although most providers screened for, were trained in, and treated and/or referred patients with PMADs, they reported feeling as though they were working in silos, unaware of what other providers offered.
Jan 2026 DOI 10.14302/issn.2470-0436.jos-25-5905
Al-Yarabi MohammedCorresponding author
Purpose To report a rare case of Mooren’s ulcer in a healthy young male without systemic autoimmune disease, and to highlight the effectiveness of conjunctival resection as therapy for cases unresponsive to medical management. Case report A 34-year-old immunocompetent male presented with progressive peripheral corneal ulceration in the left eye. Extensive systemic and infectious evaluations, including rheumatologic, immunologic, and microbiological testing, were unremarkable. Human leukocyte antigen genotyping was DR17(03)-negative and DQ2-positive. Rheumatological evaluation yielded no definitive systemic diagnosis. Despite immunosuppressive therapy with adjuvant medications, the epithelial defect and stromal inflammation persisted. The patient underwent conjunctival resection, resulting in marked reduction in inflammation, rapid re-epithelialization, and structural stabilization of the cornea. Histopathology of excised conjunctiva showed nonspecific inflammation without granulomatous changes, vasculitis, or neoplastic features. During follow-up, patient remained in remission with visual acuity preserved at 6/6 bilaterally and no recurrence. Conclusion Mooren’s ulcer is rare but vision-threatening. Early recognition, comprehensive evaluation, and timely surgical intervention can be vision-saving. This case highlights the role of a multidisciplinary approach and supports conjunctival resection as a useful adjunct in refractory disease. Long-term follow-up is essential.
Dec 2025 DOI 10.14302/issn.2690-6759.jpar-25-5496
Chigozie Divine OnwukaCorresponding author
Intestinal parasitic helminths pose a significant public health burden, particularly among children. This cross-sectional study investigated the prevalence and risk factors of intestinal parasitic helminths among 550 school children aged 4-12 years in Oru-West L.G.A, Imo State, Nigeria. Stool samples were examined using parasitological techniques, and questionnaires were administered to collect data on risk factors. The overall prevalence of intestinal parasitic helminths was 49.1% (270/550), with Ascaris lumbricoides being the most prevalent (30.37%). Multivariate analysis revealed significant associations between intestinal parasitic helminths and lack of hand-washing, insufficient toilet facilities, consumption of unwashed vegetables, and poor environmental sanitation. Males had a significantly higher infection rate than females (P < 0.05). Age-related prevalence was highest among children aged 4-6 (51.85%). Occupational status and educational level of parents were also significant predictors of infection. These findings highlight the need for public health education, provision of basic sanitation facilities, and regular de-worming as preventive measures.
Nov 2025 DOI 10.14302/issn.2574-612X.ijpr-25-5771
Cameron AnthonyCorresponding author
This article offers a literature review and theoretical synthesis and application of existential therapy and the contextual model. It reviews the contextual factors that may be predictive of positive therapy outcomes in general, identifies distinct types of existential therapy, highlights core commonalities in these existential branches, and explores how the main aims of the existential therapy approach may be foundational in facilitating improved mental health treatment outcomes and well-being. The author asserts that presence-both intrapersonal and interpersonal are at the heart of the contextual factors, along with flexibility, and meaning-making. This assertion has implications for therapist education, development, training, and supervision.
Nov 2025 DOI 10.14302/issn.2574-612X.ijpr-25-5774
A. Thyer BruceCorresponding author
Social work has its roots in the efforts of early twentieth-century charity organizations to reduce human suffering. This movement among charity workers of the era was founded in the search for theoretical knowledge that would illuminate effective treatment options for social ills and ultimately transform the provision of charity into social work. Coinciding with the birth of social work was the development of psychoanalysis (PA) as a tool for theorizing and treating mental illness. For many decades training in PA theory was common within social work graduate programs and many clinical social workers practice today psychotherapy informed by PA principles. However, clinical social workers were long excluded from enrolling in and graduating from psychoanalytic training institutes, a requirement for being able to say that one is a psychoanalyst and provides psychoanalysis. In 1985, a legal ruling asserted that psychologists and other qualified mental health professionals could not be excluded from enrollment in PA training programs. Since that watershed decision, although many social workers have gone on to enroll and graduate as psychoanalysts, the process whereby one can pursue this training path is unfamiliar to most social workers. We describe the current PA training landscape and describe the process on how a LCSW can become a legitimate psychoanalyst.
Nov 2025 DOI 10.14302/issn.2470-0436.jos-25-5503
H. Nelson MarkCorresponding author
Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.
Nov 2025 DOI 10.14302/issn.2474-7785.jarh-25-5760
Solís Herrera ArturoCorresponding author
Commotio retinae (CR) is a condition frequently observed in clinical practice, particularly following closed globe trauma (CGT) due to sport, labor, or traffic accident injuries. It is the main cause of unilateral vision loss in male patients aged between. It is characterized by transient gray-white retinal coloration and reduction of visual acuity (VA). Symptoms depend mainly on the location and severity (deep) of the injury, with less complains when only the superficial or peripheral retina is affected. It may be confined to the posterior pole, when it is also called Berlin’s edema, after the first hypothesis of Berlin (1873). There is no specific treatment since the treatment depends on the region of the retina and choroid affected. In this work we report a case of Berlin edema, treated with ǪIAPI 1®, to restore the balance of oxygen, which is generated at the intracellular level.
Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Kar SonaliCorresponding author
Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.
Dec 2024
A Shaw NigelCorresponding author
The near-death experience (NDE) is an altered state of consciousness which arises when a person is critically ill or injured and possibly clinically dead. It should not be conflated with other mental events such as the deathbed vision or the fear or anticipation of death. Many believe that the NDE represents a genuine paranormal phenomenon providing a glimpse of an otherworldly existence and proof of an afterlife. Those who are skeptical of such a survivalist or supernatural interpretation have long pointed out that the core components of the NDE can be readily simulated with a variety of states, conditions and agents. In this conception, the NDE is reduced to no more or less than an extraordinarily complex hallucination. Since its rediscovery in the 1970s, multiple, often ingenious, attempts have been made to account for the NDE in such naturalistic or neuroscientific terms. None has so far proven completely satisfactory. One of the oldest, least considered but still promising is the CO2 theory which argues that a hypercarbic brain is a necessary precursor for the induction of a NDE. Supportive evidence that CO2 does play a pivotal role in the generation of the NDE can be gathered from diverse sources. These include: 1. measurement of blood gases; 2. Meduna’s now abandoned CO2 therapy; 3. analysis of the very limited number of pathophysiological conditions underlying the NDE; 4. recent discoveries of the role of 5-HT neurons in the central respiratory system. A model is proposed in which CO2 molecules are considered to be functionally equivalent to those of the classical hallucinogens (LSD, mescaline, psilocybin, dimethyltryptamine). These agents can mimic the phenomenology of the NDE with remarkable fidelity. What is still missing from any such explanation is the long-sought transduction mechanism which converts physical events into mental ones. This is a generic problem which confronts all attempts to explain the neurogenesis of mystical, psychedelic or visionary activity.
Sep 2024 DOI 10.14302/issn.2644-1101.jhp-24-5247
Rakovic DejanCorresponding author
Nikola Tesla's visions and inventions realized in his controlled altered states of consciousness were considered previously as manifestations of his meditative insights within an extended framework of quantum-holographic macroquantum correlations of individual & collective consciousness. This Tesla-inspired paper now focuses on related psychosomatic aspects of quantum entropy & entanglement, and consequences on the usually observable biological arrow of time & spiritual-informational time reversal. Finally we discuss spiritual-informational implications for free will and individual and collective consciousness reprogramming.
Apr 2024 DOI 10.14302/issn.2997-2086.jfs-23-4651
Osama Siddiqui MuhammadCorresponding author
This article has been retracted on April 10, 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2997-2086.jfs-25-5857) Myelomeningocele (MMC), a class of spina bifida is a type of neural tube defect. According to the U.S. Centers for Disease Control and Prevention, each year approximately 1,400 babies born in the United States have spina bifida. The disease manifests with the lack of skin and bone covering the caudal part of the spinal cord. The patient developing such a condition often develops lifelong impaired lower limb mobility accompanied by hydrocephalus, and urinary and bowel incontinence. The available interventions include prenatal and postnatal surgery to fuse the dura. Prenatal surgery performed before 26 weeks of gestation reduces the risk of death or the need for ventriculoperitoneal shunting. It also enhanced results on a comprehensive index for mental and motor function. When compared to postnatal surgery, prenatal surgery reduces the manifestation of several secondary outcomes, including the degree of hindbrain herniation seen in the Chiari II malformation. Stem cell therapy for MMC on animal models of chick, ovine, and rodents with reported cases 15/63, 15, and 136, respectively, using human Embryonic Stem Cells (hESCs), Neural Stem Cells (NSCs), Mesenchymal Stem Cells (MSCs) showed significant coverage of MMC defect and slight neurogenesis was also observed. With an understanding of medical literature about in-utero regenerative capacity, it is to be appreciated that placental stem cells surgically seeded within a biocompatible scaffold of the cell patches can play a part in alleviating the spinal cord manifestation associated with MMC. Documented animal studies show that incorporating Placental Mesenchymal Stem Cells in prenatal surgery has reported improved neurogenesis and lower limb mobility. In an ovine myelomeningocele model, the development of in-utero myelomeningocele repair with human Placental Mesenchymal Stem Cells seeded onto an extracellular matrix (PMSC-ECM) enhances motor findings. The clinical trial for the first stem cell therapy on human subjects known as the “CuRe Trial: Cellular Therapy for In Utero Repair of Myelomeningocele.” is expected to be finished by 2030. So far, the cases undergoing treatment have shown significant leg movement and a greater degree of bowel and urinary control. This FDA-approved clinical trial is envisioned to be the future of treating MMC.
Feb 2024 DOI 10.14302/issn.2641-4538.jphi-23-4871
Mba-Oduwusi NnennaCorresponding author
Background This study evaluates the effectiveness of quality improvement (QI) strategies in mid-level private healthcare facilities in Lagos State, with a focus on the structural components, healthcare processes, and healthcare outcomes. Employing the Donabedian model, the research aims to comprehensively assess and enhance healthcare service quality in these facilities. Methods A before-and-after study design was employed, involving a baseline assessment of 321 health facilities and endline assessment of 239 healthcare facilities, and a subsequent 10 - 12-month quality improvement intervention. Data were collected using facility assessments, client exit interviews, and interviews with key stakeholders. The analysis included a before and after analysis of the structural components, healthcare processes, and healthcare outcomes. Results The study demonstrates positive outcomes in mid-level private healthcare facilities in Lagos State following quality improvement (QI) interventions. Structural components, including, improved equipment availability, and enhanced compliance with standards, showcased significant improvements. Renovations and heightened registration compliance further underscored commitment to regulatory standards. Challenges in service availability, particularly in family planning and laboratory services, were identified. Importantly, the implementation of a QI scoring system revealed an overall positive impact, with the average score rising from 69% to 74%, signifying enhanced quality across diverse priority areas. Implications These findings highlight the success of QI interventions in transforming healthcare processes and structural components. Despite notable progress, persistent challenges in specific services call for targeted interventions. The substantial increase in patient satisfaction and overall QI scores underscores the transformative potential of sustained efforts and tailored interventions in mid-level private healthcare facilities in Lagos State. Conclusions This research comprehensively evaluates the effectiveness of quality improvement strategies implemented in mid-level private healthcare facilities in Lagos State, Nigeria, utilizing the Donabedian Model as a guiding framework. The findings provide valuable insights for policy recommendations, with the aim of aligning healthcare services with the Donabedian model to ensure the provision of high-quality care in mid-level private healthcare facilities in Lagos State. This study contributes to the ongoing efforts to improve healthcare quality in Lagos State. Contribution to Knowledge The research provides empirical insights into the effectiveness of quality improvement strategies in mid-level private healthcare facilities, particularly within the context of Lagos State, Nigeria. It highlights the significance of addressing structural components, optimizing healthcare processes, and monitoring healthcare outcomes to enhance the quality of care provided, aligning with the Donabedian model. These findings offer a valuable basis for policy recommendations and further research efforts aimed at improving healthcare quality in similar settings.
Dec 2023
Susan Abraham MinyCorresponding author
Sphenoethmoidal encephalocoele is a rare clinical entity with varying clinical presentation. It can be seen in association with corpus callosal agnesis and midline facial defects. We are reporting a case of 44 year old female presented with progressive vision loss of right eye, and surgical correction of meningoencephalocoele and the defect prevent further visual detiortion.
Dec 2023 DOI 10.14302/issn.2691-6622.ijar-23-4636
M. Yagoub HassanCorresponding author
The present study aimed to provide baseline information of fish culture status (obstacles) of Omdurman, Khartoum and Khartoum north in the Khartoum state in Sudan due to there is little or lack of information in this field. 30 owners of farm were questioned from Omdurman, Khartoum and Khartoum north, 10 farms for each location; Descriptive analysis was done for analyzing the raw data of the study by using Excel Microsoft Software 2007. Social data showed that male farm owners group was dominant in third sites 100%. Age groups of fishermen ranged between 20 to 60 years; where age group 31- 40 Khartoum north, age group 41- 50 was dominant in O mdurman and age group 51-60 year was dominant in Khartoum. Six educational categories were recorded where University education was dominant in the three locations 50%, 50% and 70% respectively; whereas, postgraduate was the second in the tow location: O mdurman and Khartoum 20% and the secondary education were the third in Khartoum 30%. all farm owners were married 100% in three sites; As regards to the farm owners other activities results showed that most of them were practicing other activities (farmers, business owner, officers and workers). Category of farmer was dominant 90% secondly business owner and officer 70% and 50% respectively. Data showed that the problems (Varanus niloticus, birds, marketing, fees and thefts) was dominant in three locations had the highest percentage 90%, 80%, 60%, 30% and 10% respectively. and according to production cost in three locations arranged: (feeds, workers, fingerlings, water and technical supervision) 50, and 70% and 40%, 50% and 70% and 30%, 40% and 50% and 10, 20 and 40% and 10, 20 and 30% respectively. Category of feeds dominant followed by workers and fingerlings, the best Method to obtain of information, the results showed that Bulletins was dominant in three sites 80%, 30% and 90%; whereas, field visits in three location was the second 60%, 90% and 0%, Radio programs in three location was the third 60%, 10% and 60% and the lowest percentage; Seminars and television 40%, 50% and 40%, and 30%, 0% and 0%. For the best location to obtain information results revealed that the General Director of Fisheries Ministry of Agriculture, Animal Resources and Irrigation - Khartoum State was dominant in the three locations 90%, 80% and 90%, whereas, Universities in three location was the second 40%, 20% and 0%, and the lowest percentage Central Research of fisheries 40%, 0% and 0%, and Internet 10%, 20% and30%. Also result showed most of the farm owners in three sites all them need to training courses in deferent programmers (Fish extinction, Fish feeding, Fish production and Fish marketing) according to this percentages 60%, 30% and 50%, and 30%, 10% and 50%, and 10%, 10% and 30%, and 10%, 0% and 20% respectively.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4294
MA AdeniyiCorresponding author
Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti state
Aim Covid 19 is a pandemic that has ravaged the world resulting in thousands of deaths. This study aims to assess the knowledge, risk perception, and attitude of health care workers (HCWs) to the pandemic. Methodology This was a hospital based descriptive cross sectional study conducted among health care workers who were staff of the hospital. Data collected includes socio demographic characteristics, data on knowledge, risk perception and attitude. Results A total of 288 HCWs participated in the study. Participants had good knowledge at 95.6%, major source of knowledge includes internet/social media 68.8%, radio 34.6% and television 28.3%. About 92.6% of the respondents also had positive attitude while 89.75 of the respondents had a positive risk perception. Conclusion Overall, there was a high level of knowledge, high positive attitude and a high risk perception in the study. Consequently, to ensure that this high level is maintained, there is need for continuous health education and promotion.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4313
Niyonkuru MathieuCorresponding author
Public Health Department, Mount Kenya University Rwanda
Data quality is defined as a measure of data status that fulfills the following elements: accuracy, completeness, consistency, reliability, and if the data is current. The World Health Organization (WHO) reported that only 40% of all countries have an adequate system to collect information on birth and deaths. Even though the system is there, vital registration systems are inaccurate and incomplete in developing countries. In Rwanda, maternal health related data was over-reported more than other indicators. These are the main reasons for conducting the study to investigate the data quality of four maternal and newborn health indicators reported by Rwandan Western Province health centers. This concurrent-mixed method study included 61 data managers and 12 key informants. Routine data quality assessment tool and structured interview guide were used to collect data. Descriptive statistics were used to get proportion of respondents’ socio-demographic characteristics. The analysis was done for assessing median of data quality index. The results show that 55.7% of data managers were male while 58.3% of responsible of maternity were female. Majority (58.9%) of participants was in age’s category from 33-42, 61.6% have A1 education level and 53.4% have experience less than five years. Data quality index of one out of four (25%) MNH indicators was found below 95% accepted by WHO. The main reasons for insufiscient quality of data are lack of data validation meetings (57.5%) and incompleteness of reporting tools (36.4%). Monthly data validation meetings chaired by HC leaders are important to contribute to high-quality data in healthcare settings. Supportive supervisions done in data quality and management have to be organized in a supportive, and educative way.
Oct 2022 DOI 10.14302/issn.2572-3030.jcgb-22-4284
B. Little ReginaldCorresponding author
Department of Chemistry, Stillman College, Tuscaloosa, Alabama
Upon considering the anticancer effects of larger oligomeric proanthocyanidins and observing various papers reporting the high resolution mass spectroscopy of the oligomeric proanthocyanidins, it is determined that the unusual 13C enrichment in some plant oligomeric proanthocyanidins may be responsible for the anticancer activities of these food products. Such correlation of the 13C in the oligomeric proanthocyanidins also correlate with their scavenging of free-radicals, anti-virial and anti-bacterial properties. Proanthocyanidins in grape seeds are observed to have high enrichment in heavy isotopes of 2H, 13C, 15N and/or 17O. Mass analysis of DNA from human cancer cells are compared to normal human cells and cancer cells show bond specific enrichment of heavy isotopes in nucleotides G, A, T and C. On such basis, this study suggests possible stronger interactions of proanthocyanidins with DNA in cancer verses DNA in normal cells due to heavy isotope bond specific enrichments in both proanthocyanidins and the cancer DNA. Such 13C interactions from oligomeric proanthocyanidins with nucleic acids and proteins involved in replications, transcriptions and translations in cancer cells for interacting and chemically altering anabolism and cell division of the cancer cells are consistent with the author’s mechanism for normal cell to cancer cell transformations via possible replacements of primordial 1H, 12C, 14N, 16O, and 24Mg isotopes by nonprimordial 2H, 13C, 15N, and 17O and 25Mg isotopes in the proteins and nucleic acids. Such is also consistent with the proposed treatment for cancer by the author by use of foods containing proteins, nucleic acids, carbohydrates and/or drug molecules enriched with the nonprimordial isotopes of 2H, 13C, 15N, and 17O and 25Mg.
Sep 2022 DOI 10.14302/issn.2641-4538.jphi-22-4280
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
The study evaluated the users' opinions on data quality and related characteristics in ten public-health institutions of Nyarugenge district. A study used a cross-sectional design, data was collected through quantitative (n=150) methodology while qualitative data was obtained using interviews (n=20) and focus group talks (n=3). A checklist was utilized to examine the completeness, accuracy, and timeliness of data quality aspects. Collected quantitative data was analyzed through logistic regression by SPSS to examine the association of variables, while qualitative data was analyzed using the summative content analysis (SCA) to summarize the key themes. A 95 percent confidence level, Odds Ratio (AOR) were used to establish the strength of correlation among study variables, while a p-value of less than (p<0.05) was utilized to identify the variables which were statistically significant associated to HMIS data quality. The study finding showed that the majority (53.0%) was female while, 33 years was an average age, the majority of health practitioner (52.7%) had an A1 diploma. Approximately 90.6% of respondents have a positive perceptions on the system usage. Limited ability and a lack of relevant technology equipment such as computers and the internet have been cited as the challenges while using the system. Factors such as training AOR:2.62(95% CI:1.45, supervision AOR:1.81(95% CI:1.02, AOR:2.50(95% CI:0.85 for education background, works-experience AOR:1.60(95% CI:090 are factors associated with data quality. Maintaining, supportive supervision, regular training and refresher courses should be regularly offered to public health professionals to improve their knowledge in order to maximize the use of health information.
Jun 2022 DOI 10.14302/issn.2470-5020.jnrt-22-4217
O. Henderson JeffreyCorresponding author
Department of Science and Mathematics, Judson University, Elgin, IL 60123, USA
Tay-Sachs disease (TSD) is a rare neurodegenerative disorder caused by mutations in the HEXA gene, which encodes the ɑ subunit of the enzyme β-hexosaminidase A. Lacking this key enzyme in GM2 ganglioside catabolism, individuals who are homozygous for HEXA mutations suffer from abnormal accumulation of GM2 ganglioside in brain and nerve cells, ultimately resulting in the progressive deterioration of the central nervous system. TSD is one of three disorders characterized by β-hexosaminidase deficiency; Sandhoff disease (SD) and the AB variant arise by mutations in the HEXB and GM2A genes respectively, which disrupt other points of GM2 ganglioside degradation. Characterized by developmental delay and stagnation, muscular weakness, coordination deficits, seizures, and eventual hearing and vision loss, these three disorders are clinically indistinguishable and occur in three forms defined by age of onset. While there is a much higher incidence of TSD in the Ashkenazi Jewish population, community carrier screening and counseling initiatives have reduced disease prevalence to about the equivalent of non-Jewish populations; however, such efforts have raised ethical concerns in the Jewish community that are increasingly relevant in light of scientific and medical advancements. Currently, treatments for TSD and its related disorders focus on symptom management, with gene therapies and the application of modified CRISPR-Cas-9 technology being explored.
Jun 2022 DOI 10.14302/issn.2832-5311.jpcd-22-4182
Md. Iqbal FarukCorresponding author
Sclerotiniasclerotiorum, the causal agent for white mold (Sclerotinia stem rot), is a devastating fungal pathogen. Currently, Sclerotinia is most commonly managed using the chemical fungicide which can lead to Sclerotinia resistance development, impacting biodiversity and interfering with key ecosystem services. In this regards, field experiments were conducted during 2017-18 planting seasons to evaluate the efficacy of different components viz. sawdust burning, stable bleaching powder, fungal and bacterial bio-control agents, chemical fungicide Rovral 50 WP and integration of different components for the management white mold disease of bush bean, mustard and garden pea in three different locations viz. in the field of Plant Pathology Division, Bangladesh Agricultural Research Institute, Joydebpur, Gazipur, Regional Agricultural Research Station (RARS), Burirhat, Rangpur and RARS, Ishurdi, Pabna, respectively. The results showed that different treatments displayed varying levels of effectiveness against the disease. All the treatments gave satisfactory reduction of white mold disease development and increased plant growth as well as yield of bush bean, mustard and garden pea. Among the treatments, integration of saw dust burning + soil amendments with Trichoderma based bio-fungicide + bacillus based bio-control agents + application fungicide Rovral 50 WP is the best treatment which reduced 97.49%, 77.72%, 72.26% white mold disease incidence and 84.61%, 81.14%, 71.01% white mold disease severity of mustard, bush bean and garden pea, respectively and increasing plant growth parameter as well as 52.16%, 27.74%, 36.97% yield of mustard, bush bean and garden pea, respectively. Application of only fungicide Rovral 50 WP also better treatment in reduction of white mold disease incidence and disease severity and increasing plant growth parameter as well as increasing yield of mustard, bush bean and garden pea. Soil amendment with fungal or bacterial bio-control agents also gave satisfactory results in reduction of white mold disease incidence and disease severity and increasing plant growth parameter as well as increasing yield of mustard, bush bean and garden pea. It could be concluded from the obtained results that integration between bio-control agents as a soil treatment and foliar application chemical fungicide might be useful as a good tool for controlling white mold disease caused by S.sclerotiorum and obtained higher yield of bush bean, mustard and garden pea under field condition.
Apr 2022 DOI 10.14302/issn.2639-3166.jar-22-4114
Md. Iqbal FarukCorresponding author
An experiment was conducted in the field of Plant Pathology Division, BARI, Joydebpur to evaluate the efficacy of available plant nutrient for the development of purple blotch disease and tip-burn of onion. Eight different treatments viz. Potassium (MP fertilizer), Phosphorus (TSP fertilizer), Boron (Boron fertilizer), Zinc (ZnSO4 fertilizer), Calcium (CaSO4 fertilizer), Copper (CuSO4), Silicon (silica gel) and Manganese (MnSO4 fertilizer) were tested against purple blotch disease and tip-burn of garlic. The present study revealed that soil and foliar application of plant nutrients viz. Potassium, Phosphorus, Boron, Zinc, Calcium, Copper, Silicon and Manganese gave appreciable reduction of purple blotch disease and tip-burn incidence and increased plant growth parameters such as shoot and root growth as well as yield of garlic. Among the nutrients Potassium, Phosphorus, Silicon, Zinc and Calcium were performed better for reducing purple blotch disease severity, tip-burn disease incidence and increasing plant growth as well as yield of garlic. Application of Boron and Manganese also performed better than control. So, soil and foliar application plant nutrients Potassium, Phosphorus, Silicon, Zinc, Boron and Manganese may be recommended for tip-burn and purple blotch disease management and for garlic production in Bangladesh.
Jan 2022 DOI 10.14302/issn.2692-1537.ijcv-21-4044
Chukwuma Sr ChrysanthusCorresponding author
The Chrysanthus Centre for Future-Oriented Studies, Centre For Future-Oriented Studies, CTR Future-Oriented Ltd, Abakaliki, Ebonyi State, Nigeria.
This paper attempts to present the dissemination and transmission dynamics of emerging and reemerging infectious diseases and the underlying features of gain-of-function research and geopolitics in the ambient within and across borders. Research and publication are relevant from perspectives in the management of local and global health because disease is perspicuously a geopolitical issue ostensibly linked to gain-of-function research where health diplomacy undergirds present and future global functionalities regarding the emergence and reemergence of infectious diseases. These have generated vehement reactions with propensity for extreme geopolitics and gain-of-function natural and anthropogenic activities. Geopolitical parameters and gain-of-function issues impact on the social determinants of health and vice versa. The convening and convergence of countries for unprecented epidemic or pandemic treaty settings or other formulations to confront emerging and reemerging infectious diseases will afford considerable opportunities concerning challenges in action, preparedness and response. Provisions are pertinent for legal instruments, effective and efficient systems to curb future threats and outbreaks of infectious diseases.
Oct 2021 DOI 10.14302/issn.2644-1101.jhp-21-3937
Monique J. Grant CokeCorresponding author
Bullying in higher education among educators has been researched at the international level and the present evidence strongly exists with need for further research regarding prevention 23456. Strong empirical research has been published on bullying with viewpoints on the damages to leadership, supervision, incivility and abuse experienced by educators 1256. Bullying in higher educational organizations has been observed with antecedents of power, “wanting to get ahead”, favoritism, and other precursors and challenges of incivility leading to bullying 1234. Workplace bullying antecedents and effects, describe the possible experiences, background, and precursors, that would reveal workplace bullying 12. Bullying in higher academia can result from behaviours and experiences that show humiliation, overtalking others, aggression, exclusion of others, disengagement of employees, among other subtle ways of silencing others 12347. It is therefore still important that educators continue to have a positive, purposeful and productive research driven approach towards solutions for preventing bullying in educational organizations.
Oct 2021 DOI 10.14302/issn.2641-5526.jmid-21-3900
Perez Jean-claudeCorresponding author
Phd Maths Computer Science Bordeaux University, RETIRED Interdisciplinary Researcher (IBM Emeritus, IBM European Research Center On Artificial Intelligence Montpellier) Bordeaux Metropole, France.
In this theoretical discovery of a law of Life, there is MATHEMATICS (Geometry, Bits and Numbers) that UNIFY 3 universes as complementary as ATOMIC MASS, WAVES, and INFORMATION (DNA, RNA and Amino Acids). The discovery of a simple numerical formula for the projection of all the atomic mass of life-sustaining CONHSP bioatoms leads to the emergence of a set of Nested CODES unifying all the biological, genetic and genomic components by unifying them from bioatoms up to 'to whole genomes. In particular, we demonstrate the existence of a digital meta-code common to the three languages of biology that are RNA, DNA and amino acid sequences. Through this meta-code, genomic and proteomic images appear almost analogous and correlated. The analysis of the textures of these images then reveals a binary code as well as an undulatory code whose analysis on the human genome makes it possible to predict the alternating bands constituting the cariotypes of the chromosomes. The application of these codes to perspectives in astrobiology, cancer, and specifically in INFORMATION THEORY with the emergence of binary codes and regions of local stability (voting process), whose fractal nature we demonstrate, is illustrated. PREFACE by Professor Luc Montagnier Addendum by Robert Friedman M.D After the discovery of the DNA double helix structure allowing both the stable storage of genetic information and its transfer through messenger RNA to protein synthesis organelles themselves structured by RNA most abundant in cells, the ribosomal. This wonder of nature exists in ALL living beings from the virus to humans and is based on two codes, the linear sequence of nucleotides and that derived from codons where three nucleotides allow with a certain flexibility - synonymous codons - the choice in the twenty amino acids. But we are missing a third CODE the one governing at multicellular beings from the rotifer to human, the stabilized modulation of gene expression in a nutshell the differentiation of cells from the single cell of the fertilized egg. It is logical to think that this program which begins as soon as fertilization is written in the DNA. We are also prone to associate it with non-coding DNA sequences although they control gene expression. I introduce here the notion developed by Jean-Claude Pérez of mathematical harmony, a higher order present in all living beings and whose existence it finds in genomes, including those of viruses. Thus the natural evolution of variants of the genome of coronavirus Covid 19 tends towards increasingly long Fibonacci series. It remains to determine the Who, the How and the Why of such developments. I will bet with my mathematician colleague that waves and fractals play a role. Luc Montagnier ADDENDUM Jean-claude has given scientists a strong new direction for research. He has identified a unified field of science guided by the Golden Ratio and Fibonacci Sequence. By identifying an overall guiding principle that makes possible fractal-like nesting at all levels of biological manifestation, future researchers can begin with the "whole" instead of the "parts". If we know that complex systems are organized at varying levels by the Golden Ratio and Fibonacci Sequence, we can look for those universal patterns first and then fill in the gaps with small details to complete the picture. It's like having an overall view of a crossword puzzle before beginning to assemble the individual pieces. Without an overarching vision and guiding principle, completing the puzzle is infinitely more difficult. Once scientists and researchers realize and begin using this "SECRET IN HIDDEN IN PLAIN SIGHT," their discoveries will be orders of magnitude more fruitful. Robert Friedman M.D
Jul 2021 DOI 10.14302/issn.2576-6694.jbbs-21-3819
Jana SnehasisCorresponding author
Trivedi Science Research Laboratory Pvt. Ltd., Thane (W), Maharashtra, India.
The present study aimed to evaluate the effect of the Trivedi Effect®- Biofield Energy Treated/Blessed Test formulation/item (TI) composed of minerals (magnesium, zinc, copper, calcium, selenium, and iron), vitamins (ascorbic acid, pyridoxine HCl, alpha tocopherol, cyanocobalamin, and cholecalciferol), Panax ginseng extract, CBD isolates, and β-carotene on elasticity of skin, heart, muscle, and neuronal cells in the H9C2 (rat cardiomyocytes), C2C12 (mouse myoblast cells), HaCaT (human keratinocytes), and SH-SY5Y (human neuroblastoma cells) cell line in DMEM medium. The test formulation constituents were divided into two parts; one section was defined as untreated test formulation (UT), while the other portion of test formulation received Biofield Energy Healing/Blessing Treatment (BT) by a renowned Biofield Energy Healer, Mr. Mahendra Kumar Trivedi. The test items were treated with Biofield Energy Healing/Blessing Treatment and divided as Biofield Energy Treated/Blessed (BT) and untreated (UT) test items. MTT data showed that the test formulation in various concentrations was found as safe and nontoxic in the tested concentrations with viability range from 73% to 307%. Young’s modulus (YM) is a measure of cell stiffness, a decrease in YM value indicates increase elasticity of the cells and vice-versa. YM in H9C2 cells were decreased by 9.6% and 66.1% in the BT-DMEM + UT-TI group at 0.1 and 1 µg/mL respectively, as compared with untreated test group. However, C2C21 cells showed increased YM by 443.9% at 1 µg/mL in the UT-DMEM + BT-TI group, while 869.6% increased YM in the BT-DMEM + UT-TI group at 1 µg/mL as compared with untreated test group. However, 314% increased YM was reported in the BT-DMEM + BT-TI group at 1 µg/mL as compared with the untreated test group. However, the value of YM was significantly decreased in the HaCaT cell line by 247.7% (at 1 µg/mL), 225.8% (at 0.1 µg/mL), and 97.9% (at 1 µg/mL) in the UT-DMEM + BT-TI, BT-DMEM + UT-TI, and BT-DMEM + BT-TI group respectively, as compared with the untreated group. In addition, YM was significantly decreased in the SH-SY5Y cell line by 92.6%, 18.1%, and 26.6% at 1 µg/mL in the UT-DMEM + BT-TI, BT-DMEM + UT-TI, and BT-DMEM + BT-TI group respectively, as compared with the untreated group. Overall, the results showed the significant decreased YM among the SH-SY5Y, HaCaT, and H9C2 cells, while it was increased in the C2C21 cell line. Thus, the mechanical properties of cells such as cellular function, including shape, motility, differentiation, division, and adhesion to its surrounding extracellular matrix were improved. Overall, it can be useful in many disease progressions with improved cellular elasticity and its associated complications/symptoms.
Apr 2021
Asadzandi MinooCorresponding author
PhD. Assistant Professor, Research fellow. Medicine, Quran and Hadith Research Center, Head of the spiritual health workgroup of Baqiyatallah University, Baqiyatallah University of Medical Sciences. Member of the Department of Spiritual Health of the
Background COVID-19 as an infectious disease, and deadly biological crisis, threatens the bio-psycho-social- spiritual health of the people. Spiritual health from the perspective of Islam, means having a sound heart, living in the present time with sense of peace, security, patience and gratitude, safe from the fear and anxiety of future, grief and regret for the past events. It affects other dimension of health. This study was conducted to investigate the spiritual health services in the face of the COVID-19 pandemic in a Muslim society. Methods This qualitative study was conducted from March 1, 2020 to the end of May 2020 in Tehran by using the Schwartz and Kim's hybrid model concept analysis with a deductive / inductive analysis approach, in three stages: 1- Theoretical review of religious and scientific evidence, 2- Field research 3- Final analysis. Data collection was done in hospitals and hospices by semi-structured interviews, taking notes, websites and social networks search. Data were analyzed by "Contractual Content Analysis Method". Results Despite the fact that spiritual health services (spiritual care and counseling) are not taught in Iranian universities, but in this biological crisis, spiritual health services, based on religious beliefs of health system employees were implemented. The Muslims’ belief in divine test, healing power of God, helping the people as highest worship, aroused spiritual awakening and enthusiasm in the health care team. Spiritual health services at prevention levels were provided with the aim of helping the patient, family and clients, in an inter-professional model based on the jurisprudential rules derived from the religious evidences (Verses and Hadiths), in line with holistic approach, community-based care, spiritual self-care, home-care, family participation. The involvement of non-specialists in the provision of medical services was prevented. According to, preserving the human dignity in Islam, Islamic rituals were performed by the treatment team and volunteer clerics for dying and dead people. Conclusion Considering the impact of religious spirituality on Muslims’ lifestyle and health behaviors, it seems that the use of Islamic health guidelines can improve the quality of health care services and help improve the spiritual health of people in biological crises.
Apr 2021 DOI 10.14302/issn.2639-3166.jar-21-3782
Masoero GiorgioCorresponding author
Accademia di Agricoltura di Torino, Via A. Doria 10, 10123 Torino (Italy).
A systematic use of biofertilizers can improve both the quality of a farming system and the parameters of milk. Some issues related to biofertilization experiments on six farms in the Po Valley (NW Italy) involved in the production of milk from dairy cattle fed maize silage or grazed on hay produced from permanent meadows are reported in this paper. Biofertilized maize was found to lower the live stem pH by about 2.3%, and NIR spectroscopy foreshadowing major changes in the composition. Overall, the plant silage was improved in quantity (+10%) but also in quality, as shown by the delayed maturity stage of the leaves (crop maturity index -4%), the lower indigestible NDF content (-7%), and the higher digestible carbohydrates and protein in the whole plants. Such favorable feeding conditions, together with the improved palatability of the feed ration, boosted the nutrient values of the protein (+4.6%) and fat contents (+5.7%) in the milk. Moreover, the functional properties of the milk were ameliorated, as testified by the higher levels of vitamin A (+27%) and vitamin E (+25%) and the reduced levels of saturated fatty acids (-6%), especially myristic (-18%) and stearic (-32%) acids, while the unsaturated acids increased by 15%. As far as economy aspects are concerned, the biofertilization of maize for silage has led to consistent rewards pertaining to the marginal price of the milk, which in turn has led to a value chain increase of about 9%, because of the fields cultivation, but mainly of the cow transformation in milk quality issues. On another farm, intensive maize was substituted with permanent biofertilized meadows, over a greening path, and a + 17% value chain increase was obtained that already derived mainly from the best price for milk quality parameters. Such an evolutionary leap toward a new vision of sustainable agriculture for the environment and for animals, in which a better quality of products, animal welfare and company budget are combined with soil biofertilization, can be considered a bonanza.
Mar 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3756
Boulila MoncefCorresponding author
Professor, Université de Sfax- Institut de l’Olivier- B.P. 14, 4061 Sousse Ibn Khaldoun, Tunisia.
In contributing to the initiative to address the COVID-19 pandemic and in order to enhance the knowledge on driving forces shaping the evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (isolated from Tunisian patients), a comparison in relation to other coronaviruses infecting humans (SARS-CoV-1, MERS-CoV, HCoV/229E, HCoV/NL63, HCoV/OC43, and HCoV/HKU1) as well as animals (SARS-CoVs in tiger, bats, civet, pangolin, bovine, and MERS-CoV in dromedary/camel), was conducted. In-depth analysis was carried out involving 115 sequences of spike glycoprotein-coding gene extracted from the international databases. Phylogeny inference allowed the reconstruction of a bifurcating tree where four distinct groups were delineated and at the same time, three animal accessions (SARS-CoV-2/tiger, MERS-CoV/camel, and SARS-CoV/bovine) shifted from the animal group and integrated the human coronaviruses clades. Nonetheless, in the presence of reticulate events such as recombination, networks described better the phylogenetic relationships rather than the classic dendrogram. Thus, networks were produced and identified four clusters containing sharply demarcated subgroups (eight subdivisions). Except networked phylogenies of SARS-CoV-1, SARS-CoV-2, and HCoV/HKU1, all the others showed edges and boxes illustrating the occurrence of incompatibilities related to the sequences of spike glycoprotein-coding gene. Thereby and consolidating this result, three methods (RDP package, GARD, and RECCO) were used to detect breakpoints in aligned sequences. Except the clades SARS-CoV-1 and SARS-CoV-2, all the remaining phylogenetic subdivisions were subject to recombination. Furthermore, the screening of selection pressure in all studied sequences by various statistics-based models of the HyPhy package, showed that, similarly, the lineages belonging to the clades SARS-CoV-1 and SARS-CoV-2 were not under selection. In contrast, all members of the remaining clades underwent, to different extents, adaptive selection as well as purifying selection.
Feb 2021 DOI 10.14302/issn.2381-862X.jwrh-21-3708
Muthyala TanujaCorresponding author
Assistant Professor, Department of Obstetrics & gynecology, All India Institute of Medical sciences, Mangalagiri, Guntur, Andhra Pradesh
Fetal mesentric lymphangioma, a congenital fetal abdominal cystic malformation has a rare occurrence. Antenatal detection, its differential diagnosis, prenatal management options and parental counseling regarding postnatal prognosis of such a case are thus rarely discussed. We report two cases of antenatally detected fetal cystic abdominal mass with a provisional diagnosis of abdominal lymphangioma. Postnatally one of the neonates developed features of intestinal obstruction and required surgical intervention. Intra-operative findings and histopathology report confirmed a mesentric lymphangioma. The other neonate had associated subcutaneous lymphangiectasia in left lumbar region, left sided inguinal hernia, undescended testes and was asymptomatic postnatally and managed conservatively.
Feb 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3727
Keshavarz VajihehCorresponding author
Department of Occupational Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.
Jan 2021 DOI 10.14302/issn.2639-3166.jar-20-3677
Faruk IqbalCorresponding author
Principal Scientific Officer, Plant Pathology Division, BARI
The experiments were conducted in the fields of Plant Pathology Division, Bangladesh Agricultural Research Institute, Gazipur during 2016-17, 2017-18 and 2018-19 cropping years to evaluate the organic and vermi composts for mass culturing of biological control agent Trichoderma harzianum and toobserve the effect of formulated T.harzianum designated as Tricho-vermi-compost and Tricho-organic-compost as well as organic compost, vermi-compost and chemical fungicide Provax 200 WP against soil-borne pathogens, Sclerotium rolfsiiof groundnut causing foot and root rot/stem rot disease. The pathogen inoculated field soils were treated with Tricho-vermi-compost and Tricho-organic-compost, organic compost and vermi-compost 7 days before seed sowing where as seeds were treated with Provax 200 WP at the time of seed sowing. From this study it was revealed that all the treatments performed in reducing seedling mortality and increasing plant growth and yield of groundnut compared to control. Among the treatments, soil treatment with Tricho-vermi-compost and Tricho-organic-compost are the best treatments in reducing seedling mortality and increasing plant growth parameters and yield of groundnut which was significantly differed from the other treatments including control. Seed treatment with chemical fungicide Provax 200 WP and soil treatment with only vermin-compost and organic compost also promising treatments for management foot and root rot disease and increasing plant growth parameters as well as yield of groundnut compared to control.
Dec 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3670
K. Ceesay EbrimaCorresponding author
University of Gambia, Banjul, Gambia
Purpose This paper assess the impact of COVID-19 pandemic on Education, Staff development and Training in Africa. Online Research Methodology/Approach The data use in this paper was generated from online survey questionnaire, in which the participants were asked about certain questions in which covid-19 affect their social-economic situation. The questionnaire was design to help Africa to understand covid-19 impacts on their social and economic live. Results The results of this study reveal that coronavirus pandemic affected Africa in a number of ways; 1) 52.2 percent of the respondents said they should open school now in Africa, while 47.8 percent fear they should not open schools 2) 81 percent said before educational institution are closed there is public or official announcement that institutions must be closed due to pandemic—may be 3 months, ……,,…,, one week it depends on the severity of how covid-19 is spreading across the regions in Africa, 10.7 percent of the respondent said it may be and only 8.3 percent said it is not official announced.3) 65.4 percent of the respondents said government implemented an education response for continue of learning in Africa while educational institutions are closed 4) 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government, while 50 percent said television, radio, or podcast broadcast and 17.9 percent said assigning reading and exercises for home study. 5) 45.3 percent out of 100 percent said use of online or digital learning platform are the proportion of children affected by education institution closure. 38.7 percent said the proportion of children affect are the one that concentrate of using television, radio or podcast broadcasts to get academic content. 14.7 percent of the respondents are the proportion of the children affected by educational institute closure if they are assigning reading and exercises for home study. 6) 52.6 percent of the respondents from non-government organization, private schools said use of online or digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes, while 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government. The same thing government said as well. Similar respondents from government as do the non-government or private schools and 35.9 percent respondent said television, radio and podcast broadcast are method for continuity of learning is currently available for children affected by closures of educational institutes-provided by non-governmental organization, private schools etc, whereas 50 percent of the respondents said assigning reading and exercises for home study is the method for continuity of learning is currently available for children affected by closures of educational institutes-provided by government.7) 48.1 percent of the respondents said for the impact of covid-19 pandemic on staff development and training that their enterprise or organization partially suspended operation due to the pandemic and 34.2 percent of the responded said they completely suspended operation because of coronavirus pandemic and 16.5 percent said no closures on in operation for staff development and training because of pandemic. 8)According to the results of this question of the online survey, 49.3 percent said the challenges their enterprise face in delivery staff training programmes and activities using online learning or offline learning during covid-19 was due to infrastructure issues such the problem associated with internet and the like. The survey of the study also confirmed that 32.9 percent twice said limited digital skills of trainers and cost of staff training was a major setback to train staff in their enterprise or organization or department or establishment while 30.1 percent said it is due to limited digital literacy of users are the main challenges face by their department in order to train staff. Policy Implications The implication of the results from this online survey is that it has serious impacts on education closure and staff development and training. As educations are closed due to covid-19 pandemic, it will affect already problems of human capital that are hampering the development of Africa. Due to covid-19 pandemic, the achievement of sustainable development goals on quality education will be seriously halted. The government and the ministry in Africa should work hand in hand to solve the problems of children affected by schools closure after the pandemic by either additional hours or provide more study hours for schools to catch-up with what happened during the pandemic, the study noted. Originality/value The impact of covid-19 on education, staff development and training.
Oct 2020 DOI 10.14302/issn.2690-4837.ijip-20-3562
Amoo AbimbolaCorresponding author
University College Hospital (UCH), Ibadan, Nigeria
Introduction Health care personnel are exposed to a variety of material occupational health hazards while handling biological material and contaminated equipment. The use of appropriate and good qualitypersonal protective equipment in work places cannot be over emphasized. Several years ago, this need was highlighted to several physicians like Sir Thomas Morrison Legye. He identified the role of the employer of labour and those of the employee in reducing workplace hazards and consequently achieving a healthy workplace environment. Objectives This study was to determine level of awareness and utilization of Personal Protective Equipment among Medical Laboratory workers. Methods A questionnaire was structured with two sections and a total of 92 were administered. A pilot study was also carried out before the administration of the questionnaire. The data collected was analyzed on Microsoft excel spreadsheet in duplicate. It was then exported into EPI info version 3.4.1. Data was presented using frequency tables and chi square. Results About 77.3%, 72.9%, and 72.7% were aware of the use of goggle, gloves, and importance of hand washing in preventing exposure to Healthcare associated infections while working on patients’ samples. However, under the socio- demographic characteristics of the respondents and awareness level at P-value < 0.5 the results were 0.02. 0.5, 0.85, 0.92 for education, gender, years in service and age respectively. Hence, there is no significant relationship between respondents’ gender, age and year in service, and level of awareness. Conclusion The hospital management should ensure regular provision and supply of Personal Protective Equipment (PPE) to ensure continual usage. Also, regular training and re-training should be conducted to keep the laboratory workers at briefs with latest innovative and benefits of PPE developments to this end.
Sep 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3546
Sah BikashCorresponding author
Associate Professor, Department of Forensic Medicine and Toxicology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) has rapidly evolved as a pandemic with a challenge to the entire world for its management. Various modalities of treatment have been tried till date and when all the modalities failed then the only option that has been shown to be successful in some cases is lung transplantation. Decision for Solid-organ transplantation is not only made based upon its therapeutic requirement but also need to be supported by the law of land. In this regard, current Nepalese law is not with the provision for lung transplantation. Thus, in order to make the concerned authorities aware of it and also as a step toward the preparedness for COVID-19 pandemic, this research has been conducted with an aim to see the perception of health care professionals of tertiary care centre of eastern Nepal regarding the legal aspects of lung transplantation. Conclusion Outcome of this research has supported the therapeutic aspect of transplantation over its legal issue in the emergency conditions like COVID-19 Pandemic.
May 2020 DOI 10.14302/issn.2328-0182.japst-20-3347
Obioma AzuonwuCorresponding author
Department of Medical Laboratory Science, Medical Bacteriology / Virology / Parasitology Unit, Rivers State University, Nkpolu – Oroworukwo, Port Harcourt, Rivers State, Nigeria.
The study evaluated the impact of co-infection of malaria parasitaemia, and HIV positive indices on the CD4 cell count of 120 HIV infected subjects, who were already diagnosed and visiting Braithwaite Memorial Specialist Hospital Port Harcourt for routine Medical check-up. Also, a control group of 40 HIV negative were included as part of the study control group. The subjects were between the age ranges of ≤10–79 years respectively. A double check laboratory assay was conducted to detect the presence of antibody to HIV as confirmed using immunocomb 11 and Determine for HIV status. A thick Blood film stained with field stain (A and B) was used to detect the presence of malaria parasite in the subject’s blood. Furthermore, CD4 cell count was assayed using Partec cyflow counter (Partec, Germany). Excel and Graphpad statistical software were used for analysis of the data generated. The result among the HIV positive subjects and control subjects revealed that the highest positive for malaria infection was observed among ≤10 years age group as 2 (100%) and 11 (84.61%) respectively. In the HIV positive subjects, the distribution of malaria infection among sex revealed a high rate in male 42(77.78%) than in female 44 (66.67%). Similarly, the control recorded a high rate of malaria infection in male 11 (57.89%) than in female 7 (33.33%). However, 86 (71.67%) had malaria and HIV co-infection while 34 (65%) had only HIV mono infection. The positive HIV subjects who had CD4 cells count below 200 cells/mm3 were 15%, above 200-499cells/mm3 were 58.3% while 500 cells/mm3 and above had normal CD4 cells counts for 26%. Nonetheless, for the control subjects, no CD4 cells count of below 200cells/ mm was observed, 2.5% fell within the moderate category while 75% had normal CD4 cells count. Statistical analysis using ANOVA and t-test showed that there is significant difference between CD4 of seropositive and seronegative subjects infected with or without malaria (p=0.00). In addition, a t-test further demonstrated Comparison of Mean CD4 Cell Count among HIV and Malaria Infected and Non-Infected Subjects. MP/HIV Co-Infection and Mono Infection with No Infection showed strong mean difference (p=0.00) in the various CD4 counts while HIV Mono-Infection and others only had a non significant (p=0.44) mean difference between HIV Mono-Infection and No HIV or Malaria Infection. A robust and effective malaria and HIV control management programme should be strongly underpinned; so as to improve the quality of life of patients and HIV patients should be encouraged to live a healthy life style, through the provision of antiretroviral drugs and regular health education engagement, even as the provision of antimalarial treated net would be helpful to the subjects.
Apr 2020 DOI 10.14302/issn.2470-0436.jos-20-3273
Jeneena Amir AishathCorresponding author
Department of Ophthalmology, Rizal Medical Center, Pasig City, Philippines
Objective To identify common ocular and non-ocular signs and symptoms of patients with chiasmal lesions presenting to ophthalmologists. Methods This is a three year case series of patients who presented to Rizal Medical Center Ophthalmology OPD clinic, diagnosed as cases of chiasmal lesion with a complete neuro-ophthalmogical exam, ancillary test and neuroimaging. Data collected include patient profile, ocular and non ocular symptoms, duration of blurring of vision (BOV), best corrected visual acuity (BCVA), Color Vision, Optic nerve (ON) description, Visual field defects (VFD) and size & location of chiasmal lesion. Results A total of twelve patients were included with 1:1 M:F ratio and a median age of 39 years. Blurring of Vision was the presenting symptom in 10 cases, bulging of the eyes and headaches in the remaining cases. Associated symptoms include: non specific headache in all; diplopia in 3 (1 with and 2 without motility defects); and systemic symptoms related to hormonal imbalance in 2 cases. Best corrected vision ranged from 6/6 to no light perception (NLP). Color vision was affected in all cases. ON palor was seen in 6 (50%) and disc edema in 1 case. VFD include Junctional scotoma (58.33%), bitemporal hemianopia (33.3%) and generalised scotoma (8.3%). Neuroimaging revealed pituitary lesions in 10 cases, 1 craniopharyngioma and ON glioma with chiasmal extension. Conclusion Ocular and non ocular symptoms seen were comparable to other studies except that Junctional scotoma was the most common VFD identified in the included population of our case series. This highlights the importance of VF testing among patients complaining of unilateral visual loss to rule out a chiasmal lesion.
Feb 2020 DOI 10.14302/issn.2768-0207.jbr-20-3194
Mohammed AL-Namnam NisreenCorresponding author
Departmet of Oral Biology and Biomedical sciences, Faculty of Dentistry, MAHSA University, 42610 Bandar Saujana Putra, Malaysia
Rhinosinusitis is one of widely spread diseases in the region and the role of the anatomical variations in its pathogenesis remains unresolved. A retrospective study using CBCT scan was employed to locate and measure the diameter of 320 primary maxillary ostium (PMO) (n = 160 subjects) among the Malay and Chinese populations (Mongoloid race) in Malaysia. Image analysis was performed using the i-CAT Vision Software, employing the multiplanar reconstruction window in which axial, coronal and sagittal planes were visualized in 0.3 mm intervals. The mean diameter of the PMO was significantly larger in the Chinese than the Malay. Females had larger size than the male and bilateral asymmetry was noticed, where the right side PMO was larger than the left side (p < 0.05). In addition, PMO opened more in the posterior third position of the hiatus semilunaris (61.9%) than anterior and middle third. The PMO showed a statistically significant posteriorly placed position in the Chinese than the Malays and this was more evident in the right side PMO (p < 0.01). In conclusion, the PMO commonly opens in the posterior third of the hiatus semilunaris and its diameter is significantly greater in the Chinese female with evidence of bilateral asymmetry. Awareness the anatomical variation of the Ostium diameter and location among the Malay and Chinese populations potentially has important clinical effects during surgical procedures.
Dec 2019 DOI 10.14302/issn.2641-5518.jcci-19-3133
Sanikidze TamarCorresponding author
Tbilisi State Medical University, Tbilisi, Georgia
To demonstrate that percutaneous coronary intervention (PCI) may in some cases be a safe option for patients with a high-risk surgical category, we report a complex clinical case of revascularization of multivessel coronary artery disease including left main coronary artery (LMCA) quadrifurcation. Methods For safety reasons, PCI was done in 2 separate sessions (staged PCI). Stenting of the LMCA quadrifurcation was performed using different stenting techniques in combination: modified balloon mini crush stenting technique was used - for LMCA and intermediate artery (IMA) stenting; modified balloon crush stenting technique was used for LMCA, circumflex artery (CX) and first obtuse marginal branch (OM1) stenting; provisional stenting technique was used for CX stenting, followed by sequential kissing balloon post-dilatation technique between LMCA and every branch; proximal optimization technique (POT) was performed in the LMCA. Left anterior descending artery (LAD), intermediate artery, circumflex artery, first obtuse marginal branch, left main coronary artery and its quadrifurcation were stented with 5 drug-eluting stents (DES) (Resolute Integrity, Medtronic); right coronary artery (RCA) was stented with 3 bare-metal stents (BMS) (Rebel, Boston Scientific). Results The interventions ended without complications, the ejection fraction increased from 35% to 48%, congestive heart failure functional class decreased to class I. Subsequent coronary angiography, eight months after the last PCI, revealed patent stents with mild, nonsignificant restenosis. More than three years after the intervention, the patient has no complaints (according to MACE). Conclusions It should be considered that in case of the selection of suitable patients and the use of the appropriate revascularization technique, LMCA quadrifurcation lesion can be successfully treated with PCI.
Nov 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-3070
Sharma BechanCorresponding author
Department of Biochemistry, Faculty of Science, University of Allahabad, Allahabad-211002, UP, India.
The telomeres existing at the end of the eukaryotic chromosome, play an important role in localization, pairing of homologous chromosomes during cell division and synapsis formation, while telomerase is involved in maintenance of the telomere length. The application of antiHIV-1 molecules particularly NRTIs have been shown to interfere with telomerase function thereby inducing aging processes. Since the application of these molecules has already indicated production of oxidative stress and toxicity in AIDS patients, their adverse impact on telomerase function may further worsen the situation. In addition, the negative influence of antiHIV-1 regimens on certain host factors involved in telomerase function may enhance aging. HAART changes the landscape of the disease by progressively decreasing the progression of HIV-1, but exerts prolonged adverse effects on the telomerase function. Though there is no exact information available on this issue, intensive efforts are needed to explore regulation of telomerase expression in HIV infected individuals and particularly those receiving antiretrovirals.
Nov 2019 DOI 10.14302/issn.2639-3166.jar-19-3065
Marcelo Scavuzzo CarlosCorresponding author
Comision Nacional de Actividades Espaciales, CONAE. Gulich Institute, R. C45km8 Cordoba, Argentine
The importance of horticulture around the large cities, called green belt (GB), or proximity food production area is related to its contribution to the provision of food as well as its role on social, cultural and ecological aspects. Geoscience and Remote sensing (GRS) are tools that should aid in gathering and updating the information to develop science-based management plans of this areas. Recently, the improvement in terms of spatial, temporal and radiometric resolutions has changed the performance and the approach to the horticulture remote sensing. In this work, we make a brief review on the literature exploring the use of GRS techniques in horticulture, and future trends in order to exploit the available techniques for efficient crop management in the way to improve territorial planning and management. Specifically we found a lack of academic production in this area. In addition we examine the importance of this landscape areas from different points of view (food security, health, ecology, etc.). A systematic revision of published studies on remote sensing on horticulture including different platforms, sensors and methodologies are briefly presented. Finally some aspect related with future trends are discussed.
Jul 2019 DOI 10.14302/issn.2688-5328.ijp-19-2804
Francesco Fraioli MarioCorresponding author
University of Rome Tor Vergata, Department of Neurosciences, Neurosurgery
Many therapies are available for trigeminal neuralgia (TN), from medical therapy to invasive, mininvasive and non-invasive methods. There is no a unique indication concerning the choice of treatment; we report our indications for gasserian ganglion compression with balloon by percutaneous approach. Out of 421 patients affected by TN treated with various methods from 2004 through to 2014, we present 46 patients treated by gasserian ganglion compression with balloon catheter. Patients selected for this procedure were only those refractory to medical therapy and refractory to the other available therapies (radiofrequency, microvascular decompression, radiosurgery, glycerolization, peripheral alcoholizations): balloon compression was performed as third line therapy. After the procedure, twenty-eight patients were classified as BNI pain intensity score grade 1, seven other as grade 2, three other as grade 3, six were classified as BNI grade 4, and in one patient no improvement of pain occurred (BNI grade 5). After an average period of follow up of 8,6 years, four cases of pain recurrence occurred. Because balloon compression is an ablative and non-selective procedure and all three trigeminal divisions are damaged to achieve stable pain remission, the procedure was performed only in patients affected by recurrent TN refractory to the other available methods.
Feb 2019 DOI 10.14302/issn.2641-4538.jphi-19-2589
Ahmadou Diallo AlphaCorresponding author
Ministry of Health
Several studies show that policies to improve maternal and infant health must be contextualised within broader questions and commitments concerning women’s empowerment. There are, however, two-way linkages between women’s empowerment and reproductive services. Certain institutional approaches that support women’s reproductive health can themselves be experienced as empowering whereas others, however well-meaning, can be experienced as disempowering, undermining health and broader goals. It is thus important to discern and support those elements of reproductive services that might have empowerment outcomes, and to avoid others that undermine them. This paper is premised on the hypothesis that approaches to reproductive health that are rooted in women’s life worlds, that support women’s social networks and which enhance women’s confidence and control will have very different empowerment effect from those that subordinate women and their networks to external expertise and (often male) authority and undermine women’s preferences or autonomy. We (a) conduct an audit of positive practices concerning maternal and child health and (b) examine how current support to maternal and infant health articulates with this. Analysis seeks to reposition indigenous knowledge, community wisdom and their secular practices in a way that promotes better health provision that is integrated with these existing practices and that is empowering.
Jan 2019 DOI 10.14302/issn.2470-0436.jos-19-2602
Adaboh HayfordCorresponding author
Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Vision impairment and blindness remain a challenge in developing countries, especially in rural communities. Notwithstanding, VISION 2020 global initiative seeks to eliminate avoidable blindness by 2020. This community-based cross-sectional study aimed at determining the accessibility of ophthalmic services and barriers to its utilization in rural communities in the Upper Denkyira West District, Ghana. One-hundred and seventy participants from 5 randomly chosen rural communities in the district were included. Participants were interviewed using a structured questionnaire. Socio-demographic information, information regarding accessibility, utilization, and barriers to eye care services were obtained. Descriptive statistics were carried out using SPSS version 23. The Chi-squared test was employed to determine associations. P-values less than 0.05 at a confidence interval of 95% were considered significant. Only 21.8% of participants had had eye examination within the past 3 years, with over half of the examinations undertaken at screening grounds and health centres. Significant associations were found between ophthalmic services utilization and increasing age (p = 0.004), female gender (p = 0.027) and those who had a past history of eye problem(s) (p = 0.0010. The study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Public health education and eye care interventions should prioritize and target rural populations. Key Messages This study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Rural dwellers were thus compelled to resort to harmful eye care practices. Public health education and eye care interventions should prioritize and target rural populations
Nov 2018 DOI 10.14302/issn.2690-0904.ijoe-18-2389
Isaksson MarléneCorresponding author
Lund University, Department of Occupational and Environmental Dermatology, Skane University Hospital, Malmö, Sweden.
Background A survey was undertaken in all ice hockey players in 26 professional teams in Sweden representing the 2 highest divisions. All players answered a questionnaire and the players from 6 teams, 3 from each one of the 2 divisions, were patch tested with 72 test preparations in a baseline series supplemented with a series representing the work environment of the players. For practical reasons, the patch testing and test reading on day 3 (D3) took place in the arenas of the teams. As a traditional dermatologist reading on D7 was impossible to perform in all but one team, the players and coaches were asked to use their mobile phones to take photos of the tested backs of the players on D7 and send to the investigative team. In one team a dermatologist reading took place on D7 independent of the mobile photos. Aim The aim of the study was to investigate if photos from mobile phones taken on D7 by the subjects themselves or someone helping them could add positive reactions to those noted from traditional test readings on D3. Materials and Methods 107 players in the 6 teams were patch tested and reading on D3 was performed in 103 of them. Mobile photos of the backs of 100 players were taken on D7. Results 5 photos obtained from the 100 players available for the second test reading on D7 had too bad quality to allow evaluation. Thus, photos of 95/103 (92.2%) players with a live dermatologist reading on D3 were evaluated. Besides 50 contact allergic reactions noted in 26 players on D3, 7 (14%) more positive reactions were registered in 5 players, in 2 without any reactions on D3. The 7 additional reactions were noted to 7 different sensitizers - oxidized linalool, mercapto mix, mercaptobenzothiazole, PFR-2 (resol resin based on phenol and formaldehyde), paraben mix, imidazolidinyl urea, and methylenedianiline. Conclusion 14% more contact allergic reactions were diagnosed when using photos of the tested backs of the players replacing the traditional dermatologist reading on D7.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
AA OkechukwuCorresponding author
Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
May 2018 DOI 10.14302/issn.2381-862X.jwrh-18-2090
Yao Gbagbo FredCorresponding author
University of Education Winneba, Department of Health Administration & Education. P.O. Box 25 Winneba, Ghana.
Background: The Ghanaian culture expects women of reproductive age to reproduce. This makes pregnancy an acceptable occurrence in most tertiary institutions in Ghana. Although Ghanaian Universities allow pregnancy in school, challenges associated with pregnancies do not exempt pregnant students from following the academic requirements of the universities. This study therefore explores students’ experiences of copying with pregnancy in an academic environment in Ghana. Methods: This was a case study, quantitative and qualitative design using structured questionnaires and semi-structured interview guides respectively for data collection. Respondents comprised twenty (30) pregnant full time and part time female students from campuses of University of Education, Winneba. Data collection was between October 2016 and May 2017. Quantitative data were analysed using statistical package for social sciences (SPSS) version 23. The qualitative data was transcribed and manually analysed thematically. Results: The study found that majority of participants were adults between ages 26 and 30 years. More than half of them (66.7%) had no child and this was their first pregnancy which they felt was mistimed as it occurred during schooling, posing some physiological, financial and academic challenges which compelled students to devise various coping strategies to combine academic work and pregnancy amidst limited University provisions for pregnant students. Conclusions: The study results have policy and programme implications for meeting women’s needs for pursuing academic and reproductive goals concurrently. The study recommends that public universities in Ghana should institutionalise programmes on preconception counselling and coping with pregnancy in academic environment to enable female students make informed decisions on exercising their reproductive rights in whilst in the university to ensure positive maternal health outcomes.
Jan 2018 DOI 10.14302/issn.2641-5526.jmid-17-1891
Attanasio RobertoCorresponding author
Endocrinology, Galeazzi Institute IRCCS, Milan, Italy
Background Conventional tools for medical education are burdened by many drawbacks. Textbooks become rapidly outdated, meeting attendance is expensive, and results reported in journals are not easily suitable for clinical practice. Uptodate and Endotext are excellent online tools, but they have been developed for a clinical context far different from that of our country. Methodology Italian Association of Clinical Endocrinologists (AME) charged a task force aiming to develop an educational tool specifically tailored for Italian clinical endocrinologists. Required characteristics were clinical approach, modularity, continuous updating, full online availability (even by mobile devices), open sections and sections for registered members only, opportunity for individualization, indexing and search engine to facilitate browsing. Starting from an open-source platform, Joomla, several changes were implemented. Results Three editors, 2 central editorial secretaries, 30 section coordinators and over 350 authors have been involved in the writing of 21 different sections covering all fields of endocrine and metabolic diseases. The access to Endowiki is free for AME members and is fully open in sections for patients. All readers are requested to serve as referee, pointing to mistakes and need for revision. The system is attended daily by a mean of 250 individuals. Conclusions Endowiki stands alone as an opportunity for medical education in Italy. The big challenges will be the continuous updating and the link to the national certified system for CME.
Jan 2018 DOI 10.14302/issn.2474-3585.jpmc-17-1836
Róbert PókaCorresponding author
University of Debrecen, Faculty of Medicine, Department of Obstetrics and Gynecology.
Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.
Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1724
Wanby PärCorresponding author
Section of Endocrinology, Department of Internal Medicine, Kalmar County Hospital, Kalmar, Sweden
Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.
Aug 2017 DOI 10.14302/issn.2470-0436.jos-17-1721
C. Rodger DamienCorresponding author
USC Roski Eye Institute, Los Angeles, California
A 57-year-old Hispanic female presented with 3 days of blurry vision in the left eye. Eight years prior, she had a branch retinal artery occlusion in the right eye and a hematologic work-up revealed a 4G/4G polymorphism in plasminogen activator inhibitor-1. With the current episode, she was found to have bilateral branch retinal artery occlusions and mild vitritis in the left eye, simulating a toxoplasma infection. An infectious and inflammatory work up, however, was negative and the vitritis resolved after a short course of steroids. Plasminogen activator inhibitor-1 mutations may be associated with an increased risk of retinal vascular occlusions.
Aug 2017 DOI 10.14302/issn.2470-0436.jos-17-1666
P. Storey PhilipCorresponding author
USC Roski Eye Institute, University of Southern California
Purpose: To evaluate early versus late immunomodulatory therapy (IMT) for patients following initial diagnosis of Vogt-Koyanagi-Harada (VKH) disease. Methods: Retrospective review including all VKH patients seen 5/1/2014 to 4/1/2016 at LAC+USC. Early IMT was defined as starting an immunomodulatory agent within 3 months of corticosteroid initiation. Results: Twenty-seven patients were included, of whom 15 received early IMT and 8 received late IMT. Early IMT patients trended toward greater improvement in vision compared to late IMT (logMAR 0.59 vs. 0.11; p=0.14) with no differences in ocular complications including ocular hypertension (p=0.53) and cataract (p=1.0). Patients receiving early IMT averaged 0.93 recurrences versus 2.13 recurrences for late IMT (p=0.092). Of patients successfully taper off oral corticosteroids, the early IMT group was tapered in an average of 8.3 months versus 19.8 months for late IMT (p=0.0019). Conclusions: Early IMT in VKH may allow for shorter duration of corticosteroids with similar visual outcomes, ocular complications, and disease recurrences.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-16-1354
Frumence GastoCorresponding author
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania.
Tanzania is among the developing countries experiencing rapid growth of an ageing population, which has an implication in healthcare expenditure especially in resource poor settings where majority of elderly people cannot afford to pay for the cost of accessing health services. The country has developed the Tanzania National Health Policy (2007) and National Ageing Policy (2003), which, among other things, recognize the importance of having a healthcare system that provides free basic services to the vulnerable elderly population. This study aimed at exploring health service providers’ and managers’ perspectives on the factors facilitating or prohibiting access to health services among elderly people in Tanzania. The study adopted a qualitative approach and data were collected using semi-structured interviews. A total of 24 in-depth interviews were conducted with district healthcare managers, heads of public healthcare facilities, and health service providers. The data generated were analysed for themes and patterns. The results show that Tanzania’s healthcare system has made some efforts to implement the national exemption policy to ensure better access to health services for the elderly. Some of these efforts include: having in place a system to identify and exempt elderly people from paying for health services and giving them special priority during treatment. However, there are some barriers hindering elderly people’s access to health services. Among others include: lack of specific consultation rooms and doctors for serving the elderly, and lack of sufficient drugs and other medical equipment in most government-owned healthcare facilities. In summary, the healthcare system has created a good environment for the implementation of exemption policy aiming at enhancing accessibility of health services among the elderly population in the country. However, such environment cannot function effectively without addressing the identified barriers. It is recommended that the government should allocate adequate human and non-human resources to the healthcare system to enable it to function effectively, including the provision of health services to the elderly.
May 2017 DOI 10.14302/issn.2381-862X.jwrh-16-1374
Deligeoroglou EfthimiosCorresponding author
Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Obstetrics & Gynecology, University of Athens, Medical School, “Aretaieion” Hospital, Vasilissis, Sofias Avenue 76, 11528 Athens, Greece
Objectives: The aim of this study is to assess the correlation between the degree (percentage) of occlusion due to labial adhesions and vulvovaginitis. Materials and Methods: Prospective study of pre-pubertal females who attended our Division, during the past 7 years, due to labial fusion. Medical history, clinical examination and Q tip culture of vaginal fluid samples were performed, after separation of the labia. Treatment of isolated pathogens was administered, based on antibiogram results. Results: 53 patients, with mean age 3.81 years (±0.88 years, SD:2.65, range:0.33-9.5 years) had a total of 89 vaginal specimens collected, as re-culture was performed in 17 patients due to labial fusion recurrence. In 32.08% no pathogen was isolated. Gardnerella vaginalis (24.51%) and Bacteroides spp (15.09%) were the commonest isolated pathogens of the rest 67.92%. Among labial fusion recurrences the commonest isolated pathogen was Gardnerella vaginalis (23.13%), while in 36.12% no specific pathogen was detected. Conclusions: The results suggest that non-specific vulvovaginitis is responsible for lower degree (<60% closure) of labial adhesions, as well as that recurrent infection plays a role in the formation of higher degree/percentage of labial closure, especially when there are one or more pathogens present. Furthermore, the presence of anaerobes at initial cultures, together with Gram negative bacteria at re-cultures, appear to further facilitate the creation of extensive adhesions.
Apr 2017 DOI 10.14302/issn.2470-0436.jos-17-988
Chen Ying-LingCorresponding author
University of Tennessee Space Institute, 411 B. H. Goethert Parkway, Tullahoma.
Photorefraction (PR) methods have beenwidely used for pediatric vision screening since the 1980’s. While PR is easy to implement, the accuracy of refractive error measurements in humans has been unsatisfactory, largely due to the variations of intraocular scattering, the retinal reflectance, and pupil size. The objective of our studies was to clinically evaluate the accuracy of refraction measurements of an improved PR-based device, the Dynamic Ocular Evaluation System (DOES), and to investigate whether the accuracy is affected by the patient’s age, race, and pupil size, which are relevant to individual intraocular scattering and retinal reflectance. We performed DOES measurements in 99 volunteers (198 eyes) under two environmental light conditions and using four fixation targets. These results were compared to the standard clinical refraction testing performed the same day. The correlation and standard deviation were determined by Bland-Altman analysis. The influence of intraocular scattering, retinal reflectance, and pupil size was evaluated by comparing results from different age groups, races, and lighting conditions. In the region between -4 diopter (D) and +4D, the device showed a binocular refraction measurement accuracy of 0.45 D, 0.3 D, and 0.18 D root-mean-square (RMS) error (n=1337) for spherical equivalent and cross cylinders Jo and J45, respectively. Inaccuracy increased at high refraction (>4D). Age, race, and pupil size did not appear to significantly affect DOES PR measurement. This suggests that enhancements in the PR system and analysis may satisfactorily correct intersubject variability that currently limits the clinical use of PR devices and measurements.
Apr 2017 DOI 10.14302/issn.2372-6601.jhor-17-1463
Szablewska SylwiaCorresponding author
Nicolaus Copernicus University, Faculty of Health Sciences; Department of Oncology, Radiotherapy and Ginecologic Oncology, Poland
Melanoma is considered to be a very aggressive cancer due to its rapid growth, early and multiple metastases and limited response to standard treatment. Many researchers have hypothesized that the combination of radiation therapy and immunotherapy in the treatment of melanoma primary tumors and metastases improves the efficiency of these methods as compared to their use separately. Therefore, combined therapy is an increasingly popular topic in radiation oncology. Although the mechanism of immune response to ionizing radiation remains unclear, known are the factors involved in the immune response, including NK and CD8(+) T cells. Many studies have demonstrated the importance of inflammatory factors, primarily cytokines, in the response to ionizing radiation. In turn, many cytokines released in an irradiated organ, such as tumor necrosis factor α (TNFα), interleukins IL1 and IL6 and transforming growth factor beta (TGFβ), can induce the production of significant amounts of reactive oxygen species that are associated with the induction of DNA damage in tumor cells. In relation to anticancer immunotherapy, the clinical data obtained to date can encourage future studies combining radiation therapy and the inhibitors of cell division checkpoints in the treatment of advanced melanoma. In a recent study, melanoma cell lines became more sensitive to radiation after BRAF inhibition, which provides a potential synergistic mechanism of BRAF inhibitor (BRAFi) combined with radiation therapy for better effects of treatment. In this article, we present a systematic review of the literature on the use of the combination of radiation therapy and immunotherapy in the treatment of melanoma.
Aug 2016 DOI 10.14302/issn.2574-4496.jtc-16-1129
Silva FriedaCorresponding author
Nuclear Medicine Section, Radiological Sciences Department, School of Medicine, University of Puerto Rico
Objective: Radiation exposure to the general public and patients undergoing diagnostic or therapeutic procedures is of great concern, especially to the medical community. Revision of Nuclear Regulatory Commission rules several years ago yield new recommendations for the administration of therapeutic doses of 131-Iodine that included the release criteria. The guidelines for ambulatory treatment included patient education and radiation safety measures to minimize exposure and contamination. Our goal in this study was to evaluate patient compliance with the radiation safety instruction protocols given to them before the therapeutic dose and monitor radiation levels in different house areas at different times after an ablation therapy of 3700MBq or more. Method: Patients with well differentiated thyroid cancer being evaluated for ablation therapy with 131-Iodine were invited to participate. A thorough set of instructions on radiation protection were given verbally and in writing. Patient house was assessed with a Geiger Muller detector at 24 and 72 hours or above to obtain direct radiation levels in several areas. Patient radiation levels were also monitored. Results: A total of 12 patients have been included, 11 females and 1 male, median age was 53 years. Tumor histology was 10 papillary, 2 papillary-follicular variant and 1 follicular carcinoma; 92% of the cases were T1, N0, M0. Home location was urban in 77% and rural in 33% of the patients; 67% of the patients had an educational level between 9-12 grade. Radioiodine doses range from 3441-5994MBq. None of the patients had a relatives or companion in the house. Mean patient exposure 24 hours after the dose at 1 meter was 12mrem/hr, 0.120mSv/h; this represented a retained dose of 2181MBq (59mCi). Only one patient (T1, Nx, M1) had an exposure rate at 1 meter of 100mrem/hr (1mSv/hr) at 24 hours. At 72 hours the exposure changed to 4mrem/hr, 0.040mSv/hr, retained dose of 725.2MBq (19.6mCi). Higher exposure rates in the house were at 24 hours in the bed and pillows (7mrem/hr), kitchen trash (13mrem/hr) and bathroom sink (8mrem/hr). The exposure rates at the toilet and shower were similar (3-4mrem/hr). There was a significant decreased in the exposure rate at 72 hours in all house areas. Patients with the higher exposure rates were those with metastatic disease, and small living facilities. Patients living in rural or urban location had no difference in the exposure rate. The educational levels were not related either to the exposure rate. Conclusion: Patient compliance with radiation protection instructions and Nuclear Regulatory Commission release criteria was good. Radiation exposure levels in the house areas are safe. Special instructions must be design to minimize contamination in the bathroom and kitchen Caution is recommended in the release of patients with extensive metastatic disease and doses of 5920MBq or more.
Jul 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1159
Yezdani ArifCorresponding author
Sree Balaji Dental College and Hospital.
This case report reiterates the fact that a bilateral posterior crossbite with severe skeletal class II malocclusion in the growth period could be effectively treated by a comprehensive approach with a rapid palatal expansion appliance followed by fixed appliance therapy. A 14-year-old boy presented with a severe skeletal Class II malocclusion with an orthognathic maxilla, retrognathic mandible and a high mandibular plane angle with an Angles’ Class II division 1 subdivision malocclusion with maxillary constriction, increased overjet, deep bite and severe crowding of maxillary and mandibular incisors. A banded rapid palatal expansion appliance was initially given to correct the bilateral posterior cross bite and subsequently maxillary and mandibular first premolars were extracted and Roths’ Pre adjusted edgewise appliance therapy (0.022 x 0.28-inch slot) was strapped up to correct the severe tooth size-arch length discrepancy. The patient’s soft tissue profile and dentofacial esthetics improved dramatically with increased self-confidence and enthused self-esteem.
Apr 2016 DOI 10.14302/issn.2470-0436.jos-15-763
El-Assal KarimCorresponding author
Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, UK.
Background: Optic nerve head drusen are acellular hyaline deposits located anterior to the lamina cribrosa, frequently associated with visual field defects. Sometimes rapid worsening of vision may occur due to complications such as acute vascular events, choroidal neovascularization, or serous maculopathy. Case Presentation: Although there are no proven treatments for Optic nerve head drusen associated field loss, we present the case of a patient with Optic nerve head drusen and bilateral rapid progression of visual field loss that has stabilized on intraocular pressure lowering medication. This suggests a role for IOP-mediated retinal ganglion cell loss in this individual. The mechanism of progressive Optic nerve head drusen associated field loss is poorly understood, however experimental glaucoma models and human in vivo imaging studies have shown that structural differences within the optic nerve head are likely to contribute to individual susceptibility to IOP-mediated damage. Conclusion: We propose that eyes with Optic nerve head drusen may be less able to dampen IOP mediated stress, contributing to loss of retinal ganglion cells in some patients.
Feb 2016 DOI 10.14302/issn.2379-8572.joa-14-531
Ota YasushiCorresponding author
Department of Otorhinolaryngology, Toho University Sakura Medical center, Japan
Central retinal artery occlusion (CRAO) is a retinal ischemic disorder associated with sudden loss of vision and has a poor prognosis. We report a case of CRAO that occurred during frontal sinus surgery involving craniotomy in a patient with a frontal sinus cyst. The prognosis for treatment after the acute phase is generally unfavorable; however, aggressive treatment is recommended for patients with visual acuity of “hand motion” or better within 1 day after onset. This case highlights the need for informed consent prior to nasal or paranasal sinus surgery, including mention of the possibility of CRAO as a complication.
Feb 2016 DOI 10.14302/issn.2324-7339.jcrhap-15-828
E.E Enwereji,Corresponding author
College of Medicine, Abia State University, Uturu, Nigeria
Introduction Working with people who are HIV positive is a herculean task and relevant theories to assist them medically, psychologically, economically, socially and otherwise are necessary. People who are living positively with HIV and AIDS are usually ridiculed, discriminated against, rejected and isolated. Using theories to work with them will help to cushion the negative impacts of HIV and AIDS, especially stigma which has been identified as a major barrier to health care and quality of life in illness management. The fundamental human rights of people living positively with HIV and AIDS should be protected since majority of such rights are usually trampled upon. The review aimed at discussing the potential benefits of using theories to assist people living positively with HIV and AIDS to cope with their various and varying situations in life. Materials and Method: Information for this study was collected by extensive review of recent literature on theories for assisting people living positively with HIV and AIDS. The paper reviews theories that influence long-term behaviour change among people living positively with HIV and AIDS. It assesses the need for using these theories to improve HIV and AIDS intervention in developing countries including Nigeria. In this study, eleven behaviour theories were reviewed. Result It was noted that some of the theories promoted adherence as well as helped to explain the benefits of adherence to HIV and AIDS medication. Also a good number of the theories assisted researchers in designing effective intervention strategies. Conclusion: Further research is needed to determine the effective theories that will increase adherence to long-term treatment regimens of HIV and AIDS. Such theories can be used to alleviate the potential burnout of Caregivers and people living positively with HIV and AIDS who travel long distances for diagnostic procedures and work long hours without adequate remuneration, support and supervision.
Feb 2016 DOI 10.14302/issn.2574-4496.jtc-15-838
Christophe DanielCorresponding author
IBMM, Biopark Charleroi Brussels South, B-6041 Gosselies, Universite Libre De Bruxelles, Institut De Recherche Interdisciplinaire En Biologie Humaine Et Moleculaire (IRIBHM)
Thyroid transcription factor-1 (TTF-1) is known to play key roles in thyroid organogenesis, in thyroid cell proliferation and in the expression of genes involved in thyroid differentiated function. Many human thyroid cancer cell lines keep producing TTF-1 despite the loss of differentiated gene expression, raising a question about the role of the factor in these cells. In order to investigate this point, we used a chimeric protein acting as a functional antagonist of TTF-1 transcriptional activity that was expressed conditionally in 8505C cells originating from an anaplastic thyroid carcinoma. We observed a growth arrest of 8505C thyroid cancer cells when the endogenous TTF-1 transcriptional activity was inhibited. It correlated with decreased levels of several mRNAs encoding positive effectors of cell proliferation like CDK1 and cyclinB1, and increased levels of various mRNAs encoding negative regulators of cell division like CDKN2B and DUSP6. In conclusion, the persistence of TTF-1 expression observed in the dedifferentiated human thyroid cancer cell line 8505C reflects the need of TTF-1 activity for the proliferation of these tumor cells.
Dec 2015 DOI 10.14302/issn.2576-182X.jbsc-14-582
Ozdemir MevciCorresponding author
Pamukkale University, Faculty of Medicine, Department of Neurosurgery, Denizli, Turkey
Pituitary abscess is extremely rare and often misdiagnosed as pituitary tumor pre-operatively. We document a case of a 64-year-old lady presented to the outpatient department with complaints of headache and blurring vision of right eye for one month. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed Actinomyces infection. This case has been documented due to the extremely rare involvement of the pituitary gland by actinomyces infection. Pituitary abscess is a rare pathology, but it must be considered during evaluating sellar masses, since its prognosis depends on surgical drainage and on the use of specific antibiotics. We report, to our knowledge, the fourth case of Actinomyces israelii infection of the pituitary region.
Oct 2015 DOI 10.14302/issn.2470-0436.jos-14-571
SHIBA TakuyaCorresponding author
Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.
Purpose: To describe a new functional magnetic resonance imaging (fMRI) method for measuring the influence of regular astigmatism, both against-the-rule (ATR) and with-the-rule (WTR), on the human visual cortex. Setting: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan. Design: Experimental study. Methods: Images were acquired in two healthy volunteers using a 1.5 T scanner equipped for echo planar imaging. Horizontal and vertical sine wave grating flickering at a frequency of 8 Hz were simultaneously presented during the 20-second stimulation period. During the control period , subjects fixated on a control target. Stimulations were performed under three different conditions that included with hard contact lenses that were equal to emmetropia without astigmatism (condition 1); with hard contact lenses and cylindrical glasses of +6.00D at 0°, imitating WTR (condition 2); and with hard contact lenses and cylindrical glasses of +6. 00 D at 90°, imitating ATR (condition 3). Raw data were processed using in-house software with the significance of activation determined by Statistical Parametric Mapping (SPM 99). Results: Although higher activation was found in the primary visual cortex for condition 1 versus conditions 2 and 3, activation in the dorsal pathway was higher in conditions 2 and 3 compared to condition 1. Dorsal pathway activation was also higher in condition 3 versus condition 2. Conclusions: Study findings showed the potential influence of ATR and WTR on the human visual cortex , with fMRI able to detect the influence of regular astigmatism on the visual cortex. Our current results suggest that fMRI may be useful in exploring the influence of astigmatism on vision.
Jun 2015 DOI 10.14302/issn.2374-9431.jbd-12-164
Lima-Gomez VirgilioCorresponding author
Hospital Juarez de Mexico, Av. IPN 5160 Colonia Magdalena de las Salinas, CP 06770, México City, México.
Objective: To identify the efficacy of focal photocoagulation to maintain or achieve best corrected visual acuity (BCVA) ≥20/40 in eyes with clinically significant macular edema (CSME) that had a focal angiographic pattern. Material and Methods: Non-experimental, retrospective, longitudinal, descriptive study in type 2 diabetic patients of any gender, who had CSME with focal angiographic pattern, who received focal photocoagulation from January to October 2012, with a register of BCVA before and 3 weeks after photocoagulation. 101 eyes from patients aged 35-74 years (mean 60.1±8.15) were assigned to one of two groups: 1, with BCVA before treatment <20/40 (n=60), and 2, with BCVA ≥20/40 (n=41). The proportion of eyes with BCVA≥20/40 after treatment was identified, in the sample and within each group. Results: In group 1 BCVA improved in 34 eyes (56.7%), did not change in 15 (25%), and worsened in 11 (18.3%); in group 2 BCVA improved in 10 eyes (24.4%), did not change in 18 (43.9%) and worsened in 13 (31.7%). Post treatment BCVA was ≥20/40 in 57 eyes (56.4%, 95% confidence intervals 46.8-66.1%), 21 of them from group 1 (36.8%) and 36 from group 2 (63.2%). Conclusion: Treating CSME with focal photocoagulation was efficacious to maintain BCVA ≥20/40 in 87.8% of eyes with that rank of vision preoperatively, and to achieve BCVA ≥20/40 in 35% of eyes without it. Early detection and treatment of CSME is required to increase the proportion of eyes with BVCA that provides visual independence, preferably when visual function is still good.
Jun 2015 DOI 10.14302/issn.2470-0436.jos-14-528
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A previously healthy 25 year old Chinese male presented with left eye blurring of vision and was diagnosed to have left eye branch retinal vein occlusion. Initial blood investigations and thrombophilia screen were negative. The patient subsequently improved with observation and conservative management, with no further events over a 2 year follow up period. The blood investigations were repeated 2 years later as part of a health check-up and he was then tested to be heterozygous for the factor V leiden mutation. This was confirmed by sequencing of his genome that identified the mutation. The laboratory was contacted to provide details regarding the testing methods and was noted to have performed the two tests via different methods. While false negative rates in genetic testing are low, we believe that there is greater need to standardize testing methods as ascertaining genetic conditions play a great role in clinical diagnosis, treatment and prognosis. Clinicians should be aware of the limitations of these tests. When clinical suspicion is high, there may be a role for repeat tests with different methods or in different laboratories.
May 2015 DOI 10.14302/issn.2470-0436.jos-14-527
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A 66 year old Chinese male with a medical history of hypertension, diabetes mellitus and hepatitis B carrier was diagnosed with hepatocellular carcinoma in 2009. He underwent treatment with selective internal radiation spheres and sorafenib, and multiple cycles of chemotherapeutic agents such as bevacizumab, erlotinib, OXAFI ( intravenous oxaliplatin and doxorubicin given on days 1, 8 and 15 in a 28-day cycle, a daily continuous infusion of fluorouracil and subcutaneous interferon alfa-2b 5 million units administered thrice weekly), thalidomide, capecitabine, and rapamycin over the course of four years. Along the course of treatment, he developed pulmonary embolism and was initially started on anti-coagulation. Two months later, he developed hemoptysis and the anti-coagulants were stopped. During his routine ophthalmology visit for diabetic eye evaluation, he complained of blurring of vision of his left eye for the past four to five weeks. He was found to have central retinal vein occlusion (CRVO) of the left eye, associated with macular edema. Visual acuity was 6/15 for the right eye and 6/60 for the left eye. Eyelids, conjunctiva, cornea, anterior chamber, pupils, lens and ocular motility were normal. Humphrey visual field testing showed a superior arcuate and basal defect. This is the first reported case of CRVO in hepatocellular carcinoma. The etiology of CRVO is multifactorial, withhepatic malignancy, previous major surgery, multiple cycles of chemotherapy and cessation of anticoagulant therapyas possible aetiological factors. His background medical problems of diabetes and hypertension are further contributors.
Jan 2015 DOI 10.14302/issn.2379-7835.ijn-14-534
St-Onge Marie-PierreCorresponding author
New York Obesity Nutrition Research Center, St. Luke’s/Roosevelt Hospital, New York, NY 10025
Objective: Skipping breakfast has been associated with an increased risk of obesity. This randomized controlled pilot study tested whether emphasizing breakfast consumption, in conjunction with nutrition counseling, would improve weight status and dietary quality in children. Design and Methods: Twenty children were recruited and randomized to a breakfast (BF, n=11) or control (n=9) intervention. Both groups received weekly group nutrition counseling for 12 wk but breakfast consumption was emphasized, and ready-to-eat (RTE) cereal provided, to BF only. Anthropometric measurements were taken weekly. Three-day food records were taken at baseline and endpoint. Results: Weight status did not change significantly, however, children in BF displayed an overall decrease in BMI (-1.0±5.1%) whereas children in the control group had an overall increase (1.1±7.2%) from baseline (P=0.52). Three-day food records (BF, n=6; control, n=5) revealed group x time interactions on total sugars (P=0.007), folate (P=0.05), vitamin B12 (P=0.03), sodium (P=0.05), niacin (P=0.009), and vitamin B6 (P=0.023). Except for sodium, BF had improvements in these nutrients relative to the control group. Conclusions: Preliminary data from this study show that the provision of RTE cereal with weekly nutrition counseling may positively affect intake of essential nutrients. The effects of breakfast consumption on weight status are still uncertain.
Nov 2014 DOI 10.14302/issn.2379-7835.ijn-14-475
K. Bai YeonCorresponding author
Associate Professor, Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey 07043
Osteoporosis prevention among women requires obtaining proper knowledge early in life about the disease, risk factors and treatments. This study compares specific education sources to osteoporosis knowledge and calcium intake. Online survey usinga convenience sampling was performed with women between ages 18 and 40. The survey measured osteoporosis knowledge, calcium consumption, and specific education source within categories of age, school classes, television, radio, newspaper, magazine, Internet, and in-person. Multiple regression analysis determined influential education sources for osteoporosis knowledge and calcium intakes. Osteoporosis knowledge was suboptimal (13.8 ± 3.3, as a score higher than 16 defined as “adequate”) and average daily calcium intake was 1315.1 ± 609.9 mg. Age and newspaper had greatest contribution towards osteoporosis knowledge, while Internet, school classes and radio were most influential resources on calcium intakes. Creating an osteoporosis education initiative utilizing these sources is imperative for increasing disease knowledge and preventive behavior among young women.
Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-74
Madiba SphiweCorresponding author
School of Public Health, Faculty of Health Sciences, University of Limpopo, Medunsa Campus, South Africa
HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4–17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child’s age older than 10 years (OR =1.63; 95% CI: 1.44–1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47–0.87), and caregiver’s age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities.