Health Sciences

BACKGROUND The homeostasis model assessment of insulin resistance (HOMA-IR) is a useful model for application at large epidemiologic studies. The aim of this study was to determine the HOMA cut off values to identify insulin resistance (IR) and metabolic syndrome (MS) in Qazvin, central Iran. METHODS Overall, 480 men and 502 women aged 20-72 yr attended in this cross sectional study from September 2010 to April 2011. The diagnostic criteria proposed by national cholesterol education program third adult treatment panel (ATPIII), International Diabetes Federation (IDF) and new Joint Interim Societies (JIS); were applied to define MS. Lower limit of the top quintile of HOMA values in normal subjects was considered as the threshold of IR. The receiver operating characteristic (ROC) curves of HOMA for MS diagnosis were depicted. The optimal cut point to determine MS was assessed by maximum Youden index and the shortest distance from the point (0, 1) on the ROC curve. RESULTS The threshol...

The global incidence rate of frailty syndrome among older adults aged 60 years and over has been estimated to be 43.4 cases per 1000 persons/years. Objectives: This study aimed to determine the prevalence of pre-frailty and frailty syndromes in community-dwelling older adults and assess the correlated sociodemographic factors. Methods: All elderly people recruited in the second phase of the Amirkola Health and Ageing Cohort Project, including 2135 older adults aged ≥60 years living in Amirkola, North of Iran, were invited to participate in this study using the census method. The standard "FRAIL" scale was used to assess the frailty syndrome. The individuals who obtained a score of three or more and one or two were classified as frail and pre-frail cases, respectively. Results: Totally, 2010 older adults with a mean age of 70.41±7.65 years were included in this study. Out of them, 672 (33.4%; 95% CI: 31.37-35.50%) cases met the criteria for frailty syndrome, and 874 (43.5%) individuals were regarded as pre-frail. The prevalence of frailty was significantly higher in females (50.8%; 95% CI: 47.58-54.05%), compared to males (18.7%; 95% CI: 16.41-21.05%). Multivariate logistic regression analysis revealed that age ≥85 (OR=7.27; 95% CI: 4.12-24.46) and female gender (OR=2.67; 95% CI: 2.30-9.95) had the highest effect on frailty in older adults. Conclusion: One out of every three elderly people (aged ≥60) in Amirkola, North of Iran, had frailty syndrome. Older age, female gender, lower education level, low level of satisfaction with income, marital status (single), living alone, and unemployment increased the risk of frailty in older adults.

Background: We aimed to determine the gender-specific predictors of depressive symptoms among an Iranian elderly community population. Study design: A cross-sectional study. Methods: This study was performed on elderly subjects (aged ≥60 yr) who participated in the Amirkola Health and Aging Project, Amirkola, Babol, northern Iran in 2011-12. Depression was assessed by the Geriatric Depression Scale. Fourteen variables, including marital status, age, education, occupation, living alone, social support, dependency in daily activities, physical activity, smoking, body mass index, chronic pain, medicine use, comorbidities, and cognitive impairment, were analyzed as predictors of depression. Results: In males, age group of 80-84 yr (odds ratio (OR)=0.22, 95% confidence interval (CI): 0.09, 0.55), occupation (OR=0.62, 95% CI: 0.42, 0.90) and social support (OR=0.82, 95% CI: 0.77, 0.88) had protective effects against depression, and smoking (OR=1.67, 95% CI: 1.15, 2.44), cognitive impairme...

SUMMARYHIV-1 replicates in activated T cells at significantly higher levels than in resting cells. Thus, certain molecules up-regulated during T cell activation appear to be important for HIV-1 replication. In this study, we present evidence suggesting that expression of MHC class II (class II) molecules on CD4+ T cells facilitate HIV-1 replication. T cells that expressed class II supported greater virus replication than T cells lacking class II. The class II+ cells, when either infected with HIV-1 or transfected with an env-minus HIV-1 provirus plasmid, produced 10–20-fold greater virus expression than class II− cells. Anti-class II antibody markedly inhibited virus expression in class II+ cells (but not class II− cells) and also decreased the nuclear binding activity of AP-1, an inducible transcription factor important in T cell activation and HIV-1 expression. Most importantly, the induction of class II expression by transfection of the MHC class II transactivator (CIITA) stimula...

We have developed a bilayer microfluidic system with integrated transepithelial electrical resistance (TEER) measurement electrodes to evaluate kidney epithelial cells under physiologically relevant fluid flow conditions. The bioreactor consists of apical and basolateral fluidic chambers connected via a transparent microporous membrane. The top chamber contains microfluidic channels to perfuse the apical surface of the cells. The bottom chamber acts as a reservoir for transport across the cell layer and provides support for the membrane. TEER electrodes were integrated into the device to monitor cell growth and evaluate cell–cell tight junction integrity. Immunofluorescence staining was performed within the microchannels for ZO‐1 tight junction protein and acetylated α‐tubulin (primary cilia) using human renal epithelial cells (HREC) and MDCK cells. HREC were stained for cytoskeletal F‐actin and exhibited disassembly of cytosolic F‐actin stress fibers when exposed to shear stress. T...

Bitki caylari (tibbi bitki caylari olarak da adlandirilmaktadir), saglik uzerine olumlu etkilerinden dolayi her yas grubu tarafindan tuketilmektedir. Bu calismada tuketici seviyesinde ambalajli ve/veya ambalajsiz olarak satisa sunulan farkli bitki caylarinin (kekik, nane, rezene, adacayi, ihlamur, hatmi, sinameki, defne, civanpercemi ve anason) hijyenik kalitesinin belirlenmesi amaclandi. Analiz edilen 120 ornegin %95, %90, %77.5, %74.16, %42.5, %14.17, %3.3 ve %2.5’inin sirasiyla toplam mezofilik aerobik bakteriler (TMAB), kuf-maya, Enterobacteriaceae, koliform, sulfit indirgeyen anaerob bakteriler, Staphylococcus-Micrococcus spp., Escherichia coli ve Salmonella spp. ile kontamine oldugu belirlendi. Ancak orneklerin hicbirinde Staphylococcus aureus ve Bacillus cereus tespit edilmedi. En yuksek ortalama TMAB (5.03 log10 kob/g) ve kuf-maya sayisi (4.78 log10 kob/g) nane orneklerinde, Enterobacteriaceae (4.19 log10 kob/g) ve koliform sayisi ise hatmi (3.87 log10 kob/g) orneklerinde bu...

The series "Studies in Big Data" (SBD) publishes new developments and advances in the various areas of Big Data-quickly and with a high quality. The intent is to cover the theory, research, development, and applications of Big Data, as embedded in the fields of engineering, computer science, physics, economics and life sciences. The books of the series refer to the analysis and understanding of large, complex, and/or distributed data sets generated from recent digital sources coming from sensors or other physical instruments as well as simulations, crowd sourcing, social networks or other internet transactions, such as emails or video click streams and other. The series contains monographs, lecture notes and edited volumes in Big Data spanning the areas of computational intelligence including neural networks, evolutionary computation, soft computing, fuzzy systems, as well as artificial intelligence, data mining, modern statistics and Operations research, as well as self-organizing systems. Of particular value to both the contributors and the readership are the short publication timeframe and the world-wide distribution, which enable both wide and rapid dissemination of research output.

This study was undertaken in order to: (1) evaluate the cell population in carrageenan- induced inflammation and (2) investigate the extent to which this inflammation modified mitotic activity, and keratinization of the sulcular epithelium induced by daily prophylaxes in monkeys. Normal-keratinized oral gingival epithelium was also evaluated for these processes in the same gingival specimens. Each of three adult Rhesus monkeys received a thorough prophylaxis 1 week prior to the experiment. Over the 10-week experimental period, each monkey received daily rubber cup prophylaxes. In addition, during the last 10 days, daily gingival injections of a 1 % carrageenan saline solution and normal saline solution were given. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 ¿¿Ci/gram of body weight. After sacrifice and tissue processing, the histologie sections were evaluated. It was found that the carrageenan solution injected into gingival tissues produced an acute inflammatory response consisting of polymorphonuclear leuko- cytes PMNs (61.3%), lymphocytes (5.2%), monocytes/macrophages (23.5%), plasma cells (2.0%) and unidentified cells (3.8%). An Inflammatory Index and a Mitotic Activity Index were determined, and keratin length and widths were measured. Data were analyzed statistically using analysis of variance. Pairwise comparisons were also made using Scheffe's method of multiple comparisons. The study showed that: (1) carrageenan solutions injected into gingival tissues elicited an acute inflammation; (2) acute inflammation present in gingival connective tissue stimulated an increase in mitotic activity in subjacent gingival epithelium; (3) acute inflammation within gingival tissues did not modify the induced- keratinized sulcular epithelium, or the normally-keratinized oral gingival epithelium; and (4) acute inflammation may not necessarily affect tissue keratinization, if bacterial plaque is removed daily. Numerous histologie and autoradiographic studies have been done in gingival tissues to determine if a relationship exists between the degree of connective tissue inflammation and epithelial proliferation,1"10 or surface keratinization.10"14 The presence of inflam- mation was shown to be associated with an increase in epithelial mitotic activity in the gingiva of humans,1"4 rats5 and monkeys.6"9 Mitotic activity of the epithelium overlying infiltrated connective tissue was significantly * This investigation was partially supported by the Medical Re- search Division of the Veterans Administration.

The descriptive statistics for the sella-nasion-A point (SAA) arnd sella-nasion-B point (SNB) angles computed from a sample of Nubian schoolchildren are presented, by age and sex, and compared with the analogous statistics for American Cauicasian school- children. The importance of the sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles in clinical cephalometry has long been recognized, and much attention has been focused on deriving normal values for these measurements which would be applicable in the treatment of the average American child of average age. In a number of separate studies, various investigators have incorporated these angles into their batteries of di- agnostic variables in an attempt to describe the craniofacial morphology of selected groups of individuals and to quantify the concepts of upper (SNA) and lower (SNB) facial prognatlism for use in ortliodontic diagnosis, case assessment, and treatment planning. To cite a few examples, Steiner',2 studied the distributions of the SNA and SNB angles in a group of patients undergoing orthodontic treatment to determine the relative position of the maxilla to the mandible or, less formally, to answer the question of whether the chin is forward or backward in relation to those strLuctures that would affect the individuLal's facial appear- ance and the impression he would make on the people about him. Downs34 studied these variables in 20 persons, ten males and ten females, with clinically excellent occlu- sions who were from 12 to 17 years old. He also used the facial plane and the A-B plane as meaures of the degree of recession

In a recent article (J Dent Res 54: 1241, 1975), we showed that despite the fact that definite in- creases in facial height occurred in a sample of 510 adult American white males, the upper face height-total face height ratio remained remarkably constant with increasing age, being of the order of 43.5% throughout adulthood. The pur- pose of the present report is to present compar- able data for a sample of 214 adult American black males for the same age range. Each of these individuals was seen for care at the Vet- erans Administration Hospital in Ann Arbor and each had a sufficiently natural occlusion with anterior and posterior centric stops so that total face height in centric occlusion could be reliably determined. Total face height was mea- sured as the distance from nasion to menton and upper face height was measured, along this line,

Background: There is evidence that microbial heat shock (stress) proteins (Hsp) are immunodominant antigens of many microorganisms. Immunity to these proteins has been shown in non-oral infections to contribute to protection. This study was undertaken to assess the relationship(s) between immunity to human and microbial heat shock proteins, periodontal disease status, and colonization by periodontal disease-associated microorganisms. Methods: Subgingival plaque and blood samples obtained from 198 patients during an earlier clinical study were examined for the presence of specific periodontal disease-associated microorganisms and antibodies to selected human and microbial heat shock proteins (Hsp70, Hsp90, DnaK, and GroEL). Particle concentration immunofluorescence assay (PCFIA) was used to detect anti-Hsp antibodies and slot immunoblot assay (SIB) was used to detect subgingival plaque species. Regression models were used to examine the contribution of age, gender, gingival index, probing depth, attachment loss, calculus index, plaque index, and microbial colonization to the anti-Hsp antibody concentrations. Results: Our studies demonstrated that, when evaluated by ANOVA, patients with higher anti-Hsp (Hsp90, DnaK, and GroEL) antibody concentrations tended to have significantly (P ≤0.05) healthier periodontal tissues. This was most obvious when the relationship between mean probing depths and antibody concentrations were studied. For Hsp90 antibodies, 2 variables (probing depth and P. gingivalis concentration) were found to have significant contributions (R = 0.293, P <0.0002). The equation derived from the regression model was y = 12558 -2070*PD + 1842*PG. This confirmed the inverse relationship with probing depth and the positive relationship with colonization by P. gingivalis. Attempts to model the other stress protein antibodies were not successful. Conclusions: We believe that the present observations reflect the presence of protective anti-Hsp antibodies, rather than simply the presence of the microorganism in the gingival sulcus. The clinical significance of these observations lies in the potential of identifying patients who are at risk for developing periodontal disease based on their inability to mount an immune response to specific Hsp or Hsp epitopes, as well as the development of vaccines based on Hsp epitopes.

Orthodontics has never been a quiet, settled specialty, but the current controversy, touching as it does upon the very scientific bases of orthodontic diagnosis, case assessment, and treatment planning--not to mention a number of complex ethical issues--has commanded an unusual amount of attention, both at the meetings of our societies and in the pages of our journals. Computers/ large data bases, 2 and service agencies ~ are used to provide the clinician with norms, standards, growth projections and even appropriate treatment strategems. Morphometrics, computerized cephalometrics, and clinical deviations are all catchwords and phrases coined, in keeping with the best of advertising tradition, to divert attention from the intrinsic values of the product and focus on the packaging. In selling the concept of a "norm," for example, it is suggested that data generated by a computer is afortiori scientifically acceptable. What remains unspoken is the tacit assumption that the extent of the individual patient's departure from such norms is a reliable indication of his growth potential. Some have, of course, recognized--and rejected--this assumption. The result of the ensuing dialogue has been a bipolarization of opinion among orthodontists--From the

IL-1β is one of the important IL-1 superfamily cytokines that shows crucial role in the pathogenesis of various inflammatory disorders like osteoarthritis, epidermolysis bullosa, psoriasis and type II diabetes. Dugs with IL-1βinhibitory effect can show promising results in these types of inflammatory disorders. Diacerein and its active metabolite rhein prevent the generation of active IL-1 and are consequently used to treat inflammatory conditions such as osteoarthritis, epidermolysis bullosa, psoriasis, and Type II diabetes.

Gender-based violence (GBV) is a major public health concern resulting in physical, psychological, sexual, and social issues. GBV during pregnancy may results in complicated and grave consequences for mother and unborn child. The prevalamce of GBV was reportedly higher in developing countries, indicating higher maternal and child mortalities. Effect of GBV on pregnancy has been reported to enhance the chances of prolonged labor, obstructed labor and in severe injuries higher incidents of miscarriages and abortions are also been reported. Moreover, fetal respiratory distress, diarrhea, small for gestaional age and Intra Uterine Growth Retardation (IUGR) have also been reported. This review aims to present a systematic view of genderbased violence and its association with adverse pregnancy outcomes and to contribute by filling the existing information gap. Review assessed the effect of GBV during pregnancy on fetal health, reporting infant diarrhea more frequently, along with fever, vomiting, and respiratory distress. The significant association between adverse maternal and fetal outcomes and gender-based violence has been evaluated extensively.

The current study was conducted at the center for Diabetes and Endocrinology of the Health Directorate at Thi-Qar province, during the period from January to July (2022). The study aimed to evaluate Biochemical Markers of diabetic foot ulcers patients by measuring the levels HbA1c, Urea, and Creatinine in the serum. The study included a total of 50 patients with diabetic foot ulcers they were (39 males and 11 females) and they were aged between 40-80 years. When compared with 50 apparently healthy people as control. The results showed a significant increase (P≤0.01) in the levels of HbA1c, urea, and creatinine in the serum of all patients with diabetic foot ulcers compared to the control group.

The aim of this study is to evaluate the level of Interleukin-6 in patient with diabetic foot ulcers. The present study was carried out in the Diabetes and Endocrinology Center of the Health Directorate at Thi-Qar Provence, at the period between January to July (2022). The immune status investigates for patients with diabetic foot ulcers by measuring the levels of Interleukin-6 (IL-6) in serum using a technique enzyme-linked immune Sorbent adsorptive (ELISA). The study included 100 subjects, (50) patients with diabetic foot and (50) were healthy control. The statistical analysis showed that a high significant increase (P≤0.01) in serum the rate of concentration of (IL-6) in patients (6.16 ± 5.24) pg/ml compared to the healthy control group (5.42 ± 7.74) pg/ml with significant difference (0.01). These results revealed that the excessive presence of (IL-6) might play a role in Thi-Qar Provence population.

Choledochal cyst is congenital dilatation of the biliary tract, present primarily in infants. This condition in pregnancy is very rare, and the clinical manifestations are nonspecific and variable. In late pregnancy, the symptoms may exacerbate due to hormonal effects and the compression of the common bile duct by the enlarging uterus. The need for urgent therapy of the complications associated with danger of exposing the mother and fetus to surgical operation and ionizing radiation, always represent a therapeutic challenge to surgeons. Step-by-step treatment of complicated choledochal cyst in pregnancy must be carefully planned, once the diagnosis is established, in order to avoid complication during pregnancy. Definitive surgical management of the choledochal cyst should be delayed until the patient's general physiological condition becomes normal after elective cesarean section. We reported our experience in managing a case of choledochal cyst in pregnant patients, complicated with cholangitis and review the literature regarding choledochal cyst in pregnancy.

Background: Oral Submucous Fibrosis (OSMF) is a well-established oral potentially malignant disorder (OPMD) affecting people of Pakistan, India, Bangladesh and Sri Lanka because these nations have a long-standing history of chewing areca nut.

Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women's access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women's access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.

We declare no competing interests. BG is employed by WHO. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affi liated. The Swedish Research Council funded this workshop. The funding source were not involved in the workshop design, content, organisation, or any other aspect pertinent to the workshop or this article. We thank all the workshop participants for their contributions.

This study aimed to assess women´s acceptability of diagnosis and treatment of incomplete abortion with misoprostol by midwives, compared with physicians. This was an analysis of secondary outcomes from a multi-centre randomized controlled equivalence trial at district level in Uganda. Women with first trimester incomplete abortion were randomly allocated to clinical assessment and treatment with misoprostol by a physician or a midwife. The randomisation (1:1) was done in blocks of 12 and stratified for health care facility. Acceptability was measured in expectations and satisfaction at a follow up visit 14-28 days following treatment. Analysis of women's overall acceptability was done using a generalized linear mixed-effects model with an equivalence range of -4% to 4%. The study was not masked. The trial is registered at ClinicalTrials.org, NCT 01844024.

Misoprostol is established for the treatment of incomplete abortion but has not been systematically assessed when provided by midwives at district level in a low-resource setting. We investigated the effectiveness and safety of midwives diagnosing and treating incomplete abortion with misoprostol, compared with physicians. We did a multicentre randomised controlled equivalence trial at district level at six facilities in Uganda. Eligibility criteria were women with signs of incomplete abortion. We randomly allocated women with first-trimester incomplete abortion to clinical assessment and treatment with misoprostol either by a physician or a midwife. The randomisation (1:1) was done in blocks of 12 and was stratified for study site. Primary outcome was complete abortion not needing surgical intervention within 14-28 days after initial treatment. The study was not masked. Analysis of the primary outcome was done on the per-protocol population with a generalised linear-mixed effects m...

Unsafe abortion in Africa continues to be a major contributor to the global maternal mortality which affects young women in particular. In Uganda, where abortion is legally restricted and stigmatised, unsafe abortion is a major public health issue. We explored reproductive agency in relation to unsafe abortion among young women seeking post-abortion care. Through in-depth interviews we found that reproductive agency was constrained by gender norms and power imbalances and strongly influenced by stigma. Lack of resources and the need for secrecy resulted in harmful abortion practices and delayed care-seeking. Women did not claim ownership of the abortion decision, but the underlying meaning in the narratives positioned abortion as an agentive action aiming to regain control over one&#39;s body and future. Women&#39;s experiences shaped contraceptive intentions and discourse, creating a window of opportunity that was often missed. This study provides unique insight into how young wome...

Lifestyle factors such as weight, salt intake, and physical activity have shown to be important in treating hypertension. The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure (BP) of Iranian women. This randomized controlled trial was conducted in four health centers by recruiting 161 women aged 35-65 years with high BP and randomizing them to a 4-week lifestyle modification (n = 80) or control group (n = 81). BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months. The mean systolic BP changed from 158.8 (±8.1) mmHg to 153.2 (±6.4) mmHg during 4-week and to 145.5 (±4.6)) mmHg after 6 months in the intervention group (P &lt; 0.001). There was a significant difference between two groups of study after 4-week mean = 5.6 (confidence interval [CI] = 5.1-6.6) and 6 months follow mean (CI = 12.3-14.6).(P &lt; 0.001) A signifi...

Background: The Buteyko Breathing Method is a unique breathing therapy that uses breath control and breath-holding exercises to treat a wide range of health conditions believed to be connected to hyperventilation and low carbon dioxide. The therapy involves instructing patients in controlled shallow breathing through the nose only, with breath-holding at the end of the exhalation and resuming normal breathing calmly and gently. Aim: To Study the immediate effect of Buteyko breathing technique on cardio-respiratory parameters in young Adults Methodology: 80 subjects recruited for the study were explained the entire procedure and subject were taught how to perform Buteyko Breathing Technique (BBT). Baseline HR, BP, RPE and PFT were noted as pre-test evaluation. Post-BBT for 12 min, evaluation was done for outcome measures like HR, RPE, BP and PFT (PEFR, FEV1 and FEF25-75). Results: When subject performed five minute Buteyko at rest it was seen that HR increased and SBP decreased, the ...

In modern era, communication technologies need a significant development. In order to improve the capacity and coverage, a massive technological advancement has become a widespread subject. However, the pollution caused by Radio Frequency Electromagnetic Field (RF-EMF) radiation is considered as the greatest environmental hazard. Hence, the present analysis proposes a suitable solution to mitigate the RF pollution or smog from base station installation in hot spot areas. On the basis of mitigating the RF frequencies, much amendment has to be made on the design of base station, decreasing of signal transmission between the entities and also considering the distance. Heterogeneous networks security will increase the signalling transmission for getting user authentication. On the basis of authentication, fast authentication and re-authentication, this paper mainly focuses on the reduction of communication signal transmission between the entities. Before data transmission, the entities ...

Objective: Acquired Hemophilia A (AHA) is a rare autoimmune disease that can result in life threatening bleeding. Formation of auto-antibodies (inhibitors) against coagulation factor VIII develops the hemorrhagic syndrome that may appear at any age; however, prevalence of AHA is chiefly observed in post-partum and elderly persons. Idiopathic acquired hemophilia is commonest type of acquired hemophilia whereas it is also associated with autoimmune disease, malignant neoplasm, medication and vaccinations. Post-partum acquired hemophilia (PAH) may develop due to development of antibodies against fetal FVIII. In this case report, 36-year-old Asian woman presented with complain of bruises from 2 months. There was history of cesarean section four months ago. Family history, past medical and drug history were not significant. As there was no active bleeding, patient was started an oral prednisolone along with azathioprine and was counseled regarding disease and precautions. Patient presented after 2 weeks with severe PV bleed, anemia secondary to self-induced medicine abortion. For this she receives pack cells and cryoprecipitate. Steroids and azathioprine were continued and patient was discharged in stable condition. Her ultrasound pelvis however showed small fibroids. Patient went back to her village where she again develops severe PV bleed and for that she underwent hysterectomy. Patient presented in our hospital with severe operative site bleeding, pain and anemia. She was managed with Packed Red Blood (PRBCs), Fresh Frozen Plasma (FFP), Recombinant Activated Clotting Factor VII (rFVIIa), prednisolone IV and azathioprine PO. Her Activated Partial Thromboplastin, Hemoglobin were continuously monitored. After a week bleeding was stopped but Activated Partial Thromboplastin Time (APTT) was still prolonged so we tapered rFVIIa dose and advice two sessions of plasmapheresis. APTT, hemoglobin levels, inhibitor titer, High-Sensitivity C -reactive protein (hs-CRP) levels were improved. Patient was discharged in a stable condition and was advised to continue medication at home with supportive care and wound dressing.

Aplastic Anemia (AA) incidence is threefold higher in Asia compared to the western world. It is associated with pancytopenia that is induced by impaired bone marrow function. Cytopenias of at least two lineages are required for the diagnosis. Symptoms include pallor, weakness, fever, frequent infections, bruises, petechiae, and mucosal bleeding. Bone Marrow Transplant (BMT) and immunosuppressive therapy are the treatment options. Patients with Severe Aplastic Anemia (SAA) are susceptible to developing malignancies like acute myeloid leukemia (AML) or Myelodysplastic Syndrome (MDS). In this report, we present a case of SAA who transformed to AML/MDS. 5 years of post-Anti-Thymocyte Globulin (ATG), she acquired monosomy 7, RUNX1 & SETBP1 gene mutations. RUNX1 and SETBP1 mutations are correlated with poor overall survival and are predicted to have a lack of response from hypo-methylating agents. As the aspect of somatic mutation is complex and still not fully understood, it should be cautiously analyzed along with morphologic and cytogenetic results.

Background: The elimination target for measles as an acute and contagious disease in Eastern Mediterranean Region (EMR) and Iran is planned by high-quality surveillance. We aimed to monitor the surveillance quality indicators of measles by in all districts of Iran during 2014-16. Study design: A cross-sectional study. Methods: Four quality surveillance indicators of measles including non measles discarded rate, percent of suspected cases with adequate investigation, percent of adequate blood specimen collection and percent with timely availability of laboratory results were assessed in Iran. Surveillance data of measles were extracted from the measles surveillance system and the risk point score for each district was calculated based on WHO Risk Assessment Tool by a function of four indicators. Results: Overall, 14312 suspected cases and 322 districts were assessed and the risk points of measles&#39; quality surveillance showed that 92.8% of Iranian districts were categorized as low...

The absorption mechanism of several penicillins was characterized using in situ single-pass intestinal perfusion in the rat. The intrinsic membrane absorption parameters were determined using a modified boundary layer model (fitted value rf: SE.

Smoking is known to cause interstitial lung diseases, such as interstitial pneumonia and the prognosis, which are well seen when patients quit smoking. Smoking cigarette negatively affects the effectiveness of therapy, cure rates, and a higher risk of recurrence in pulmonary TB. This study analyzes smoking habits' influence on therapy outcomes in patients with pneumonia infection at RSP (Pulmonary Hospital) Respira Yogyakarta. The researchers conducted an observational study with a cross-sectional study design and a retrospective data collection method employing medical records. Observations were carried out on pneumonia patients divided into two groups: the smoking and non-smoking groups. The data collection method used total sampling. The observed outcomes of therapy were the length of stay and the effectiveness of therapy. This study utilized chi-square as its statistical analysis. The 130 patients who met the criteria were divided into two groups: the smoking and non-smoking groups with 65 people each. The results revealed that the effectiveness of therapy in the smoking group had a 26% chance of recovery, an improvement of 61%, and not-yet-cured of 13%. Meanwhile, in the non-smoking group, they had a 47% chance of recovery, an improvement of 43% and not-yet-cured of 10%. The statistical test results with Chi-square obtained p-value of < 0.05 (p = 0.039). The results on the length of stay showed that 82% of patients in the smoking group and non-smoking group had a length of stay of ≤ 5 days, and 12% of patients had a length of stay of > 5 days in both group. Hence, smoking habits significantly affected therapy's effectiveness but did not significantly influence the length of stay.

Measures #1-6 and #9 are designed for any physician caring for patients with a diagnosis of stroke or transient ischemic attack (TIA) in the hospital setting Measures #7-8 are designed for radiologists and other physicians reading the imaging studies of patients with a diagnosis of stroke or TIA in the hospital setting Patients aged 18 years and older These clinical performance measures are designed for individual quality improvement. Some of the measures may also be appropriate for accountability if appropriate sample sizes and implementation rules are achieved.

aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods: We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings: Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 338% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (247%), residential facility beds (120%), and for prison populations (360%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation: Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries.

BACKGROUND: Pityriasis versicolor (tinea versicolor) is a chronic superficial mycosis caused by yeasts of the Malassezia spp. genus commensal of the keratinized layers of the skin. Under conditions not yet understood, it becomes pathogenic determining the clinical manifestations of the disease. It is a recurrent skin condition and persistent hypopigmentation may remain after treatment, causing social problems to those affected. OBJECTIVE: To describe the clinical and epidemiological features of patients diagnosed with tinea versicolor treated at a referral center for dermatology (Alfredo da Matta Foundation). METHODS: Case-studies in which cutaneous manifestations and epidemiological characteristics of patients diagnosed with tinea versicolor treated at Alfredo da Matta Foundation were detailed. RESULTS: One hundred and sixteen patients were included in the study from January to August 2008. Most subjects were male, of mixed ethnicity and young age. Most were students who were predisposed to the development of macules. The majority had extensive injuries and past history of the disease. CONCLUSION: The results revealed a high proportion of individuals with extensive clinical manifestations and duration of the disease.

The lives of the elderly are constantly changing due to factors including retirement, loss of spouse, chronic illnesses that prevent them from being active, living alone, and a lack of social connection. As a result, loneliness can be a problem for the elderly. The study aimed to analyse the levels of loneliness among community-dwelling elderly people. The study employed a cross-sectional design. A total sampling technique was used to collect the sample. The inclusion criteria of the study included being at least 60 years old, willing to participate, free of dementia or schizophrenia, and without any physical restrictions. To assess respondents' levels of loneliness, the University of California, Los Angeles (UCLA) Loneliness Scale was employed. There are 151 older people who participated in this study. According to the findings, just 72% of the elderly community's residents reported feeling lonely. The fact that the average age of the respondents was 68 years old and that the majority were female, employed, living with family, and actively participating in social activities is likely what contributed to the low level of loneliness. Living circumstances and family support have an impact on how lonely elderly people are. The family plays a significant role in providing care for the elderly in accordance with their developmental stages. Community nurses could activate elderly people in social activities and provide elderly schooling programs to prevent loneliness among older residents of the community.

Domestic waste disposal is considered to be one the causes of environmental pollution and can be associated to various health problems. Proper waste management and disposal of household waste is a major concern of many people. Research Objective: The objective of this survey was to assess the level of awareness and to identify the willingness to change towards the domestic waste disposal amongst the people. Research Design: An exploratory research was done using a semi-structured questionnaire. Using simple random sampling method, a total of 204 respondents were studied. Data was analyzed using the SPSS software. Findings: In the study 84.8% were aware of the term Domestic waste disposal Management while the rest 15.2 % were not aware at all of the term. Around 51.5% says that they have been given proper education on the domestic waste disposal. About 64.2% responded by saying that are very well aware that domestic waste requires a special treatment before disposal rest of the study...

The data, focusing on the supply of pineapple for industrial processing in Thailand during the period from 2011-2020, was acquired. The data indicated that productivity had tended to decrease during the period between 2011-2015 due to phenomena of drought and a reduction in prices, while increasing trends were observed during the years between 2016 - 2019. In the year 2020, Thailand was the biggest exporter of canned pineapple in the world, and the export value was approximately 345 million U.S. dollars. During the process, the generated by-products were peels, cores, stems, and crowns at approximately 35.5, 14.7, 4.6, and 4.3%, respectively. Based on the annual production of 1,689,884 tons, the total by-products from pineapple processing would generate 993,402.4 tons, which could be divided into peels, cores, stems, and crowns at 596,713.8, 247,089.9, 773,20.7, and 722,78.0 tons, respectively. Valorization of by-product for health applications such as pharmaceutical, cosmetic, and ...

The serendipitous discovery of antibiotics in the 20th century resulted in a major decline in infection related death rate, but soon after, overexploitation of antibiotics led to the development of antibiotic resistance in microbial populations. The emergence of multidrug resistance and extreme drug resistance in pathogens further intensified the whole situation. Around 100000-2000000 tons of antibiotics are being used in agriculture, horticulture, and medicine annually at a global level. The death rate due to antibiotic-resistant bacteria has risen far greater than the death rate due to HIV/AIDS and Tuberculosis. Modification of the site of action, efflux of antibiotics and degradation of drugs are the main mechanisms bacteria use as a defense strategy against antibiotics. Finding better drugs and methods to combat antibiotic resistance has become a need of the hour. This increase in antibiotic resistance has forced researchers to go back to the pre-antibiotic era in order to develop alternative drugs and processes to combat drug resistance. This review emphasizes the urgency of tackling this situation and deploy all promising alternatives of antibiotics like phage therapy, use of bacteriocins, organic acids, nanotechnology and CRISPR-Cas technique to address the antibiotic resistance challenge.

This initiative explores the profound interconnections between consciousness, vibrational harmony, and universal laws, presenting a cohesive framework for healing, innovation, and planetary coherence. By integrating advanced technologies, creative exploration, and sustainable practices, it invites humanity to co-create a future rooted in alignment, awareness, and transformation. Core Philosophy • Premise: Consciousness is the foundation of reality, evolving through vibrational alignment and fractal expansion, guided by universal principles. • Vision: To develop tools, practices, and systems that enhance humanity's ability to resonate with universal frequencies, fostering personal and collective transformation.

The current study aimed to add to this of knowledge by examining the effect of chewing gum on smoking withdrawal severity over a long period, as well as identifying the specific characteristics of chewing gum that may be responsible for the reported reductions in withdrawal. Chewing, flavour, and the combination of the two were all investigated separately. The study is based on quantitative research. The data has been classified on basis of smoker and non-smoker. Participants reported a significant difference in withdrawal severity across conditions using repeated measures Chi square, F(3, 69)=2.89, p.05. The flavoured gum condition had considerably lower withdrawal scores than the flavourless gum base and no product control conditions, according to follow-up analyses. These data suggest that chewing gum is effective in reducing the severity of nicotine withdrawal symptoms over a 24-hour period of nicotine abstinence, and that the impact is due to a combination of flavour and chewin...

This research article is based on a survey that did not provide a full or detailed assessment of the entire Indian population or segment, nor did it anticipate future actions. However, it has been closed for a few weeks in order to provide early insight into the local market, and it will remain closed until the influence of the Covid-19-transmitted community virus has not infected any humans. This poll aims to compare how India&#39;s informal sector has been affected by the lockdown. The study examines how revenue or income varied across different types of businesses during the country&#39;s shutdown. It also notes that there is no cash flow in the market because the store or shop, if not the entire market, has been shut down. The major goal of this article is to review and summarise the impact of the shutdown on small vendors who undertake daily cash business. The research based on both qualitive and quantities method. The data has been collected from 201respondent from small busin...

Lipomatosis of the appendix is extremely unusual. It can be focal, diffuse and asymmetric. Radiological investigations such as CT abdomen and ultrasonography are usually used imaging modalities for diagnostic workups. However, histopathological examination is always the gold standard. A rare case of lipomatosis appendix was diagnosed based on a microscopic examination of a suspected acute appendicitis case in a 65-year-old female patient.

A spontaneous otoacoustic emission (SOAE) measured in the ear canal of a guinea pig was found to have a counterpart in spontaneous mechanical vibration of the basilar membrane (BM). A spontaneous 15-kHz BM velocity signal was measured from the 18-kHz tonotopic location and had a level close to that evoked by a 14-kHz, 15-dB SPL tone given to the ear. Lower-frequency pure-tone acoustic excitation was found to reduce the spontaneous BM oscillation (SBMO) while higher-frequency sound could entrain the SBMO. Octave-band noise centered near the emission frequency showed an increased narrowband response in that frequency range. Applied pulses of current enhanced or suppressed the oscillation, depending on polarity of the current. The compound action potential (CAP) audiogram demonstrated a frequency-specific loss at 8 and 12 kHz in this animal. We conclude that a relatively high-frequency spontaneous oscillation of 15 kHz originated near the 15-kHz tonotopic place and appeared at the measured BM location as a mechanical oscillation. The oscillation gave rise to a SOAE in the ear canal. Electric current can modulate level and frequency of the ot-oacoustic emission in a pattern similar to that for the observed mechanical oscillation of the BM.

A spontaneous otoacoustic emission (SOAE) measured in the ear canal of a guinea pig was found to have a counterpart in spontaneous mechanical vibration of the basilar membrane (BM). A spontaneous 15-kHz BM velocity signal was measured from the 18-kHz tonotopic location and had a level close to that evoked by a 14-kHz, 15-dB SPL tone given to the ear. Lower-frequency pure-tone acoustic excitation was found to reduce the spontaneous BM oscillation (SBMO) while higher-frequency sound could entrain the SBMO. Octave-band noise centered near the emission frequency showed an increased narrowband response in that frequency range. Applied pulses of current enhanced or suppressed the oscillation, depending on polarity of the current. The compound action potential (CAP) audiogram demonstrated a frequency-specific loss at 8 and 12 kHz in this animal. We conclude that a relatively high-frequency spontaneous oscillation of 15 kHz originated near the 15-kHz tonotopic place and appeared at the measured BM location as a mechanical oscillation. The oscillation gave rise to a SOAE in the ear canal. Electric current can modulate level and frequency of the ot-oacoustic emission in a pattern similar to that for the observed mechanical oscillation of the BM.

The diagnosis and screening of retinal illnesses is one use of image processing in the medical field that is being explored in the current study. DR is an eye condition that worsens over time, eventually resulting in blindness. A more advanced stage of DR, known as PDR, is when new retinal vessels (neovascularization) begin to form. PDR is characterised by fragile new arteries developing on the retina that leak blood onto the retina&#39;s surface, resulting in significant vision loss. Automatic segmentation of retinal arteries and PDR diagnosis are presented in this article. Extraction of the blood vessel is done using matching filtering and adjusted local entropy thresholding. A new machine learning technique known as the Extreme Learning Machine (ELM) classifier is used to classify the images as either normal, NPDR, or PDR. SVM classifier performance is compared to that of the algorithm.

Insulin resistance or insulin deficiency can cause diabetes, which has a high level of glucose in the blood (American Diabetes Association 2014). It&#39;s one of the most pressing issues in modern public health. Around 366 million individuals had diabetes in 2011, according to the &quot;International Diabetes Federation&quot; (IDF). This figure is expected to rise to 552 million by the end of 2030. The average score of the semantic measure and the Pearson correlation were used to create a similarity index in this study. Gene similarity can be determined by this procedure. &quot;One&quot; indicates perfect similarity between two genes, whereas &quot;zero&quot; indicates perfect dissimilarity. Algorithms based on Pearson and semantic measures were used to identify genes that were genetically similar. PERL was used to write the algorithm (Practical Extraction and Reporting Language). PERL found gene-to-gene similarity and gradually deleted redundant information. An algorithm known as &...