Abstract: Objective: Acute coronary syndrome is a clinical
condition encompassing ST segments elevation myocardial
infraction, Non ST segment is elevation myocardial infraction and un
stable angina is characterized by ruptured coronary plaque, stress and
myocardial injury. Angina pectoris is a pressure like pain in the chest
that is induced by exertion or stress and relived with in the minute
after cessation of effort or using sublingual nitroglycerin. The present
research was undertaken to study the drug utilization pattern of
antiplatelet drugs for the ischemic heart disease in a tertiary care
hospital. Method: The present study is retrospective drug utilization
study and study period is 6months. The data is collected from the
discharge case sheet of general medicine department from medical
department Rajiv Gandhi institute of medical sciences, Kadapa. The
tentative sample size fixed was 250 patients. Out of 250 cases 19
cases was excluded because of unrelated data. Results: A total of 250
prescriptions were collected for the study according to the inclusion
criteria 233 prescriptions were diagnosed with ischemic heart disease
17 prescriptions were excluded due to unrelated information. out of
233 prescriptions 128 are male (54.9%) and 105 patients are were
female (45%). According to the gender distribution, the prevalence of
ischemic heart disease in males are 90 (70.31%) and females are 39
(37.1%). In the same way the prevalence of ischemic heart disease
along with cerebrovascular disease in males are 39 (29.6%) and
females are 66 (62.6%). Conclusion: We found that 94.8% of drug
utilization of antiplatelet drugs was achieved in the Rajiv Gandhi
institute of medical sciences, Kadapa from 2011-2012.
Abstract: Gastric Cancer (GC) has high morbidity and fatality
rate in various countries. It is still one of the most frequent and
deadly diseases. Gastrokine1 (GKN1) and gastrokine2 (GKN2) genes
are highly expressed in the normal stomach epithelium and play
important roles in maintaining the integrity and homeostasis of
stomach mucosal epithelial cells. In this study, 47 paired samples that
were grouped according to the types of gastric cancer and the clinical
characteristics of the patients, including gender and average of age.
They were investigated with gene expression analysis and mutation
screening by monitoring RT-PCR, SSCP and nucleotide sequencing
techniques. Both GKN1 and GKN2 genes were observed significantly
reduced found by (Wilcoxon signed rank test; p
Abstract: Noninvasive diagnostics of diseases via breath
analysis has attracted considerable scientific and clinical interest for
many years and become more and more promising with the rapid
advancements in nanotechnology and biotechnology. The volatile
organic compounds (VOCs) in exhaled breath, which are mainly
blood borne, particularly provide highly valuable information about
individuals’ physiological and pathophysiological conditions.
Additionally, breath analysis is noninvasive, real-time, painless, and
agreeable to patients. We have developed a wireless sensor array
based on single-stranded DNA (ssDNA)-functionalized single-walled
carbon nanotubes (SWNT) for the detection of a number of
physiological indicators in breath. Seven DNA sequences were used
to functionalize SWNT sensors to detect trace amount of methanol,
benzene, dimethyl sulfide, hydrogen sulfide, acetone, and ethanol,
which are indicators of heavy smoking, excessive drinking, and
diseases such as lung cancer, breast cancer, and diabetes. Our test
results indicated that DNA functionalized SWNT sensors exhibit
great selectivity, sensitivity, and repeatability; and different
molecules can be distinguished through pattern recognition enabled
by this sensor array. Furthermore, the experimental sensing results
are consistent with the Molecular Dynamics simulated ssDNAmolecular
target interaction rankings. Thus, the DNA-SWNT sensor
array has great potential to be applied in chemical or biomolecular
detection for the noninvasive diagnostics of diseases and personal
health monitoring.
Abstract: Current study established for EEG signal analysis in
patients with language disorder. Language disorder can be defined as
meaningful delay in the use or understanding of spoken or written
language. The disorder can include the content or meaning of
language, its form, or its use. Here we applied Z-score, power
spectrum, and coherence methods to discriminate the language
disorder data from healthy ones. Power spectrum of each channel in
alpha, beta, gamma, delta, and theta frequency bands was measured.
In addition, intra hemispheric Z-score obtained by scoring algorithm.
Obtained results showed high Z-score and power spectrum in
posterior regions. Therefore, we can conclude that peoples with
language disorder have high brain activity in frontal region of brain
in comparison with healthy peoples. Results showed that high coherence correlates with irregularities
in the ERP and is often found during complex task, whereas low
coherence is often found in pathological conditions. The results of the
Z-score analysis of the brain dynamics showed higher Z-score peak
frequency in delta, theta and beta sub bands of Language Disorder
patients. In this analysis there were activity signs in both hemispheres
and the left-dominant hemisphere was more active than the right.
Abstract: Objective: Sharing devastating news with patients is
often considered the most difficult task of doctors. This study aimed
to explore patients’ perceptions of receiving bad news including
which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the
SPIKES model for breaking bad new. 20 patients receiving treatment
for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised
their consultation. ‘Poor’ was more commonly rated by women and
participants aged 45-64. The main differences between the ‘excellent’
and ‘poor’ consultations include the doctor’s sensitivity and checking
the patients’ understanding. Only 35% of patients were asked their
existing knowledge and 85% of consultations failed to discuss the
impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing
literature. The commended aspects include consultation set-up and
information given. Areas patients felt needed improvement include
doctors determining the patient’s existing knowledge and checking
new information has been understood. Doctors should also explore
how the diagnosis will affect the patient’s life. With a poorer
prognosis, doctors should work on conveying appropriate hope. The
study was limited by a small sample size and potential recall bias.
Abstract: Numerous investigations suggest that Mesenchymal
Stem Cells (MSCs) in general represent a valuable tool for therapy of
symptoms related to chronic inflammatory diseases. Blue Horizon
Stem Cell Therapy Program is a leading provider of adult and
children’s stem cell therapies. Uniquely we have safely and
efficiently treated more than 600 patients with documenting each
procedure. The purpose of our study is primarily to monitor the
immune response in order to validate the safety of intravenous
infusion of human umbilical cord blood derived MSCs (UC-MSCs),
and secondly, to evaluate effects on biomarkers associated with
chronic inflammation. Nine patients were treated for conditions
associated with chronic inflammation and for the purpose of antiaging.
They have been given one intravenous infusion of UCMSCs.
Our study of blood test markers of 9 patients with chronic
inflammation before and within three months after MSCs treatment
demonstrates that there is no significant changes and MSCs treatment
was safe for the patients. Analysis of different indicators of chronic
inflammation and aging included in initial, 24-hours, two weeks and
three months protocols showed that stem cell treatment was safe for
the patients; there were no adverse reactions. Moreover data from
follow up protocols demonstrates significant improvement in energy
level, hair, nails growth and skin conditions. Intravenously
administered UC-MSCs were safe and effective in the improvement
of symptoms related to chronic inflammation. Further close
monitoring and inclusion of more patients are necessary to fully
characterize the advantages of UC-MSCs application in treatment of
symptoms related to chronic inflammation.
Abstract: Background: Diabetic sensorimotor polyneuropathy
(DSP) is one of the most common microvascular complications of
type 2 diabetes. Loss of sensation is thought to contribute to a lack of
static and dynamic stability and increased risk of falling. Purpose:
The purpose of this study was to compare the effects of low-level
laser (LLL) and monochromatic near-infrared photo energy (MIRE)
on pain, cutaneous sensation, static stability, and index of lower limb
blood flow in diabetic patients with peripheral neuropathy. Methods:
Forty diabetic patients with peripheral neuropathy were recruited for
participation in this study. They were divided into two groups: The
MIRE group, which contained 20 patients, and the LLL group, which
contained 20 patients. All patients who participated in the study had
been subjected to various physical assessment procedures, including
pain, cutaneous sensation, Doppler flow meter, and static stability
assessments. The baseline measurements were followed by treatment
sessions that were conducted twice a week for six successive weeks.
Results: The statistical analysis of the data revealed significant
improvement of pain in both groups, with significant improvement in
cutaneous sensation and static balance in the MIRE group compared
to the LLL group; on the other hand, the results showed no
significant differences in lower limb blood flow between the groups.
Conclusion: LLL and MIRE can improve painful symptoms in
patients with diabetic neuropathy. On the other hand, MIRE is also
useful in improving cutaneous sensation and static stability in
patients with diabetic neuropathy.
Abstract: In recent years a new method of combination
treatment for cancer has been developed and studied that has led to
significant advancements in the field of cancer therapy. Hyperthermia
is a traditional therapy that, along with a creation of a medically
approved level of heat with the help of an alternating magnetic AC
current, results in the destruction of cancer cells by heat. This paper
gives details regarding the production of the spherical nanocomposite
PVA/γ-Fe2O3 in order to be used for medical purposes such as tumor
treatment by hyperthermia. To reach a suitable and evenly distributed
temperature, the nanocomposite with core-shell morphology and
spherical form within a 100 to 200 nanometer size was created using
phase separation emulsion, in which the magnetic nano-particles γ-
Fe2O3 with an average particle size of 20 nano-meters and with
different percentages of 0.2, 0.4, 0.5 and 0.6 were covered by
polyvinyl alcohol. The main concern in hyperthermia and heat
treatment is achieving desirable specific absorption rate (SAR) and
one of the most critical factors in SAR is particle size. In this project
all attempts has been done to reach minimal size and consequently
maximum SAR. The morphological analysis of the spherical
structure of the nanocomposite PVA/γ-Fe2O3 was achieved by SEM
analyses and the study of the chemical bonds created was made
possible by FTIR analysis. To investigate the manner of magnetic
nanocomposite particle size distribution a DLS experiment was
conducted. Moreover, to determine the magnetic behavior of the γ-
Fe2O3 particle and the nanocomposite PVA/γ-Fe2O3 in different
concentrations a VSM test was conducted. To sum up, creating
magnetic nanocomposites with a spherical morphology that would be
employed for drug loading opens doors to new approaches in
developing nanocomposites that provide efficient heat and a
controlled release of drug simultaneously inside the magnetic field,
which are among their positive characteristics that could significantly
improve the recovery process in patients.
Abstract: Auditory hallucinations among the most invalidating
and distressing experiences reported by patients diagnosed with
schizophrenia, leading to feelings of powerlessness and helplessness
towards their illness. In more severe cases, these auditory
hallucinations can take the form of commanding voices, which are
often related to high suicidality rates in these patients. Several
authors propose that the meanings attributed to the hallucinatory
experience, rather than characteristics like form and content, can be
determinant in patients’ reactions to hallucinatory activity,
particularly in the case of voice-hearing experiences. In this study, 48
patients diagnosed with paranoid schizophrenia presenting auditory
hallucinations were studied. Multiple regression analyses were
computed to study the influence of several developmental aspects,
such as family and social dynamics, bullying, depression, and sociocognitive
variables on the auditory hallucinations, on patients’
attributions and relationships with their voices, and on the resulting
invalidation of hallucinatory experience. Overall, results showed how
relationships with voices can mirror several aspects of interpersonal
relationship with others, and how self-schemas, depression and actual
social relationships help shaping the voice-hearing experience. Early
experiences of victimization and submission help predict the
attributions of omnipotence of the voices, and increased hostility
from parents seems to increase the malevolence of the voices,
suggesting that socio-cognitive factors can significantly contribute to
the etiology and maintenance of auditory hallucinations. The
understanding of the characteristics of auditory hallucinations and the
relationships patients established with their voices can allow the
development of more promising therapeutic interventions that can be
more effective in decreasing invalidation caused by this devastating
mental illness.
Abstract: Theory of Mind (ToM) refers to the ability to infer
another’s mental state. With appropriate ToM, one can behave well in
social interactions. A growing body of evidence has demonstrated that
patients with temporal lobe epilepsy (TLE) may damage ToM by
affecting on regions of the underlying neural network of ToM.
However, the question of whether there is cerebral laterality for ToM
functions remains open. This study aimed to examine whether there is
cerebral lateralization for ToM abilities in TLE patients. Sixty-seven
adult TLE patients and 30 matched healthy controls (HC) were
recruited. Patients were classified into right (RTLE), left (LTLE), and
bilateral (BTLE) TLE groups on the basis of a consensus panel review
of their seizure semiology, EEG findings, and brain imaging results.
All participants completed an intellectual test and four tasks measuring
basic and advanced ToM. The results showed that, on all ToM tasks,
(1) each patient group performed worse than HC; (2) there were no
significant differences between LTLE and RTLE groups; and (3) the
BTLE group performed the worst. It appears that the neural network
responsible for ToM is distributed evenly between the cerebral
hemispheres.
Abstract: Availability of different genetic tests after completion
of Human Genome Project increases the physicians’ responsibility to
keep themselves update on the potential implementation of these
genetic tests in their daily practice. However, due to numbers of
barriers, still many of physicians are not either aware of these tests or
are not willing to offer or refer their patients for genetic tests. This
study was conducted an anonymous, cross-sectional, mailed-based
survey to develop a primary data of Malaysian physicians’ level of
knowledge and perception of gene profiling. Questionnaire had 29
questions. Total scores on selected questions were used to assess the
level of knowledge. The highest possible score was 11. Descriptive
statistics, one way ANOVA and chi-squared test was used for
statistical analysis. Sixty three completed questionnaires were
returned by 27 general practitioners (GPs) and 36 medical specialists.
Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4).
About 40% of the participants rated themselves as having poor level
of knowledge in genetics in general whilst 60% believed that they
have fair level of knowledge; however, almost half (46%) of the
respondents felt that they were not knowledgeable about available
genetic tests. A majority (94%) of the responders were not aware of
any lab or company which is offering gene profiling services in
Malaysia. Only 4% of participants were aware of using gene profiling
for detection of dosage of some drugs. Respondents perceived greater
utility of gene profiling for breast cancer (38%) compared to the
colorectal familial cancer (3%). The score of knowledge ranged from
2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score
of knowledge of GPs and specialists were observed, with score of
4.19 and 4.58 respectively. There was no significant association
between any demographic factors and level of knowledge. However,
those who graduated between years 2001 to 2005 had higher level of
knowledge. Overall, 83% of participants showed relatively high level
of perception on value of gene profiling to detect patient’s risk of
disease. However, low perception was observed for both statements
of using gene profiling for general population in order to alter their
lifestyle (25%) as well as having the full sequence of a patient
genome for the purpose of determining a patient’s best match for
treatment (18%). The lack of clinical guidelines, limited provider
knowledge and awareness, lack of time and resources to educate
patients, lack of evidence-based clinical information and cost of tests
were the most barriers of ordering gene profiling mentioned by
physicians. In conclusion Malaysian physicians who participate in
this study had mediocre level of knowledge and awareness in gene
profiling. The low exposure to the genetic questions and problems
might be a key predictor of lack of awareness and knowledge on
available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling
into practice for eligible patients.
Abstract: The effects of hypertension are often lethal thus its
early detection and prevention is very important for everybody. In
this paper, a neural network (NN) model was developed and trained
based on a dataset of hypertension causative parameters in order to
forecast the likelihood of occurrence of hypertension in patients. Our
research goal was to analyze the potential of the presented NN to
predict, for a period of time, the risk of hypertension or the risk of
developing this disease for patients that are or not currently
hypertensive. The results of the analysis for a given patient can
support doctors in taking pro-active measures for averting the
occurrence of hypertension such as recommendations regarding the
patient behavior in order to lower his hypertension risk. Moreover,
the paper envisages a set of three example scenarios in order to
determine the age when the patient becomes hypertensive, i.e.
determine the threshold for hypertensive age, to analyze what
happens if the threshold hypertensive age is set to a certain age and
the weight of the patient if being varied, and, to set the ideal weight
for the patient and analyze what happens with the threshold of
hypertensive age.
Abstract: Content Based Image Retrieval (CBIR) coupled with
Case Based Reasoning (CBR) is a paradigm that is becoming
increasingly popular in the diagnosis and therapy planning of medical
ailments utilizing the digital content of medical images. This paper
presents a survey of some of the promising approaches used in the
detection of abnormalities in retina images as well in
mammographic screening and detection of regions of interest
in MRI scans of the brain. We also describe our proposed
algorithm to detect hard exudates in fundus images of the
retina of Diabetic Retinopathy patients.
Abstract: In this paper, we propose an intelligent system that is
used for monitoring the health conditions of patients. Monitoring the
health condition of patients is a complex problem that involves
different medical units and requires continuous monitoring especially
in rural areas because of inadequate number of available specialized
physicians. The proposed system will improve patient care and drive
costs down comparing to the existing system in Jordan. The proposed
system will be the start point to faster and improve the
communication between different units in the health system in
Jordan. Connecting patients and their physicians beyond hospital
doors regarding their geographical area is an important issue in
developing the health system in Jordan. The ability of making
medical decisions, the quality of medical is expected to be improved.
Abstract: Background: The effectiveness of mirror therapy
(MT) has been investigated in acute hemiplegia. The present study
examines whether MT, given during chronic stroke, was more
effective in promoting motor recovery of the lower extremity and
walking speed than standard rehabilitation alone. Methods: The study
enrolled 30 patients with chronic stroke. Fifteen patients each were
assigned to the treatment group and the control group. All patients
received a conventional rehabilitation program for a 4-week period.
In addition to this rehabilitation program, patients in the treatment
group received mirror therapy for 4 weeks, 5 days a week. Main
measures: Passive ankle joint dorsiflexion range of motion, gait
speed, Brunnstrom stages of motor recovery, plantar flexor muscle
tone by Modified Ashworth Scale. Results: No significant difference
was found in the outcome measures among groups before treatment.
When compared with standard rehabilitation, mirror therapy
improved Ankle ROM, Brunnstrom stages and waking speed
(p < 0.05). However, there were no significant differences between
two groups on MAS (P > 0.05).Conclusion: Mirror therapy combined
with a conventional stroke rehabilitation program enhances lowerextremity
motor recovery and walking speed in chronic stroke
patients.
Abstract: To evaluate the factors which predetermine the
coronary artery disease in patients having positive Exercise Tolerance
Test (ETT) that is treadmill results and coronary artery findings. This
descriptive study was conducted at Department of Cardiology,
Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
from 1st January, 2014 to 31st August, 2014. All patients who had
done ETT (treadmill) for chest pain diagnosis were studied. One
hundred and four patients underwent coronary angiogram after
positive treadmill result. Patients were divided into two groups
depending upon the angiographic findings, i.e. true positive and false
positive. Positive treadmill test patients who have coronary artery
involvement these are called true positive and who have no
involvement they are called false positive group. Both groups were
compared with each other. Out of 104 patients, 81 (77.9%) patients
had true positive ETT and 23 (22.1%) patients had false positive
ETT. The mean age of patients in positive ETT was 53.46± 8.06
years and male mean age was 53.63±8.36 years and female was
52.87±7.0 years. Sixty nine (85.19%) male patients and twelve
(14.81%) female patients had true positive ETT, whereas 15
(65.21%) males and 8 (34.79%) females had false positive ETT, this
was statistically significant (p
Abstract: Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.
Abstract: Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs 29.07±2.4years, weight 63.6±7 vs 60±7.8kg, and height 162.73±4 vs 162.8±6cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p
Abstract: Since nickel is a known toxic and carcinogenic metal, the present study was designed to evaluate the level of nickel released into the saliva of orthodontic patients. Non-stimulated saliva was collected from 18 patients attending The Orthodontic Clinic of Dental Faculty of Benghazi University. Patients were divided into two groups and level of nickel was determined by atomic absorption spectrophotometry. Nickel concentration value (mg/L) in first group prior to starting treatment was 0.097± 0.071. An increase in level of nickel was followed by decrease 4 and 8 weeks after applying the arch wire (0.208± 0.112) and (0.077±0.056 mg/L) respectively. Nickel levels in saliva of the second group were showed minimal variation and ranged from 0.061± 0.044mg/L to 0.083±0.054 throughout period of study. It may be concluded that there could be a release of nickel from the appliances used in first group but it doesn't reach toxic level in saliva.
Abstract: Nonstationary and nonlinear signals generated by living complex systems defy traditional mechanistic approaches, which are based on homeostasis. Previous our studies have shown that the evaluation of the interactions of physiological signals by using special analysis methods is suitable for observation of physiological processes. It is demonstrated the possibility of using deep physiological model, based on the interpretation of the changes of the human body’s functional states combined with an application of the analytical method based on matrix theory for the physiological signals analysis, which was applied on high risk cardiac patients. It is shown that evaluation of cardiac signals interactions show peculiar for each individual functional changes at the onset of hemodynamic restoration procedure. Therefore, we suggest that the alterations of functional state of the body, after patients overcome surgery can be complemented by the data received from the suggested approach of the evaluation of functional variables’ interactions.