Search results for “Assessment”

Assessment of Nurses' Knowledge, Attitudes, And Willingness Towards Organ Donation: A Cross- Sectional Study at Tibebe-Ghion Specialized Hospital, Bahir Dar, Ethiopia, 2023

Objective To assess knowledge, attitude and willingness towards organ donation of nurses in Tibebe-Ghion Specialized Hospital, Bahir Dar, Ethiopia, 2023. Method A hospital based cross-sectional study was conducted from March 1 to May 30, 2023, using a census of all eligible nurses (N=215). Data were collected with a structured questionnaire adapted from validated tools. Binary logistics regression was used to identify factors associated with willingness to donate, with results presented as adjusted odds ratios with 95% confident intervals. Results The overall response rate of this study was 98% (n=206). The mean age was 29.5 (±4.8) years, and 55.8% were male. Overall, 61.7% (95% CI: 54.9-68.5) of nurses had good knowledge, and 45.6% (95% CI: 38.8-52.5) had a favorable attitude. In multivariable analysis, female sex (AOR=3.50, 95% CI: 1.18-3.92, p<0.001) and greater years of experience (AOR=2.15, 95% CI: 1.18-3.92, p=0.012) were independent predictors of willingness. Conclusion While a majority of nurses were willing to donate organs, significant gaps in knowledge and legal awareness persist. Female nurses and those with more experience were more willing to donate. Targeted educational interventions are recommended to address knowledge deficits and foster a more supportive environment for organ donation advocacy.

Uptake of Cervical Cancer Screening and Its Determinants among Refugee Women in Uganda: Insights from the Uganda Refugee Population-based HIV Impact Assessment

Cervical cancer is the fourth most common cancer in women globally, with 660,000 new cases and 350,000 deaths in 2022. The burden is disproportionately high in low- and middle-income countries (LMICs), particularly sub-Saharan Africa. Despite proven interventions like HPV vaccination and screening, uptake remains low. While cervical cancer screening has been studied in the general population, little is known about uptake among refugee women in Uganda, which hosts approximately 1.7 million refugees. This study examines cervical cancer screening uptake and associated factors among refugee women in Uganda. Methods We conducted a cross-sectional secondary analysis of the 2021 Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) survey, focusing on women aged 21–49 in refugee settlements in the West Nile and South-Western regions, which host 90% of Uganda’s refugee population. The primary outcome was self-reported cervical cancer screening status. We used descriptive statistics and logistic regression to identify factors associated with screening uptake. Results Among 731 women, only 72 (9.8%) reported undergoing cervical cancer screening. The mean age of screened women was 37 years (±7), compared to 32 years (±8) for unscreened women. Screening uptake was significantly higher among women aged 31–39 years (AOR = 2.67, 95% CI: 1.32–5.52, p = 0.007), married women (AOR = 12.0, 95% CI: 1.76–163, p = 0.03), and those in polygamous relationships (AOR = 4.76, 95% CI: 1.96–11.1, p < 0.001) Conclusion Cervical cancer screening uptake among refugee women in Uganda is critically low. Integrating culturally sensitive screening programs into refugee health services and addressing socio-economic barriers could improve access and utilization.

Degradation assessment of Vinyl Ester Matrix Fiber Reinforced Plastics Exposed to Cyclic Hydrochloric Acid Concentrations using Gravimetric Analysis for Chemical Storage Tank use

The roof of an HCl fiber-reinforced plastic (FRP) chemical tank failed by accident after it had been operated for less than its expected lifetime. A possible cause is the change in day and night temperature, which lead to the cyclic change in the concentration of HCl vapor in contact with roof part. To investigate this possibility, a detailed analysis on the durability of the material exposed to cyclic solution concentration is required. In this research, vinyl ester-glass fiber composite specimens were exposed to 35 mass % and 0 mass% of HCl alternately at 40°C to replicate cyclic concentration exposure in both the vapor and liquid phases. The mass uptake and penetration depth of HCl as well as the strength loss of the material were investigated. Mass uptake and thickness change in vapor phase shows two times higher than liquid phase, at 3.5% and 6% respectively. This occurs due to differences in the concentration of solutions that diffuse to the specimen in the vapor phase and liquid phase. This phenomenon arises from variations in the concentration of solutions that diffuse to the specimen in both vapor and liquid phases. The diffusion process is facilitated by osmotic pressure, leading to material swelling and contributing to their degradation. The result of flexural strength measurement of specimens indicated a decreasing trend as exposure time increased. The flexural strength decreases by up to 36% due to plasticization. The Cl and water content profile in specimens that obtained from elemental mapping of cross-sections using Energy-Dispersive X-ray Spectroscopy (EDS) are enhancing the study on how materials degrade, which may be a reason for damage to FRP tank roofs.

Assessment of Reproductive Performances and Sex Ratio of Newborn in Cross Breed Dairy Cattle of Hawassa City, Ethiopia

Reproductive performance is an essential trait of cows in dairy cattle. The effect of different factors on reproductive performances and sex ratio difference in dairy cattle were not well documented in Ethiopia. In this research, cross-sectional study was conducted from December 2021 to June 2022 in Hawassa city to assess reproductive performances and effect of breeding methods on sex ratio difference of newborn. Questionnaires and observational study were used to collect data. In this study, the mean+SE of age at first service was 17.53+0.035 with difference of relatively one month from onset of puberty. The mean number of services per conception was higher in animals breed naturally (1.87+0.056) as compared to AI (1.69+0.049). Higher conception rate of 74.26% was obtained in age group of <4years as compared to old age >6years at rate of 4.11% with statistically significant difference (P<0.05). Animals with medium level of milk production (15-20L/day) more conceived to first service 43.14% than higher milk production group (20-25L/day) with 35.59%. The presence of reproductive problems significantly affect conception rate to first service with higher conception rate of 54.47% in negative animals and 22.41% in animals with reproductive problems. Conception rate was increased with increasing number of services in both breeding types. Sex of newborn was not significantly affected by breeding methods used and difference in the study area. Generally this research found that reproductive performances and use of AI in the study area were satisfactory even though age, level of milk production and presence of reproductive health problems had significant impacts on performances. In order to sustain and improve reproductive performances age, reproductive health problems and breeding management should be considered. Therefore, reproductive health management and application of AI for genetic improvement should be well practiced to improve dairy cattle reproductive performances.

Assessment of Environmentally Responsible Health-Oriented Behaviors in Students

Background & Objective Changing people’s attitude toward the environment is an important approach to the prevention of environmental damages. The present study aimed to evaluate environmentally responsible health-oriented behaviors in students. Materials and Methods This research was performed on 360 medical students (180 males and 180 females) who were selected via stratified random sampling. Data were collected using a responsible environmental behaviors questionnaire. Data analysis was performed in SPSS version 21 using linear regression analysis and Pearson’s correlation-coefficient. Results The scores of the environmental attitude, environmental knowledge, and environmental behaviors of the participants were estimated at 52.63±5.74, 74.43±5.99, and 103.37±11.51, respectively. An insignificant correlation was observed between the environmental knowledge and environmental behaviors of the students (r=0.07; P=0.20). However, the correlation-coefficient between the environmental attitude and environmental behaviors of the students was positive and significant (r=-0.54; P<0.001). A negative, significant correlation was also denoted between the environmental knowledge and environmental attitude of the students (r=-0.39; P<0.001). Conclusion Despite relatively poor environmental awareness and attitude, the majority of the students had proper environmental behaviors. Therefore, it seems that having an environmentally responsible behavior does not rely on environmental attitude and knowledge. In fact, behaviors influenced by social conditions and structure encourage and facilitate environmental behaviors.

Assessment of Dam Operation Impacts on Downstream Surface Hydrology: The Case of Fincha’a-Amarti Hydroelectric Project

Dams are built to produce electricity, store water for irrigation, control flood hazards and other uses. The operation of dam has a complicated problem, which includes multiple decision variables, several conflicting and contradictory objectives together with significant uncertainty and risk. The objective of this study was to make an impact assessment that Fincha’a-Amarti dam operation can bring on the downstream activity. Fincha’a-Amarti dam downstream irrigation water requirement was done by using CROPWAT software. The SWAT model was also used to model the watershed and simulate the flow. Meteorological data and spatial data of the study area were used as an input of the model. The meteorological stations considered were Shambu, Fincha’a, Homi, Nashe and Harato. The study shows that downstream water requirement greater than the existing downstream water release during the months of: January, February, March, April, May, September, October, November and December; but existing water release is greater than downstream water requirement during wet season only. Therefore, the study concludes that there is downstream water stress except during wet season.

Assessment of the Factors that Contribute for the Cause of Asthma Disease in Ambo Town

Asthma is a chronic disease of airways; that is widely characterized by an increased responsiveness to a large variety of stimuli, airway inflammation and obstruction. It is the most common respiratory disorder disease in developed and developing countries. The study was aimed to assess the factors that contribute for the cause of asthma disease in Ambo town and cross-sectional survey was conducted to gather information from March to April 2022. 30 respondents were selected using purposive sampling technique for interview and data collections. According to the study the more affected age group were 22-32(53%) and the major risk factor for the disease was air pollution (53%). The pollution is due to domestic wastes that are discharged to the environment. Therefore, the government and extension health workers should aware the community about the risk factors of asthma and proper waste disposal mechanisms.

Detection of Smuggled Genetically Modified Crops and Assessment of its Environmental Impact in the Ethio -Sudan Trans Boundary Area, North West Ethiopia

Background The genetic material of the genetically modified crop has been altered to develop the necessary insect resistance features by introducing genes from the Bt (Bacillus thuringiensis) bacterium. The objective of this study was to find smuggled GM Bt crops in the Metema farming area and examine its environmental effects. Method An experimental; Completely Randomized Design (CRD) was used to collect crop samples in the study area. The CTAB (Cetyltrimethyl ammonium bromide) technique was used to isolate DNA from all transported samples, and the purity was determined using a Nano Drop spectrophotometer. Conventional PCR with particular primers for different Bt gene events was used to detect the presence of genes. Furthermore, utilizing Bt cotton specific primer sets, the prevalence of GM cotton was measured, and amplified fragments were confirmed using agarose gel electrophoresis. Result The PCR results revealed that 15 (33.3 percent) of the samples were Bt cotton smuggled from Sudan. The PCR assay also revealed the presence of GM maize. Moreover, the effects of GM genes on the environment were studied in diseased samples, and no transgenes were found. Furthermore, domestic and indigenous crops were used to determine horizontal gene transfers of GM genes to other crops, and the transgene was not found in any of the samples analyzed. Conclusion: In the current study, 28 (13.4%) of the 209 (100%) total analyzed samples were GM crops which indicated the presence of unauthorized GM seeds in the study area. Environmental impact studies and horizontal gene transfer data similarly revealed that the Bt gene was not transferred to other crops and had no harmful environmental effects. For a better understanding of the Impact of imported unauthorized GM seeds, more additional detection of GM events should be done by expanding the sampling site and sample types.

Context Specific Complementary Feeding Recommendations for Children in Pakistan Based on Secondary Analysis of National Complementary Feeding Assessment and Pakistan Demographic Health Survey 2018

Background In Low Middle-Income Countries (LIMCs), malnutrition, especially undernutrition is one of the leading causes of childhood mortality and morbidity. Poor complementary feeding practices are among the most notable contributors to poor nutritional indicators in children under five. This article provides an output of secondary data analysis of the Cost of Diet (CoD) and Optifood component of National Complementary Feeding Assessment conducted by UNICEF Pakistan along with Pakistan Demographic Health Survey (PDHS) 2018. Methods For correlation of Optifood data and CoD data with PDHS data of CF, GraphPad software, MS Excel was used along with manual quantifications. The analysis of DHS-2018 data was conducted using STATA software. Univariate analysis included comparison of categorical variables i.e. various individual, household and community level parameters with that of outcome variables of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum dietary diversity (MAD) using chi-square test. Findings The overall rate of MMF was 56.6% among children of 6-23 months of age with MDD in 18.6% and MAD in 13.8% of children. Percentage of annual cost spent on nutritious diet for MDD, MMF and MAD varies from 27.86% to 43.08% across all the provinces. Children aged 6–8 months and 9–11 months often consumed infant milk and cereals, while children aged 12–23 months often consumed eggs and grain products. Consumption of dairy products was highest in Punjab, Sindh, AJK, and Islamabad, that of grains roots and tubers was highest in KPK, FATA and GB. Conclusion Considering CF practices in Pakistan are inadequate as indicated by poor MDD, MMF, and MAD, therefore it is imperative that a holistic approach using both communication and non-communication based interventions is to be employed through active stakeholder engagement.

Assessment of Oral Health-Related Quality of Life Among a Sample of Yemeni Population

The study aimed to assess the oral health condition and its impact on the quality of life (QoL) among a sample of Yemeni population. The study including 256 individuals who responded to the Oral Health Impacts Profile (OHIP) through completing a face-to-face survey of the OHIP-14 Arabic version. The data were collected by one dentist trained in the terms of oral health-related quality of life (OHRQoL). The study revealed that the impact of OHRQoL among the study sample was found with a weighted OHIP-14 score of 1.1 (±0.9). Physical pain (3.7±2.3), followed by physical disability (2.4±2.2), and psychological disability (2.1±2.3) were the highest scoring. A significantly higher effect (p < 0.05) was found for the adults (18-44 years old) compared to those elderly individuals (> 64 years). The OHRQoL was better in male than in female and in employees than in both pensioners and un-employees. Females had a significantly higher effect when compared to males in the OHRQoL (p < 0.05). The unemployed subjects were significantly higher than those pensioners and employees in the OHRQoL (p < 0.05). The OHRQoL was also better in subjects with higher income and education than those participants with low. However, there were no significant differences for OHRQoL with respect to the educational level and monthly income of participants (p > 0.05). Conclusion, the quality of life is greatly affected by the oral health conditions of the elderly. This impact of oral health on quality of life has an association with individual and contextual variables.

An Assessment of The Knowledge, Risk Perception and Attitudes of Healthcare Workers in A Tertiary Health Facility in Southwest Nigeria to The Covid 19 Pandemic

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.

Principles and Constants of the Golden Proportion as a Criterion in Donosological Diagnostics of the Functional States of The Body and in the Assessment of the Probability of their Changes

A theoretical paper proposes applications of golden proportion principles to physiological diagnostics. It outlines proposed metrics and discusses validation needs and limitations.

Validity of PIRO Score as an Assessment Tool for Mortality Risk of COVID-19 Pneumonia among Patients Admitted to World Citi Medical Center from March to August 2020. A Retrospective Observational Cohort Study

Introduction In December 2019, cases of serious illness causing pneumonia and death were first reported in Wuhan, China.2 The clinical features of Corona Virus Disease-19 (COVID-19) are ranging from asymptomatic to multi organ dysfunction. The disease can progress to pneumonia, respiratory failure and death.4 Thus, a tool is needed that can predict the severity and in-hospital mortality risk of a patient with COVID-19 Pneumonia. The PIRO (predisposition, insult, response, and organ dysfunction) scoring was developed for use in the emergency department to risk stratify sepsis cases.15 Eventually it was adapted in pneumonia cases to predict its severity. Objective To validate PIRO score as an assessment tool for COVID-19 mortality risk among patients with confirmed COVID-19 RT-PCR test among patients aged 19 and above admitted in World Citi Medical Center from March 2020 to August 2020 Methods This study included 93 patients aged 19 and above admitted in World Citi Medical Center with a primary diagnosis of COVID-19 Confirmed with pneumonia between March 2020 to August 2020. The patients’ charts were retrieved from the hospital medical records and case notes were reviewed. A severity assessment score was developed based on PIRO score (Predisposition comorbidities and age; Insult multilobar opacities and viremia; Response shock and hypoxemia; Organ Dysfunciton) were extracted. The patients were stratified in four levels of risk: a)Low,0-2 points; b)Mild,3 points; c)High,4 points; d)Very High,5-8 points. The PIRO score and the clinical outcome were compared. The discriminative ability of PIRO score to predict mortality risk was evaluated under receiver operating characteristic curve (AUC). Results The PIRO score had an excellent predictive ability for in-hospital mortality (AUC0.9197). Analysis of variance showed that higher levels of PIRO scores were significantly associated with higher mortality (p<0.001). Patients with Mild PIRO risk category were 98.65% less likely to expire (p<0.001, 95%CI 0.0015) and High PIRO risk category were 94.47% less likely to expire (p<0.001, 95%CI 0.0124), both compared to patients with Very high PIRO risk category. Finally, Very High PIRO risk category were more than 44 times likely to expire compared to patients with Low, Mild and High PIRO risk category (p<0.001, 95%CI 11.738). Conclusions The PIRO score is a valid risk model that can be used to predict in-hospital mortality, that can help clinicians provide timely and accurate assessment, and hence appropriate management to patients with COVID-19 Pneumonia.

A Cross Section Survey Assessment Study on the Knowledge and Practice of Periodic Medical Check up among the Saudi population

In Saudi Arabia most of the individuals give very little attention to issues like health or no priority to medical checkup. This investigation was carried out to measure knowledge, practice of periodic medical checkup in Kingdom of Saudi Arabia people. A cross-sectional investigation was conducted among 1015 participants. A structured interviewer administered an online questionnaire were distribute by social media and whatsApp. We collected data and analyzed using SPSS version 21. Association between categorical variables were explored using bar chart and tables, Level of significance was set at 5%. The main age of the respondents was 21-30 years, 78.4% were females and 64.2% were married. About 42.1% have ever heard of periodic medical check-up , 57% of those who haven’t ever heard of periodic medical checkup and only 21.9% among those who had ever done it had frequent medical check-up and 78.1% didn’t do it. Attempt is required in ensuring that periodic medical check-up is urged. There is a need to study the factors associated with the uptake of medical check-up among the study population and effort should be made by health agencies to educate traders on the various types of medical check-up, their indications and benefits as well as its practice encouraged

Assessment of Knowledge, Attitude and Preventive Practices towards Sexually Transmitted Infections among Secondary School Students in Mlimba Division, 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.

Community Health Needs Assessment in Urban Communities in Kigali City In Rwanda: A Cluster-Randomized Trial

Introduction Reporting of suspected or confirmed communicable diseases is paramount. Although physicians have primary responsibility for reporting, school nurses, laboratory directors, infection control practitioners, daycare center directors, health care facilities, state institutions and any other individuals providing health care services are also required to report communicable disease. Therefore, community health needs assessment in urban communities remains an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the national health regulations and other communicable diseases of public health importance, including emerging or re-emerging infections. Purpose of the Study Todescribe relevant medical needs of townspeople so that treatment plans can be developed accordingly. Methods The Study was a cross-sectional with qualitative approach. In-depth interviews and focus group interviews was used as research technique. Data was categorized to look for emerging themes then further distilled to identify any abstract themes that could be understood holistically. Results Urban decision-makers need to advocate the problem of human resources in public health facilities and the mutual health insurance to revise its insurance policy to allow their clients to be received even in private clinics. Dental services was wished to be available in public health centers. Study participants suggested that new useful information could be posted in private public premises rather than to be in public institutions only. Conclusion The patient waiting time, dental services in health centers, and the way of dissemination new health information, mutual health insurance and insufficient human resources are the major concerns of townspeople that they wish improvement.

Assessment of Physical, Thermal and Spectral Properties of Consciousness Energy Treated Cholecalciferol

Cholecalciferol (vitamin D3) is used nowadays in nutraceuticals regarding the prevention and treatment of vitamin D deficiency and associated diseases. This study was done to analyse the effect of the Trivedi Effect® - Energy of Consciousness Treatment on the physicochemical, thermal, and spectral properties of cholecalciferol using PSA, PXRD, DSC, TGA/DTG, FT-IR, and UV-Vis analysis. For this study, the cholecalciferol sample was divided into control/ untreated and Biofield Energy Treated vitamin D3. The treated vitamin D3 sample received Biofield Energy Treatment (the Trivedi Effect®) remotely for ~3 minutes by Mr. Mahendra Kumar Trivedi, who was located in the USA, while the test samples were located in the research laboratory in India. The treated sample was designated as the Biofield Energy Treated sample. The PSA analysis showed that the particle size values at d10, d50, d90, and D(4, 3) of the treated sample were significantly decreased by 5.80%, 16.49%, 17.52%, and 16.23%, respectively compared to the control sample. However, the specific surface area of the treated cholecalciferol was significantly increased by 7.26% compared to the control sample. Besides, the PXRD analysis revealed that the relative intensities regarding the characteristic diffraction peaks in the treated sample were significantly altered from -42.56% to 22.42%, along with -41.69% to 72.71% alterations in the crystallite sizes, compared with the control sample. Also, the treated sample showed 2.80% decrease in the average crystallite size. The DSC analysis showed a slight increase (0.24%) in the melting point of the treated sample along with 3.68% increase in the latent heat of fusion (ΔH) compared to the control sample. Also, the decomposition temperature of the treated sample was decreased by 0.29%, whereas the ΔH was increased by 5.79%, compared to the control sample. Moreover, the TGA/DTG analysis revealed the significant decrease in weight loss in the 1st and 3rd step of degradation of the treated sample by 18.58% and 89.81%, respectively, along with 1.83% increase in the maximum thermal degradation temperature compared with the control sample. Overall, the thermal stability of the treated cholecalciferol sample was observed to be increased in comparison to the control sample. Thus, the Trivedi Effect® might be used to produce a different polymorph of cholecalciferol, which possesses the improved qualities in terms of appearance, dissolution, absorption, bioavailability, and thermal stability as compared with the untreated sample. Thus, the Biofield Energy Treated cholecalciferol might be used in designing of better nutraceutical and pharmaceutical formulations possessing improved therapeutic response regarding the treatment of vitamin D deficiency associated diseases.

Proposition and Practical Significance of Two Classes of New Teaching Methods and Diversified Assessment During the Coronavirus Disease 2019 Epidemic

After entering the new century, people are facing a new external environment. Recently human society is coming into knowledge economy era, and the industrial structure has deeply been adjusted. Today, the past teaching method of imparting knowledge and getting people to accept education, or exam-oriented teaching ideas have been unable to keep up with the needs of the development of the Times. In the future, the key point of education is to promote people to understand the knowledge, and grasp rules between things. Based on this, it is particularly necessary for the talents cultivation to adopt a new idea of training. The paper takes the major in mathematics as an example, designs two classes of new teaching methods CT&CL and BOOF with the diversified assessment to cultivate students’ innovative thinking, providing a reference for the other students. The two classes of new teaching methods and the diversified assessment are worthy of further spreading and exercising during the coronavirus disease 2019 epidemic.

Comparative Survival Assessment of Two-Dimension (2D) vs Three-Dimension (3D) Brachytherapy Treatment in Cervical Cancer: A Retrospective Case Control Study

Purpose The purpose of this study was to assess the efficacy (overall survival, local control, progression free survival (PFS) and toxicities between two dimension (2D) and three dimension (3D) CT guided brachytherapy without using interstitial needles in cervical cancer patients. Material and Methods A retrospective case-control study was performed in Figo stage IB-IVA cervical cancer patients treated between March 1990 and August 2018. Concurrent chemoradiation using external beam radiotherapy followed by brachytherapy (BT) was the treatment method used in all patients. Clinical endpoints were overall survival, local control, progression free survival, acute toxicities and late toxicities. Results A 102 cervical cancer patients were included,52 patients have been treated with 2D and 50 patients with 3D using CT scan brachytherapy without interstitial needles. Baseline characteristics were similar between both groups. External beam was used in all patients during concurrent chemoradiation period before brachytherapy. All patients completed the treatment. Similar 3-year overall survival and local control was reported between 2D and 3D techniques. Overall 3-year survival rate was 95.7% in 2D and 91.8% in 3D brachytherapy (P value = 0.188). Local control at the 3 year follow up was 88.6% in 2D and 93.3% in 3D (P value = 0.571). Progression free survival was better in 2D rather than 3D (86.13% in 2D vs 27.4% in 3D, p value = 0.006). No grade 3 or 4 toxicity in 3D technique was observed whereas there are 1.9% of grade 3 acute GI toxicity and grade 3 late GI and GU toxicities in 2D technique (7.7% and 5.8 %). The 3D brachytherapy significantly reduced acute grade 2-3 GI side effect and grade 2-3 late GU side effect (acute GI 25% in 2D vs 4% in 3D, late GU (56% in 2D vs 16% in 3D). Conclusion Using CT guided 3D brachytherapy in treatment of cervical cancer showed similar outcomes in survival and local control but reduced toxicity compared to the 2D technique. Disease progression including metastasis was found better in the 2D brachytherapy technique. CT guided brachytherapy helped reduce dose to organs at risk and long term follow up for survival outcome and toxicities was needed.

Assessment of Body Size by Structural Equation Model Using Anthropometric Traits of Fishermen Community: A Methodological Approach

Objectives Aim of the study was to develop a ‘composite body size score’ (CBSS) using anthropometric traits to estimate body size and to assess the nutritional status of each study individual on the basis of CBSS. Materials and Methods Data on seventeen anthropometric traits were collected from 710 individuals (Male, Female) from fishermen community inhabiting coastal villages of West Bengal, India. For estimating body sizes, Structural Equation Model (SEM) was constructed with Path Analysis (PA). Later, second order Confirmatory Factor Analysis (CFA) was applied on SEM to determine CBSS. It was hypothesized in the models that CBSS is composed with three sets of latent variables viz., linear, circular and skinfold, constructed from anthropometric traits. Applying new derived optimal cut off points of CBSS was used to determine lean, normal and robust body sizes. Individuals with negative values of CBSS were categorised as lean body size,. Positive values of CBSS were categorised into two categories- normal and robust body size. Results On the basis of CBSS, result showed that 50.6%, 48.8% and 0.6% of the individuals were categorised under lean, normal and robust body size respectively. Females showed relatively higher percent of lean body size i.e. under nutrition (73.8%) compared to males (26.2%). Conclusion The hypothesized model estimate more accurate composite body size score, based on anthropometric traits. All the traits are highly significant on the model. The lean body size category can be use in predicting ‘Undernutrition’.

Assessment of Self Medication Practice and Drugs Storage Among South Sudanese Community in Addis Ababa, Ethiopia

Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.

Assessment of Prescribing and Dispensing Practices Based on WHO Core Prescribing Indicators in Hospital and Community Pharmacies in Khartoum State - Sudan

Background Rational drug management has become an increasingly important topic in order to make optimal use of the drug budget to offer health services of the highest possible standard. It is important that continuous assessment for rational prescribing and use of drug have to be carried. Objective of this study was to gather data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing indicators as described by the WHO. Method Observational, cross-sectional, prospective study was designed and conducted to evaluate the performance of hospital and community pharmacies in Khartoum state, related to rational drug use and prescribing and dispensing practices during the period from November 2018 to March 2019. 297 Hospital and community pharmacies from public and private sectors were contacted for carrying out this study survey and the collected data were analysed against WHO standards for core drug use indicators. Results The average number of drugs per encounter was 3.98 drugs. Hospital pharmacies had a higher (4.18±1.516) number of drugs prescribed than community pharmacies (3.87±1.331) with significance difference between mean of two types of pharmacies (P = 0.015). The percentage of antibiotic per prescription was (53.7%). Antibiotic prescribing was much higher (54.0%) in the hospital pharmacies compared to (48.6 %) in community pharmacies. The average percentage of injections per prescription at the facilities was found to be (57.6%). The percentage of prescription with written diagnosis was (26%.0) and the percentage of prescriptions with written dose was (78%.0). The average dispensing time was (1.75) minutes, The Percentage of drugs actually dispensed was (55.99%), the average adequacy of labelling of drugs was (30.4%). Overall prescribing and dispensing indicators were higher than WHO standard. Conclusion The degree of poly pharmacy was greater than of WHO criteria. The completeness and rationality of prescription was found suboptimal and components were missed.

Assessment of Traffic Policemen Exposure To Benzene by Using Trans, Trans-Muconic Acid Biomarker in Ahvaz City, Iran

Benzene is known as an environmental and industrial pollutant. One way to check the amount of exposure to benzene is to measure its metabolites in the urine. Trans, Trans-Muconic Acid which is one of its metabolites is also as a biological indicator of exposure to benzene. In this study, the relationship between the amount of this biomarker and the environmental benzene concentration was investigated in two groups of policemen working outdoors in the traffic-congested areas and indoor in the same area. The results showed that the highest amount of benzene was in Salman Farsi Station at 4.44 ppm. At the same time, the biomarker measured in the urine showed 127.20 μg / L, which was the highest amount. In addition, the amount of benzene in the outdoor was approximately 3 times more than indoor and the amount of biomarker measured in outdoor employees was two times more than indoors ones. In general, wherever there was more benzene, the biomarker would also show a higher amount.

Assessment of Target Volume Definition for Radiosurgery of Atypical Meningiomas with Multimodality Imaging

Objective Meningiomas are most common intracranial benign tumors comprising around one third of all intracranial neoplasms, and typically have benign and indolent nature with slow-growing behaviour. Benign meningiomas are slow growing tumors typically following an indolent disease course. Nevertheless, atypical or anaplastic meningiomas may follow a more aggressive disease course with invasion of critical structures and recurrences. In the current study, we evaluate the incorporation of magnetic resonance imaging (MRI) for radiosurgery treatment planning of atypical meningiomas. Materials and Methods Atypical meningioma radiosurgery target volume determination with and without incorporation of MRI has been evaluated. Ground truth target volume used as the reference has been outlined by the board-certified group of radiation oncologists after comprehensive assessment, thorough collaboration and consensus. Results Target volume definition by use of Computed Tomography (CT)-only imaging and by CT-MR fusion based imaging has been comparatively evaluated in this study for linear accelerator (LINAC)-based radiosurgical management of atypical meningioma. Ground truth target volume defined by the board-certified radiation oncologists after detailed evaluation, collaboration, colleague peer review and consensus has been found to be identical to target determination by use of CT-MR fusion based imaging. Conclusion Despite significant progress in neurosurgical techniques over the years, complete surgical resection may not be feasible in the presence of meningiomas located at eloquent brain areas in close association with important neurovascular structures. RT may have a role in multidisciplinary management of meningiomas. Incorporation of MRI into treatment planning for radiosurgery of atypical meningiomas may improve target definition despite the need for further supporting evidence.

Assessment of Ocimum basilicum as Potentially Fruit Flies Attractant

The Basil plant (Ocimumbasilicum L) is an annual herb; belongs to family Lamiaceae. It is found to be an important source for Methyl Eugenol (ME), the fruit flies attractant. This study was carried out at Shendi area with main objective to assess the amount of ME extracted from Ocimumbasilicumplant to evaluate its potentiality as fruit fly attractant. Plants of basil were grown till to maturity, then the differential harvest of leaves, flower and seeds were chemically investigated for volatilome. Five basil formulations (paste and powder of leaves, paste and powder of flowers, isolated ME from basil oil) were used for trapping potential of Bactrocera spp in mango orchards, as compared to the synthetic ME. The oil was extracted using Soxhlet apparatus, steam and water distillation, and analyzed using GCMS. The results revealed that highest extracted oil percentages was obtained from flowers, leaves, seed and stem were 5.75%, 3.03%, 0.02% and 0.21% respectively. Moreover, the basil traps catch was found to be lower compared with that of the control traps. Furthermore, when extracted ME from basil plant was compared with the standard synthetic, it gave lower catch fruit flies numbers, but the difference was not significant (>0.05). In conclusion, the basil raw derivates are confirmed not to be attractive for flies but the oil distillable from the leaves could be in force of its attractant ME contents and insecticide potency.

RETRACTED: Assessment of the Risk of Hemochromatosis in Polytransfused Sickle Cell Patients at the Abidjan Transfusion Therapy Unit

This article has been retracted on 29 January 2021. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2372-6601.jhor-25-5854) In Côte d'Ivoire, sickle cell disease affects 14% of the population. It is responsible for significant morbidity and mortality. Transfusion is a significant element in the management of major sickle cell anemia, which exposes them to post-transfusion hemochromatosis. The biological diagnosis is based on the determination of serum iron and the transferrin saturation coefficient (CST). As the determination of the CST was not available in our exercise context in Côte d'Ivoire, we determined only the ferritinemia. The interest of this work lies in the therapeutic implication linked to the identification of patients at risk of hemochromatosis because chelators are difficult to access for most patients. This was a prospective, descriptive and analytical study, on polytransfused sickle cell patients, followed at the transfusion therapy unit (UTT) of the CNTS of Abidjan, from 2010 to 2018. We included 78 sickle cell patients, all ages and genders who have received at least ten transfusions. The ferritinemia assay was carried out by ELISA. Transfusion exchange, with 59% of cases, was the most used mode of transfusion. The mean ferritinemia was 1719.19 ng / ml. Hyperferritinemia was found in 63% of patients. Most of the patients were on a long-term transfusion program with an average of 27.5 bags of red blood cell concentrates. Thirty-two patients had received at least 20 bags of red blood cell concentrates. We noted 21 patients treated, including 3 with deferoxamine and 18 treated with oral deferasirox. We have identified 33 sickle cell anemia patients at risk for hemochromatosis. The determinants of the risk of hemochromatosis were the high number of blood bags and the method of transfusion.

Retraction Note: Assessment of the Risk of Hemochromatosis in Polytransfused Sickle Cell Patients at the Abidjan Transfusion Therapy Unit

A Qualitative Assessment of an Innovative Suicide Prevention and Treatment Approach: Contextual-Conceptual Therapy

Mental health and mental illness is a critical to a person’s overall health. In the United States alone, mental illness effects one in six adults. Furthermore, 40% of those individuals who die of suicide have been diagnosed with a mental health condition or illness. Yet, there is a paucity of research on innovative methods that help prevent suicide. The Contextual-Conceptual Therapy (CCT) approach introduces an innovative way to treat suicide by working to uncover the strengths of the suicidal person and addressing a person’s true self. The CCT approach was developed over the course of 25 years working with more than 16,000 suicidal patients in Seattle, Washington, and is tailored specifically for primary and secondary prevention of suicide. While there has been anecdotal evidence of the effectiveness of the CCT program, the program has yet to be formally evaluated. This qualitative research study aims to understand the impact the CCT approach has had on its clients. Eleven former CCT clients were recruited to participate in semi-structured interviews. Outcomes described by participants included an increase in curiosity and self-efficacy as a means through which to decrease suicide ideation and behavior, and proved to be incredibly powerful in changing long-term outcomes. This qualitative study is a first-step in providing critical insight on suicide prevention for wider dissemination. At a time when adverse mental health and illness is impacting the lives of millions of people, the CCT approach has the potential to address suicide, mental illness and mental health across diverse populations.

Assessment of Sex from the Anthropometric Measurements of the Foot in Ogbomosho North Local Government Area

The aim of this physical anthropometric study is to determine sex by foot measurements. Dismembered human remains are frequently found in cases of mass disasters and criminal mutilation. It is therefore of interest to use foot dimensions for the determination of sex (gender) of an individual in order to assist in establishing personal identity. Another application of anthropometrical measurement is in ergonomics which is the design of working space and the development of industrialized products such as furnishing, cars, tools, shoe designing etc. 500 adult subjects(250 males, 250 females)aged 18-50 years without any foot disability within Ogbomosho North Local Government, Oyo State were randomly selected for the study. The males had an average foot length about 1cm greater than females and foot breadth in males was about 1cm greater as compared to females. Difference in foot length and foot breadth in males and females of the population was highly significant. With the statistical analysis, any foot with length lesser than 26cm and breadth lesser than 11cm can be suggested to be that of a female while any foot with length greater than 26cm and breadth greater than 11cm can be suggested to be that of a male. Therefore, 26cm can be taken as the cut-off point for foot length and 11cm as the cut-off point for foot breadth in this locality.

In Vitro Assessment of Antioxidant Enzymes, Phenolic Contents and Antioxidant Capacity of the Verdolaga (Portulacaceae)

In this study, the antioxidants and photosynthetic compounds of Verdolaga were examined. Compounds were extracted from distinctive segments of the verdolaga using various solvents such as methanol (40, 60, 80%), ethanol (40, 60, 80%), acetone (40, 60, 80%), and deionized water. The use of 80% methanol led to the highest extracted concentration of phenolic substances and flavonoids. The extracted products (Leaves, Stem strips, and Root strips) were evaluated for their radical scavenging capabilities with DPPH (IC50= 22.26, 20.56, and 32.10), and ABTS (IC50= 2.86, 3.70, and 5.24), reducing power (EC50= 15.70, 16.39, and 21.69), and peroxide scavenging activity (1C50= 1.717, 2.937, and 3.255), respectively. The extracted products were analyzed by a gas chromatography-mass spectrometer. Peroxidase, catalase, and polyphenol oxidase assays were completed for the crude extract of verdolaga’s leave, stem strips, and root strips. As indicated by these tests, extracts of the verdolaga’s roots, stems and leaves using 80% methanol yielded high antioxidant activity. The most elevated concentrations of extracted chlorophyll, lycopene, and carotenoids were from the leaves and the highest concentration of extracted tannin was noted from strips of stems. The highest measures of peroxidase and polyphenol oxidase were identified in root strips and the highest units of catalase was identified in leaves.

Assessment of Heavy Metals Contamination of Water and Cupscale Grass (Sacciolepisafricana) along the Epie Creek in Bayelsa State, Nigeria

This study was conducted to investigate the concentration of three heavy metals; iron, chromium and lead in surface water and plant (Sacciolepisafricana) tissues along the Epie creek. This was aimed at determining the heavy metal loading of surface waters and the extent of bioaccumulation in the most prevalent grass species found growing within the river course. Metals were determined using atomic absorption spectrophotometer. Result of water analysis recorded the least and most significant iron concentrations of 3.42 ± 0.06 mg/L and 12.06 ± 0.06 mg/L for Agudama and Edepie axis respectively. Contrastingly, water samples showed chromium and lead levels which were below their instrument measurable limits. Consequently, lead (Pb) and chromium (Cr) levels were within WHO permissible limits, while iron (Fe) exceeded regulatory standard for water samples collected from all field locations. Similarly, iron recorded elevated iron concentrations in plant (cupscale grass) with the least amount being revealed for Igbogene stem (196.63 ± 5.21 mg/kg), and the most concentration been reflected for Edepie root sample (9,423.17 ± 48.55 mg/kg). Even though iron levels prevalently exceeded recommended threshold in plants, the stem were mostly within limit for iron. The only grass sample depicting significant lead amount (0.34 mg/kg) was the stem section collected at Akenfa location. Evidently, metals were least stored in plant stems and most bioaccumulated in plant roots. Furthermore, Cr and Fe are the only significantly correlating metals in plants (r = 0.700, p < 0.01). Overall, the increasing level of Fe in the water environment is further indication of the impact of unregulated dumping of scraps and domestic waste along the creeks embankment.

Assessment of Anticancer Effect of Alendronate in Breast Cancer: An In vitro Study

Breast cancer has high incidence in women from both developed and developing countries. Approximately 2 million women are diagnosed with breast cancer in 2018. In Asia, unfortunately Pakistan leads the highest number of breast cancer patients. Various treatment strategies are present but they are not well developed. There is a great need to develop effective methods for early detection and treatment of the disease. For cancer treatment chemotherapeutic interventions have always been a method of choice. One of the mechanisms involved in cancerous cell proliferation is Mevalonate (MVA) pathway. It is hypothesized that arresting MVA pathway leads to cell death hence cancer cell growth is suppressed. Various inhibitors of MVA pathway have been studied that can suppress cell proliferation. Nitrogen containing bisphosphonates are MVA pathway inhibitor and clinically used for treatment of bone diseases. Their anticancer efficacy is also reported. Current study focuses on alendronate, a nitrogen containing bisphosphonate to examine their anticancer effect on breast cancer cell line. Results of this study may help in addition of new anticancer drug for breast cancer.

MRI Study and Psychological Assessment in Children and Youth with Deviation Behaviour

Objective Antisocial behavior (ASB) in children and youth is public health problem in Georgia. Nevertheless, there has been no systematic study the risk factors for ASB that could counteract on ASB development. To prevent ASB development and acceleration the understanding of biological (assessment of Brain morphology using MRI) and psychological (assessment using Freiburg Personality Inventory) risk factors is critical. This was the aim of this study. Method The children/youth with ASB tendency (AST) were identified by the Freiburg Personality Inventory (FBI). The biological and psychosocial factors contributing to AST were evaluated using a semi-structured clinical interview. Brain anatomy and morphology was studied using magnetic resonance imaging (MRI). Results Children/youth with AST had significant abnormalities in most axial elements of the DSM multi-axial system but not in brain anatomy measured by MRI. Conclusion Early identification of ASB tendencies and a provide correlationship between specific psychiatric, medical and family stress factors will likely reduce the number of children/youth with ASB and will promote their integration into society.

Cell-Based Vital Organs Specific Biomarkers Assessment using Biofield Energy Based Novel Test Formulation

The aim of the present study was to determine the impact of Biofield Energy Treated test formulation using six differentcell-lines. The test formulation/item (TI) and cell media (Med) was divided into two parts; one part was untreated (UT) and other part received Biofield Energy Treatment remotely by a renowned Biofield Energy Healer, Janice Patricia Kinney, USA and labeled as Biofield Energy Treated (BT) test item (TI)/media. Based on cell viability assay, test formulation was found as safe at tested concentrations. Cytoprotective activity of test formulation showed a significant restoration of cell viability by 60.6% (10 µg/mL), 67.5% (63.75 µg/mL), and 117.5% (63.75 µg/mL) in UT-Med + BT-TI, BT-Med + UT-TI, BT-Med + BT-TI, respectively compared to untreated in human cardiac fibroblasts cells (HCF) cells. Moreover, restoration of cell viability was improved by 64% and 127.3% in UT-Med + BT-TI and BT-Med + UT-TI, respectively at 1 µg/mL compared to untreated in human liver cancer (HepG2) cells. Cellular restoration in A549 cells was improved by 314% and 112.3% at 1 µg/mL in BT-Med + UT-TI and BT-Med + BT-TI, respectively than untreated. ALP activity in Ishikawa cells was significantly increased by 175.5%, 547.2%, and 220.8% in UT-Med + BT-TI, BT-Med + UT-TI, and BT-Med + BT-TI, respectively at 0.1 µg/mL as compared to untreated. Additionally, in MG-63 cells showed increased ALP activity by 76.9%, 78.4%, and 79% in UT-Med + BT-TI, BT-Med + UT-TI, and BT-Med + BT-TI, respectively at 50 µg/mL compared to untreated. The percent cellular protection of HCF (heart) cells (decreased of LDH activity) was significantly increased by 60.6% (10 µg/mL), 67.5% (63.75 µg/mL), and 117.5% (63.75 µg/mL) in UT-Med + BT-TI, BT-Med + UT-TI, and BT-Med + BT-TI, respectively as compared to untreated. An improved HepG2 cells protection (represents decreased ALT activity) by 115.1% (1 µg/mL), 42.5% (25.5 µg/mL), and 60.8% (10 µg/mL) in UT-Med + BT-TI, BT-Med + UT-TI, BT-Med + BT-TI, respectively as compared to untreated. Percentage cellular protection of A549 (lungs) cells (represents increased of SOD activity) was significantly increased by 191.1% and 81.4% at 0.1 µg/mL in UT-Med + BT-TI and BT-Med + BT-TI, respectively as compared to untreated. Serotonin level was significantly increased by 31.8% (10 µg/mL) and 56.9% (25.5 µg/mL) in UT-Med + BT-TI and BT-Med + BT-TI, respectively compared to untreated in human neuroblastoma cells (SH-SY5Y). Relative quantification (RQ) of vitamin D receptor (VDR) was significantly increased by 304.3% (0.01 µg/mL), 128.4% (0.1 µg/mL), and 240% (0.1 µg/mL) in UT-Med + BT-TI, BT-Med + UT-TI, and BT-Med + BT-TI, respectively compared to untreated in MG-63 cells. Thus, Biofield Energy Treated test formulation (The Trivedi Effect®) significantly improved organ specific functional biomarkers and would be useful for multiple organs health related to coronary artery disease, arrhythmias, congenital heart disease, cardiomyopathy, cirrhosis, liver cancer, hemochromatosis, asthma, chronic bronchitis, cystic fibrosis, osteoporosis, etc.

Outcome Assessment of Open Foot Injuries in A Teaching Hospital in Ghana

Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.

In vitro Assessment of the Biofield Treated Test Item on Cardiac Function Using Rat Cardiomyocytes Cell Line (H9c2) via Multiparametric Analysis

Introduction Heart disorders are the major concern of population health worldwide. According to WHO estimates 2018, 17.9 million peoples were died due to cardiovascular disorders. Aim The aim of this study was to investigate the cardioprotective activity of Biofield Energy Treated test item, Dulbecco's Modified Eagle Medium (DMEM) using rat cardiomyocytes (H9c2). Methods The test item (DMEM) was divided into three parts, first part received one-time Biofield Energy Treatment by a renowned Biofield Energy Healer, Mahendra Kumar Trivedi and was labeled as the one-time Biofield Energy Treated (BT-I) DMEM, while second part received the two-times Biofield Energy Treatment and is denoted as BT-II DMEM. The third part did not receive any treatment and defined as the untreated DMEM group. Results Cell viability of the test samples by 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay showed 89.03% and 98.49% in the BT-I and BT-II groups, respectively suggested a nontoxic and safe in nature of the tested test item. The BT-I group showed 16.01% restoration of cell viability. The level of lactate dehydrogenase (LDH) was significantly inhibited by 50.37% and 49.35% in the BT-I and BT-II groups, respectively compared to the untreated DMEM group. Moreover, percent protection of creatine kinase-myocardial band (CK-MB) by 49.48% and 59.79% in the BT-I and BT-II groups, respectively, compared to the untreated DMEM group. Reactive oxygen species (ROS) level in terms of mean fluorescence unit (FU) was reduced by 6.64% in the BT-I group than untreated DMEM. Besides, BT-I and BT-II groups significantly increased the level of % apoptotic cells by 63.16% and 97.37% (p≤0.05), respectively than untreated DMEM. Conclusion Allover, results envisaged that Biofield Treatment significantly improved different cardiac parameters. Thus, Biofield Energy Treatment (The Trivedi Effect®) could be utilized as a cardio-protectant against several cardiac disorders such as coronary artery disease, heart attack, arrhythmias, heart failure, congenital heart disease, cardiomyopathy, etc.

Environmental and Health Risk Assessment of Particulate Matter Associated with Dusty Football Field

Over the decades there have been problems associated with Particulate Matter (PM) arising from anthropogenic activities. Evaluation and health risk assessment of PM associated with football field was carried out in 5 sampling locations, including the control station. Digital portable AEROCET 513 (Metone instrument) PM meter was used for the evaluation Results showed levels of PM for; PM1.0(13.73 – 20.18 µg/m3), PM2.5 (19.11 – 28.83 µg/m3), PM4.0 (24.73 – 44.63 µg/m3), PM7.0 (41.07 – 67.04 µg/m3), and PM10 ranging from 65.48 – 90.82 µg/m3. In addition, value of the control station was lowest amongst all recorded values of PM (p<0.05). Based on Air Quality Index evaluation, the football fields were predominantly rated as unhealthy, with other cases rates as; hazardous and unsafe for sensitive group. This investigation therefore concludes that the emission of PM from the football field are reflection of vehicular emissions and agitated dust particles. Hence mitigable measure must be applied without much ado, in order to ameliorate the daily chronic exposure to PM.

Evaluation of the Effects of Health Impact Assessment (Hia) Practice in Monteregie

This study explores the effects of the collaborative model of health impact assessment (HIA), as deployed in Monteregie (Quebec), on the development, adoption and implementation of municipal projects that include health considerations. Nine HIA processes were studied in nine territories and 35 individuals were interviewed. Data collection was based on the six steps of contribution analysis, and included document analysis, semi-structured interviews, and on-site observations. The study design is cross-sectional design were every HIA was analysed at least six month after completion. The individuals interviewed where those implicated into the HIA process (no matter at what point of the process). No exclusion criteria were applied considering that all points of view were important for this analysis. The Contribution Analysis (CA) was used to analyze the data. The study results emerged form by the interviews, the field observations and document analysis. They showed that the HIAs had varying results. First, the actors involved acquired new knowledge. However, the HIAs had little impact in terms of increasing the municipal actors’ awareness of health issues. Rather, it helped them acquire arguments for raising awareness among and convincing their municipal council members of the merits of certain actions and their potential positive impacts on citizens’ health. In fact, the HIAs were generally undertaken by municipal actors already aware of the importance of promoting citizen health. Second, as observed in the document, in a few of the HIAs, some recommendations were integrated into planning documents, but usually, as reported by the actor, the HIA report constituted an additional planning document and was not merged with the original planning documents. Lastly, following the HIAs, document analysis and interviews showed that most of the municipal actors continued to include health considerations in their subsequent planning of public policies and projects. Prerequisites for effective HIA include the presence of municipal actors, who are aware of the importance of their role in their local population’s health, municipal policies that include health considerations, and the municipality’s active participation in the HIA process. This study sheds light on the complexity of the factors that ensure HIA impact on municipal decision making and decisions. The particularities of each HIA process play a major role.

Ecotoxicological Assessment of Leachate from Municipal Solid Waste Dumpsites

The ecotoxicological effects of leachates from dumpsite have become a major problem. Leachates arising from waste dumpsites are transported by surface runoff or infiltration through the soil and become bioavailable in the ecosystem. The ecotoxicological assessment of leachates from 6 dumpsite in Yenagoa Metropolis were investigated against adult and fingerlings of Clarias gariepinus (African catfish). Ecotoxicological activities (LC50 values) were reported for the following stations; Akenpai (124.57 ppm), and Etegwe stations (95.38 ppm), as well as Opolo (157.95 ppm), and Kpansia Markets (123.82 ppm). In addition, leachates of the two stations from the central dumpsite (CDS), were the most active (CDS 1; 60.97 ppm, and CDS 2; 76.65 ppm). Notwithstanding, the order of toxicological activities of the leachates were reported as; CDS 1>CDS2>Etegwe>Akenpai>Kpansia market>Opolo Market. These results confirm the toxicity of leachates from the dumpsites. In addition, we recommend that government, regulators and all stakeholders should enact policies to treat, reduce, recycle and reduce waste stream in order to mitigate the adverse effects on the ecosystem.

Assessmentof Hair Growth Treatment with the Consciousness Energy Healing Treated Williams Medium E Using Mouse Vibrissae Hair Follicle Organ Culture

Hair is playing an interesting part in human for social and sexual communication. Loss of hair follicle leads to various skin disorders. For this consequence, the present study has investigated the potential of the Biofield Energy Healing (The Trivedi Effect®) Treated test item (William’s Medium E) on the vibrissae hair follicle organ culture cells for the assessment of hair cell growth and development in vitro. The test item was divided into two parts. One part was defined as the untreated test item, where no Biofield Energy Treatment provided, while the other part was defined as the Biofield Energy Treated test item, which received the Biofield Energy Healing Treatment by renowned Biofield Energy Healer, Mahendra Kumar Trivedi. The study parameters like bulb thickness and formation of telogen were assessed using cell-based assay with the help of UTHSCSA Image tool version 3. The experimental results showed that the untreated test item group showed 20.9% and 28.2% increased bulb thickness on day 5 and 7, respectively compared to the day 1, while did not produce telogen follicles upto day 7. Besides, the percentage of telogen follicle was found as 43%, 57%, and 71% on day 3, 5, and 7, respectively of the Biofield Energy Treated test item group compared to the day 1. The overall results demonstrated that the Biofield Energy Treatment has the potential for hair growth promotion as evident via increased the formation of telogen. Therefore, the Biofield Energy Healing (The Trivedi Effect®) Treatment might be useful as a hair growth promoter for various treatment of skin injuries and skin-related disorders like necrotizing fasciitis, actinic keratosis, sebaceous cysts, diaper rash, decubitus ulcer etc.  

Demonstration of the Capabilities of Transabdominal Ultrasonography in Assessment of Structures and Functional Disorders of Locally Advanced Gastric Cancer of Diverse Localization

Introduction: Ultrasound study of locally advanced gastric cancer that has spread to adjoining tissue and lymph nodes. This tumor can be associated with T2 to T4 stages of cancer. A “Locally advanced gastric cancer” is a tumor, which may be categorized as ‘resectable’ cancer when compared with M1 advanced cancer. Objective: The aim of this study was to evaluate the Capabilities of transabdominal ultrasonography in assessment of structures and functional disorders of the locally advanced gastric cancer of diverse localization Materials and Methods: A total of61 patients with locally advanced gastric cancer were analyzed of which 36 (59,0%) were males (mean age 62.7 years) and 25 (41,0%) were females (mean age 59.3 years). All patients were managed surgically and underwent preoperative X-ray, virtual gastroscopy techniques, multidetector computed tomography and transabdominal ultrasonography (USG). Histopathology results found, in 58 (95,1%) cases adenocarcinoma, in 3 (4,9%) – ring-cell carcinoma (cricoidal) gastric cancer was established. Stage T2 was diagnosed in 16 (26.2%) cases, T3 - in 41 (67.2%) cases, T4 - in 4 (6.6%) cases. The stomach tumor in 29 (47.5%) cases was localized mainly in the antrum, 27 (44.3%) – in the body, 5 (8.2%) in the cardia and fundus (Table 1). In 24 (39,3%) cases, pyloric stenos was diagnosed - of which in 6 (9,8%) it was compensated, in 18 (29,5%) - sub compensated. All patients underwent preoperative X-ray, virtual gastroscopy techniques, multidetector computed tomography and transabdominal ultrasonography (USG). Normal ultrasound features were observed in 35 patients without gastric pathology. Ultrasonography was carried out with the convex and micro convex transducers in the frequency range of 2-5 MHz and 4-7 MHz respectively in B and color Doppler modes. Results: The polypoid type of gastric cancer was detected in 3 (4,9±2,8%) cases, the ulcerative type – in 18 (29,5±5,8%), the infiltrative ulcerative type – in 27 (44,3±6,4%) and the diffuse infiltrative type – in 13 (21,3%±5,2%) cases respectively. In 24 (39,3%) cases, pyloric stenos was diagnosed - of which in 6 (9,8%) it was compensated, in 18 (29,5%) – sub compensated. The layers of the gastric wall were not differentiated in all patients with sub compensated pyloric stenos. The gastric wall thickness of the affected area was 10,2±2,9mm in the case compensated pyloric stenosis, the length was 27,1±6,2mm, the diameter of the pylorus was 8,3±0,8mm. Among patients with sub compensated pyloric stenos, the thickness of the gastric wall was 19,8±4,1mm, the length was 43,6±4,5mm, the pyloric diameter was 4,3±1,1mm. Among the 61 patients studied, pathological vascularization was detected in 42 (68.8%) cases. It was observed that, all 4 (6.5%) patients with gastric cancer were stage T4 and 38 (62.3%) were stage T3. Vascularization was weak in 13 cases, in 24 cases - moderate, and in 5 cases - enhanced. Metastases to the regional lymph nodes were diagnosed in 52 cases. Ultrasonographically, they were detected only in 37 (71.2%) cases. Conclusions: In the diagnosis of locally advanced gastric cancer, ultrasonography demonstrates good capabilities for determining the extent and depth of the affected area. Color doppler mode allows the study of vascularisation of a locally thickened area, as well as nearby enlarged lymph nodes, which is very important to ascertain the degree of malignancy of the hyperplastic process. ltrasonography can independently determine the degree of pyloric stenosis in patients with distal gastric cancer.

Assessment of Water Quality of Blue Nile River in Sudan

The objectives of this study were to quantify the fresh water quality of Blue Nile River before processing, identify the pollutants, and to determine the most polluted areas, and their impacts on living organisms as well as the surrounding environment. Thus, random water samples were collected and analyzed at the laboratory of the Ministry of Irrigation and Water Resources, Ground water and Wadis Directorates - Khartoum. The outcomes were compared with the World Health Organization standardization. The results revealed variations in the concentration of the studied elements taken from the different locations. But, the results indicated that the water quality is good, and it is within the permissible water use. However, further study is recommended to include seasonal variation as well as the biological analysis.

In Vitro Assessment of Estrogenic Potential of Biofield Energy Treatment using Human Endometrial Adenocarcinoma Cell Line

The objective of the study was to investigate the effect of Consciousness Energy Healing based DMEM medium on the level of alkaline phosphatase enzyme (ALP) activity in Ishikawa cells. The test item, DMEM medium was divided into two parts. One part of the test item received Consciousness Energy Healing Treatment by a renowned Biofield Energy Healer, Mahendra Kumar Trivedi and was labeled as the Biofield Energy Treated DMEM, while the other part did not receive any treatment, and defined as the untreated DMEM group. The cell viability using MTT assay of the Biofield Energy Treated DMEM group was observed as 108%, which indicated that the test item was safe and non-toxic. The estrogenic potential using ALP level showed a significantly increase by 73.21% in the Biofield Energy Treated DMEM group as compared to the untreated DMEM group. Overall, the experimental data suggested that the Biofield Energy Treated DMEM has significantly improved ALP level, which play a vital role for the promotion and maintenance of estrogen level. Based on the study outcomes, it is concluded that Biofield Energy Healing Treatment showed a significant improved ALP level, which can be used in various estrogenic disorders such as hypophosphatasia, osteoporosis, severe anemia, malnutrition, hypothyroidism, magnesium deficiency, heart surgery, aplastic anemia, chronic myelogenous leukemia, enteritis in children, Wilson’s disease, pernicious anemia, bacterial infection and intrauterine infection is a leading cause of pelvic inflammatory disease, subfertility, infertility, endometritis, early pregnancy loss, fetal defects, and preterm birth.

Assessment of Biofield Energy Healing Based Vitamin D3 Effects on Bone Health Parameters Using Human Osteoblast Cell Line (MG-63)

Poor bone health is the primary health issue, which leads to significant health problems, stress and worsening the patients' quality of life. The potential of The Trivedi Effect®- Biofield Energy Healing on vitamin D3 as a test item (TI) and DMEM on MG-63 cells was investigated. The test items were treated with The Trivedi Effect® by Mahendra Kumar Trivedi and divided as Biofield Energy Treated (BT) and untreated (UT) test items. An increase in ALP activity, collagen levels, and bone mineralization was considered as the biomarker for bone health. MTT data showed that the test samples observed nontoxic in the tested concentrations. The level of ALP was significantly increased by 832.9% and 209.4% in the UT-DMEM+BT-TI and BT-DMEM+UT-TI groups, respectively at 10 µg/mL, while 222.9% increase in the BT-DMEM+BT-TI at 1 µg/mL compared to the untreated group. Collagen was significantly increased by 487.7% and 544.5% in the BT-DMEM+UT-TI and BT-DMEM+BT-TI groups, respectively at 100 µg/mL, while 116.2% at 1 µg/mL in UT-DMEM+BT-TI compared to the untreated group. Moreover, the percent of bone mineralization was significantly increased in the UT-DMEM+BT-TI and BT-DMEM+UT-TI groups by 344.9% and 149.7%, respectively at 50 µg/mL, while 183.6% in the BT-DMEM+BT-TI group at 100 µg/mL compared to the untreated group. Thus, the role of Biofield Energy Treated vitamin D3 and DMEM in order to control osteoblast function and its direct effects on bone mineralization can be used to improve bone disorders.

Assessment of Energy of Consciousness Healing on Cell Growth of Plant Stem Cells Callus Culture

The present study was aimed to evaluate the effect of Consciousness Energy Healing Treatment on plant callus of Mandukparni (Centellaasiatica), Katsarika (Barleriacristata), and Amla (Phyllanthus emblica) in Murashige & Skoog liquid medium (MS) for its growth and yield on day 7. The plant callus of all the three plants were divided into two parts, one part received Biofield Energy Treatment remotely (known as The Trivedi Effect®-Energy of Consciousness Healing Treatment) by a renowned Biofield Energy Healer, Gopal Nayak and denoted as Biofield Energy Treated group, while another part did not receive any treatment and defined as control. Plants callus were observed on day 7 after treatment and visualized under phase contrast microscope for cell growth, captured photomicrographs along with wet weight compared with day 0. Results suggested that three plants viz. Mandukparni, Katsarika, and Amla callus after 7 days showed a significant improved growth rate as compared with the respective untreated groups. The weight of the callus growth (in mg) after Biofield Energy Treatment among Mandukparni, Katsarika, and Amla callus on day 7 was 630, 782, and 920 mg, respectively. However, the percentage increase in weight of the callus in Mandukparni, Katsarika and Amla was 11.1%, 52.4%, and 68.5%, respectively than untreated. Hence, results concluded a significant growth in callus weight after Biofield Energy Treatment, which suggested the action as complementary and alternate approach in order to produce most high-value phytoconstituents from plant callus that can be used for making various drugs, food flavoring and colouring agents.

Assessment of Pupils’ Knowledge and Practices Towards Prevention and Control of Tungiasis Infestation in Ugenya Sub County, Kenya

Background: Tungiasis is a parasitic tropical disease caused by female Tungapenetranswhich has remained an important public health problem and it affects resource-poor communities causing different health disabilities hence the need for behavior change. Main objective of the study was to determine factors influencing prevention and control of tungiasis infestation among school age children in Ugenya Sub County, Kenya. Methods: A descriptive cross sectional design and utilizing quantitative data collection method. Simple random sampling technique was applied to select the participants. Quantitative data was collected through a pretested structured questionnaire. The data was keyed-into excel and analyzed using SPSS version 23. Results: Study findings indicate that majority of the pupils infested with tungiasis were in classes 5 – 6 at 191(49%). Male participants were 200 (51%), while 185(49%) were female. Gender of pupils (χ2=4.383a, df=1, P<0.005) and household head occupation (χ2=44.729, df = 28, P<0.005) had a statistical significance with tungiasis infestation. Further significance was noted between participants who had ever heard of jiggers (χ2=6.361, df=1, P<0.005), Knowledge on important causes of jiggers (χ2=36.482, df = 9, P<0.005), mode of disease transmission (χ2=17.215, df = 5, P<0.005), signs and symptoms (χ2=4.088, df = 1, P<0.005), seriousness of jiggers in the area (χ2=13.175, df = 1, P<0.005) as well as pupil’s wearing of shoes (χ2=3.934, df = 1, P<0.005) and tungiasis infestation. Conclusions: Study concludes that tungiasis is still a big problem in rural settings and knowledge on tungiasis infestation does not translate to prevention and control in the areas. More emphasis should be given to improving practices touching on personal hygiene and health education to increase awareness both at school and in the households.

Quantitative Microbiological Risk Assessment: Underrated Tool in Process Improvement in Food Microbiology

This article advocates for routine use of quantitative microbiological risk assessment to strengthen process control. It illustrates how modeling hazard levels and uncertainty informs critical limits, verification, and continuous improvement.

Assessment of Cardiac Function and Prevalence of Sleep Disordered Breathing using Ambulatory Monitoring with Acoustic Cardiography – Initial Results from SWICOS

The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.

Implementing a Cold-Chain System for Nutritional Assessment in Rural Uganda; Field Experiences from FtF Nutrition Innovation Lab Cohort Study

Objective: To elaborate on the procedures undertaken to establish blood draws and cold chain for nutrition assessments. Setting: A total of 5,044 birth cohort households were enrolled and assessed using household questionnaires, anthropometry, and blood sampling to assess nutritional issues and exposures to environmental contaminants. The challenge was to obtain, transport, process, store, and analyze tens of thousands of serum samples obtained in sites that were often difficult to reach. Approach:  Before enrollment began, 24 healthcare facilities in the North and Southwest of Uganda were assessed for suitability as local nodes for processing and storage. Equipment needs included functional centrifuges, refrigeration, ice machines, and -20oC freezers. Other important physical infrastructure included the presence of backup power (generator or solar generated) in the event of electricity failure. Once samples were obtained, they were transported within 5 hours to the facility laboratories, where serum was separated and aliquoted into properly labelled storage tubes and then frozen. Relevant Changes: At community level, our team visited households or small group of household members close to their homes to reduce on travel time hence contributed to high retention rates. Our immediate testing for anemia and malaria results benefited enrollees and enhanced community acceptance. By using Village Health Teams (VHTs), we could accommodate household preferences for the timing of sample collection. Our engagement with phlebotomists transformed their role from a simple service into active team members. Lessons Learned: Our first lesson was that in our setting, the success of this nutrition biological sampling system required community engagement and acceptance. By combining an immediately actionable set of tests (for anemia and malaria), and visiting cohort households, we greatly enhanced the success of the system.

Assessment of Knowledge, Attitudes and Practice on Prevention of Sparganosis Infection among Inhabitants of Babati District, Tanzania

The knowledge,attitudes, and practice among inhabitants of Babati district in Tanzania on sparganosis were evaluated. A cross-sectional study was carried out among 160 participants from the district. Demographic and socioeconomic information of the participants and their KAP on sparganosis was collected by using a pre-tested questionnaire. All 160(100%) participants had no knowledge about sparganosis. Regarding attitude of participants to keeping dogs and cats; all 160 (100%) participants were not aware of dangers associated with dogs and cats to transmission of sparganosis. 39 (30.0%) of the participants had knowledge of drinking boiled water. There is a need to organise health education programme about sparganosis to increase community knowledge.

Evaluation of an External Quality Assessment Program for HIV Testing in Tigray North Ethiopia 2016

Background: Point-of-care diagnostic tests (POCTs) are increasingly used in both developing and developed countries. They allow same day testing and treatment at remote locations where no laboratory support is available. Quality control measures, which are routinely used in laboratories, have not been widely implemented for POCTs. This aimed to assess the integrity of the entire laboratory testing process, and aims to educate and improve performance in quality of HIV rapid testing. Methods: A health facility based cross section study was conducted from April to June 2016.Randomly selected health facilities were participated in the external quality assessment. Onsite evaluation and panel test were used to collect data using structured checklists and formats. Data was entered and analyzed using SPSS version 16. Results: Between April to June 2016, a total of 60 health facilities (145 testing points) from governmental health facilities (hospitals and health centers) were participated in the study. Among the participated testing points 41% have no designated area, 40% have no clean water for hand washing and 51% have no national test algorithm. The average performance of testing points was varies from 89.6% to 99.1% (Laboratory 99.1%, ANC 90.4%, TB clinic 91.4% and VCT 89.6%). In a multivariable logistic regression model, didn’t follow national testing algorithm to report client test results have statistical significance. Conclusions: High quality test results underpin accurate diagnosis and appropriate treatment for patients. But in the study area the score of proficiency testing result and coverage of training is slightly low comparing to other findings. Therefore following national testing algorithm to report client test results, training and monitoring are critical points to improve the proficiency testing score of testing points.

Assessment of the Preferred Methods Used by Mothers to Prevent Malaria Infection among Children Under Five Years in the Hohoe Municipality Of Ghana

Background: The use of Long Lasting Insecticide Nets (LLINs) is seen as a major public health intervention and has shown to have both direct and indirect effects on the dynamics of malaria transmission. This report assessed the methods used by mothers to prevent malaria infection among their children under five years in the Hohoe Municipality. Method: A cross-sectional survey carried out in February 2017 among 418 mothers with children under five. Data were collected in the form of interviews using questionnaires on the usage of LLIN alone, LLIN with other methods (LLIN+) and use of other methods only (OMs). Chi square test and multinomial logistic regression were used to determine the association between dependent and independent variables. Results: Of the 418 mothers, 28.5% used LLIN only, 50.7% used LLIN+ and 20.8% used OMs only to prevent malaria. Mothers aged 30-39 and 40-49 years were 3.87 and 5.55 times more likely to use LLIN only rather than OMs as compared to those aged less than 20 years (AOR=3.87, p=0.019) and (AOR=5.55, p=0.029) respectively. Similarly, mothers aged 30-39 and 40-49 years were 3.08 and 4.02 times more likely to use LLIN+ rather than OMs as compared to those aged less than 20 years (AOR=3.08, p=0.023) and (AOR=4.02, p=0.050) respectively. Mothers who attained a higher level of education were 2.08 times more likely to use LLIN+ rather than OMs as compared to those with no formal education (AOR=2.08, p=0.015). Those who resided in rural areas were 2.00 times more likely to use LLIN only and LLIN+ rather than OMs only as compared to urban dwellers (AOR=2.00, p=0.002) and (AOR=2.00, p=0.013) respectively. Conclusion: More than half of the mothers preferred using LLIN+. One out of 3 mothers used only LLIN while one out of 5 used OMs only to prevent malaria. Age, educational level and place of residence were significantly associated with methods used to prevent malaria. There is the need for targeted education on LLINs in order to improve usage among younger mothers and mothers residing in urban areas. Further investigations to determine reasons for using OMs only and also determine the added value of OMs to LLINs in preventing malaria are recommended.

Assessment of the Immune Response Induced in Neonatal Calves by Vaccination with Mycobacterium Bovis BCG Phipps Under Field Conditions

Immunization of cattle with the bacillus Calmette-Guérin (BCG) vaccine, especially neonates, induces protection against Mycobacterium bovis (M. bovis) and has been proposed as a strategy for bovine tuberculosis (bTB) control. Therefore, the aim of this study was to evaluate the immune response induced under field conditions in neonatal calves vaccinated with BCG Phipps, a strain that has rarely been evaluated in the bovine population, using interferon (IFN)-γ and tuberculin tests, flow cytometry and enzyme-linked immunosorbent assay. Two groups (vaccinated and control) of 5 calves were monitored for 12 weeks, and increases in the in vitro IFN-γ production, the percentage of cluster of differentiation (CD)8+ T cells and the activation levels of CD4+ and CD8+ T cells were observed 3 to 4 weeks post-vaccination. Bovine purified protein derivative-specific IFN-γ production was increased about 4.8- and 5.5-fold in vaccinated animals compared to non-vaccinated animals 3 and 4 weeks post-vaccination respectively. CD8+ T cells of the vaccinated group were increased 1.6-, 1.5- and 1.6-fold at weeks 2, 3 and 4 respectively. Levels of activation were 1.7- and 1.9-fold higher for CD4+ T cells and 2.3- and 1.8-fold higher for CD8+ T cells in the vaccinated group at weeks 3 and 4 respectively in response to M. bovis antigens. However, no animals (vaccinated or control) showed positive results for the single intradermal comparative tuberculin test (SICTT). Therefore, our results indicate that vaccination with M. bovis BCG Phipps strain stimulated peripheral blood T cell activity and induced a cell-mediated immune response. In addition, vaccination did not interfere with the SICTT, as previously reported, which indicates that this vaccine could be successfully applied in bTB control campaigns.

The Assessment of Alchornea Cordifolia Activity in Aflatoxicosis Reduction in Rat.

Introduction: Aflatoxins are cytotoxic andserve as one of the key risk factors of hepatocellular carcinoma. Currently, plants and extract are widely used as potential scavenging substances for the detoxification of mycotoxins. Thus, this study aims to investigate the activity of the crude ethanolic leaves extract from Alchorneacordifolia in aflatoxicosis prevention. Material and Methods: The phytochemical screening was performed through qualitative analysis based on coloring and/or precipitation reactions. Groups of rats were treated daily with a mixture dose of aflatoxin B1 (AFB1) at 150 µg/kg and the crude extract of Alchorneacordifolia at doses of 50, 100, and 300 mg/kg for 21 days. The body weight, biochemical, and histological assessments were determined. Results: The phytochemical screening revealed the presence of polyphenols, flavonoids, sterols and terpenoids, quinoid compounds, tannins catechic and alkaloids. AFB1 treatmentcaused a significant increase of transaminases, urea, and creatinine abundances but reduced the rates of albumin and total proteins. Alchorneacordifolia administration alleviated biochemical parameters and body weight gain compared with the AFB1 group (p<0.05). The histological lesions of organs (liver and kidney) caused by AFB1 were significantly improved after administration of the extract at a dose of 300 mg/kg. Conclusion: This plant plays a beneficial role in AFB1-induced injury and may be used in the treatment of aflatoxicosis.

Can Poor Hydration Amongst Older Hospitalized People be Identified by Single Point Total Body Water Assessment? – A Pilot Study

Dehydration in acute care is associated with increased morbidity and mortality. However, no standard approach to hydration assessment exists in clinical settings. The pilot study aimed to explore total body water content as means for immediately assessing hydration status in clinical settings. People aged 60 years or more, voluntarily admitted to a tertiary teaching hospital’s Geriatric and Rehabilitation Unit were eligible for participation. Total body water assessment by tracer dilution was compared with standard clinical assessment of hydration status. The study participants (78.6±8.5 years, 6/14, 43% male) clinically assessed with poor hydration (3/14) had a higher percentage of body weight as water (59.0±2.3 vs 50.6±6.4%), and lower mean weight (54.1±12.9 vs 77.5±24.1 kg) and lower body mass index (20.0±3.7 vs 30.2±6.5 kg/m2) than the well-hydrated (11/14). Weight (n=14) and body mass index (n=11) explained a substantial proportion of variation in total litres of body weight as water (r=0.92, R2=0.85; r=0.80, R2= 0.64) and percentage of body weight at water (r=0.6, R2= 0.36; r=0.72, R2= 0.52) respectively. This pilot study revealed higher percentages of body weight as water amongst those clinically assessed with poorer hydration. Future regression analysis of total body water and hydration needs to adjust for the potential confounding effect of weight and body mass index. Implications for practice from this preliminary study indicate that findings did not support single point measurements of either total body water or percentage of body weight as water as potentially simple methods for clinically assessing hydration status amongst older hospitalised people.

Performance Assessment of Some Operational Aspects of Revised National Tuberculosis Control Programme in Tuberculosis Unit, Nagpur, India

Background : DOTS is the current international strategy for tuberculosis control endorsed by the World Health Organization and the International Union against Tuberculosis and Lung Diseases. Maharashtra achieved full coverage under RNTCP in October 2003. The programme was launched in Nagpur in the last quarter of 2002. Three years after its launch, it is the ideal time to assess the performance of programme to identify the operational challenges. Methods: This is a cross sectional study carried out in 'Sadar Tuberculosis Unit' of Nagpur Municipal Corporation with the objective to study performance of some aspects of RNTCP. Programme performance was explored through laboratory records review and non participant observations of all four designated microscopy centres. DOT centres were observed for accessibility, identifiability and the facilities provided to patients visiting for treatment. Performance of some operational aspects of RNTCP was assessed using standards, norms, procedures etc described in programme guidelines. Results: It was observed that the TB unit was manned with RNTCP- trained supervisory team. Three of four microscopy centres were established in multispecialty health facilities. Adequate space for sputum microscopy was available at two centres. Laboratory technician was available at three centres. Separate tables for smearing and staining were available at three centres. Sink, staining racks, spirit lamp, binocular microscope and drugs in patient - wise boxes were available in all four centres. Laboratory registers were completely and correctly filled in all centres. No false positive or false negative error was found in rereading of AFB smears. Conclusions: It is concluded that the performance of the programme at the unit is satisfactory. Still some aspects of the programme components need to be strengthened at microscopy centres for better performance of RNTCP.

Synthesis and Assessment of a New Tetrahydrogeraniol Derivative as Penetration Enhancer for Transdermal Drug Delivery

Background: Skin is one the most important sites for administration of drugs to obtain desired pharmacological effects either locally or through systemic bioavailability; and this has placed the transdermal route of drug delivery as an attractive and as one of the most innovative areas for conducting drug delivery research. However the stratum corneum in skin creates hurdles and acts as significant barrier for the permeation of drugs through skin. Penetration enhancers play a pivotal role to overcome such barriers and help enhance the permeation of drug through skin. However, penetration enhancement technology is challenging development and needs to be properly and skillfully addressed. Objective: The present investigation aimed to study the penetration enhancing effect of a newly synthesized alcohol derivative of an acyclic monoterpene (Tetrahydrogeraniol-THG). Methodology: The new derivative, 5,9-Dimethyl-1-Decanol (DIMDOL), has been synthesized by a chemical reaction of the THG with Grignard reagent and ethylene oxide. Permeation enhancing effect of the synthesized derivative was explored for better transdermal penetration of the two model drugs viz. tramadol hydrochloride and 5-fluorouracil (5-FU) through the excised rat skin by conducting in-vitro permeation experiments employing Franz diffusion cells apparatus. The standard enhancers Azone and THG were used to compare penetration enhancing effect of the enhancers. Results: It was revealed that DIMDOL could effectively enhance the permeability of both the drugs by 18.60 and 73.19 folds across the skin used with a lag time of 3.35 and 1.20 h, respectively. The newly synthesized derivative was found to significantly increase the partition coefficient and diffusion coefficient values. Conclusion: The results obtained suggest that DIMDOL can more effectively enhance the permeation of these model drugs, expectedly by affecting the stratum corneum and interacting with both lipid-rich layers and keratin-rich layers of the excised rat skin.

Hand Grip Strength as A Potential Nutritional Assessment Tool in Long-Term Care Homes

Loss of muscle mass and functionality leads to increased risk for falls and onset of frailty, especially residents of long term care (LTC) homes. Hand grip strength (HGS) is emerging as a promising tool to measure muscle strength and a proxy for functionality. Given its promise as a screening tool, several studies report cut-offs below which measured strength was predictive of risk of poor mobility in older subjects. A scoping review was conducted to examine whether HGS was currently being used in LTC, as studies demonstrate hand grip strength as positively correlated with activities of daily living, implying increased dependence on caregivers including mealtimes. Of 19 published studies in 2015, only two report HGS use. As there is an association of grip strength with nutrition-related outcomes, hand grip strength should be used as part of nutritional assessment by dietitians in LTC, as poor muscle strength adversely affects activities of daily living that may impact intake.

Bedside Lung Ultrasound in the Assessment of Volume Status in Chronic Hemodialysis Patients

Introduction: Sonographic B-lines, also known as lung comets, have been shown to correlate with the presence of extravascular lung water. The aim of this study is to assess if chest ultrasound could detect lung water imbibition and its variations induced by dialysis, an experimental model of controlled rapid fluid loss. Methods: A cross-sectional study was conducted in a hemodialysis center in the city of Fez. Lung ultrasounds, impedance measurement, and ultrasound of the inferior vena cava were achieved 30-60 minutes before and after the hemodialysis session. Results: The values, measured by the different techniques used, decrease significantly after hemodialysis (p <0.001). The values studied before and after the hemodialysis, had shown a significant correlation between the results of the impedance measurement, lung ultrasound, and the maximum and minimum of the VCI index diameter and its collapsibility. The decrease in B-lines was correlated with weight decrease during dialysis (p0.005); none of the parameters concerning the IVC were correlated with fluid removal. Conclusion: ultrasound performed at the bedside is now emerging as a reliable, easy-to-apply, and safe method for measuring both lung water and intravascular overload and their decrease after dialysis even on asymptomatic patients. These observations strongly support the use of lung ultrasound in estimating volume overload and monitoring the response to therapy in hemodialysis patients.

Exploring the use of an iPhone App: A Novel Approach to Dietary Assessment

Recent advancements in smartphone technology have provided new methods of dietary assessment. An iTunes application (app) called Meal Snap lets users take pictures of the meal they eat, and then estimates the calories of the food items eaten. We conducted a pilot study to explore the user-friendliness and calorie estimation functions of the Meal Snap app. Two female nutrition graduate students pilot-tested the Meal Snap app. Using the app, each student took pictures of foods and drinks consumed daily for two weeks. The data were analyzed using the Nutritionist ProTM software, version 4.4.0. The mean daily caloric intake obtained from the Meal Snap was then compared with that of Nutritionist ProTM. Paired samples t-tests and correlations were carried out using SPSS, version 19.Results indicated there was no significant difference in mean daily caloric consumption between Meal Snap and Nutritionist ProTM (p= 0.706). Additionally, there was a significant correlation between Meal Snap and Nutritionist ProTM calorie counts (Spearman r= 0.625, p< 0.001). It took about 35 minutes per week (or 5 minutes/day) to snap pictures and edit descriptions, whereas entering data for calorie analysis with Nutritionist ProTM took about 85-90 minutes per week (about 13 minutes/day).Findings suggest that Meal Snap may be a user-friendly tool to estimate dietary intake. Future research should include a larger sample and people of diverse ethnic backgrounds, dietary habits and age groups.

What Do Primary Care Prediabetes Patients Need? A Baseline Assessment of Patients Engaging in A Technology-Enhanced Lifestyle Intervention.

Objective: This study assessed the baseline knowledge, perceptions, attitudes and behaviors of prediabetes patients in order to tailor a new technology-enhanced primary care-based lifestyle modification intervention. Methods: Patients with a diagnosis of prediabetes were enrolled in a randomized, controlled pilot study, Avoiding Diabetes Thru Action Plan Targeting (ADAPT), a technology-based intervention to promote action plan discussions around patient-selected behavior change goals. Results: A total of 54 adults (82% female) were enrolled in the pilot study. Most (89%) had comorbid conditions and mean BMI was 36. Participants exhibited significant levels of diabetes risk knowledge and diabetes risk perception, as well as high levels of willingness to make changes to decrease diabetes risk. Number of daily steps was inversely correlated with perceived physical activity (r=-0.35082, p<0.001). Poorer scores on diet quality were inversely correlated with BMI. Conclusion: Participants in this sample demonstrated requisite levels of knowledge, self-efficacy, motivation and risk perception for effective behavior change. These data suggest that primary care-based prediabetes interventions can move beyond educational goals and focus on enhancing patients’ ability to select, plan and enact action plans.  

From Pelvis to Foot: A Functional Approach to Preventing Ankle Sprains in Athletes

Background Ankle sprains are among the most common injuries in sports, often characterized by high recurrence rates despite appropriate local treatment. Traditional approaches primarily focus on the injured joint, with limited attention to proximal biomechanical factors that may predispose athletes to injury. Objective To propose a functional, longitudinal kinetic chain model in which sacroiliac joint dysfunction may act as a predisposing factor for ankle sprain/strain injuries in athletes. Methods This paper presents a clinical hypothesis based on biomechanical reasoning and observational findings. The proposed model describes how sacroiliac joint dysfunction, particularly posterior innominate rotation (PI), may lead to pelvic obliquity and functional leg length discrepancy. These changes may induce compensatory femoral external rotation and foot toe-out, altering ground contact mechanics during gait and running. Results (Hypothesis) The altered alignment and loading pattern may increase the vertical impact force and modify the ground reaction vector on the functionally shorter limb, resulting in reduced mechanical stability at the ankle during heel strike or foot contact. Over time, this may increase susceptibility to inversion or eversion injuries, manifesting clinically as recurrent sprain/strain. Conclusion Ankle sprains in athletes may, in some cases, represent the distal expression of a proximal biomechanical imbalance. Incorporating assessment of the sacroiliac joint and the longitudinal kinetic chain into routine clinical evaluation may improve injury risk identification and contribute to more effective prevention strategies. Further research is needed to investigate this proposed relationship.

Intravascular Laser Irradiation of Blood (ILIB) on Sleep Quality Improvement: A Randomized Placebo-Controlled Clinical Trial

Introduction Sleep quality is a fundamental determinant of human health and well-being. Modified Intravascular Laser Irradiation of Blood (ILIB), a non-invasive therapeutic modality, has emerged as a potential intervention for sleep-related disturbances. Proposed mechanisms include reduced blood viscosity and platelet aggregation, activation of superoxide dismutase, increased oxygen bioavailability, enhanced microcirculation, elevated serotonin levels, and decreased cortisol concentrations—physiological processes intricately involved in sleep regulation, mood modulation, and the stress response. Objective To evaluate the effects of Modified Intravascular Laser Irradiation of Blood (ILIB) on sleep quality in individuals with self-reported sleep disturbances. Methods A randomized, placebo-controlled clinical trial was conducted with participants who reported poor sleep quality. Subjects were randomly assigned to one of two groups: the intervention group received ILIB using a 660 nm red laser, while the control group received a placebo treatment (light emission with sub-therapeutic power, <1 mW). Both groups underwent the same treatment schedule. Sleep quality was assessed at baseline and after six treatment sessions using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Results Participants in the ILIB group showed statistically significant improvements in the primary outcome of global sleep quality. PSQI scores decreased from 10.24 at baseline to 6.47 post-treatment. ESS scores showed a non-significant change from 10.44 to 10.12. These results suggest enhanced overall sleep quality and reduced sleep latency, although the observed reduction in daytime sleepiness did not reach statistical significance. Conclusion Modified Intravascular Laser Irradiation of Blood appears to be a promising non-invasive approach for improving sleep quality. The clinical outcomes observed are comparable to those reported in both pharmacological and behavioral sleep interventions, particularly in terms of PSQI improvements. These preliminary findings support the need for further research to clarifyunderlying mechanisms, optimize treatment parameters (e.g., dosimetry and duration), and expand outcome assessments to include biomarkers and polysomnographic data.

Strengthening TB Infection Control and Its Impact on TB Screening Practices Among Healthcare Workers During The COVID-19 Pandemic in Zimbabwe

Introduction The risk of exposure to M. tuberculosis among healthcare workers (HCW) remains a public health concern worldwide. During the COVID-19 pandemic, the Biomedical Research and Training Institute supported the Zimbabwe Ministry of Health and Child Care in strengthening infection prevention and control (IPC) practices in healthcare facilities (HCF), integrating tuberculosis (TB) infection control (TBIC) into the intervention strategy. We describe the impact of this intervention on TBIC practices and HCW screening outcomes. Methods The strategy, implemented from June 2021–September 2022, included IPC mentorship training, competency assessments, and use of a standardized risk assessment tool for progress monitoring. For the training purposes, the project developed eight practical problem-solving IPC modules including an occupational health component. Trained mentors conducted bi-monthly site support visits (SSV), used a checklist to track compliance, and assessed competencies of HCW at the targeted facilities. Facility-based risk assessments were conducted three times during the project implementation. Results During the intervention, 1,865 HCW from 105 facilities were trained. Availability and use of personal protective equipment improved by 49% and 42%, respectively. The proportion of HCF with designated areas for sputum collection increased by 43%. The proportion of HCF that screened HCW for TB increased by 42% with 3,761 HCW screened during the project period. Fourteen were diagnosed with TB and referred for care, resulting in 372 new cases per 100,000. Conclusion The implemented strategy of training, mentorship, and regular SSV strengthened TBIC measures, improved TB screening practices and case finding among HCW. Improving and maintaining practices is critical for effective TBIC.

Evaluation of Combined Ultrasonography and Cone Beam Computed Tomography for Clinical Imaging: A Negative Results Study

The combination of ultrasonography (US) and cone beam computed tomography (CBCT) has been proposed as a multimodal imaging strategy capable of uniting realtime softtissue assessment with highresolution threedimensional visualization of osseous structures. This study critically evaluated whether such integration provides measurable diagnostic or workflow advantages in mandibular imaging. Despite strong theoretical justification, the combined use of US and CBCT failed to demonstrate clinically meaningful improvements in diagnostic accuracy, confidence, or efficiency when compared with CBCT alone. Fundamental physical mismatches, hardware incompatibilities, geometric constraints, and operatordependent variability limited the anticipated synergistic benefits. These negative findings underscore the importance of reporting unsuccessful integration attempts to guide future research and prevent premature clinical adoption of technically incompatible imaging paradigms.

Assessing The Nutritional Status and Health Outcomes of Women and Children in Rajshahi, Bangladesh: A Comprehensive Study

Background Malnutrition is a significant public health issue in Bangladesh, particularly impacting women and children. Rajshahi, marked by socio-economic disparities, offers a distinctive context to explore the nutritional status and health outcomes of these vulnerable groups. Objectives This study aims to assess the nutritional status of women and children in Rajshahi and investigate associated health outcomes. Additionally, it seeks to identify socio-economic and cultural factors that influence nutrition. Methods A mixed-methods approach was utilized, incorporating a cross-sectional survey of 460 households and in-depth interviews with mothers and caregivers. Anthropometric measurements were taken to evaluate the nutritional status of women and children, while dietary assessments measured nutrient intake and diversity. Logistic regression analysis was performed to determine the likelihood of malnutrition based on socio-economic characteristics, thereby identifying key risk factors. Results The findings indicate a troubling prevalence of malnutrition, with 36% of children under five classified as stunted and 25% as underweight. The analysis highlights critical factors contributing to chronic undernutrition, including maternal education, employment, and dietary diversity. Notably, mothers aged 27-37 exhibit a lower risk of undernutrition, and urban households with secure food access demonstrate better nutritional outcomes. Discussion Maternal education and employment were positively associated with better nutritional outcomes, as educated and employed mothers had higher chances of maintaining a normal BMI. Regular ANC visits (≥4 visits) were crucial for improved maternal nutrition. Household food security emerged as a significant determinant, with food-secure households showing better maternal nutritional status. Safe water access and adequate dietary diversity were also linked to improved maternal BMI. Additionally, factors such as child birth weight, exclusive breastfeeding, and childhood diarrhea significantly influenced maternal nutrition. Moreover, frequent antenatal care visits and a diverse diet are vital in mitigating undernutrition risks among children. Conclusion This study emphasizes the urgent need for targeted interventions to combat malnutrition in Rajshahi. Recommendations include implementing community-based nutrition education programs and improving access to healthcare services. By addressing the socio-economic and cultural determinants of nutrition, stakeholders can enhance health outcomes for women and children in the region, ultimately contributing to broader public health objectives in Bangladesh.

Trading on Impulse: The Role of ADHD, Impulsivity, and Gender in Financial Risk and Investment Outcomes

Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.

Call to Action: The Need for Adverse Drug Event (ADE) Standardization and Codification Through Improved ADE Definitions, Documentation and Mapping, as well as More Refined Medication Definitions

Information on adverse drug event (ADE) assessment and prevention within Electronic Health Records (EHRs) is difficult for clinicians to use and produces wide-ranging results. Challenges include inconsistent ADE and drug product definition and documentation, workflows, terminology standardization, interoperability, and clinical decision support (CDS) to inform clinical decision-making within EHRs. These factors contribute to care issues for clinicians, such as alert fatigue and provider burden for clinicians and medical errors, patient harm, and even death for patients. Clinicians play the primary role in documenting, reviewing, detecting, and preventing ADEs within EHRs. It is essential that clinicians, clinical informaticists, nursing informaticists, pharmacy informaticists, and the health informatics profession understand the current electronic ADE paradigm to advocate for improved detection and prevention of ADEs within EHRs.

A Cross Sectional Analysis of Frailty and Markers of Frailty in Young People Living with HIV/AIDS

Background Frailty is an ageing-associated state linked to poor prognostic outcomes. Chronic inflammation due to HIV-infection, AIDS-related infections. and the adverse effects of antiretroviral therapy (ART) all contribute to frailty in people living with HIV/AIDS (PLHA). Frailty has been comprehensively studied in populations comprising predominantly of Caucasian PLHA. However, there remains a dearth of such data in Indian populations, especially in younger PLHA. Methodology This cross-sectional study aimed to estimate the prevalence of frailty in PLHA (18 - 50 years) who had been on ART for 24-60 months and identify markers linked to frailty. Frailty was assessed in 152 subjects using the Fried frailty-index. Parameters measured included the mid-upper arm and calf circumferences, pain-severity (using the Brief Pain Inventory), highly-sensitivity C-reactive protein, d-dimer, and interleukin-6. Results The prevalence of frailty and pre-frailty were 6.58% and 23.02%, respectively. Reduced grip strength and self-reported exhaustion were associated with frailty (15.79% and 13.16%, respectively). Low calf-circumference and mid-upper arm circumference were not significantly associated with frailty/pre-frailty. The prevalence of pain was 21.7% and both pain severity and pain interference were significantly associated with frailty/pre-frailty. CD-4 counts at the time of assessment showed an inverse association with frailty. Elevated C-reactive protein (CRP of 0.04 associated with 0.49 probability of frailty (95% CI 0.40 – 0.59), CRP of 0.12 associated with 0.63 probability of frailty (95% CI 0.47 – 0.76)). D-dimer levels were not significantly associated with frailty /pre-frailty. Conclusion In this first-of-its-kind study on frailty in young PLHA (mean age 37 years) from the Indian sub-continent, the prevalence of frailty and pre-frailty was 6.58% and 23.02%, respectively. Multivariate analysis showed a strong association of frailty with pain severity, CD4 count at time of assessment, hs-CRP levels and duration of ART.

Effects of a Novelty Virtual Interactive Brain Atlas on Student Perception of Neuroanatomy

The instructional techniques in neuroanatomy laboratories continue to evolve to incorporate online interactive resources to improve student experience and outcomes. This study aims to design an “all in one”Virtual Interactive Brain Atlas (VIBA) that provides students with an educational resource that will improve their knowledge of neuroanatomy while in the brain lab and provide them with lab resources they can self-study and self-test. Coronal, midsagittal, whole brain, and horizontal brain slices were used to create detailed descriptions, interactive features, and quiz assessments to create VIBA. Upper level undergraduate and optometry students taking a neuroanatomy one-semester course were provided with VIBA for use during the semester. A paper survey was distributed after completing the course to determine student perception. No significant difference was indicated between the student groups regarding their self-reported understanding prior to the brain lab (p= 0.194) and after the brain lab (p= 0.308). There was a significant difference between the student populations when stating that they strongly agreed that the online brain atlas improved their understanding of neuroanatomy (p= 0.032) and that the VIBA tool was easy to navigate (p=0.048). There was a significant difference between the two student groups that strongly agreed that the online brain atlas quality was sufficient (p= 0.015). This online interactive brain atlas was created in a time-efficient manner from readily available models and was well received by experienced neuroanatomy faculty and students.

Changes in Cellular Morphology in Bronchoalveolar Lavage Fluid of Children with Mycoplasma Pneumoniae Pneumonia

Objective To study changes of cell morphology in BALF in children with Mycoplasma pneumoniae pneumonia (MPP). Methods From December 2021 to May 2022, a group of 32 children diagnosed with Acute MPP and admitted for treatment in the Pediatrics Department and PICU of the First Affiliated Hospital of Xinxiang Medical University were selected for our study. These patients underwent bronchoalveolar lavage as part of their clinical assessment. For comparison, we included a control group comprising 10 children who were not infected but had bronchial foreign bodies. We investigated the cellular composition in the bronchoalveolar lavage fluid (BALF) using Wright-Giemsa staining and microscopic evaluation, aiming to understand the relationship between shifts in cell proportions and extra-pulmonary symptoms associated with MPP. Results In this study, a total of 42 cases were enrolled, with 32 cases in the study group and 10 cases in the control group. There were no statistically significant differences in gender, age, height, weight, and BMI between the two groups (p > 0.05). The study group exhibited significantly higher levels of neutrophil percentage (GRA%), CRP, D-dimer, and LDH in blood routine tests compared to the control group (p < 0.05). Furthermore, the proportions of neutrophils (%) and macrophages (%) in BALF were significantly higher in the study group compared to the control group (p< 0.05), while the proportion of lymphocytes (%) in BALF showed no statistically significant difference between the two groups (p> 0.05). Conclusion In the acute phase of MPP in children, BALF is predominantly composed of neutrophils. A lower proportion of lymphocytes in BALF is associated with a higher incidence of extra-pulmonary manifestations and longer hospitalization duration.

Effectiveness of Integrated Teaching Among First MBBS Students

Introduction The arrangement of teaching content to relate to or unite concepts that are regularly taught in different academic courses or departments is referred to as integration of teaching. It simply refers to creating links between theoretical knowledge and actual application. Teaching the fundamental sciences in separate blocks prevents students from having the opportunity to connect and integrate their newly acquired knowledge. Objectives To evaluate the effectiveness of Integrated teaching method over traditional teaching and perception of students towards integrated method among first MBBS students Methodology The total of 62MBBS first year students are randomly divided into two groups, with 31 in each group. Group A is subjected for Conventional teaching and Group B for Integrated teaching method in the same topic. Among the 2 sessions one session is Horizontal and other is Vertical method of integrated teaching have been implemented. Finally, an evaluation test was conducted for both the groups and the mean marks obtained by the students were analyzed by using SPSS software version 17. Student’s perception towards this method was evaluated by pre-validated feedback questionnaire and analyzed. Results The mean marks (outof40) obtained by Group B (Conventional teaching) is 13.82 and by Group A (Integrated Teaching) is 31.18. So, the marks obtained by students after integrated method were found to be higher than the other group which underwent conventional teaching and this difference was found to be statistically significant (P <0.0001). Discussion and conclusion In comparison to the typical conventional method, integrated teaching has been found to be a more successful mode of instruction in terms of students' performance and assessment exams.

Evaluating the Effectiveness of Quality Improvement Strategies in Mid-Level Private Healthcare Facilities of Lagos State: A Donabedian Model-Based Approach

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.

Spirometric profile of people living with HIV on antiretroviral drugs in Abidjan

Introduction People living with HIV (PLHIV) are susceptible to developing non- communicable chronic respiratory diseases. Our objective was to study the spirometric profile of this population. Material and methods This was a descriptive and analytical cross-sectional retro-prospective study conducted from March 15 to June 15, 2022 and relating to the analysis of the medical files of asymptomatic and eligible for spirometry PLHIV, aged 18 years and above. They were received in the voluntary counselling and testing (VCT) centres of one of the two pulmonology departments in Abidjan. Results The study involved 54 subjects including 22 men (40.7%) and 32 women (59.3%) with an average age of 48.9 years. The majority of patients were non-smokers (81.4%) and the main history was pulmonary tuberculosis (35.2%). Only 29.6% had chronic respiratory symptoms and 42.6% had a normal BMI. The frequency of spirometric abnormalities was 57.4%. These spirometric abnormalities included 40.7% peripheral obstructive pattern; 9.3% restrictive pattern; 3.7% asthma and 3.7% COPD. A more than 10 years duration of HIV infection (p=0.001 OR= 0.2 (0.1 – 0.7)) and a duration of ART of at least 10 years (p=0.001 OR= 0, 2 (0.1 – 0.7)) were significantly associated with the existence of ventilatory abnormalities. Conclusion The high frequency of ventilatory anomalies in PLHIV independently of the existence of chronic respiratory signs leads us to propose spirometry in the follow-up assessment of PLHIV while paying particular attention to those on ARVs for more than 10 years.

Auricular Vagus Nerve Stimulation Improves Chronic Pain and Pain-Related Cytokine Levels: A Clinical Study

Periauricular Vagus Nerve Stimulation (pVNS) has been proven safe and effective in reducing chronic pain and related comorbidities in numerous clinical studies. This multicenter, interventional study used a non-randomized, interrupted time-series analysis to test the efficacy of an 8-week treatment protocol using the Stivax neurostimulator device. Subjects (n=33, 15 F, 18 M, age 40-77) were recruited at 3 clinic sites in California and Colorado. All subjects had long-term chronic pain and had failed other treatments. Subjects were treated with the Stivax device 3 times (2 weeks on, 1 week off). Subjective assessments of pain (Visual Analog Scale), disability (Oswestry Disability Index), depression (PHQ-9), and activity (IPAQ-E) were collected at baseline and weekly. Objective blood levels of pain-related cytokines collected at the end of weeks 2 and 8. Most subjects reported reduced pain, disability, and depression, with increased activity levels. At the end of week 8, subjects reported an average reduction in pain by 38.5% (3 subjects reported no pain), depression by 43.6% (2 subjects reported no depression), disability by 38.6% (2 subjects reported no disability), and an average 26.1% increase in activity level (5 subjects doubled their activity level). Levels of the pain-related cytokines IL-1ꞵ, IL-2, IL-3, IL-7, IL-10, IL-15, IL-17α, IL-21, TNF-α, IFN-γ, and FLT3-ligand showed improvement at week 8. pVNS is believed to “reset” central sensitization underlying chronic pain and other central sensitization syndromes, engaging the body’s pain modulation systems. Our results indicate that pVNS can clinically significantly improve chronic pain and associated morbidities without adverse effects.

Long COVID-19 Syndrome and Frailty: Cause or Consequence or Both?

Background Many older adults remain vulnerable to COVID-19 infections. They are also often at risk for frailty and poor health outcomes.  Aim This exploratory review examines the correlates of long COVID and frailty and their association insofar as the older adult’s wellbeing may be jeopardized.  Methods and procedures Articles that emerged between January 1 2022 and 2023 in major electronic data bases that addressed the current topic of interest were sought using the key words: Long COVID and Frailty. Those deemed relevant were duly downloaded, analyzed and summarized in narrative form.  Results A high proportion of older adults can be expected to remain vulnerable to COVID-19 long term impacts, plus new variants of infection, along with frailty as both an outcome and mediator. Many too are at risk for persistent long COVID-19 complications and a low life quality if more concerted preventive and rehabilitation efforts to avert frailty early on are not forthcoming in a timely manner.  Conclusion Prompt and continuing frailty assessments of older adults at risk for COVID-19 or recovering from this disease, especially those with long COVID manifestations who are frail or may become frail are strongly indicated.

Characterization of The Oncogeriatric Population Attended at the Arturo López Perez Foundation (Falp) Cancer Institute

This study characterizes an oncogeriatric cohort at a cancer institute, reporting tumor types, comorbidities, geriatric assessments, and treatment patterns. Findings inform service planning and individualized care for older adults with cancer.

Quality of Maternal & Newborns Health indicators in Western Province of 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.

Psychosomatics: Exploring the Role of the Mind-Body Connection in Causing Physical Illnesses

An overview of psychosomatic medicine explores how mind–body interactions contribute to physical illness. It reviews mechanisms, assessment approaches, and implications for integrated care.

Biological Effects of High Radiofrequency Radiation on Wistar Rats: A Literature Review

Aim and Objective Despite the growing concerns about the relationship between exposure to radiofrequency radiation (RFR) and detrimental health effects due to the changes in biological processes of experimental animals, there is still ongoing debate on the significance of these findings in causing significant public health problems with the growing advancement in internet technology. The aim of this study is to review existing literature on the effects of high RFR on wistar rats. Method A search was conducted on Google scholar and PubMed to identify relevant peer-reviewed articles to be included into the review. Studies eligible for inclusion included free full text articles on wistar rats exposed to ≥ 2.45GHz RFR conducted in the past 5 years. Studies included in this review were written or transcribed in English language. From 286 titles, 36 eligible studies were included in the review and assessed for quality using the Strengthening the Report of Observational Studies in Epidemiology – Veterinary Extension (STROBE-Vet) quality assessment tool. Results Studies included in this review generally had good quality (>60%) based on the STROBE-Vet assessment. This review identified numerous biological changes in wistar rats exposed to high RFR including variations in biochemical, cholinergic, genetic, histopathologic, psychological, optical, and dermatological parameters. In this review, studies identified variations in protein and liver enzymes while high RFR was found to induce oxidative stress and cellular damage of exposed wistar rats compared to the unexposed groups. This was seen in the changes in protein, lipids, enzymatic and non-enzymatic antioxidants. Studies also identified changes in expression of genes and neurotransmitters with imbalance in hormones. In addition, this review identified structural changes of cells, tissues and organs indicative of apoptosis, damage and death. Exposed rats were identified to have behavioral changes indicative of anxiety and memory decline while studies identified optical and dermatologic changes in exposed rats compared to the unexposed. Conclusion With numerous biological changes identified in wistar rats exposed to high RFR, there is an increasing risk of detrimental health events giving the advancement in internet technology and limited regulations to control exposures to RFR. Therefore, studies should be conducted to identify strategies to mitigate human exposure to RFR while policies are developed and enforced to protect human health.

Scrutinizing Famine Disaster Based On Rainfall Trend Investigation (A Case Study of Khorasan Razavi Province)

Rainfall is one of the most important components of the hydrological cycle. The importance of rainfall in arid and semi-arid regions is more apparent. Due to the important role of rainfall trend assessment in the proper management of water resources, in the present study, Khorasan Razavi province, the second-most populous province of Iran located in the northeast of the country, for this purpose was studied. Currently, this region is facing water shortage problems. In this study, the non-parametric Mann-Kendall method was used to evaluate the annual rainfall trend over a thirty-year period from 1989 to 2019. On the other hand, Sen's slope estimator method was used to determine the magnitude of the rainfall trend in the studied synoptic and rain gauge stations. The results showed that the root of water shortage problems is not due to drastic changes in rainfall. Therefore, water shortage problems in Khorasan Razavi province are mainly due to a lack of proper management (i.e., mismanagement). The present study, by examining the rainfall trend using an appropriate framework, tried to take an effective step towards improving the management of water resources in the northeast of Iran.

Analysis of Risk of Death due to COVID-19 in Cameroon

Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.

A Proposal of Revised Curriculum to Circumvent the Impact of COVID Restrictions on Final Year Medical Students

Medical education has been extraordinarily disrupted during the COVID-19 era worldwide. The pandemic limited routine ward or patient-based medical education. These limitations have resulted in new challenges for medical students, especially the final year students in completing their mandated curriculum. We are suggesting a revised curriculum for final year medical students, by following which we can address COVID restriction while making sure all competencies have been achieved by students. This revised curriculum centers around the usual placement of students in Surgical Assessment Unit (SAU), however all students will be posted in simulation wards/labs on their turn to enhance and consolidate their understanding and learning of common surgical cases in these wards, so that they can replicate these skills in SAU and wards on their turns. This article highlights how the proposed curriculum addresses the learning needs of final year medical students in their surgery rotation. The article will also summarize the critical appraisal process of our curriculum in the context of curriculum design theories. Finally, the article will highlight the quality assurance measures adhered to while developing the curriculum.  

Fear of Falls and Frailty: Cause or Consequence or Both?

Background Many older adults are vulnerable to becoming frail. They are also often at risk for falling and serious injuries and poor health outcomes. Aim This exploratory review examines the correlates of frailty, and fear of falling and their association insofar as older adults wellbeing may be jeopardized.   Methods and Procedures Articles extracted from major electronic data bases that addressed the current topic of interest were used. Key findings regarding the syndromes of frailty and fear of falling were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to exhibit frailty or become frail as they age. Many too are at risk for falls and fear of future falls, regardless of frailty status. A persistent fear of falls may however, heighten frailty risk or manifestations if not duly addressed in a timely manner. Conclusion Prompt comprehensive assessment of at risk older adults, as well as the frail and pre frail older adult, plus those who have fallen may avert serious injury and long term disability plus excess frailty and its deleterious impacts this syndrome has on aging older adults as well as societies.

The Use of Metabolomic Tool in Assessing Environmental Exposure

The impact of the environment on the development of non-communicable chronic diseases has gained prominence in recent years. In this context, a new chemical exposure assessment strategy is needed that is capable of revealing multiple exposures, as well as reflecting the cumulative interaction between such environmental contaminants in the biological system. From this perspective, metabolomics emerges as a promising tool in this field of knowledge, since it is able to identify changes in metabolism and/or gene expression resulting from exposure to environmental factors. The aim of this study was to describe important concepts, as well as the steps that permeate the metabolomics analysis, and also to present some relevant works with the application of metabolomics in the assessment of chemical exposure. A literature review showed a significant increase in the use of metabolomics in environmental toxicology in recent years. This increase is mainly due to advances in analytical techniques and the improvement of data processing tools. However, this field of investigation remains little explored, especially with regard to the study of toxicity associated with chronic exposure to low levels of chemical agents. Thus, it is urgent that omic biomarkers can be used as a tool for decision-making, especially with a view to protecting, diagnosing and recovering human health.

Infection Prevention and Control in Healthcare Facilities During the Covid-19 Pandemic in Ghana

Background Infection prevention and control system in healthcare facilities is essential in dealing with the spread of infectious diseases, especially during an outbreak period such as the COVID-19 pandemic. Objectives The study assessed the infection prevention and control (IPC) situation in selected healthcare facilities in the Greater Accra and Ashanti Regions of Ghana during the Covid-19 pandemic. Methods This was a multi-facility based cross-sectional study that used a monitoring tool of the Health Facilities Regulatory Agency (HeFRA) of Ghana to collect information on the IPC practices at the peak of the Covid-19 pandemic. Data was gathered from 501 healthcare facilities in the Greater Accra (335) and Ashanti (151) Regions. Descriptive, Chi-square, and multiple logistic regression were performed. All statistical analyses were considered significant at an alpha level of 0.05. Results 50.6% of health facilities were assessed as having good IPC systems in the overall assessment. The majority of the health facilities were evaluated as good on governance/leadership. Similarly, the majority (54.3 %)of the facilities had effective infectious waste management. The assessment levels of governance/leadership, management, quality assurance system, human resource, IPC equipment, and water management were all significantly associated with the adherence to good IPC systems. Conclusion IPC systems in most facilities were assessed as good, but some areas require critical attention to help prevent the spread of infections in healthcare facilities in Ghana. Support systems such as revised policy on IPC, governance/leadership, and infectious waste management infrastructure are needed to strengthen facilities with weak or poor IPC systems.

Comparative Healing Efficacy of Platelet Rich Fibrin and Zinc Oxide Nanoparticles on Critical-Sized Ulnar Bone Defects in Rabbits

Objective Evaluation of the ability of autogenous Platelet Rich Fibrin (PRF) and Zinc Oxide Nanoparticles (ZnONPs) to repair critical-sized ulnar defects in rabbits based on radiographic assessment. Design Randomized controlled study. Animals Twenty-four healthy male white New Zealand rabbits with an age of 6.0 ± 0.3 months and weight of 2.5 ± 0.29 Kg were used. Procedures A 12 mm defect was created in the diaphysis of the right ulnae in allrabbits,then the rabbits were randomly allocated into three groups (8 each): Control group, (the defect left for healing without grafts), platelets rich fibrin group (PRF group, the defect filled with PRF) and combination group (PRF/ZnONPs group, the defect filled with both PRF and ZnONPs). Healing capacity between the groups was evaluated by immediate postoperative radiographic assessment and subsequently at the first and the second postoperative months. Results Statistical analysis showed significant differences in the radiographic healing score between the groups (P = 0.000) at all-time points (P = 0.000- 0.003) during the study.  Rabbits in the combination group showed the highest radiographic healing scores followed by the PRF group meanwhile, the Control group showed minimal radiographic healing scores. Conclusion and Clinical Relevance The addition of ZnONPs to PRF can accelerate the healing of ulnar critical-size defects in rabbits.

“Happy Village” Concept Helping Villages to Face COVID-19

“Health Promoting Village” concept named as “Happy Villages” started in 2007 in Badulla District in Uva Province was a community mobilization process through which village communities have been empowered to look after their community health. The areas included were Early Childhood Care and Development (ECCD), Non-Communicable Diseases (NCD) prevention , Alcohol and drug abuse. Gender Based Violence. The programmed used many interactive tools as “Mood Chart” or “Happiness Calendar” which was giving a visualizing effect. Continuous assessments done from 2009 to 2013 showed that the Health promotion strategies used in the Happy Village concept in the Uva Province can effectively and efficiently be utilized for improvement of nutrition and achievement of milestones in children. From 2017 a National program is launched named “Happy Villages”. During the Covid 19 outbreak health promotion approaches were initiated to change in lay communities successfully. Villagers had actively engaged, collectively acted in responsible manner, and identified measures to prevent COVID-19 transmission in their households, neighbourhood and community. The use of village empowerment had become a fruitful source to face the Covid pandemic in Sri Lanka. Almost 300 “Happy Villages” around the country have made facing the Covid epidemic their chief task. Many innovative ideas and practices in facing Covid 19 pandemic at village level including a visualizing calendar to identify the risk behaviours of the family members as well as the Happiness calendar to identify the family stress levels are among them. Health promotion concept is getting rooted around the country with active participation of the villages with a multisectoral support. Continuous monitoring and evaluation and sharing best practices will show the world the effectiveness of Health Promotion and the ability of empowered people in facing pandemic situations

Antimicrobial Resistance: A Situational Analysis in the Deido Health District, Douala, Cameroon

Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.  

Anatomical Structure of the Umbilical Cord in Sudanese and Correlation with Neonatal Outcome 

Background The neonatal morbidity and mortality is very high in the Sudan, the umbilical cord association and contribution to this is planned to be answered. Therefore the present study was designed to provide some information on the morphological variations of human umbilical cord via gross anatomical assessment and their correlation with foetal factors such as foetal weight and length. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018 Results The mean diameter of the 371 umbilical cords was 2.1±0.24cm. Length was 53.8±3.8 cm length ranging from 48 – 62 cm and 10 (2.7%) of 371 umbilical cords were uncoiled. of which, 1 (0.3%) cords were with absent Wharton’s Jelly. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. There was just significant strong positive correlation between umbilical cord length and length of neonates. Also Umbilical cord diameter had a positive correlation with length of neonates and negative correlation with weight of neonates and APGAR Score. Conclusion The present study suggests that ‘normal’ cord length should be between 40 cm and 70 cm in length. Umbilical cord diameter had a positive correlation with fetal length and negative correlation with fetal weight and APGAR score. The diameter range of 1-2 cm suggests that a normal cord must not exceed 2 cm in diameter. However the umbilical cord index had negative correlation with length of neonates.

Vitamin D, Falls and Balance Capacity Impacts in Older Adults: Update

Background Falls injuries continue to contribute to numerous premature deaths as well as high disability levels, and excess morbidity rates among older adults, worldwide. But can vitamin D account for excess falls injuries among older adults? This review specifically focuses on what is known about vitamin D in the context of postural stability or balance control, both fairly consistent independent predictors of falls among older adults. Methods and Procedures Drawn largely from a review of current relevant English language peer reviewed research publications published over the last 10 years detailing the relationship between vitamin D levels and balance control among the elderly, as this relates to falls injuries, evidence for any emerging consensus on this controversial topic was sought. Used to conduct the search were various key word combinations including: falls injuries and older adults, vitamin D or vitamin D deficiency and balance or postural control. The database used predominantly to provide input into this largely descriptive assessment and narrative overview was PUBMED. Results The prevailing data show falls injuries currently constitute a widespread costly major impediment to successful aging and longevity for many older adults, despite numerous efforts to prevent this disabling set of events over the past two to three decades. However, no consistent association appears to exist between the variables of vitamin D, falls, and balance attributes in the older population-despite years of research, regardless of study approach, and a strong rationale for hypothesizing a clinically meaningful relationahip. Conclusion It is not possible to arrive at any universal recommendation concerning the value of vitamin D supplementation as regards its possible influence on balance capacity among older adults in the realm of falls prevention efforts, as has been frequently proposed. However, until more definitive research is conducted, there still appears sufficient justification for considering the screening of vulnerable aging adults for serum vitamin D levels, along with balance impairments, and intervening as required in the case of deficits in either or both of these possible falls determinants.

Vineyard Clusters Monitored by Means of Litterbag-NIRS and Foliar-NIRS Spectroscopic Methods

There is currently a lack of rapid indirect analysis methods for the assessment of the effects of soil microbiota on vine production. Fifteen clusters of two Nebbiolo and Erbaluce varieties were identified in five vineyards belonging to a cooperative of winemakers in North West Italy, according to the differences in the NDVI index, as monitored by the Crop Monitoring OES system. The vineyards were surveyed in 2019 and the experimental monitoring of 75 vines was conducted in 2020. The first indirect method (Litterbag-NIRS) involved examining hay litterbags with a smart SCiOTM device. The average litterbag-NIR spectra of the clusters, as far as the yield is concerned, were closely fitted with the measured production yield, with an R2 cross-validated value of 0.91 in the Nebbiolo vines and 0.67 in the Erbaluce vines. The results in yield were accounted for by considering a few dominant variables in both vines, namely the microbic respiration of the soil and the crude protein of the litterbag (positive), opposed to the soil NO3--N and litterbag ADF (negative). The pruning wood was also closely correlated to the litterbag spectra. A second rapid method, foliar pH coupled with the NIR spectroscopy of the leaves, was then performed. The overall results predicted from the foliar NIRS were 0.73 for yield and 0.79 for the Canopy Cover. However, the most interesting result concerned the yield regressions on the foliar pH, which were clearly negative in both vines and of a similar amount: -5.15 kg/pH in Nebbiolo (R2 0.68) and -5.63 kg/pH (R2 0.23) in Erbaluce. Litterbag-NIRS, which shows a high predictive capacity, and foliar pH - with or without foliar-NIRS - are indirect and frugal methods that can be recommended for a rational assessment of the microbial soil fertility of vineyards.

A Predictive Tobacco Control Mass Media Programming Model to Achieve Best Buys in Low –and Middle-Income Country Settings

Background Evidence based message design and efficient dissemination of messages are critical to the success of tobacco control mass media campaigns. Although evidence to measure effectiveness of messages is emerging within low -and middle-income country (LMIC) settings, evidence-based approaches for mass media message dissemination is currently lacking due to challenges in accurate assessment of gross rating points (GRPs) for efficient delivery of campaign messages. Approaches to more accurately predict optimal campaign impact are required to achieve best-buys in resource constrained settings Method A case study approach compared findings from two national tobacco control mass media campaigns implemented in Bangladesh. Stage one reviewed protocols to assess the efficacy of message designs. Second stage analysis involved a review of the mass media campaign recall findings from cross-sectional, post-intervention surveys. Last, a post assessment of GRPs for both campaigns was conducted to support the development of an algorithm to better predict campaign impact at the greatest cost-efficiencies. Results Message mean pre-test scores identified that the Baby Alive campaign scored approximately 20% lower than mean pre-test scores of messages for the Graphic Health Warning campaign. Media dissemination for the Baby Alive campaign was also relatively low at 165GRPs achieving 16.8% prompted recall while the Graphic Health Warning campaign delivered 292GRPs to achieve 47.0% prompted recall. The analytic-predictive model identified that for messages with high pre-test scores an increase of only 1.5GRPs was required to the existing media plan to potentially achieve an additional percentage point of recall. Discussion Given the weaknesses in GRP calculations in LMIC settings, analysis of multiple metrics should be considered to achieve best buys for tobacco control mass media campaigns. Based on optimal message mean pre-test scores of 90%+ and delivery of 292GRPs, which achieved 47% campaign recall, optimal recall of 70% could be predicted with a media plan delivering 342GRPs. More analytical-predictive mass media programming models need to be developed in other LMIC settings examining multiple campaign findings to confirm if this algorithm can provide better returns on investment with efforts directed toward delivering interventions that are supported by a strong evidence base.

The Additional Diagnostic Value of the Three-dimensional 3D ultrasound and Doppler angiography imaging  in the prenatal diagnosis of left isomerism

Objective To highlight the value of 3D ultrasound and Doppler angiography imagingin the prenatal assessment of left fetal isomerism. Methods A retrospective offline analysis of volume datasets of 3 fetuses with left atrial isomerism by 3D ultrasound was conducted. Conclusion We believe that parasagittal view demonstrating the heart and the abdominal vessels is easy to obtain and interpret, offer a realistic anatomic image, needs no mental reconstruction of spatial relationships and is very beneficial mainly in detecting the situs. We propose to use 3D ultrasound systematically in suspected cases of atrial isomerism, and better understand and interpret fetal anatomy.

Cephalometric Antero-Posterior Parameter Evaluation in Orthodontic Patients with Facial Asymmetries

Aesthetic and functional problems associated with significant facial asymmetry can negatively affect the patient's facial appearance, nutritional and psychosocial development. Therefore, a critical assessment and accurate treatment planning is absolutely necessary. The aim of this study was to evaluate the parameters of PA cephalometric analysis defined by Ricketts and Grummons and establish statistically relevant correlations and their importance in diagnosing orthodontic patients with varying degrees facial asymmetries. The research included facial asymmetry Romanian patients from the Department of Orthodontics and Dento-Facial Orthopedics of UMF "Victor Babes", Timisoara. The PA cephalogram investigations that met the inclusion criteria were digitally analyzed. Dental and skeletal cephalometric parameters described by Ricketts, Grummons and Kappeyne Van De Coppello were collected through linear, angular and volumetric measurements. Statistically significant correlations between the degree of asymmetry and the dimension of the internal structures were observed.Our conclusion is that PAcephalograms are cost effective and useful investigations in identifying and evaluating skeletal and dental imbalances in orthodontic facial asymmetry patients.

Use of Fluoride and Silver Ion Compounds in Three International School Based Oral Health Programs – A Case Report

Untreated dental caries in children is one of the most common diseases and largest public health problems in the world. A novel caries management program, using 50% silver nitrate, 38% silver diamine fluoride, and 5% sodium fluoride varnish, was developed at Shoreview Dental, LLC, a private dental practice in Oregon USA, and then introduced into schools in Ecuador, Ghana, and Bolivia. Cavitated carious lesions were treated with 50% silver nitrate, followed by covering with 5% sodium fluoride varnish, three times over two weeks for 165 children in Ecuador at initial assessment, 3 months, and 6 months. This protocol was repeated for 271 children in Ghana at initial assessment and 12 months. In Bolivia, 130 children were treated with 38% silver diamine fluoride, followed by covering with 5% sodium fluoride varnish, once per visit at initial assessment, 6, 12, 18, 24, 30, and 36 months. The percentage of children with active cavitated carious lesions at initial evaluation was 92.7% (Ecuador), 55.4% (Ghana), and 92.3% (Bolivia). The final arrest rate of treated surfaces was 98.8% (Ecuador), 67.6% (Ghana), and 90.2% (Bolivia). Effectiveness of cavitated caries lesion arrest is increased when it is thoroughly cleaned and dried before the treatment protocol. Further optimization is obtained when this protocol is repeated multiple times.

Impact of Low Birth Weight on Early Vascular Aging and Cardiometabolic Phenotypes in Later Life Among Cameroonian Adults

Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.

Confirming Tonality at Residences Influenced by Wind Turbines

For 5 years, since the start-up of an array of 140 wind turbines, residents have filed complaints with the Ontario Ministry of the Environment (the regulator), and K2 Wind (the operator). Residents complained that the turbines produce a tonal sound, and that the irritation this produced impacted their sleep, their health, and the enjoyment of their property. To confirm tonality from the wind turbines, this research examined over 200 data examples from two families. These families collected data by two independent methods, a continuously recording system, and by making selected audio recordings. The recorded data was correlated with the wind turbine operational performance, and local weather conditions. The correlated data was analyzed for tonality using international standard evaluation methods. The analysis confirmed over 84% correlation between complaints of irritating conditions, and tonality from 5 dB to over 20 dB. Finally, the results showed that the assumption of the regulator to only require assessment of compliance when the resident was downwind of the nearest wind turbine was incorrect. Most complaints arose from other wind directions. Neither was the regulator’s assumption correct that curtailing the wind turbine operation to continue operating at only partially reduced outputs would give remediation. The research concludes that tonality arises consistent with the wind turbine operation, identifying a critical need to revise the practices to prevent chronic irritation. In the original issuance of this paper, the author inadvertently erred by stating that there was a difference between the method for assessing wind turbine tonality of an expert group panel and the method now prescribed by regulations. That statement was incorrect, and the author apologizes for the error and for any confusion it may have caused. The error, miscalculations resulting from the error, where necessary conclusions drawn from erroneous calculations are corrected.

Organic and Symbiotic Fertilization of Tomato Plants Monitored by Litterbag-NIRS and Foliar-NIRS Rapid Spectroscopic Methods

Rapid analyses methods for the assessment of soil microbiota are lacking. In a commercial farm tomato plants were subjected to different fertilization strategies: 1. mineral Control (C); 2. Organic amendment (O); 3. Organic amendment + Micosat F © biofertilizer (OM). A first rapid method (Litterbag-NIRS) concerned hay litterbags coupled with a smart SCiOTM device. A second method (Foliar-NIRS) used the same device on the leaves. The plants showed positive responses to the amendment and biofertilization in the yield: C 60.5.1 t ha-1vs. 70.8 in O (+17%) and 74.2 in OM (+23% from C and + 5% (P 0.08) from O). The use of Litterbag-NIRS fingerprinting, completed with litterbags phenotyping and elaborated with a multivariate support vector machine classifier provided a similar knowledge to that obtained from microbial and chemical analyses of the soil. The reason for this response is that the analyses were embedded in the Litterbag-NIRS at medium-high precision. A polydromic function was hypothesized in order to disentangle the activities of different soil microbial populations from each other. The organic amendment delayed the functionality of the rapid r-strategist microbial populations, but at the same time activated slow k-strategists to intake the walls of the hay inside the litterbags. In this sense, the Litterbag-NIRS test can provide an effective “swamp” of the microbial fertility of the soil. Briefly, the Litterbag-NIRS coupled with Foliar-NIRS accounted for 95% of the average yield results, and both are therefore recommended for a rational assessment of microbial soil fertility.

Study of Hypercoagulability in Patients with Acute Leukaemia in the Hematology Department of Teaching Hospital of Yopougon (Abidjan)

Introduction Acute leukaemia are the clonal and malignant proliferation of immature hematopoietic cells (blast), blocked in their differentiation process. There is an interaction between cancer cells and the clotting process. This could be the expression of Tissue Factor (TF) on the surface of tumor cells; or a lesion of the vascular endothelium and platelet activation. The result is an activation of clotting that can lead to disseminated Intravascular Coagulation (DIC). The objective of this study was to assess the risk of DIC occurring in patients with acute leukaemia. Methods This was a cross-sectional study for analytical purposes that took place on 40 frozen samples from the biobank of the haematology laboratory of Teaching Hospital Yopougon for which the diagnosis of acute leukaemia had been taken from myelogram. The myelogram results were accompanied by hemogram data. PTTa, QT, fibrinogen and D-Dimers were performed on these samples. The risk assessment of DIC occurred was determined on the recommendations of the International Society of Thrombosis and Hemostasis (ISTH). Results We noted a female predominance with a Sex Ratio (M / F) of 0.90. The average age of the patients was 38 years (± 23 years) with extremes ranging from 2 to 84 years. ALL represented 20 % of cases against 80 % for AMLs. Hemogram parameters were characterized by severe anaemia (Tx Hb < 6 g / dL) in 52.5 % of cases; hyperleukocytosis > 100.103 / mm3 in 35 % of cases; thrombocytopenia < 25.103 / mm3 in 40 % of case; and significant blood and spinal cord blastosis (> 80 %). The lengthening of the PTTa was observed in 50 % of cases, compared to 40% for the QT. Similarly, hyperfibrinemia was present in 65% of cases. D-Dimers were high in almost all subject (95 % of cases). According to the ISTH criteria, 17.5 % of subjects were at risk of developing a DIC. Conclusion The risk of occurrence of DIC is indeed present during acute leukaemia. The parameters of haemostasis are thus found to be crucial data in the follow-up assessment during the diagnosis of acute leukaemia.