Health Sciences

Background: Obesity is one of the most prevalent health issues impacting kids and teens in both industrialized and developing countries, yet  it is a complex illness brought on by both inherited and environmental factors, Obesity develops as a result of a combination of low energy expenditure (such as exercise) and excessive calorie intake. Obesity-related problems such hypertension, metabolic disease, cardiovascular disease, and kidney disease are linked by Ang II and electrolytes. This study was designed to evaluate the alteration of Angiotensin II, electrolytes, Vit D in obese individuals. Methods: 88 persons with ages range between (20-55) years. Angiotensin II was determined by ELISA method. While serum Electrolytes estimated by GE300 Electrolyte analyzer, and Vitamin D determined by High pressure liquid chromatography (HPLC). Results: The findings of the present research reveals a significant increase in Ang II concentration (p<0.001) and decrease in Vit D (p<0.003), iCa...

To learn about the major processes in communication 2. To know the definition of language 3. To understand the processes and systems that underlie speech and language development 4. To differentiate between language form, content, and use To learn about important changes in language development that occur during four major periods of development: infancy, the preschool years, the school-age years, and adulthood This is a book about communication and the ways that it can be disrupted. Com- munication is any exchange of meaning between a sender and a receiver. This seemingly simple exchange is the primary means by which humans share their thoughts and feelings, express their identity, build relationships, pass on traditions, conduct business, teach, and learn. Some communication is intentional, as when you tell your friend about your course schedule. Some communication is unintentional, as when your friend interprets your facial expressions or your body language that indicate that you do not like your schedule. Most of the time, meaning is exchanged via a code, called language. Language is best defined as a standard set of symbols 29 CHAPTER 2

Massive open online courses (MOOCs) provide accessible and engaging information for Physical Therapy and Occupational Therapy students. The objective of this research was to determine the usefulness in improving academic performance and empathy in health sciences undergraduates, and to test a hypothetical model through structural equation analysis. This research was carried out using a descriptive and quasi-experimental design. It was conducted in a sample of 381 participants: 176 used a MOOC and 205 did not. The results of the Student’s t-test showed statistically significant differences in academic performance between the groups in favor of those students who had realized the MOOC. Participants carried out an evaluation rubric after taking MOOC. Statistically significant differences in empathy were also obtained between the pre (X = 62.06; SD = 4.41) and post (X = 73.77; SD = 9.93) tests. The hypothetical model tested via structural equation modeling was supported by the results. ...

Background. Early life factors can program future risk for cardiovascular disease. Objective. We explored associations between adolescent adiponectin levels and concomitant metabolic alteration, and also looked at the association between early life factors and adolescent adiponectin levels. Methods. We studied a longitudinal cohort of low-to middle-income Chilean adolescents who were enrolled in an infancy iron deficiency anemia preventive trial and follow-up

Developmental transcription programs are epigenetically regulated by multi-protein complexes, including the menin-and MLL-containing trithorax (TrxG) complexes, which promote gene transcription by depositing the H3K4me3 activating mark at target gene promoters. We recently reported that in Ewing sarcoma, MLL1 (lysine methyltransferase 2A, KMT2A) and menin are overexpressed and function as oncogenes. Small molecule inhibition of the menin-MLL interaction leads to loss of menin and MLL1 protein expression, and to inhibition of growth and tumorigenicity. Here, we have investigated the mechanistic basis of menin-MLL-mediated oncogenic activity in Ewing sarcoma. Bromouridine sequencing (Bru-seq) was performed to identify changes in nascent gene transcription in Ewing sarcoma cells, following exposure to the menin-MLL interaction inhibitor MI-503. Menin-MLL inhibition resulted in early and widespread reprogramming of metabolic processes. In particular, the serine biosynthetic pathway (SSP) was the pathway most significantly affected by MI-503 treatment. Baseline expression of SSP genes and proteins (PHGDH, PSAT1, and PSPH), and metabolic flux through the SSP were confirmed to be high in Ewing sarcoma. In addition, inhibition of PHGDH resulted in reduced cell proliferation, viability, and tumor growth in vivo, revealing a key dependency of Ewing sarcoma on the SSP. Loss of function studies validated a mechanistic link between menin and the SSP. Specifically, inhibition of menin resulted in diminished expression of SSP genes, reduced H3K4me3 enrichment at the PHGDH promoter, and complete abrogation of de novo serine and glycine biosynthesis, as demonstrated by metabolic tracing studies with 13 C-labeled glucose. These data demonstrate that the SSP is highly active in Ewing sarcoma and that its oncogenic activation is maintained, at least in part, by menin-dependent epigenetic mechanisms involving trithorax complexes.

Ovarian cancer, the second most common gynecological malignancy, accounts for 3% of all cancers among women in the United States, and has a high mortality rate, largely because existing therapies for widespread disease are rarely curative. Ovarian endometrioid adenocarcinoma (OEA) accounts for about 20% of the overall incidence of all ovarian cancer. We have used proteomics profiling to characterize low stage (FIGO stage 1 or 2) versus high stage (FIGO stage 3 or 4) human OEAs. In general, the low stage tumors lacked p53 mutations and had frequent CTNNB1, PTEN, and/or PIK3CA mutations. The high stage tumors had mutant p53, were usually high grade, and lacked mutations predicted to deregulate Wnt/b-catenin and PI3K/Pten/ Akt signaling. We utilized 2-D liquid-based separation/mass mapping techniques to elucidate molecular weight and pI measurements of the differentially expressed intact proteins. We generated 2-D protein mass maps to facilitate the analysis of protein expression between both the low stage and high stage tumors. These mass maps (over a pI range of 5.6-4.6) revealed that the low stage OEAs demonstrated protein over-expression at the lower pI ranges (pI 4.8-4.6) in comparison to the high stage tumors, which demonstrated protein over-expression in the higher pI ranges (pI 5.4-5.2). These data suggest that both low and high stage OEAs have characteristic pI signatures of abundant protein expression probably reflecting, at least in part, the different signaling pathway defects that characterize each group. In this study, the low stage OEAs were distinguishable from high stage tumors based upon the proteomic profiles. Interestingly, when only high-grade (grade 2 or 3) OEAs were included in the analysis, the tumors still tended to cluster according to stage, suggesting that the altered protein expression was not solely dependent upon tumor cell differentiation. Further, these protein profiles clearly distinguish OEA from other types of ovarian cancer at the protein level.

Carvalho J C, Wasco M J, Kunju L P, Thomas D G & Shah R B
(2011) Histopathology58, 169–179 Cluster analysis of immunohistochemical profiles delineates CK7, vimentin, S100A1 and C‐kit (CD117) as an optimal panel in the differential diagnosis of renal oncocytoma from its mimics Aims:  To develop an immunohistochemical strategy for distinguishing renal oncocytoma (RO) from the eosinophilic variant of chromophobe (ChRCC), and papillary (PRCC) and clear cell (CRCC) renal cell carcinoma containing eosinophilic cytoplasm in core biopsy specimens.Methods and results:  Cluster analysis was performed on immunohistochemical data from 21 RO, 16 ChRCC, 16 CRCC and 20 PRCC patients. A panel of CK7, C‐kit, S100A1 and vimentin clustered into four groups. Cluster A (94% ChRCC) expressed C‐kit and CK7 and lacked S100A1 and vimentin. Cluster B (95% RO) expressed C‐kit, S100A1, focal CK7 (single or small clusters of cells) and lacked vimentin. Cluster C comprised a mixture of PRCC and CRCC with no expr...

BACKGROUND: Leiomyosarcoma (LMS) can be categorized into uterine, retroperitoneal, nonretroperitoneal soft tissue, cutaneous, visceral, and osseous anatomic subtypes. The differential expression of smooth muscle markers, estrogen receptor (ER), progesterone receptor (PR), and Wilms tumor-1 protein (WT1) by anatomic subtype and gender was explored. METHODS: A total of 78 LMS comprised of 30 uterine and 48 nonuterine tumors were studied. Nonuterine tumors were comprised of 17 soft tissue, 16 retroperitoneal, 7 cutaneous, 5 visceral, and 3 osseous subtypes. Immunohistochemical staining intensity on tissue microarray slides was scored as 0, 1þ, or 2þ, and cluster analysis was performed on the data. RESULTS: Smooth muscle actin was the most sensitive antibody (95%), followed by muscle-specific actin (91%), calponin (88%), desmin (73%), caldesmon (66%), and myosin (64%). Caldesmon and myosin were usually coexpressed, and were highest in retroperitoneal tumors (94%). There was no discernable correlation noted between histologic differentiation and smooth muscle marker expression. ER was much more common in women, with the highest frequencies noted in female retroperitoneal (86%) and uterine (63%) tumors. Nuclear WT1 was expressed in 11% of all tumors, and was limited to ER-positive uterine and female retroperitoneal tumors. Cluster analysis segregated 4 groups, most notably 1 driven by ER and PR, with the vast majority being uterine and female retroperitoneal tumors. CONCLUSIONS: Smooth muscle markers demonstrated variable sensitivities in LMS, with a tendency for anatomic subtypes to segregate based on expression patterns of these markers. ER defined a subgroup of uterine and female retroperitoneal tumors, and WT1 was limited to such tumors, suggesting a common line of differentiation as well as potential therapeutic targets. Cancer 2009;115:4186-95.

The Trans‐Proteomic Pipeline (TPP) is a suite of software tools for the analysis of MS/MS data sets. The tools encompass most of the steps in a proteomic data analysis workflow in a single, integrated software system. Specifically, the TPP supports all steps from spectrometer output file conversion to protein‐level statistical validation, including quantification by stable isotope ratios. We describe here the full workflow of the TPP and the tools therein, along with an example on a sample data set, demonstrating that the setup and use of the tools are straightforward and well supported and do not require specialized informatic resources or knowledge.

Chronic renal allograft injury is often reflected by interstitial fibrosis (IF) and tubular atrophy (TA) without evidence of specific etiology. In most instances, IF/TA remains an irreversible disorder, representing a major cause of long-term allograft loss. As members of the protease family metzincins and functionally related genes are involved in fibrotic and sclerotic processes of the extracellular matrix (ECM), we hypothesized their deregulation in IF/TA. Gene expression and protein level analyses using allograft biopsies with and without Banff'05 classified IF/TA illustrated their deregulation. Expression profiles of these genes differentiated IF/TA from Banff'05 classified Normal biopsies in three independent microarray studies and demonstrated histological progression of IF/TA I to III. Significant upregulation of matrix metalloprotease-7 (MMP-7) and thrombospondin-2 (THBS-2) in IF/TA biopsies and sera was revealed in two independent patient sets. Furthermore, elevated THBS-2, osteopontin (SPP1) and b -catenin may play regulatory roles on MMP. Our findings further suggest that deregulated ECM remodeling and possibly epithelial to mesenchymal transition (EMT) are implicated in IF/TA of kidney transplants, and that metzincins and related genes play an important role in these processes. Profiling of these genes may be used to complement IF/TA diagnosis and to disclose IF/TA progression in kidney transplant recipients.

Background: Nurses are facing different types of job-related stress like unpredicted work shifts, patients load, and critically ill patient care. Poor mental health affects the personal life of nurses but also influences their professional life. In their personal life, it may lead to drug abuse, eating disorders, cardiovascular disease, and broken relationships. Moreover, in the professional life, anxiety and depression block communications with colleagues and patients. It affects their job performance and appropriate health service to patients. Objective: To understand the state of depression among nurses at Mayo Hospital, Lahore. Methodology: It is a cross-sectional study conducted at Mayo Hospital, Lahore. Data was collected by questionnaire based on demographic profile and Beck's depression Inventory scale among 105 participants. The data was analyzed by "Statistical Package for Social Sciences" SPSS (version 20.0). Results: Our results showed that2.8%, of nursing staff experienced extreme depression, 1.9 % experienced severe depression, 6.6% experienced moderate depression, 2.8% experienced borderline clinical depression, 22.8% experienced mild mood disturbance and 62.8% had normal mood. A significant relationship is found between education degree, marital status, sleeping status, physical exercise, weekly working hours and levels of depression. Conclusion: The frequency of depression is reasonably high among nurses. Prolonged exposure of mental conditions may emerge as a potential risk factor for the disease. This study provides information to health professionals for better understanding the distress of the nurses. Bearing in mind the results found it is obvious that just like physical health, it is important to focus the mental health of the health professionals including nurses.

We tested whether human postural responses can be described in terms of feedback control gains, and whether these gains are scaled by the central nervous system to accommodate biomechanical constraints. A feedback control model can describe postural responses for a wide range of perturbations, but biomechanical constraints-such as on the torque that can be exerted on the ground-make a single set of feedback gains inappropriate for all perturbations. To observe how postural responses change with perturbation magnitude, we applied fast, backward perturbations of magnitudes 3-15 cm to 13 healthy young volunteers (4 men, 9 women, aged 20-32 years). We used a 3-segment, sagittal-plane biomechanical model and a linear state feedback controller to reproduce the observed postural responses. Optimization was used to identify the best-fit feedback control gains for each trial. Results showed that trajectories of joint angles and joint torques were scaled with perturbation magnitude. This scaling occurred gradually, rather than abruptly changing at magnitudes where biomechanical constraints became active. Feedback gains were found to fit reasonably well with data (R 2 =0.92) and to be multivariate and heterogenic in character, meaning that the torque produced at any joint is generally a function of motions not only at the same joint, but other joints as well. Hip gains increased and ankle gains decreased nearly linearly with perturbation magnitude, in accordance with biomechanical limitations on ground reaction torque. These results indicate that postural adjustments can be described as a single feedback control scheme, with scalable heterogenic gains that are adjusted according to biomechanical constraints.

PhD by Portfolio: What is it? Who is it for? What does it look like? - how it works? How does supervision work? Benefits:  impacts of doctoral learning - in process and in product.

PhD by Portfolio at ULAN is:
Practice-based PhD created by Clive Palmer at the University of Lancashire in 2021
Born from NTFs National Teaching Fellows – sharing good practice – I copied!
PhD by Portfolio is not a new concept in the UK, but ‘my’ PhD by Portfolio (ULAN) welcomes in external applicants i.e. it is not a ‘reserved qualification’ for academic staff only. Still only approx. 6 HEIs in the UK that offer PhD by Portfolio, 2 to external applicants. (ULAN and USW)
PhD by Portfolio values reflection and philosophising about past experience as a major element of the research. i.e. It treats experience and accomplishments as ‘data’ to be critiqued and analysed.
Therefore, half of the PhD is built upon current reflection on retrospective evidence. Describe and analyse: I.e. What new things can be said and learned about what you have done in the past?
PhD by Portfolio appeals to career professionals with a lot of experience under their belt.
Typical ages of PhD by Portfolio candidates: 40s 50s 60s … up to and including Gerald in his 90s.
You are an asset to the UK Treasury who values your input to the economy by returning to education and creating IMPACT as LATE CAREER RESEARCHERS LCRs (NCUB)
Completion: 48-60 month programme, but most are finishing in 36 months (approx. 2500 p/a p/t)

Background: Human brucellosis is an infectious zoonotic disease caused by Brucella spp. It is one of the most public health problems that remains largely neglected in developing counties, including Saudi Arabia. Brucellosis is particularly prevalent among rural people who have constant contact with livestock. Methods: A cross-sectional sero-epidemiological study conducted in Aseer Central Hospital, South Saudi Arabia, between 2014 and 2018 among 7567 patients. Serum samples were analyzed for Brucella antibodies using slide agglutination test. Serology results and patient's demographic data were analyzed by GraphPad Prism. Results were presented as mean ± SEM and differences between two groups were assessed by t-test and p < 0.05 was considered significant. Results: The prevalence of brucellosis among the admitted suspected 7567 cases was 12.8% (10.4-15.7%; CI 95%). The highest prevalence rate was detected during 2015, the rate decreased to the lowest level during the last three years (p < 0.05). Higher rate of brucellosis was observed among males than females (p < 0.05) and most cases were reported during summer season (p < 0.05). The highest prevalence rate was observed in age group 21-40 year old (40.5%) followed by 41-60 years (27.7%). The lowest prevalence rate was noticed in old and young children (15 and 3%, respectively). Cross-transmission of brucellosis was seen within family (1%) and high titers (> 1280) was noticed in 22% of the hospitalized patients. The major symptoms were fatigue, hyperhidrosis, fever and joint pain. Conclusion: Our findings showed a high prevalence of human brucellosis among suspected patients in Aseer region. This indicates that clinical suspicion is a valid criterion and the endemic nature of the disease. The disease status requires early laboratory detection and confirmation to start prompt treatment to decrease patients suffering.

This study was designed to describe a modified technique for management of primary double pterygium using ipsilateral conjunctivo-limbal auto graft and to know its surgical outcome and success rate. This was an interventional study in which 35 eyes of 35 patients were included for conjunctivo-limbal autograft for primary double pterygium. Conjunctivo-limbal autograft was taken from nasal side of neck and body of pterygium to cover the temporal bared area left after excision of pterygium. The same procedure was followed for the opposite side. The patients were followed up on day 1 and after 1 week, 6 weeks, 6 months and 1 year to check for any recurrence or complications. RESULTS: Average age of patients was 56.35±10.25 while male is to female ratio was 2.5 :1, 2 (5.71%) cases had recurrence, 5 (14.28%) cases had post operative graft oedema which resolved with medication. No serious complication observed. This modified technique had 94% success rate. CONCLUSIONS: Modified technique was easy technique to manage double pterygia with less limbal stem cell dysfunction. Preservation of superior conjunctiva also needful for trabeculectomy or small incision cataract surgery. Advantages of this technique are cost effective, easy learning curve, no complications from mitomycin C (0.02%) like sclera melting, granuloma formation etc.

Objective: To know the demography and clinical profile of patients of vernal keratoconjunctivitis (VKC) presented in the out-patient department of regional institute of ophthalmology (RIO), IGIMS Patna, Bihar over a period of 1 year from May 2017 to April 2018. Materials and Methods: This was a retrospective study done on diagnosed patients of vernal keratoconjunctivitis. Out of total 25344 OPD patients, 1267patients were in age group of 1-25 years and either sex. Out of which 240 patients were included in this study had diagnosis of vernal keratoconjunctivitis (VKC) on the basis of their history, symptoms and clinical findings. Detailed history was taken from each patient including age at the onset of the disease, gender of the patient, any seasonal variations, his/her place of residence, any associated allergic or "atopic" illnesses. Thorough examination was done to find out visual acuity, condition of cornea, limbus, bulbar, palpebral conjunctiva and associated complications. Results: Out of 240 patients, VKC was more common in male (86.66%) than female (13.33%) patients with maximum cases seen between 6-10 years of age. Majority of cases reported in summer in the month of May and June. Palpebral form was predominant among all that is around 174(72.5%) cases followed by mixed 50(20.83%) and Limbal form 16 (6.66%). Most common symptom was itching (100%) seen in almost all cases. Palpebral papillae were commonest sign. Associated allergic conditions were found in 16 (6.66%) patients. Vernal keratoconjunctivitis is a recurrent bilateral disorder in which both IgE and cell mediated immunity play important roles. It primarily affects boys and onset is generally from about age of 5 years onwards and resolves around puberty. The clinical course of this disease is usually benign and self-limiting, with vision in most children remains normal but sight threatening complications may manifest if cornea gets involved. Few cases showed history of atopy and other allergic conditions. VKC is one of the leading causes of outpatient ophthalmic morbidity.

A 30-year-old woman was referred to the Acute Pain Team for their advice on how to manage her current pain, in light of her unique pre-admission medications. On questioning it was discovered that the patient was receiving 50 mg of intramuscular methadone daily, in the community. She was a former intravenous drug user who had been enrolled into a methadone substitution programme for 10 years and had been receiving her methadone intramuscularly for the past 6 years. It had been discovered that her addiction was not solely to opioids but, moreover, to the process of injecting as well. She was diagnosed with obsessive compulsive disorder, with a needle fixation, and started on the intramuscular methadone regimen on which she has maintained abstinence from heroin for 6 years.

A 30-year-old woman was referred to the Acute Pain Team for their advice on how to manage her current pain, in light of her unique pre-admission medications. On questioning it was discovered that the patient was receiving 50 mg of intramuscular methadone daily, in the community. She was a former intravenous drug user who had been enrolled into a methadone substitution programme for 10 years and had been receiving her methadone intramuscularly for the past 6 years. It had been discovered that her addiction was not solely to opioids but, moreover, to the process of injecting as well. She was diagnosed with obsessive compulsive disorder, with a needle fixation, and started on the intramuscular methadone regimen on which she has maintained abstinence from heroin for 6 years.

The experience-based knowledge of users is considered to provide vital input in shared decision making (SDM). However, mental health service users frequently express having negative experiences from meetings with providers, which are of an epistemic nature (e.g., being ignored or not regarded as credible). This study aimed to explore the barriers involved in legitimizing user knowledge in decision-making processes. Interview data from service users and providers were viewed from a theoretic framework of epistemic injustice. Abductive content analysis was conducted on data collected during a project to develop and implement SDM in mental health services. In describing obstacles to legitimize user knowledge, service users highlighted relational issues: being dependent, often dismissed and choosing to edit their testimonies. Service providers typically described workflow issues, users' insufficient decision-making competence and users' vulnerability to stress factors. The findings suggest that greater epistemic justice might be achieved by a SDM process in which the service user is engaged as a full partner in collaboration in various activities related to their care.

Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the i...

Carbon monoxide (CO) remains an insidious and silent killer due to its physical and chemical properties; its lethal effects are encountered in cases of household accidents, occupational hazards or suicide. Deaths due to CO poisoning were studied retrospectively in the period 2000-2018 at the Institute of Forensic Medicine, Timişoara, Romania. These cases represent 1.75% of all the autopsies and 0.63% of all violent deaths. There have been cases of single deaths and cases with multiple victims - concomitant deaths. The analysis of lethal CO intoxication cases that occurred in different circumstances (incomplete burning with CO accumulation, fires - associated with burns, death in the fountain - due to fossil fuel pump failure, suicide due to exhaust gases) was based on the examination of 298 autopsy files. In this type of poisoning, the forensic examination of the body is marked by the non-specific character of most of the macroscopic and microscopic changes. Although inconstant, the...

Background: Growth and development of the infants were highly influenced by their first nutrition and breast-milk. Mothers were encouraged to give exclusively breastfeeding as soon as possible after birth up to two years old. However, for working mothers it becomes a challenge for them to continue breastfeeding. Objectives: The aim of this study was to identify the factors that are affecting in termination of breastfeeding among working mothers. And also, the association between socio-demographic data, work related factors and workplace support with breastfeeding practice were examined. Materials and Methods: Self-administered questionnaires were distributed to the government hospital and health clinics in Kuantan, Pahang from March until May 2015. A total of 152 participants were included in this study involving working mothers with children aged six months up to two years old. The factors affecting termination of breastfeeding among working mothers were sociodemographic data, work...

 Elucidated, for the first time globally, the role of several pathogens in diseases of humans and animals, including Cryptococcus neoformans, Fusarium solani, Aspergillus fumigatus, Candida tropicalis, and Trichophyton verrucosum.  First to establish the prevalence of Cryptococcus neoformans in the environment of New Zealand, Nepal, and Djibouti and to report several first isolations from clinical samples in animals.

INTRODUCTION Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells which occur in the head and neck region only in 25% of cases. Primary non epithelial tumours of the thyroid gland are rare. Schwannoma of the thyroid is extremely rare. Only 19 cases have been described in English literature [1-6]. A case of schwannoma of thyroid gland which simulated a thyroid nodule is reported here. Its clinical and pathological features are discussed.

Osteoporosis is a condition that is associated with an increased susceptibility for fractures. In the past few years, several drugs have become available that can reduce the incidence of fractures in patients with osteoporosis. Since these drugs work through different cellular mechanisms, combining agents of different classes may have an additive or multiplicative effect on fracture risk reduction. Combination treatments that have been evaluated in clinical trials include bisphosphonates with estrogen, raloxifene or PTH/ bisphosphonates and PTH/ estrogen. In general, these trials have shown increases in bone mineral density over that observed with each agent alone. However, whether anti-fracture efficacy is improved, or worsened remains to be established. This article reviews the combination treatments that have been evaluated in clinical trials, with a discussion of the potential benefits and risks that those treatments entail. Integrating safety and cost issues will eventually det...

Background: The term low back ache is used for any cause which is between the ribs and the top of the leg. Work-related low back ache is originates in the conditions of work and is considered clinically to be caused by or exacerbated by the person's job. Low back ache affects the working and psychological status. Material and Method: Total 10 physiotherapists were selected from the Kanpur city in India. A self-modified questionnaire was provided to the participants. Results: Out of 10 physiotherapists, 8 were having low back ache. And among 8 participants, 5 were males and 3 were females who suffered from low back ache. The highest prevalence of low back ache was found in the age group of 29-45 years. Chi-Square test result was 0.551. Analysis by weight showed high prevalence of low back ache in weight group 44-89. Pearson chi-square test result was 0.803. Conclusion: Low back pain is the most common problem which affects both [male & female]. Low back pain is associated with weight and age of the physiotherapist. The study concluded that male and younger physiotherapists were having a high prevalence of low back ache. It also concluded that physiotherapists within low weight groups were having a high prevalence as compare to physiotherapists in high weights groups.

Rat neural lobes and isolated nerve terminals from the neurohypophysis were stimulated in the presence of different opioid agonists and antagonists. The secretion of arginine vasopressin and oxytocin and rise in cytoplasmic calcium induced by depolarization were analyzed by radioimmunoassay and the fluorescent probe fura-2, respectively. The kappa-agonists dynorphin A~t-t3) and dynorphin A~_ ~) did not affect electrically evoked release of vasopressin, although oxytocin release was slightly reduced. U-50 488, a relatively specific kappa-receptor agonist, had no effect on the amount of vasopressin or oxytocin secreted, although it significantly reduced K +-evoked changes in [Ca 2 +]i in isolated nerve endings. Two kappa-receptor antagonists, MR 2266 and diprenorphin, alone had no effect on vasopressin and oxytocin secretion from isolated nerve endings depolarized with potassium. Opioid agonists less selective for the kappa receptors, etorphin and ethylketocyclazocin, were found to inhibit the release of both vasopressin and oxytocin significantly. Naloxone, a nonselective opiate receptor antagonist, alone had no effect on vasopressin release but potentiated the electrically evoked release of oxytocin. Naloxone also could overcome the inhibitory effect of etorphin on oxytocin and vasopressin release observed after electrical stimulation of the neural lobe. A number of inconsistencies therefore exist between the effects of opioid agonists and antagonists on neuropeptide release and on the evoked changes in [Ca 2 +]i. In view of these inconsistencies and the high concentrations of opioid agonists and antagonists necessary to modify release, we conclude that it is doubtful that opioid molecules have a physiological role in controlling neurohypophysial secretion.

1. The effects of Na+ on vasopressin release and on redistribution of Ca2", Na+ and H+ in isolated rat neurohypophysial nerve endings have been studied. 2. Substituting Na+ for a non-permeant cation produced a pronounced and sustained release of vasopressin. This increase occurred in the absence of external Ca2+ and in nerve endings loaded with the Ca2+ chelator dimethyl-BAPTA (1,2-bis- (O-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid). 3. The effect of Na+ was independent of a rise in intracellular Ca2+ as judged by the measurement of [Ca2+]i using the indicator fura-2 and 45Ca2+ efflux studies. Although Na+ could release Ca2+ from internal reservoirs the small elevation in [Ca2+]i induced by Na+ could not explain the large and sustained increase in vasopressin secretion. 4. The channel blockers TTX (tetrodotoxin), D888 (desmethoxyverapamil), N144 (5-nitro-2-(phenylpropylamino)-benzoic acid) or SITS (4-acetamido-4'-isothiocy- anatostilbene-2,2'-disulphonic acid) could not prevent the Na+-dependent increase in vasopressin release. Similarly this increase was not affected by metabolic inhibitors (Ruthenium Red and KCN) nor by CCCP (carbonyl cyanide m-chlorophenyl- hydrazone), an uncoupler of oxidative phosphorylation. 5. Selectivity among monovalent cations to promote secretion was found with the largest effect on the secretory response being produced by Na+. Similarly Cl-was found to be the most potent anion studied for inducing, in the presence of Na+, an increase in neurohormone release. 6. Measuring [Na+]i by means of the Na+ indicator SBFI showed that the extent of the secretory response was correlated with the intraterminal Na+ concentration. 7. The Na+-induced, Ca2+-independent release of vasopressin occurred by exocytosis as judged (i) by the linear relationship between the amount of vasopressin secreted and that of the co-localized neurophysin and (ii) by the demonstration that the extracellular marker horseradish peroxidase was only found in endocytotic vacuoles and not in the cytoplasm of the stimulated nerve endings. 8. The Na+-dependent secretory response found on addition of extracellular Na+ was not the result of the change in internal pH as measured with the indicator BCECF and as mimicked by addition of propionic acid. MS 1412 E. L. STUENKEL AND J. J. NORDMANN 9. Addition of Na+ to digitonin-or streptolysin-O-permeabilized nerve endings in the presence or absence of Ca2+ also gave rise to an increase in vasopressin secretion. 10. It is concluded that an increase in internal Na+ per se can promote, in the absence of a rise in intracellular Ca2+, an increase in neuropeptide secretion.

Smart device-based applications (apps) are enjoying an exponential increase in productivity and usability. 1,2 Health care has fallen behind in incorporating smartphone technology in communication and education with patients. At our institution, parents receive postoperative instructions in the form of a paper pamphlet. The usefulness of disseminating postoperative information via paper instructions has not been studied. It is our hypothesis that the practice of paper instructions could be improved and that parents would prefer information relayed via a smartphone format. Methods | This study was approved by the University of Michigan institutional review board (approval IRB HUM00124899),

This study explores two key aspects of intercultural sensitivity (IS) among in-service EFL teachers in Greece. First, it investigates the extent to which participation in a Master's-level intercultural module relates to observable changes in their self-reported IS immediately following the intervention. Second, it examines how selected demographic factors (including age, teaching experience, and place of residence) relate to teachers' IS. Using a quantitative approach, Chen and Starosta's (2000) Intercultural Sensitivity Scale (ISS) was administered to 124 teachers pre-and post-module. Findings indicate no statistically significant overall change in self-reported IS scores immediately after module completion, suggesting the limited measurable impact of this specific short-term educational intervention on this complex trait. However, the study reveals significant relationships between certain demographic factors and teachers' IS levels. These results underscore the complexities of fostering intercultural sensitivity and highlight the importance of considering individual teacher characteristics in the design of professional development.

Antiretroviral therapy (ART) has revolutionized the management of Human Immunodeficiency Virus (HIV), transforming a once-fatal disease into a chronic, manageable condition. Despite these advances, hematologic toxicities associated with ART-including anemia, neutropenia, thrombocytopenia, and, in severe cases, pancytopenia-remain an often-overlooked dimension of HIV care. These adverse effects arise from a combination of direct bone marrow suppression, mitochondrial toxicity, immune-mediated destruction of blood cells, and metabolic disturbances, and they are exacerbated by coexisting infections, nutritional deficiencies, and drug interactions.Hematologic toxicities have profound implications for patient outcomes and public health. They compromise immune function, increase susceptibility to opportunistic infections, reduce adherence to ART, and elevate morbidity and mortality, particularly in resource-limited settings where laboratory monitoring and pharmacovigilance systems are inadequate. Routine hematologic assessment, nutritional interventions, and early detection of cytopenias are essential strategies to mitigate these risks.This narrative review synthesizes current evidence on the mechanisms, clinical manifestations, and public health consequences of ART-related hematologic toxicities. It also outlines evidence-based strategies to integrate hematologic monitoring into HIV programs, including strengthening laboratory capacity, promoting pharmacovigilance, implementing nutritional supplementation, and engaging communities in awareness and early reporting. Addressing hematologic complications through a comprehensive, multidisciplinary approach is critical for optimizing treatment efficacy, enhancing patient safety, and ensuring the long-term sustainability of ART programs.

Background: Termination of pregnancy (TOP) is an issue that continues to spark debate and controversy worldwide, with HCWs being at the forefront of this discussion. Understanding the perception of healthcare workers (HCWs) towards TOP and post-abortion care (PAC) is vital for reproductive healthcare and can affect the quality of care HCWs provide to patients seeking these services. Aims: This study aimed to explore the perception of HCWs in Nowshera, Khyberpakhtunkhwa (KPK), Pakistan, toward TOP and PAC from three main dimensions, including knowledge, attitude, and practice. Material and Methods: This study was conducted using a qualitative cross-sectional study from August 2022 to March 2023 using a self-administered questionnaire to collect data from a purposive sample of 40 HCWs including obstetricians and Gynaecologists (OBGYNs), and Lady Health Visitors (LHVs) in Nowshera. Results: The data were analyzed in SPSS 2022 using thematic analysis, and the results revealed three them...

Background: Menstrual hygiene refers to promotion of hygienic practices and prevention of serious health conditions such as infections of genital tract, poor pregnancy outcomes and cancers. This study was planned with an objective to determine socio-demographic associates of awareness regarding menstruation and genital hygiene among adolescent girls in rural and urban areas of Faridabad. In Faridabad, as per census 2011,total female population is 843623 and in rural, it is 172775 while in urban it is 67048. Methodology: A community based observational survey was conducted in urban and rural areas of Faridabad among 2100 adolescent girls aged 10-19 years. Data was collected using a pre-tested, semi-structured interview schedule containing items to assess socio-demographic prole like age, sex, knowledge and practices regarding menstrual hygiene etc. Data was analyzed using Statistical Package for Social Sciences software 25 version. Chi-square and sher's exact tests were used and accepted statistically signicant if P value was less than 0.05. Findings: The education status of mothers in urban areas was signicantly better than those in rural areas but there was no difference in working status (p<0.05). In both rural and urban areas, majority of study participants knew that 12-14 years is most common age for menarche. Higher number of urban girls felt comfortable in changing sanitary pads in schools as compared to rural girls (p<0.05). Conclusion: Improved knowledge and practices of menstrual hygiene, as well as a better environment in terms of facilities and services for its proper management is required.

Objectives. We examined if the accumulation of neighborhood disadvantages from adolescence to mid-adulthood were related to allostatic load, a measure of cumulative biological risk, in mid-adulthood, and explored whether this association was similar in women and men. Methods. Data were from the participants in the Northern Swedish Cohort (analytical n = 818) at ages 16, 21, 30, and 43 years in 1981, 1986, 1995, and 2008. Personal living conditions were self-reported at each wave. At age 43 years, 12 biological markers were measured to operationalize allostatic load. Registered data for all residents in the cohort participants’ neighborhoods at each wave were used to construct a cumulative measure of neighborhood disadvantage. Associations were examined in ordinary least-squares regression models. Results. We found that cumulative neighborhood disadvantage between ages 16 and 43 years was related to higher allostatic load at age 43 years after adjusting for personal living conditions...

Background: Numerous cross-sectional studies have examined neighborhood effects on health. Residential selection in adulthood has been stressed as an important cause of selection bias but has received little empirical attention, particularly its determinants from the earlier life course. The present study aims to examine whether neighborhood, family, school, health behaviors and health in adolescence are related to socioeconomic disadvantage of one's neighborhood of residence in adulthood. Methods: Based on the prospective Northern Swedish Cohort (analytical N = 971, 90.6% retention rate), information was collected at age 16 years concerning family circumstances, school adjustment, health behaviors and mental and physical health. Neighborhood register data was linked to the cohort and used to operationalize aggregated measures of neighborhood disadvantage (ND) at age 16 and 42. Data was analyzed with linear mixed models, with ND in adulthood regressed on adolescent predictors and neighborhood of residence in adolescence as the level-2 unit. Results: Neighborhood disadvantage in adulthood was clustered by neighborhood of residence in adolescence (ICC = 8.6%). The clustering was completely explained by ND in adolescence. Of the adolescent predictors, ND (b = .14 (95% credible interval = .07-.22)), final school marks (b = 2.18 (2.26-2.10)), socioeconomic disadvantage (b = .07 (.01-.14)), and, with borderline significance, school peer problems (b = .07 (2.00-.13)), were independently related to adulthood ND in the final adjusted model. In sex-stratified analyses, the most important predictors were school marks (b = 2.21 (2.32-2.09)) in women, and neighborhood of residence (ICC = 15.5%) and ND (b = .20 (.09-.31)) in men. Conclusions: These findings show that factors from adolescence -which also may impact on adult health -could influence the neighborhood context in which one will live in adulthood. This indicates that residential selection bias in neighborhood effects on health research may have its sources in early life.

To apply the continuous quality improvement model commonly associated with the business sector to entrylevel athletic training education program accreditation. We applied athletic training educational program accreditation as a tool for ensuring quality in the entrylevel athletic training education programs accredited by the Commission on the Accreditation of Allied Health Education Programs. Literature from the business, education, and athletic training fields is integrated to support this paradigm shift in athletic training education. The advent of mandated entry-level athletic training educational program accreditation has forced institutions to evaluate their educational programs. Accreditation will promote continuous quality improvement in athletic training education through mechanisms such as control measures and process improvement. Although accreditation of entry-level athletic training education programs has created some dissonance among athletic training professionals, it ...

Background: Health behaviours have direct influence to individuals’ health and remain major explanatory factors for the differences in health-related outcomes. Aim: To investigate adolescents’ hygiene behaviours, dietary behaviours and the associated dental and medical consultation. Materials and Methods: A cross-sectional survey that was carried out in twelve regions of Tanzania among school going adolescents. A structured questionnaire was used for data collection. Data processing and analysis was done using SPSS computer program version 20, whereby proportions, cross-tabulations for bivariate analysis and binary logistic regression in OR (95% CI) for multivariate were conducted. The level of significance was set at p-value ˂ 0.05. Results: 4,847 adolescents aged 11-17 years participated in the study. Slightly more than half (51%) exhibited good hygiene behaviours, 36.3% often consumed at least three sugary items, 76.2 % vegetables and 42.1% fresh fruits. Significantly larger prop...

Pleomorphic adenomas (PA) are the commonest salivary gland tumors of parotid gland. Central pleomorphic adenomas are extremely rare and so far only 7 cases have been reported in the literature; 2 in maxilla and 5 in mandible. The mean age of occurrence of central PA is 58.8, none of the case of central PA in children has been reported in the literature; hence this is the first report of central PA in a child. An 11 year old Indian boy presented with the jaw swelling from 1 year. Radiographic examination revealed a multilocular osteolytic lesion of mandible. A complete surgical removal of the lesion was performed and the defect was restored with reconsctruction plates. Histopathological features were consistent with central PA. Till now this is the first description of central PA in a child.

Background: Premenstrual syndrome (PMS) is considered as a cyclic late luteal phase disorder of the menstrual period in which affected women daily living activities and their quality of life which recognized as a series psychological and physical indicators such as grief, anxiety, psychological disturbances, decreased daily living activities, fatigue, altered dietary habits, and sleep pattern disturbances. Aim : to identify health beliefs and coping strategies regarding Premenstrual syndrome among health college students at Qassim University .Methods: A cross-sectional descriptive research design was used for carried out this study on Convenience sampling from all available students at the healthy colleges aged 18-25 years old from 2 nd to 4 th levels (239) female students from Medicine , Nursing , Pharmacy Applied medical sciences Medical rehabilitation and Dentistry at Qassim university . The data was collected by  using 3 self-administered tools  to collect data as follows ; Firs...

Background: Colorectal cancer (CRC) is considered as a significant worldwide health problem1 and there is strong suggestion that screening can reduce CRC mortality rate. Thus, the effectiveness of awareness toward screening may be encouraged screening performance and screening intensity to those at highest risk. Aim: to find out community awareness regarding risk prediction of colorectal cancer at port-said city , Egypt. Subject and methods: A descriptive cross-sectional study was carried out using A purposive sampling on 220 female from age more than 20 year at outpatient clinics from governmental hospitals (Alsalam general , Port-fouad general hospital  Algawhara hospital at Port-Said city, Egypt responded to the self-administered online survey. Statistical tools such as frequency, percentage, were used for the descriptive analysis.  Results: there are a statistically significant relation was found in all items of participant&#39;s attitude regarding colorectal cancer with ps= (0....

Introduction: Diabetic foot is one of the most incapacitating chronic complications resulting from poor disease management. It has a social and economic impact on families, health system, and society as a whole in both developing and developed countries. Aim: The present study was carried to Suggested guidelines for preventive measures of diabetic foots among diabetic patients Subject and Methods: A descriptive exploratory research study was carried out on convenience sampling of 200 diabetic patients from the governmental hospitals and Health Care centers in port -Said city were included in this study during six months from the starting of data collection using one tool which includes 4 main parts as follows ; patient's socio-demographic characteristics , circulato Assessment sheet , Foot risk Assessment for diabetic foot sheet , and observational checklists for diabetic foot risks Results: The finding results revealed that there are significant association was found between patient's occupations with their dermatological condition which the majority of high risk patients for diabetic foots were worked. Also, a significant association was fo between patient's level of education with their dermatological condition which the majority of high risk patients for diabetic foots were illiterate and patient with regular appointment and make skin assessment are low risk for diabetic foots. Recommended Guidelines: The present study concluded recommended that there are obvious needs for educational programme to increase diabetic patient's @ IJTSRD |

The speciation of chemical elements in groundwaters of Apatity Kirovsky district may affect their bioavailability and toxicity. A complete hydrochemical analysis showed measurable concentrations of uranium, molybdenum, silver, barium, nickel, vanadium, aluminum, and lead, which contributed to a growing database of the chemical compositions of groundwater. Physical and chemical models showed that the vital elements calcium, sodium, potassium, magnesium and sulfate ion are in chemical forms that are favorable for human health (Ca2+, Na+, K+, Mg2+, SO42-). Forms of migration of carcinogenic or toxic elements (nickel, barium, vanadium, strontium, aluminum, lead) are among the most toxic (Ni2+, Ba2+, Sr2+) and remain so at the temperatures studied +3, +25, +37°C. One of the most insidious effects of inorganic compounds of lead, barium and strontium is the ability to replace calcium in bones isomorphically, nickel in the form of free ions (Ni2+) is 2 times more toxic than its complex comp...

HIV infection significantly impacts the immune system, often resulting in various hematological complications, including anemia, neutropenia, and thrombocytopenia. These cytopenias are influenced by several factors, including the direct effects of HIV on the bone marrow and the side effects of antiretroviral therapy. However, there are notable ethnoracial differences in the immunohematological profiles of HIV-infected individuals, particularly between African and Russian populations. Africa, with its high prevalence of co-infections such as malaria, tuberculosis, and helminthiasis, presents unique challenges in managing HIV-related cytopenias. In contrast, in Russia, chronic comorbidities such as hepatitis and alcohol use significantly influence the immune and hematological responses to HIV. These differences underline the importance of considering both genetic and environmental factors when diagnosing and managing HIV-related hematological disorders. While both regions face substantial HIV burdens, the immunohematologic outcomes differ considerably due to regional co-morbidities and genetic predispositions. In Africa, malaria and helminth infections frequently exacerbate anemia, neutropenia, and thrombocytopenia, while in Russia, liver diseases, alcohol use, and chronic viral infections contribute to myelosuppression and hematological abnormalities. Moreover, certain genetic factors, such as Benign Ethnic Neutropenia in African populations, complicate the interpretation of hematological data. These disparities necessitate region-specific

Renal infective cystic diseases frequently mimic renal cell carcinoma (RCC) in clinical and imaging settings, leading to diagnostic challenges, especially in patients with chronic kidney disease (CKD). These misdiagnoses can result in unnecessary surgical interventions and extended antibiotic treatments without clear benefits. This report highlights two unique cases, demonstrating the critical role of a structured antibiotic regimen in accurately diagnosing and managing such conditions. The first case involves a 40-year-old woman with CKD presenting with high-grade fever, left flank pain, and oliguria. Imaging revealed two renal lesions suggestive of malignancy. However, following a ten-day course of intravenous antibiotics and a subsequent six-week course of oral antibiotics, her symptoms improved, and a renal biopsy confirmed benign interstitial nephritis. The second case describes a 58-year-old male with a history of multiple comorbidities who presented with high-grade fever and pyuria. Imaging indicated a renal mass with high fluorodeoxyglucose uptake. After a six-week antibiotic treatment, follow-up imaging showed complete resolution of the mass, confirming its benign nature. These cases illustrate the diagnostic complexity of differentiating renal infective cysts from RCC. A six-week course of broad-spectrum antibiotics effectively resolved infective lesions, significantly reducing the need for invasive procedures. The findings underscore the importance of considering infectious etiologies in atypical renal masses and highlight the potential benefits of conservative management strategies in preserving renal function and improving patient outcomes.

To explore whether patients' desires for and expectations of medical care differ between the United States and Canada, we surveyed 652 patients and 105 physicians at primary care sites in Michigan and Ontario. Patient desires were similar at both sites, but expectations were higher in Michigan. Michigan physicians gave higher estimates of patient desire than physicians in Ontario. Physicians at both sites, however, similarly underestimated patients' desires. These between-site differences in expectation may reflect differences both in general cultural factors and in patient exposure to different clinical policies within the medical systems.

OBJECTIVESThe Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study is testing the effectiveness of a multifactorial intervention to prevent serious fall injuries. Our aim was to describe procedures that were implemented to optimize participant retention; report retention yields by age, sex, clinical site, and follow‐up time; provide reasons for study withdrawals; and highlight the successes and lessons learned from the STRIDE retention efforts.DESIGNPragmatic cluster randomized trial.SETTINGA total of 86 primary care practices within 10 US healthcare systems.PARTICIPANTSA total of 5451 community‐living persons, 70 years of age or older, at high risk for serious fall injuries.MEASUREMENTSStudy outcomes were collected every 4 months by a central call center. Reconsent was required to extend follow‐up beyond the originally planned 36 months.RESULTSOver a median follow‐up of 3.2 years (interquartile range = 2.8‐3.7 y), 439 (8.1%) participants died and 600 (11.0%...

Older adults continue to be underrepresented in clinical research despite their burgeoning population in the United States and worldwide. Physicians often propose treatment plans for older adults based on data from studies involving primarily younger, more‐functional, healthier participants. Major barriers to recruitment of older adults in aging research relate to their substantial health problems, social and cultural barriers, and potentially impaired capacity to provide informed consent. Institutionalized older adults offer another layer of complexity that requires cooperation from the institutions to participate in research activities. This paper provides study recruitment and retention techniques and strategies to address concerns and overcome barriers to older adult participation in clinical research. Key approaches include early in‐depth planning; minimizing exclusion criteria; securing cooperation from all interested parties; using advisory boards, timely screening, identific...

This study aims to investigate EFL teachers&#39; perspectives towards using extracurricular activities in developing secondary school students&#39; performance in learning English language. To achieve the aim of the study, the researchers conduct a survey of a questionnaire. The participants were 340 (235 females and 105 males) EFL teachers from the public schools in the Second Al-Karkh General Directorate of Education in Baghdad, Iraq during the academic year 2020-21. The design of the study is a quantitative descriptive study which based on a questionnaire to collect the data. After analyzing the data, the results revealed that EFL teachers have positive perspectives toward applying extracurricular activities in developing secondary school students&#39; language performance. There are no statistically significant differences in the Iraqi EFL teachers&#39; perspectives towards applying extracurricular activities in developing secondary school students&#39; language performance due ...

Latar Belakang Penelitian :anak usia prasekolah memiliki tugas kemandirian salah satunya dalam hal kemandirian personal hygiene, karena kebersihan diri mempengaruhi kesehatan dan psikis seseorang. Kemandirianpersonal hygienepada anak prasekolah dapat dipengaruhi oleh beberapa faktor yaitu, emosi anak, intelektual anak, lingkungan, karakteristiksosial, pendidikan orangtua,pekerjaan orangtua. Dukungan keluarga juga merupakan salah satu faktor penting yang mempengaruhi bagaimana perilaku personal hygienepada anak prasekolah. Tujuan: Mengetahui hubungan dukungan keluarga dengan kemandirian personal hygiene pada anak prasekolah. Metode Penelitian: Penelitian ini menggunakan desain penelitian kuantitatif dengan pendekatan deskriptif korelasi.Pendekatan waktu cross secional. Jumlah responden 37 orangtua murid pengambilan sampel dengan cara sampling jenuh.Penelitian dengan kuisioner dukungan keluarga dan kemandirian personal hygieneskala ordinal, analisa data dilakukan dengan kendall-Tau. H...