bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Cysticercus Ovis among Slaughtered Goats in Makkah, Saudi Arabia
Authors: Bakhraibah Areej O. , Alsulami Muslimah N.
Published: January 2019

Cysticercus ovis the intermediate stage of a canine tapeworm, Taenia ovis, produces cystic lesions in the skeletal and cardiac muscle of goats. This study was carried out to determine the prevalence of cysticercus ovis in goats collected from Al Kakee’s Slaughter, Makkah, Saudi Arabia. A number of goats were collected for examination, a total of 51,750 locally raised goats and 61,911 imported goats. The experiment started at May 2017 and ended in April 2018. The results revealed that cysticercus ovis is common among imported goats more than local goats as implied in the tables attached below. As well as the evidence that the highest rate of infections was found during the warm months of summer.
Factors Influencing in vitro Germination and Seed Storage Behavior of Couroupita guianensis Aubl. – A Useful Tropical Tree Species
Authors: Arokiamary P. Shiny , Alphonse A. Vinoth , Ravindhran R.
Published: January 2019

Couroupita guianensis Aubl. popularly known as cannonball tree is widely distributed in the tropical regions. The tree parts are commonly used to treat wounds and tumors. Leaves, flowers, and fruits contain active phytochemicals with significant biological activity. In the recent years, destruction of natural habitats by mankind has reduced its distribution. Natural propagation of C. guianensis by seeds is greatly hindered by poor seed germination and viability. Therefore, the present study was undertaken to optimize the conditions for in vitro embryo germination and to investigate the seed storage behaviour. Mature seeds inoculated on MS basal medium germinated within 10 d with a frequency of 61.6%. Supplementation of plant growth regulators (PGRs) to MS medium improved the embryo germination frequency (100%). Seedlings with highest shoot length (8.10±0.11 cm) and root length (6.27±0.14 cm) were produced in MS medium supplemented with 1.0 mg/l kinetin and 0.1 mg/l indole-3-butyric acid. Among different strength liquid MS basal salts, quarter-strength produced a greater number of secondary roots (8.00±0.28) with average root length of 17.83±0.58 cm. Seed storage behaviour studies clearly proved the recalcitrant nature as only freshly harvested mature seeds retained the germination potential upon storage at 15 ºC for up to 45 d. Desiccation of seeds on exposure to air-dry storage resulted in rapid deterioration of germination. Pre-conditioning of germinated seedlings in liquid MS basal salts was required for their survival under field conditions. Plantlets with well-developed roots were successfully acclimatized to the field with 100% survivability. This protocol facilitates conservation, sustainable utilization and re-introduction of C. guianensis into its natural habitats.
Congenital pseudarthrosis of the tibia: Biological and biomechanical considerations to achieve union and prevent refracture
Authors: Paley D.
Published: January 2019

Congenital pseudarthrosis of the tibia (CPT) is likely to be a primary periosteal disease and secondary bone disease. The primary goal of treatment is to obtain union, correct the diaphyseal deformity, correct any proximal fibular migration and prevent refracture. The pathobiology demonstrates increased osteoclasis by the surrounding fibrous hamartoma and reduced osteogenesis and bone morphogenic protein production by the bone. This leads to a loss of remodelling potential and gradual bowing and atrophy of the bone with eventual fracture of the tibia and or fibula. This recommends the synergistic use of bisphosphonates and bone morphogenic protein. The pathomechanics of CPT implicate the anterolateral bowing, narrow diameter of the atrophic bone ends and proximal fibular migration. These biomechanical factors can be addressed by means of straightening of the deformity, intramedullary support of both bones, stable fixation and reduction of proximal migration of the fibula. A summary of the literature on CPT shows that the mean probability of achieving primary union without refracture, by most treatments is 50% (12% to 80%). Two recent studies have shown a much higher success rate approaching 100%, by creating a cross-union between the tibia and fibula. The cross-union with intramedullary reinforcement of the bone makes refracture unlikely due to the cross-sectional area of union with its two-bar linkage. A new classification to guide such treatment is also proposed.

Level of Evidence

V – expert opinion
ENDOSCOPIC SURGERY OF LUMBAR DISC HERNIATION. A STUDY OF 1562 CASES
Authors: Destandau Jean
Published: January 2019

Objective. To describe the microendoscopic discectomy technique by an endospine operating tube assembly for all types of lumbar disc herniations. Material and Methods. 1562 patients were operated on between April 1999 and December 2001. In order to permit a valid analysis of the results, a study was begun. Before the operation, each patient was given a questionnaire and an explanation of what exactly was being asked. Results. Of the questionnaires given to 1562 patients, 1156 (74 %) were returned showing excellent results in 1105 cases (95.5 %°), good in 7 (0.6 %), moderate in 1 (0.1 %) and poor in 43 (3.7 %). The complications observed were: discitis in 5 cases (0.32); reoccurrence in 102 (6.5 %), of which 91 (5.8 %) needed a second surgery, 58 (3.7 %) at the same level and side; dural tear in 25 (1.6 %); nerve root injury but of no postoperative sequelae in 7 (0.45 %); and resection of the articular process in 36 (2.3 %). Of the 841 patients who were working before the operation and answered the questionnaire, 795 (94.5 %) were able to return to work within an average delay of 4 weeks. In answer to the questions on global satisfaction and on the accuracy of the information given before surgery, 1132 (97.9 %) responded as satisfied and 1115 (96.4 %) felt the information given was accurate. Conclusion. The results of this study are comparable to, or even better than those of open and microsurgical discectomy methods. Early post-operative mobilization allows early return to work.
Antihypertensive and anticoagulant properties of glycosaminoglycans extracted from the sturgeon (Acipenser persicus) cartilage
Authors: Karimzadeh Katayoon
Published: January 2019

Large amounts of valuable waste are produced during sea food processing. This has a great potential for conversion to biologically active proteins and polysaccharides. Among these compounds, sulfated polysaccharides have been considered due to their many biological properties.

The present work was conducted to study anticoagulant activities and angiotensin-I converting enzyme (ACE) inhibitory effects of glycosaminoglycans (GAGs) extracted from the cartilage of sturgeon (Acipenser persicus). The enzymatic extraction of sturgeon cartilage was performed in the presence of cetylpyridinium chloride salt. The structure was characterized via electron microscope and Fourier transform infrared spectroscopy (FTIR) analysis. Herein, ACE inhibitory and anticoagulant properties of extracted GAGs were determined.

The amount of GAGs was 6.8±1.3% of cartilage dry weight. GAGs showed good activity in ACE inhibitory – with a highest level of 85.7%. The derived anticoagulant activity indexes, APPT (activated partial thromboplastin time) and TT (Thrombin time) of the extracted polysaccharide showed a prolonging of clotting time, compare to control.

The results of this study revealed that the cartilage extracted GAGs possess promising ACE inhibitory properties and anticoagulant effects. Thus, the product can be substituted for blood reducing drugs and antithrombotic agents at least in laboratory conditions.
Upper respiratory tract microbiota in health and disease – a minireview
Authors: Chwiejczak Edyta , Kosikowska Urszula
Published: January 2019

A most common infection is that the upper respiratory tract. The human body is inhabited by millions of microorganisms, most of which enable the proper functioning of some systems and constitute a barrier protecting against harmful external factors. Due to the continuous contact of the upper airway microbiota with the external environment, it may seem to be extremely unstable and very diverse. A number of studies have been conducted that have assessed the effect of various factors on the composition of the upper respiratory tract microbiota. This paper presents a literature analysis which showed that the anatomical area is rich in terms of the microbiota that forms it, and despite the constant changes in many parameters, including physical – very stable.
Developing a diagnostic test to identify the selected mutation within the CFTR gene that determines the onset of cystic fibrosis
Authors: Szymczak Angelika , Ksiazek Piotr , Mojsym-Korybska Sylwia , Skorupa Wojciech , Zbikowska-Machul Albertyna
Published: January 2019

Cystic fibrosis is one of the most common genetic diseases among Caucasians due to its prevalence. Modern methods of molecular diagnostics and treatment of the disease allow to prolong the life of patients. In order to apply the appropriate treatment, the genetic basis of this disease should, however, first be known. The most common and the most severe mutation present in the CFTR gene (60-70% of cases) takes the form of an allele. This is responsible for the deletion of phenylalanine in position 508 (Δ508) of the CFTR protein. Determination of mutations in the CFTR gene using molecular techniques makes it possible to identify the causes of the disease in people who do not show the characteristic symptoms of cystic fibrosis.
In vitro propagated Mentha rotundifolia (L.) Huds and antioxidant activity of its essential oil
Authors: Benahmed Amira , Harfi Boualem , Benbelkacem Ibtissem , Daas Abla , Laouer Hocine , Belkhiri Abdelmalik
Published: January 2019

Mentha rotundifolia (L.) Huds is an aromatic plant used for its medicinal values. This study aims to select appropriate conditions for in vitro propagation of M. rotundifolia (L.) Huds and to evaluate yield and antioxidants activity of its essential oils (EOs).

The explants were cultured on Murashige and Skoog (MS) medium containing different concentrations of growth regulators 6-benzylaminopurine (BAP) and Gibberellin (GA3).

Hydrodistillated EOs obtained from acclimatized and mother plant, were evaluated for their antioxidant activity. Tests were performed on DPPH free radical-scavenging, ABTS and CUPRAC assays.

Shoot induction and multiplication were successfully carried out on MS medium supplemented with the following hormones combinations: 1 mg/l BAP, 1 mg/l GA3 and 0.5 mg/l BAP, 0.5 mg/l GA3, respectively. Stem length, nodes and leaves number measured from development vitroplant were 6.89 cm, 5.22 nodes and 11.92 leaves per vitroplant, respectively.

In vitro rooted plants were successfully acclimatized at a temperature of 23 ± 2°C and a long day photoperiod with a total survival rate exceeding 95%.

EO yield of acclimated plant varied between (0.88-1.49 ml/100 g dry matter) compared to wild plant (0.73 ml/100 g dry matter). The antioxidant potential of EOs from acclimated plant showed on DPPH free radical-scavenging, ABTS and CUPRAC assays values of (IC50: 4.18-24.93 mg/ml), (IC50: 0.51-1.56 mg/ml) and (A0.50: 0.34-2.71 mg/ml), respectively. In contrast, the wild plant exhibited on the same tests the values of (IC50: 10.35 mg/ml), (IC50: 0.12 mg/ml) and (A0.50: 0.99 mg/ml), respectively.

The results suggest that micropropagation of M. rotundifolia (L.) Huds can be an interesting alternative for producing important plant material with the possibility to modulate EO yield and its antioxidant potential for future commercial purposes.
Yes, Creativity Can Predict Academic Success!
Authors: Sternberg Robert J.
Published: January 2019

Tests of creativity can meaningfully predict academic and other outcomes in schooling, over and above the prediction provided by standardized tests. However, for such prediction to occur, the tests must measure creativity in a meaningful way and success in school must in some way be linked to creative performance. We should change our tests and schooling to require the creativity that is so important for a world in which rapid change is the norm rather than the exception.
Evaluation of Spatial and Temporal Variations of Surface Water Quality in the Nile River Damietta Branch
Authors: El-Tohamy Wael S. , ABDEL-Baki Samar N. , Abdel-Aziz Nagwa E. , Khidr Abdel-Aziz A.
Published: January 2019

The objective of this study is to reveal the spatial and temporal variations of surface water quality in this part of the River Nile with respect to heavy metals pioneerution. Seventeen parameters in total were monitored at seven sites on a monthly basis from October 2013 to September 2014. The dataset was treated using the tools of univariate and multivariate statistical analyses. Cluster analysis showed three different groups of similarity between the sampling sites reflecting the variability in physicochemical characteristics and pollution levels of the study area. Six PCs factors were identified as responsible for the data structure explaining 91 % of the total variance. These were eutrophication factor (23.2 %), physicochemical factor (20.6 %), nutrients (16.3 %) and three additional factors, affected by alkalinity and heavy metals, recorded variance less than 15 % each. Also, the heavy metals pollution index (HPI) revealed that most of the calculated values were below the critical index limit of 100. However, two higher values (124.89 and 133.11) were calculated at sites V and VI during summer due to the temperature and increased run-off in the river system.
Soybean Seedlings Enriched with Iron and Magnesium - Impact on Germination, Growth and Antioxidant Properties
Authors: Chmielowska-Bąk Jagna , Zinicovscaia Inga , Frontasyeva Marina , Milczarek Aleksandra , Micheli Sabrina , Vysochanska Mariia , Deckert Joanna
Published: January 2019

Iron (Fe) and magnesium (Mg) deficiency in human diets is a widespread problem observed in various regions of the world. Insufficient Fe uptake results in the development of iron dependent anaemia and depressed physical and intellectual performance. In turn Mg deficiency is associated with alterations in neuromuscular and cardiovascular systems. An emerging alternative to traditional supplementation of these elements in the form of pills, liquids or effervescent tablets, is introduction of fortified food products. In present study we show that preincubation of soybean seeds in Fe and Mg solutions leads to elevated content of these elements in the seedlings. Importantly the pretreatment did not affect germination rate, seedlings growth or, with an exception of Fe supplementation at highest concentration, antioxidant capacity. The obtained results indicate that preincubation of seeds in Fe and Mg solutions may be a promising method of obtaining enriched soybean sprouts.
Security validation of VP-based SoCs using dynamic information flow tracking
Authors: Goli Mehran , Hassan Muhammad , Große Daniel , Drechsler Rolf
Published: January 2019

Modern System-on-Chips (SoCs) are notoriously insecure. Hence, the fundamental security feature of IP isolation is heavily used, e. g., secured Memory Mapped IOs (MMIOs), or secured address ranges in case of memories, are marked as non-accessible. One way to provide strong assurance of security is to define isolation as information flow policy in hardware using the notion of non-interference. Since, an insecure hardware opens up the door for attacks across the entire system stack (from software down to hardware), the security validation process should start as early as possible in the SoC design cycle, i. e. at Electronic System Level (ESL). Hence, in this paper we propose the first dynamic information flow analysis at ESL. Our approach allows to validate the run-time behavior of a given SoC implemented using Virtual Prototypes (VPs) against security threat models, such as information leakage (confidentiality) and unauthorized access to data in a memory (integrity). Experiments show the applicability and efficacy of the proposed method on various VPs including a real-world system.
Multi-level encryption algorithm for user-related information across social networks
Authors: Yin Lijie , Hassan Nasruddin
Published: January 2019

The traditional RSA information encryption algorithm uses one-dimensional chaotic equations to generate pseudo-random sequences that meet the encryption requirements. This encryption method is too simple and the security performance is poor. A multi-level encryption algorithm for user-related information across social networks is proposed, and a user association model across social networks is constructed to obtain user-related information across social networks. This multi-level chaotic encryption algorithm based on neural network is used to select three different chaotic mapping models based on user-related information, and a multi-level chaotic encryption algorithm is designed. According to the characteristics of error sensitivity of chaotic system, the neural network is used to inversely propagate the error. A chaotic encryption algorithm that implements multi-level encryption of user-related information across social networks is optimized. The experimental results show that the average rate for which the proposed algorithm correctly identified the user-related information across social networks was 97.6%, the highest frequency of average character distribution probability in cipher text was 0.021, and the average time for encryption was 18.45 Mbps. The average time for decryption was 21.90Mbps.
Multi-target tracking algorithm in intelligent transportation based on wireless sensor network
Authors: Lei Yang , Wu Yuan , Chowdhury Ahmad Jalal Khan
Published: January 2019

The traditional extended Kalman algorithm for multi-target tracking in the field of intelligent transportation does not consider the occlusion problem of the multi-target tracking process, and has the disadvantage of low multi-target tracking accuracy. A multi-target tracking algorithm using wireless sensors in an intelligent transportation system is proposed. Based on the dynamic clustering structure, the measurement results of each sensor are the superimposed results of sound signals and environmental noise from multiple targets. During the tracking process, each target corresponds to a particle filter. When the target spacing is relatively close to each other, each master node realizes distributed multi-target tracking through information exchange. At the same time, it is also necessary to consider the overlap between adjacent frames. Since the moving target speed is too fast, the target occlusion has the least influence on the tracking accuracy, and can accurately track multiple targets. The experimental results show that the proposed algorithm has a target tracking error of 0.5 m to 1 m, and the tracking result has high precision.
A Review of Herbal Therapy in Multiple Sclerosis
Authors: Mojaverrostami Sina , Bojnordi Maryam Nazm , Ghasemi-Kasman Maryam , Ebrahimzadeh Mohammad Ali , Hamidabadi Hatef Ghasemi
Published: January 2019

Multiple sclerosis is a complex autoimmune disorder which characterized by demyelination and axonal loss in the central nervous system (CNS). Several evidences indicate that some new drugs and stem cell therapy have opened a new horizon for multiple sclerosis treatment, but current therapies are partially effective or not safe in the long term. Recently, herbal therapies represent a promising therapeutic approach for multiple sclerosis disease. Here, we consider the potential benefits of some herbal compounds on different aspects of multiple sclerosis disease. The medicinal plants and their derivatives; Ginkgo biloba, Zingiber officinale, Curcuma longa, Hypericum perforatum, Valeriana officinalis, Vaccinium macrocarpon, Nigella sativa,Piper methysticum, Crocus sativus, Panax ginseng, Boswellia papyrifera, Vitis vinifera, Gastrodia elata, Camellia sinensis, Oenothera biennis, MS14 and Cannabis sativa have been informed to have several therapeutic effects in MS patients.
Anti-CD24 bio Modified PEGylated Gold Nanoparticles as Targeted Computed Tomography Contrast Agent
Authors: Ghaziyani Mona Fazel , Moghaddam Mohammd Pourhassan , Shahbazi-Gahrouei Daryoush , Ghavami Mostafa , Mohammadi Ali , Abbasi Mehran Mesgari , Baradaran Behzad
Published: January 2019

Purpose: Molecular imaging is one of the import methods for recognition of cancer at the early stage in order to enhance the capacity of remedy. This study was aimed to introduce a new contrast agent that was targeted with CD24 so as to improve the CT scan detection of cancer cells with higher CD24 expression. Methods: The surface modifications of gold nanoparticles (Au-NPs) were done with long PEG (HS-PEG-CH3O) and short PEG (HS-PEG-COOH) chains to enhance their stability and capacity for immobilization of different antibodies. MTT assay was carried out to assess the biocompatibility of the NPs. The obtained contrast agent was implemented in the targeted CT imaging based on in vitro and in vivo studies of breast cancer. Results: The results revealed that the attached CD24 to the cell surface of PEGylated Au-NPs could enhance significantly the cells CT number (40.45 HU in 4T1, while it was 16.61 HU in CT26) It was shown that the attenuation coefﬁcient of the molecularly targeted cells was more than 2 times excessive than the control groups. Further, the tumor region in model of xenograft tumor has higher density compare to the omnipaque groups, 60 min after injection (45 Hu vs.81 Hu). These results showed that the nanoparticles stayed in tumor region for longer time. Conclusion: It is predicted that the synthesized nanoparticle can be used as computed tomography contrast agent. Also, it can be used to identify the tumor cells with higher expression of CD24 at the early stages more efficiently compare to the other routine methods.
Molecular Identification and Probiotic Potential Characterization of Lactic Acid Bacteria Isolated from Human Vaginal Microbiota
Authors: Nami Yousef , Haghshenas Babak , Yari Khosroushahi Ahmad
Published: January 2019

Purpose: The increased demand for probiotics because of their health purposes provides the context for this study, which involves the molecular identification of lactic acid bacteria (LAB) obtained from the vaginal microbiota of healthy fertile women. The isolates were subjected for examination to prove their probiotic potential. In particular, the isolates were subjected to various tests, including acid/bile tolerance, antimicrobial activity, antibiotic susceptibility, Gram staining, and catalase enzyme activity assessment. Methods: Several methods were utilized for the molecular identification of the isolates, including ARDRA, (GTG)5-PCR fingerprinting, and the PCR sequencing of 16S-rDNA amplified fragments. Disc diffusion and well diffusion methods were used to assess antibiotic susceptibility and antibacterial activity of isolates. Tolerance to acid and bile was performed at pH 2.5 and 0.3% bile oxgall. Results: A total of 45 isolates of 88 separate organisms was selected. All of the isolates demonstrated an antibacterial effect on the exploited indicator microorganisms. All selected strains also maintained their viability at low-pH and high-bile salt conditions and exhibited abroad variation in their survival. Only the Enterococcus avium strain showed resistance to all 9 tested antibiotics. Based on the molecular identification and clustering, the 45 isolated bacteria were classified into three major groups of LAB: Enterococcus, Lactobacillus and Lactococcus. Conclusion: LAB are microorganisms that have a particularly important function in maintaining the health of the vaginal and gastrointestinal tract and in protecting it from infection by other pathogenic organisms. The isolates found to be a promising probiotic candidate by showed desirable characteristics. Therefore, strain DL3 can be used as natural food preservative with some more potential investigations.
Metformin Protects against Radiation-Induced Pneumonitis and Fibrosis and Attenuates Upregulation of Dual Oxidase Genes Expression
Authors: Azmoonfar Rasoul , Amini Peyman , Saffar Hana , Rezapoor Saeed , Motevaseli Elahe , Cheki Mohsen , Yahyapour Rasoul , farhood Bagher , Nouruzi Farzad , Khodamoradi Ehsan , Shabeeb Dheyauldeen , Eleojo Musa Ahmed , Najafi Masoud
Published: January 2019

Purpose: Lung tissue is one of the most sensitive organs to ionizing radiation (IR). Early and late side effects of exposure to IR can limit the radiation doses delivered to tumors that are within or adjacent to this organ. Pneumonitis and fibrosis are the main side effects of radiotherapy for this organ. IL-4 and IL-13 have a key role in the development of pneumonitis and fibrosis. Metformin is a potent anti-fibrosis and redox modulatory agent that has shown radioprotective effects. In this study, we aimed to evaluate possible upregulation of these cytokines and subsequent cascades such as IL4-R1, IL-13R1, Dual oxidase 1 (DUOX1) and DUOX2. In addition, we examined the potential protective effect of metformin in these cytokines and genes, as well as histopathological changes in rat’s lung tissues. Methods: 20 rats were divided into 4 groups: control; metformin treated; radiation + metformin; and radiation. Irradiation was performed with a 60Co source delivering 15 Gray (Gy) to the chest area. After 10 weeks, rats were sacrificed and their lung tissues were removed for histopathological, real-time PCR and ELISA assays. Results: Irradiation of lung was associated with an increase in IL-4 cytokine level, as well as the expression of IL-4 receptor-a1 (IL4ra1) and DUOX2 genes. However, there was no change in the level of IL-13 and its downstream gene including IL-13 receptor-a2 (IL13ra2). Moreover, histopathological evaluations showed significant infiltration of lymphocytes and macrophages, fibrosis, as well as vascular and alveolar damages. Treatment with metformin caused suppression of upregulated genes and IL-4 cytokine level, associated with amelioration of pathological changes. Conclusion: Results of this study showed remarkable pathological damages, an increase in the levels of IL-4, IL4Ra1 and Duox2, while that of IL-13 decreased. Treatment with metformin showed ability to attenuate upregulation of IL-4–DUOX2 pathway and other pathological damages to the lung after exposure to a high dose of IR.
Physiological and Biochemical Effects of Echium Amoenum Extract on Mn2+-Imposed Parkinson Like Disorder in Rats
Authors: Sadeghi Leila , Tanwir Farzeen , Yousefi Babadi Vahid
Published: January 2019

Purpose: Manganism is a cognitive disorder take places in peoples are exposed to environmental manganese pollution. Overexposure to manganese ion (Mn2+) mainly influences central nervous system and causes symptoms that increase possibility of hippocampal damages. Methods: In this study rats were administrated by two different doses of MnCl2 and behavioral and physiological consequences were evaluated. We also investigated effects of E. Amoenum on Mn2+-imposed toxicity by behavioral, biochemical, immunoblotting and histological studies on hippocampus tissue. Results: Results showed metal overexposure increases oxidative stress mainly by lipid peroxidation and reactive oxygen species overproduction. Histological studies and caspase 3 analyses by immunoblotting revealed Mn2+ induced apoptosis from mitochondrial-dependent pathway in the presence of low metal dose. This study provides evidence that oral administration of E. amoenum extract inhibited manganese neurotoxicity by oxidative stress attenuation and apoptosis reduction that lead to improved depression like behavior. Plant extract also increased catecholamine content in Mn2+ treated hippocampus. Conclusion: As molecular and pathophysiological effects of E. amoenum, it could be considered as a pre-treatment for Parkinson and Parkinson like disorders in high-risk people.
Determination of the Predictive Value of Serum Bilirubin in Patients with Ischemic Stroke: A Prospective Descriptive Analytical Study
Authors: Sagheb Asl Elnaz , Taheraghdam Aliakbar , Rahmani Farzad , Javadrashid Reza , Golzari Samad Eslam Jamal , Ghaemian Neda , Sadeghpour Yalda , Mehdizadeh Esfanjani Robab , Soleimanpour Hassan
Published: January 2019

Purpose: In all types of ischemic stroke, especially in the acute phase, excessive oxidative stress causes structural and functional damage to the brain. This may play a major role in the pathophysiology of the brain damage. Higher serum levels of bilirubin have therapeutic effects in oxidative stress-induced stroke. Nevertheless, role of increased serum levels of bilirubin in the acute phase of ischemic stroke is controversial. Methods: This study was a cross-sectional prospective descriptive study conducted in the Emergency Department (ED) of Imam Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran, throughout six months. 275 ischemic stroke patients were evaluated based on their brain CT scan infarct size, NIHSS, MRS, and serum levels of bilirubin. Later, data were analyzed using SPSS software. Results: Total, direct and indirect bilirubin levels were significantly higher in expired patients (p< 0.0001). Total (p< 0.0001), direct (p< 0.0001) and indirect (p< 0.0001) bilirubin levels, NIHSS score (p< 0.0001), and ischemic area (p< 0.0001) significantly predicted the outcome in these patients. Conclusion: Total, direct and indirect bilirubin levels was significantly associated with mortality in the acute phase of ischemic stroke patients.
Overcoming Poor Solubility of Dimenhydrinate: Development, Optimization and Evaluation of Fast Dissolving Oral Film
Authors: Jadhav Yuvraj Govindrao , Galgatte Upendra Chandrakant , Chaudhari Pravin Digambar
Published: January 2019

Purpose: To develop fast dissolving oral film to address vomiting and nausea in pediatric population. Methods: Oral films of Dimenhydrinate were prepared by solvent casting method by using hydroxypropylmethyl cellulose E5 (HPMC E5), polyethylene glycol 400 (PEG 400) and croscarmellose sodium. Solubility of dimenhydrinate was enhanced by ethanol as a co-solvent. To make dimenhydrinate palatable sodium saccharin and peppermint oil were used. All films were evaluated for mechanical parameters, surface pH, morphology, disintegration time and percent dissolution. Results: Films were smooth, acceptable and white in colour. For optimized batch, drug content (99.106%), disintegration time (25 sec), dissolution (99.10% in 210 sec), surface pH (6.81) were acceptable. Conclusion: Optimized batch, due to its potential to deliver through fast dissolving film, can be developed for clinical use.
From Craft to Reflective Art and Science Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review"
Authors: Boivin Antoine
Published: January 2019

Patient engagement practices are increasingly incorporated in health research, governance, and care. More recently, a large number of evaluation tools and metrics have been developed to support engagement evaluation. This growing interest in evaluation reflects a maturation of the patient engagement field, moving from a "craft" to a reflective "art and science," with more explicit expected benefits and risks, better understood conditions for success and failure, and increasingly rigorous evaluation instruments to improve engagement theories and interventions. It also supports a more critical view of engagement science, moving beyond reductionist views of engagement as a "black box technology" to a more subtle view of this broad category of complex interventions. Structured evaluation can advance patient engagement by supporting more reflective partnerships between patients, clinicians, health system leaders and citizens. This can help clarify mutual (and potentially contradictory) expectations toward engagement, provide a reality check toward claims of benefits and harms, and increase health systems’ capacity to implement effective engagement practices over time. To do so, closer collaborations are required between engagement scientists and practitioners to align the theories, practice and evaluation of patient and community engagement.
The Human Resources for Health Program in Rwanda – Reflections on Achievements and Challenges Comment on "Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda"
Authors: Delisle Hélène
Published: January 2019

This commentary is a further discussion of a paper published in this journal on the health professional training initiative led by the Government of Rwanda since 2012 and presented as a case study. According to the authors, the partnership program with international academic institutions may serve as model for other countries to address the shortage of health professionals and to strengthen institutional capacity, based on the competencybased and innovative training programs, the numbers of graduates, the improved quality of health services and institution strengthening. However, the conditions may not be as optimal elsewhere. A supportive government policy, massive funding and an academic consortium comprised of 19 United States academic institutions have contributed to the success of the program. We also noted that the trained professionals were clinicians almost exclusively, at the expense of public health specialists and other health professionals who can better address emerging issues such as non-communicable diseases (NCDs) particularly for their prevention, which is now compelling. Among others, the training of more nutritionists as members of the health team is needed.
Coming Full Circle: How Health Worker Motivation and Performance in Results-Based Financing Arrangements Hinges on Strong and Adaptive Health Systems
Authors: Kane Sumit , Gandidzanwa Crecentia , Mutasa Ronald , Moyo Irene , Sismayi Chenjerai , Mafaune Patron , Dieleman Marjolein
Published: January 2019

Background: This paper presents findings from a study which sought to understand why health workers working under the results-based financing (RBF) arrangements in Zimbabwe reported being satisfied with the improvements in working conditions and compensation, but paradoxically reported lower motivation levels compared to those not working under RBF arrangements. Methods: A qualitative study was conducted amongst health workers and managers working in health facilities that were implementing the RBF arrangements and those that were not. Through purposeful sampling, 4 facilities in RBF implementing districts that reported poor motivation and satisfaction, were included as study sites. Four facilities located in non-RBF districts which reported high motivation and satisfaction were also included. Data was collected through in-depth interviews and analyzed using the framework approach. Results: Results based financing arrangements introduce a wide range of new institutional arrangements, roles, tasks, and ways of doing things, for facility staff, facility managers and, district and provincial health management teams. Findings reveal that insufficient preparedness of people and processes for this change, constrained managers and workers performance. Results based financing arrangements introduce explicit and tacit changes, including but not limited to, incentive logics, in the system. Findings show that unless systematic efforts are made to enable the absorption of these changes in the system: eg, through reconfiguring the decision space available at various levels, through clarification of accountability relationships, through building personnel and process capacities, before instituting changes, the full potential of the RBF arrangements cannot be realised. Conclusion: Our study demonstrates the importance of analysing existing institutional, management and governance arrangements and capabilities and taking these into account when designing and implementing RBF interventions. Introducing RBF arrangements cannot alone overcome chronic systemic weaknesses. For a system wide change, as RBF arguably is, to be effected, explicit organisational change management processes need to be put in place, across the system. Carefully designed processes, which take into account the interest and willingness of various actors to change, and which are cognizant of and constructively engage with potential bottlenecks and points of resistance, should accompany any health system change initiative.
Association of serum immunoglobulin G level with peritonitis in patients undergoing peritoneal dialysis: An analytical study
Authors: Abedi Azar Sima , Jafari Nakhjavani Mohammad Reza , Kalami Niousha , Pourlak Tala , Ghamari Behnaz , Karkon Shayan Farid
Published: January 2019

Introduction: Peritonitis is one of the most common complications of peritoneal dialysis. On the other hand, reduced levels of immunoglobulins (Igs), mainly IgG, can increase the risk of infection in various pathologic conditions. Here, we aimed to determine the association of severity and frequency of peritonitis with serum IgG levels in peritoneal dialysis patients. Methods: 100 patients with chronic renal failure referred to Imam Reza Hospital, Tabriz, Iran, for peritoneal dialysis were included in the study. Serum IgG levels were measured in all of these patients at the beginning of the study and after six months of follow-up. In case of peritonitis, serum IgG levels were also measured, and samples were sent to Imam Reza Hospital laboratory for analysis. Results: 40 cases (40%) were women, and 60 cases (60%) were men with a mean age of 47 years. 24 cases (24.0%) had at least one episode of peritonitis during the study. Among those with peritonitis, 14 cases (60.9%) had at least one more peritonitis episode in the 6-month follow up. The mean serum IgG levels were 1079 mg/dl and 429 mg/dl at the beginning and after six months of follow up, respectively. The difference was shown to be statistically significant (P = 0.006). There was no correlation between serum IgG level reduction and peritonitis in these patients (P > 0.999). Conclusion: This study found reduced levels of serum IgG in patients undergoing peritoneal dialysis. However, it was not associated with increased risk of peritonitis in these patients.
Atorvastatin and carnitine combination versus atorvastatin alone impacts on the lipid profile of haemodialyzed patients: A randomised clinical trial
Authors: Noshad Hamid , Mohammadi Nejhad Davoud , Hoseini Parastou , Montazer Majid , Ghamari Behnaz , Karkon Shayan Farid
Published: January 2019

Introduction: Dyslipidemia is one of the most common problems in hemodialysis patients and healthcare system. Some studies have suggested the use of carnitine in the treatment of dyslipidemia in hemodialysis patients. This study was carried out aiming to evaluate the effect of atorvastatin and carnitine combination versus atorvastatin alone on the lipid profile of hemodialyzed patients. Methods: In this clinical trial, 50 hemodialysis patients referred to the educational centres of Tabriz University of Medical Sciences, Tabriz, Iran, for haemodialysis were enrolled. Patients were randomly assigned into two groups. In the first group, patients were treated with carnitine (1000 mg three times daily) and atorvastatin (10-80 mg/day based on the baseline lipid profile of the patients) and in the second group, the patients were treated with atorvastatin alone for six months. The levels of triglyceride (TG), cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and haemoglobin before and after intervention were compared. The side effects of carnitine administration were also evaluated. Results: Results showed that TG, cholesterol, and LDL levels were significantly lower in the carnitine group compared to those in the other group at the end of study (P < 0.050). In addition, HDL and haemoglobin levels were significantly higher in the carnitine group in comparison to the other group (P < 0.050). No major side effects of carnitine were observed among the patients. Conclusion: The use of carnitine plus atorvastatin combination is an effective and safe method in the treatment of dyslipidemia in patients undergoing hemodialysis without imposing significant side effects.
Prediction of clinical outcomes of patients treated with percutaneous coronary intervention for ST-Elevation myocardial infarction using familial history of premature coronary artery disease
Authors: Sohrabi Bahram , Separham Ahmad , Habibolahi Hadi , Enamzadeh Elgar , Ghamari Behnaz , Karkon Shayan Farid
Published: January 2019

Introduction: ST-elevation myocardial infarction (STEMI) is a relatively common cause of mortality among patients. The effects of risk factors as predictors of mortality in patients has been shown in different studies. The present study was performed aiming to evaluate the association between a family history of premature coronary artery diseases (CADs) with clinical outcomes among patients treated with percutaneous coronary intervention (PCI) for STEMI. Methods: This descriptive-analytical study was conducted in Shahid Madani Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, on 200 patients with STEMI with a PCI. 100 out of these 200 patients had a family history of premature CAD. Patients were followed up within 48 hours after PCI, as well as one year after admission, and the secondary outcomes including myocardial infarction (MI), heart failure, ventricular arrhythmias (VAs), pulmonary edema, and death were evaluated. Results: The mean age of the patients with positive and negative family history of premature CAD was 56.37 ± 8.20 and 61.72 ± 7.42 years, respectively. The mean age of the patients with a family history of a premature CAD was significantly lower than that of patients without a family history of a premature CAD (P = 0.001). There was no significant difference in the frequency of CAD risk factors, angiographic findings, and its complications, ST-segment resolution and frequency of secondary outcomes during 48 hours and one year after admission between the study groups (P > 0.050). Conclusion: The present study showed that a family history of premature CAD does not predict the clinical outcomes in patients treated with PCI for STEMI which should be validated across future studies.
Human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis co-infections among patients with anogenital warts in Tabriz, Iran
Authors: Saniee Sara , Herizchi Qadim Hamideh , Ranjkesh Mohammadreza , Afshari Niloofar , Davarnia Ghazaleh , Nahchami Elham , Ahmadi Maleki Davood , Razaghi Neda , Ebrahimi Sahar , Sadri Asal , Hatamnejad Leila , Mousavi Mir Ahad
Published: January 2019

Introduction: Genital infection with papilloma virus is the most common sexually-transmitted disease (STD). It is recommended that individuals who have a sexual risk factor, should be screened for syphilis, human immunodeficiency virus (HIV), and hepatitis B and C. However, this strategy is often not carried out in Iran. In the present study, patients with genital warts were screened for syphilis, HIV, and hepatitis B and C. Methods: We evaluated 311 patients with anogenital warts visiting dermatology clinics from June 2016 to June 2017. In addition, demographic data were collected using a pre-designed questionnaire. Patients who presented to Sina Hospital, Tabriz, Iran, were examined for HIV, syphilis, hepatitis B and C, urethral and vaginal discharge, and history of painful genital lesions, while patients presenting to Bahar Behavioral Disease Counseling Center of Tabriz were examined only for HIV. Data were analyzed using chi-square and Fisher’s exact tests via SPSS software. Results: Out of 263 cases with genital warts presenting to Sina Hospital, 1, 1, and 2 cases were positive for HIV, syphilis, and hepatitis B, respectively. At the same time, one of the patients presenting to Bahar Center showed HIV infection. Conclusion: We found two HIV-positive, two hepatitis B virus (HBV)-positive, and one syphilis cases in 311 patients with genital warts, so it is recommended to assess these tests routinely in high-risk individuals with genital warts, including multi-partner and addicted patients.
Barriers of Drug Adherence among Patients with Epilepsy: in Tertiary Care Hospital, South India
Authors: Das Ancy M , Ramamoorthy Lakshmi , Narayan Sunil k. , Wadwekar Vaibhav
Published: January 2019

Introduction: Epilepsy is a treatable and curable brain disorder. However major proportion of individuals with this disease in developing countries receives no treatment because of misunderstandings of the public. Other than that, poor adherence to ordered medication is considered the primary cause of drug therapy failure in epilepsy. This study conducted to assess the adherence pattern to antiepileptic regimen, among patients with epilepsy and to identify the clinical and patient-related factors contributing as barriers. Methods: A cross sectional survey design was used in 100 epilepsy patients in an Outpatient unit of tertiary care center. A Convenient sampling technique was used to enroll the patients who meet inclusion criteria. Structured interview with pre-tested questionnaire and eight item Morisky Medication Adherence Scale was used to collect the data. Descriptive and inferential statistics were used for analysis of data. Descriptive statistics (mean, standard deviation, frequency and percentages) were used to describe the clinical and demographic variables of study participants. The determinants of medication adherence were analyzed using Chi-Square test and independent student t- test. The analysis was done with SPSS 20th version. Results: Majority (71%) of patients were not adherent to antiepileptic treatment. Severity of seizure (indicated by the presence of seizure last year), medication frequency and complexity of treatment were found to have significant association with the Anti-Epileptic Drugs (AED) adherence status. Status of adherence is significantly associated with frequency of seizure/year and positive life style. Conclusion: As Medication adherence was observed to be low, services for adherence counseling and health educational interventions in the epilepsy clinics is recommended.
The Effect of Family-Centered Empowerment Model on the Illness Perception in Heart Failure Patients: a Randomized Controlled Clinical Trial
Authors: Rahimi kordshooli khadijeh , Rakhshan Mahnaz , Ghanbari Alireza
Published: January 2019

Introduction: Heart failure is a chronic medical condition that, despite the existing therapies, involves different aspects of an individual’s life (such as self-care capability). Illness perception is one of the most important variables which seem to improve the self-efficacy skills in chronic diseases such as heart failure. Therefore, this study aimed to investigate the effect of family–centered empowerment model on the perception of the illness in heart failure patients. Methods: This interventional study was performed on 70 heart failure patients, assigned into control and experimental groups, admitted to the heart clinic of Hazrate Fatemeh hospital in Shiraz. After the convenience sampling, the patients were divided into two control and intervention groups by block randomization method. For experimental group, the family-centered empowerment modeling was done in 5 sessions. The research materials included demographic information and Brief illness perception questionnaires (B-IPQ). Data were analyzed using SPSS v.13 software. The statistical tests included Wilcoxon, Man-Whitney, and Independent t-test. P value less than 0.05 was considered as significant. Results: In this study, both control and experimental groups were homogeneous with demographic information. Before the intervention in different dimensions of illness perception, all of the values in both groups were the same; However, after the intervention, a significant difference was observed in all of the dimensions of illness perception, except for Time line; so that the most and the least changes were related to the concern (1.09 (0.61) vs 3 (0.93)), and identity dimensions (0.97 (0.61) vs 2.11 (0.67)), respectively. Conclusion: On the basis of the above, it can be concluded that this model modifies the illness perceptions in heart failure patients. Cardiac nurses should consider family- based empowerment model as a treatment for heart failure patients