1 A Huge Retroperitoneal Large B-Cell Lymphoma Presenting As Chronic Small Bowel Obstruction: A Case Report , Ningi AB1*, Aliyu S2, Adewunmi OL2, Zarami AB2
Retroperitoneal tumours are an aggregate of multiple types of neoplastic lesions with a preponderance of tumours of mesenchymal origin. Other histological types such as Lymphoma, are reported to be commoner now. Retroperitoneal tumours are generally rare and clinical diagnosis is often difficult due its cryptic location. It is often diagnosed incidentally following abdominal radiological studies or following complications. The most common complication being an extrinsic compression, particularly, on the retroperitoneal structures; such as the ureters, duodenum or the major abdominal vessels. It may also present as a vague abdominal pain or chronic bowel obstruction like our index patient. Abdominal CT Scan is the most sensitive tool of diagnosis and complete surgical excision often, an enbloc excision with involved adjoining organs offers the best chance of cure. Adjuvant chemotherapy, radiotherapy or chemo-radiation improve disease free interval and overall survival. The mainstay of retroperitoneal lymphoma is however a cytotoxic chemotherapy or more recently Rituximab combination therapy. We present a case of a huge retroperitoneal large B-cell Lymphoma presenting as chronic small bowel obstruction.
2 Verrucous Squamous Cell Carcinoma of the Scalp: Rare but Exists , Mounia Bennani1*, Sara Dahouki1, Khadija Issouale1, Hanane Baybay1, Sara Elloudi1, Zakia Douhi1, Fatima Zahra Mernissi1
Verrucous carcinoma is a rare, low-grade, well-differentiated squamous cell carcinoma most commonly seen on mucosa. It has been infrequently reported to occur on the skin, where it is a slow-growing and locally aggressive tumour. It is not uncommon for cutaneous verrucous carcinomas to be mistaken for the more frequent verruca vulgaris and treated accordingly. We report a case of a rare localization of this tumor in the sclap of a 57 year old patient.
3 The Genetic Discrepancy-Lynch Syndrome , Anubha Bajaj
Lynch syndrome is a frequently discerned hereditary cancer syndrome demonstrating the occurrence of colorectal carcinomas in around 80% subjects and endometrial cancers in nearly 60% individuals. Lynch syndrome is accompanied by germ line chromosomal mutation of one of the four Mismatch Repair (MMR) genes, enunciated as MLH1, MSH2, MSH6 or PMS2, which can be discerned with cogent immune histochemical reactions or evaluation of Microsatellite Instability (MSI). Lynch syndrome is generally associated with a cumulative emergence of fewer than ten (<10) colonic adenomatous polyps which can rapidly metamorphose into poorly differentiated, medullary-type carcinoma, mucinous adenocarcinoma, signet ring cells or a Crohn’s like reaction. Lynch syndrome requires a segregation from Attenuated Familial Adenomatous Polyposis (AFAP), Turcot’s syndrome, MUTYH associated polyposis, MSH3 related susceptibility to polyposis, NTHL1 mutation susceptible polyposis, POLE mutation susceptible colorectal carcinoma, Li-Fraumeni syndrome, hereditary diffuse gastric cancer or hereditary breast and ovarian cancer syndrome. Colonoscopy commencing at 20 years to 25 years, repeated annually or every 2 years to 5 years with colectomy is recommended in colonic cancer or surgically unamenable colonic adenoma.
4 Somatic Comorbidities among Senior Schizophrenics: A Local Pilot Estimation , Saeed Shoja Shafti1*, Alireza Memarie1, Masomeh Rezaie1, Behjat Rahimi1
Introduction: Comorbidity between mental disorders and physical illnesses is the rule rather than the exception.  Approaches to study the impact of comorbidity become challenging also due to lack of consensus about how to define and measure the concept of comorbidity. The aim of the present study was to evaluate the clinical profile of medical comorbidity among a group of local chronic elderly schizophrenic patients to see their prevalence and physiognomies. Methods: While geriatric section of Razi psychiatric hospital had been selected as the field of investigation, all elderly schizophrenic patients, who have been hospitalized there for lifelong, had been selected as accessible sample and surveyed with respect to recorded checkups and comorbid medical diagnoses. Psychiatric diagnosis was in essence based on ‘Diagnostic and Statistical Manual of Mental Disorders’, 5th edition (DSM-5) and medical diagnosis was principally based on ‘International Classification of Diseases’, 10th edition. Results: Assessment had been performed on 168 aged schizophrenic patients (≥65 years old), including 101 men and 67 women. According to results, 89% (n=151) of elderly patients had some kind of registered non-psychiatric co-morbidity, which was meaningfully higher than frequency of comorbidity among senior group of local residents. Amongst recorded co-morbidities falls, hypertension and osteoarthritis were the most prevalent comorbidities with a frequency around 48.8%, 44.6% and 39.2%, respectively. Hypertension, renal disease and malnutrition were significantly more prevalent among male patients (p<0.0000, p<0.0045 and p< 0.0018, in turn) and hyponaremia, aspiration/asphyxiation and seizure were meaningfully more prevalent among female patients (p<0.0075, p<0.0000 and p<0.0009, one-to-one). As stated by the findings and in comparison with the senior group of local people while diabetes, renal diseases and malnutrition were significantly more frequent, coronary artery disease, gastrointestinal disorder and osteoarthritis were significantly less frequent among the present sample of elderly schizophrenic patients. Conclusion: While in comparison with senior group of local people the rate of medical co-morbidities, particularly diabetes, renal diseases and malnutrition, were significantly higher in chronic elderly schizophrenic patients, a significant difference, as well, was palpable regarding the interrelated items between male and female patients, which demands further methodical and gender-based studies to define proper care and interventions for this vulnerable group of patients.
5 Trunnionosis: What We Should Know As an Orthopaedic Surgeon , Nishikant Kumar1*, Andalib Kashani1, John Mukhopadhayay1
The main question is what is Trunnionosis and what do we need to know as a surgeon. So trunnionosis is basically metallosis. It is the generation of metallic debris from a combination of motion at head on neck junction and an electrochemical corrosion [1,2]. Trunnion is part of the femoral stem where head gets engaged1; Corrosion of this part is called Trunnionosis. Taper is the slotted part of head which fits into trunnion of stem; corrosion of this part is called Taperosis (Fig. 1). Trunnionosis is basically a electrochemical corrosion and metallosis due to micromotion and both are basically synergestic and generates huge amount of metallic particles [2]. It causes the same adverse local tissue reaction as metal on metal heads as in ALVAL, Pseudotumours. Trunionosis also causes osteolysis [3]. Trunnion is an independent source of metal ion [3-5]. In Rush Clinical Series, 27 patients of THR were revised for advanced local tissue reaction secondary to head neck corrosion with metal on poly bearings. The revision rates because of trunnionosis was 4.3% between 2009-2013.
6 Tricholeichomania by Proxy , Ramon Grimalt
To the editor: When preparing a talk for a hair meeting on self-inflected hair loss I read with interest the letter published by W. Burgdorf in November 2009 about “Trichodaknomania by proxy” [1]. While I was working at home on my laptop and seating on the sofa dealing with trichotemnomania, trichoteiromania, trichorrhizophagia and trichodaganomania my dog, an extremely friendly female Vizla, came close to me and, with the idea of calling me out to the garden to play with her, she started licking my forearm [2-5]. Having myself at home both a cat and a dog I decided to experiment about this peculiar phenomenon described by W. Burgdorf. It is well known by pet’s owners that cats have a much rougher tong than dogs. With the purpose of stimulating both of my animals which commonly come to sit on the sofa one in each side while I prepare my lessons on my laptop, I decided to gently apply a commercial solution (Easy treat Bacon and cheese flavour Kong® Inc. USA) highly attractive for dogs on one of my forearms and just some commercial ice tea (Nestea® Nestle Inc. Switzerland), sweet and appealing to my stray cat on the left forearm. They both responded as expected and started licking with fruition my forearms. When I saw they started losing interest I added further stimulus.
7 A Comparative Study of the Effects of Ethanolic Extract of Sesamum indicum Seeds and Mesterolone on Some Testicular Morphometry of Adult Male Wistar Rats Secondary to Ketoconazole-Induced Damage , Yusuf MK 1*, Ibegbu AO 1, Alawa JN 1
Aim: The study aimed at comparing the effects of ethanolic extract of Sesamum indicum seeds with mesterolone on some testicular morphometry following ketoconazole induced damage in Wistar rats.                                                                                          . Methods: Thirty-six (36) adult male Wistar rats were divided into six (6) groups of six rats each. Groups 1,2,3,4,5 and 6 were administered 1 ml of normal saline, 100 mg /kg body weight (bwt) of Ketoconazole only, 500 mg/kg bwt of Ethanolic Extract of Sesamum indicum (EESI) seeds then 100 mg/kg bwt of Ketoconazole,100 mg/kg bwt of Ketoconazole then 250 mg /kg body weight of EESI seeds,100 mg/kg bwt of Ketoconazole then 500 mg/kg bwt of EESI, 100 mg/kg body weight of Ketoconazole, respectively. All administrations were carried out orally and once per day. The histological slides were prepared for morphometric analyses. Results: No observed significant differences in the morphometry of the groups administered EESI and Mesterolone.  However, the morphometry of the group administered EESIS and Mesterolone were significantly increased when compared with group 2 alone (P ≤ 0.05).  Conclusions: The effects of the administration of ethanolic extract of Sesamum indicum seeds on the morphometry of the testis appeared to be indifferent with Mesterolone; and both EESIS. Mesterolone also appeared to have minimize the distortion of the normal dimensions of the testis caused by ketoconazole which may be due to their androgenic properties.
8 Mechanism of Action, Kinetics and a Bioactive Metabolites AM404 of Paracetamol , Sarbjeet Singh1, Mandeep Kaur2*
Paracetamol is that the one amongst the foremost broadly speaking NSAIDS used as antipyretic and analgesic drug within the world. However, still its Mechanism of Action (MOA) is not fully recognize.  The potential Mechanism of Action (MOA) of paracetamol as its antipyretic and analgesic impact was thought multiple pathway. Some action relies on the inhibition of the Cyclooxygenases (COX enzyme) and a lot of recently study show that it additionally acts on serotonergic pathways (5HT pathway). A brand new metabolic pathway of paracetamol (as a prodrug) is come back to grasp, involving the generation of a lively matter, AM404 (N-4Hydroxyphenyl-5Z, 8Z, 11Z, 14Z-eicosatetraenamide), by the (FAAH) carboxylic acid organic compound hydrolase protein within the brain, was recently known. This review describes the theoretical knowledge that show the affiliation of this metabolic pathway within the analgesic & antipyretic action of acetaminophen (PCM) and its relationship with the enzyme protein (COX) and (5-HT) serotonergic systems. It additionally shows that the new systems (cannabinoid and vanilloid systems) and targets as well as the atomic number 20 channel receptor (Cav3.2), play an important role within the flightless bird of paracetamol.
9 Characterization the Teenage Students from the Schools “Boris Luis Santa Coloma” and “Seguidores de Camilo” in Risk about the Drug Consumption , Dania Velázquez Ronda1, Fé Fernández Hernández 1*, Efraín Sánchez González2, Alexis Gil Lans1, Ricardo Izquierdo Medina1
Background: Teenage people should be sensible to the drugs consumption. This attitude often is related with personal and social problems. This is a multi-social problem present for the Public health, education and families too. Objective: To characterize the teenage students from the schools “Boris Luis Santa Coloma” and “Seguidores de Camilo” in risk about the drug consumption. Materials and methods: The research was made in the schools “Boris Luis Santa Coloma” and “Seguidores de Camilo” from the “10 de Octubre” municipality in 2018. The population was separated in four groups. The group one was for professors from these schools, group two for parents from the teenage asked, the group three for the teenage students and the group four for health workers related with the selected students. Like inclusive criteria for the different groups were assumed the following. Group one and group four: be working at school for at least five years, group two: be parent for some teenage student selected and group three: student from the schools “Boris Luis Santa Coloma” or “Seguidores de Camilo” from the “10 de Octubre” municipality in 2018 who had consumed some illegal drug at least one time at life. The group one was selected according to the Snow Ball criteria and for the others groups were selected intentionally. Finally the whole group keeps formed by 21 professors, 15 health workers related with the selected students, 35 students and 35 parents from these students. Results: The teenage students have not sufficient risk perception about the drug consumption. The parent’s haven´t control for all activities that these students make out home and usually are drugs consumer too. Professors understand they haven´t all needed tools to help the teenage students. Health workers intervention was useful helping to teenage students. Conclusion: Students from the schools “Boris Luis Santa Coloma.” and “Seguidores de Camilo” are often consumer of drugs. They haven´t sufficient risk perception about drugs consumption and consequences. Society should assume a more active position around drug consumption prevention in the cited schools.
10 Sickle Cell Anemia: A Succinct Look into Recently Tested Disease Modifying Interventions , Malena Allbright1, Antonio Fernandez1*
Sickle Cell Anemia (SCA) is a globally prevalent, monogenic, life-threatening blood disorder with a complex pathology that remains obscure. A deepened understanding of the malady in the recent years has led to pharmaceutical advancements that target pathophysiology and ultimately ameliorate associated multivariate clinical manifestations. Abnormal cell to cell interactions, endothelial adhesion, induced oxidative stress, intracellular erythrocyte dehydration and concentration levels of fetal hemoglobin are a few factors know to play a key role in microvascular obstruction in individuals with hemoglobin S. All of which have recently been manipulated in-vitro to pharmaceutically alter clinical complications, disease progression and mortality patterns. The purpose of this paper is to provide a condensed overview of recent discoveries made within SCA pathology and subsequent pathologic based therapeutic agents. A general overview of the molecular basis of the malady, global prevalence and the efforts toward advancing stem cell transplantation technology will also be discussed.
11 Potential Risk Factors of Glioblastoma Multiforme in Greek Adults: A Case- Control Study , Nikolaos Andreas Chrysanthakopoulos1,2*, Panagiotis Andreas Chrysanthakopoulos3
Aim: The aim of the current report was to assess the association between potential risk factors in the pathogenesis of Glioblastoma Multiforme (GBM) in a Greek adult sample. Materials and Methods: The study sample consisted of 68 individuals who suffered from GBM and 280 healthy no GBM individuals. Initial diagnosis of GBM based on Magnetic Resonance Imaging (MRI) findings diagnosis, however definitive confirmed by the histopathological examination of the intraoperatively removed tumor or its parts, using traditional histological, cytologic and histochemical methods .The associations between known potential risk factors of GBM and the GBM risk was assessed using univariate and multivariate logistic regression analysis models. Results: The application of logistic regression model showed that higher Socio-Economic Status (SES) (p=0.032, OR=3.79, 95% CI=1.36-8.61), previous infection with Cytomegalovirus (CMV) (p=0.048, OR=3.11, 95% CI=1.12-6.89), and previous Traumatic Brain Injury (TBI) (p=0.028, OR=5.58, 95%  CI=2.14-11.40), were statistically significantly associated with GBM risk. Conclusion: Higher SES, previous CMV infection and previous TBI were significantly associated with the risk of developing GBM.
12 Occlusal Plane Dictated Skeletal and Dental Malocclusion with Concomitant Postural Diagnostic Findings-A Pilot Study Using Functional Positioning Overlays , Ogliara F1,3, Bagnasacco A1, Greven M2,3*
Objective: Aim of this investigation is to find evidence that the correction of the class II malocclusion and/or deep bite in children with mix dentitions using Functional Positioning Overlays (FPO) is faster and more stable than traditional approach and associated with an improvement in head posture and cervical spine. Material and Method: Twenty patients (aged of the patients ranged from 6 to 9 years, mean age 7.5 years) presenting a dental class II occlusion 1) Underwent to preliminary instrumental evaluation: photos, models, cephalometrics and condilography (cadiax compact), GPA (Global Postural Analysis) 2) They were divided in two homogeneous groups (matching by age and sex) Ten patients were treated with acrylics crowns FPO (Functional Position Overlay) according to German Patent Number 10 2005 052 068 (2014) (similar to table tops) Ten patients were treated only with traditional treatment (fixed) 3) Instrumental revaluation was performed: after 7-8 months from the beginning of the therapy and at the end of the therapy Results: A more rapid improvement in the mandibular adaptation (SNB/SND) was found in the cases treated with FPO than traditional approach; a more marked tendency to normalization was found in the values concerning cranio-cervical cephalometry and more quickly reach normality in the distribution of weight at level of the feet in patients treated with FPO that group control. Conclusion: The results obtained demonstrated a tendency to reach faster the correction of the malocclusion in association with the improvement of the posture. The results are most likely related to the fact that FPO acts 24 hours a day on the mandibular position in growing patients.
13 Unusual Case of Pyoderma Gangrenosum and Bilateral Ear Changes Secondary to the Use of Cocaine with Levamisole in a Patient with Systemic Lupus Erythematodes , Andrey Manov1*, Nisha Dhanabalsamy1, Menalee Hapuarachchi1
The knowledge of skin as well as ear complications caused by cocaine with levamisole is evolving. We described a patient with primary autoimmune rheumatological disorder- Systemic Lupus Erythematosus (SLE) as well as Chronic Hepatitis C and Pyoderma Gangrenosum (PG) as well as ear changes which might be in differential diagnosis of Relapsing Polychondritis (RP). Also the patient had positive P- ANCA and C- ANCA antibodies as well as elevated titers of ANA and decreased complement levels of C3, C4, CH50. Although pyoderma gangrenosusm is described in patients with SLE, hepatitis C etc. the time course of consumption of cocaine with levamisole as well antibody changes described were typical for drug induced ear changes and pyoderma gangrenosum. We think clinicians should always include the urine/ blood drug test when dealing with those disorders to exclude drug induced pyoderma gangrenosusum and ear changes, before attributing those changes to primary rheumatological or infectious disorder.
14 MR Imaging in Unilateral Hydrocephalus in Adults , Lokesh Rana1*, Dinesh Sood2, Naresh Rana1, Deepak Singh3
We present a case of a 19-year-old male who presented with history of headache and seizures of 3 years duration. There was unilateral lateral ventricle hydrocephalous. One of the two lateral ventricles was dilated. Idiopathic stenosis of foremen of Monro was found. It is one of the important causes, though it is a rare entity. Delayed clinical presentation may lead to delay in the diagnosis and thus causing delay in surgical planning if required.
15 Evaluation of Therapeutic Adherence among Moroccan Hypertensive Patients: About 1482 Cases , Oumaima Naour1*, Rime Benmalek1, Imad Nouamou1, Hatim Zahidi1, El Ghali Benouna1, Rachida Habbal1
Background and Aims: High Blood Pressure (HBP) is a common condition, however, its several complications especially cardiovascular can be associated with significant morbidity and mortality. Hence, the importance of improving its management through patients’ medication, which is a challenge for both the practitioner and the patient. The aim of our study was to evaluate predictive factors of therapeutic adherence in Moroccan hypertensive outpatients. Patients and Methods: We conducted a cross-sectional study from September 2015 to June 2019 including hypertensive patients treated in ambulatory cardiology check-ups. Data was collected from a valid questionnaire: Morisky Medication Adherence Scale (MMAS-8). Results: 1482 patients were included in this study. Good drug adherence was found in 73.6% according to MMAS-8. Poor compliance predictive factors were: lack of social support (p = 0.002), depression (p= 0.017), poor control of hypertension (p <0.0001), insufficient knowledge about the disease (p= 0,031) and some treatment characteristics: daily multiple administration (p = 0.005) and polytherapy (p= 0.005). Conclusion: Non-compliance to antihypertensive treatment remains a public health issue in Morocco responsible of additional cost for both the patient and society. Hence, the urgent need to put in place effective strategies to limit this phenomenon in our population.
16 Assessment of Renal Function Tests and Serum Total Protein among Pregnant Women with Pregnancy-Induced Hypertension Attending in Asrade Zewudie Memorable Hospital (ASZMPH), Gojjam, Ethiopia: Case-Control Study , Haymanot Tewabe1*, Mistire Wolde1
Background: Pregnancy-induced hypertension has remained a significant global public health threat in both developed and developing countries. Therefore, this study aimed to assess renal function tests and serum total protein among pregnant women with pregnancy-induced hypertension. Methods: A case-control study was done on 200 pregnant women, 100 with pregnancy-induced hypertension (case group) and 100 normotensives (control group) at Asrade Zewudie Memorable Primary hospital Gojjam, Ethiopia, from January 24, 2020 to April 30, 2020. 5 ml of venous blood was collected on the SST test tube and analysed for serum lipid profile, renal function test, and serum total protein. The analysis was done by using SPPS software (version 20.0). The level significance was set at a 95% confidence interval (p-value is less than 0.05 was considered clinically significant). Results: There was a significant increase in blood urea, and serum creatinine (p < 0.05) in case groups as compared to normal groups (p < 0.05). The elevation of serum total protein was not significant (p > 0.05). The outcome of the final multiple logistic regression model indicated that factors like Body Mass Index (BMI), habits of doing scheduled exercise, habit of drinking alcohol, habit of fruit consumption, trimester and gravidity were having significant association with high blood urea, and serum creatinine results of the study participants. Conclusion: It might be better for clinicians to use renal function tests as screening test than requesting other costly tests. Further studies in different areas of the country by considering life style variation also recommended.
17 Osmolality Threshold for Sickle Cell Erythrocyte Hemolysis , Victoria M Richardson1, Kay Woollen, MT1, William A Anong1,2*
Background: The importance of fluid intake is well document as metabolic and physiological processes operate effectively in a homeostatic environment. Normal red cells are more resilient to changes in serum osmolality compared to other cells, remaining intact when serum osmolality decreases to as low as 190-mOsM from the 270-290-mOsM reference interval. The membrane’s ability to deform/reform under shear confers the red cell high resistant to changes in serum osmolality. Although normal red cells are resilient, the osmolality threshold for hemolysis of abnormal red cells such as sickle cell blood remains unclear. The primary objective of this study was to determine the osmolality threshold for hemolysis of sickle cell blood vis-a-vis that of normal red cells. Methods: As described under methods, red cells were prepped and exposed to solution of varying osmolality ranging from 290 to 65-mOsm of sodium chloride. Following incubation, the supernatant and pellets were analyzed for hemoglobin (spectrometry) and Glycophorin A (GPA) content by western blotting techniques. Results: While the osmolality threshold for normal red cells was 190-mOsM, sickle erythrocytes osmolality threshold for hemolysis was surprisingly 170-mOsM. Both cells ruptured rapidly displaying an S-shaped-like “cooperativity” pattern. Complete (100%) hemolysis occurred at ≤150-mOsM. The hemoglobin retained in pellets decreased to ~50% (normal red cells) and ~20% (sickle red cells) when solution osmolality drops to 65-mOsM. Conclusion: Sickle cell erythrocytes are more resilient than normal red cells to serum osmolality changes. This finding provides insight into how normal and sickle cell individuals would withstand changes in serum osmolality during dehydration/rehydration states. To alleviate pain, intravenous fluids are routinely administered as adjuvant therapy to slow or reverse the sickling process. Hence, balancing electrolytes and fluid volume during acute pain episodes may significantly benefit African American who are disproportionately afflicted by the sickle cell disease.
18 Pandemic and Modern Medicine: Time to Recognize and Correct Previous Misconceptions , Igor Klepikov1*
A year ago, few people doubted the scientific validity and practical feasibility of existing approaches to the treatment of Acute Pneumonia (AP). Even the use of a single antibiotic as the main treatment for completely different and disparate diseases was a common situation, the contradiction of which to the basics of clinical medicine was not questioned. The activity of antibiotics only against bacterial pathogens without additional effects on other manifestations of the disease did not prevent them from achieving the image of an almost panacea. The gradual decrease in the effectiveness of antibiotics with the biologically natural appearance of resistant bacterial strains was regularly compensated by the release of new, more active drugs. Decades of close attention to the suppression of pathogens have formed a persistent infectious ideology of the causes of AP, and the disease itself has become classified as infectious. However, this terminology did not correspond to the actual situation, since in practice patients with AP were not subject to mandatory isolation and other strict anti-epidemic measures. At the same time, during the period of antibacterial therapy, the number of patients in need of additional medical care steadily increased, but the infectious interpretation of the nature of the disease suggested the choice of methods tested for other inflammatory processes. The specifics of pulmonary inflammation faded into the background and no longer determined the specifics of treatment.
19 Real Time Health Monitoring For Palliative Patients through MSE-WBAN Architecture , Minimol VK1*
The mobile-Health (mHEALTH) is the application of digital technology in health care services to bring the health care services into a digital format and to introduce the culture of digitalization in health-related matters. There are many varieties of health apps available to purchase from apps stores which are really helpful for patients. Around 325,000 mHEALTH applications are available now. Development of tiny sensor networks that can be implanted inside or out- side the human body gave a novel development in the field of mHEALTH. The sensor devices can access the vital parameters from the human body and can be sent to any near-by personal devices through any of the network protocols like Bluetooth, Zigbee etc. The sensor devices change the mHEALTH application more dynamic and ensure the consistency of data by the real time monitoring. The paper proposed a new architecture for mHEALTH with multiple sensors to monitor the vital signals of patients in a palliative clinic and proved that the architecture is more efficient and consistent than existing mobile health applications.
20 Breast-Implant Associated Anaplastic Large Cell Lymphoma: A Case Report , Kumkum Vadehra MD1*, Rashmi Rekha Bhuyan MD1, Xin Qing MD, PhD1, Hany Meawad MD1
The Food and Drug Administration (FDA) released a statement in the beginning of 2017 regarding a rare cancer, Anaplastic Large Cell Lymphoma (ALCL) that has been related to textured breast implants and resulted in nine deaths. The first case of Breast Implant-Associated ALCL (BIA-ALCL) was published in 1997. This entity is more recently recognized and has been provisionally classified in the 2016 revision of the World Health Organization classification of lymphoid neoplasms. Here we report a case of a 58 year old woman with history of sub glandular silicone implants for bilateral breast augmentation 25 years ago, with complaints of bilateral breast pain and found to have bilateral Baker Grade III capsular contracture, and a suspicious chest wall lesion on imaging. Patient underwent removal of bilateral breast implants and total capsulectomies. The capsule and all associated abnormal lesions were sent for excisional biopsy. Microscopic examination revealed breast implant-associated anaplastic large cell lymphoma on the left side. On immunohistochemistry the lymphoma cells were positive for CD3 (subset), CD4, CD7, CD30, and CD43, and negative for CD2, CD5, CD8, CD68 and ALK1; supporting the diagnosis of breast implant-associated anaplastic large cell lymphoma. No lymphoma cells were identified in the submitted sections of right breast capsule which was confirmed by CD30 stain. This diagnostic workup proves it to be a Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) which is an uncommon peripheral T- cell lymphoma arising around textured-surface breast implants.
21 Scaffolds Combined with Stem Cells have Synergistic Effect in Regenerative Dentistry , Michel Goldberg1*
Tissue engineering generates alternatives for tissues regeneration and/or reconstructive surgery. Materials and fabrication technologies are important in designing temporary extracellular matrices (scaffolds), implicated in three-dimensional tissue formation. In this review, we reference the relationship between tissue engineering and materials science. Materials for porous solid-state scaffolds include linear aliphatic polyesters Poly Glycolic Acid (PGA) and their co-polymers Poly Lactic-Co-Glycolic Acid (PLGA), poly (Ɛ-caprolactone) (PCL) and Poly Hydroxyl Butyrate (PHB)]. Biodegradable polymers include Poly Propylene Fumarate (PPF) and phosphoresters. Natural macromolecules such as proteins and polysaccharides including collagen, either denatured as gelatin, or combined with glycosaminoglycan(s), silk, alginate, chitosan, and hyaluronate. Inorganic materials are categorized as porous bioactive glasses or calcium phosphate, β-tricalcium phosphate, hydroxyapatite and their derivatives. Research’s on implantable materials for tissue regeneration shed lights on biodegradable polymers and specifically, on synthetic proteins promoting regeneration of the dental pulp despite infectious degradation and necrosis of the pulp tissue.
22 The Influence of Gene Mutations on Bone and Teeth: Osteogenesis and Dentinogenesis Imperfecta , Michel Goldberg1*
Osteogenesis Imperfecta (OI) are inherited disordesr generating skeletal fragility. It is caused by mutations in one of the two genes encoding type I collagen (COL-1A1, COL1A2). Four subtypes of OI has been identified: Classic non-deforming OI with blue sclerae (Type I), perinatally lethal OI (Type II), progressively deforming OI (Type III) and common variable OI with normal sclerae (Type IV). Type IV comprises patients with phenotype intermediate to types I and III. More recently, other types of OI (V-XV) have been reported. Although they phenotypically resemble to types I-IV, they are not associated to type I collagen mutations. Dentinogenesis Imperfecta (DI), associated or not with OI, was classified in five types: Dentin Dysplasia types I and II (DD1 and DD2) and Dentinogenesis Imperfecta (DGI-types I-III). Cleavage of DSPP gives rise to three molecules susceptible to mutations, respectively dentin sialoprotein (DSP), Dentin Glycoprotein (DGP) and Dentin Phosphoprotein (DPP). Pharmacological treatments contribute to reduce adverse effects of OI, whereas cells and genes therapies still need improvements.
23 Essential Newborn Care Practice and Associated Factors among Home Delivered Mothers within the Past Six Months, in Abaya District, West Guji zone, Oromia Regional State, Ethiopia, 2019 , Nigusu Derese1*, Kemal Ahmed2, Edao Tesa2, Tariku Derese3
Background: Poor immediate new-born care practice increases risk of morbidity and mortality by predisposing the new-borns to sepsis and hypothermia. In developing countries nearly 3 million new-borns babies die every year mostly where many births happen at home. Therefore, assessment of essential new-born care practice among home delivered mothers is important for the improvement of new born health and reduction of risk of morbidity and mortality. However, to the best knowledge of researcher, there was no previous study on this title at this study area. Objective: Assess essential new-born care practices and associated factors among mothers delivered at home during the six months preceding the study in Abaya district of West Guji zone, Oromia, Ethiopia from August 1-August 30, 2019. Methods: Community based cross-sectional study design was employed. Stratified-multi stage sampling technique was used to select 632 study subjects. Structured pretested questionnaire was used for data collection. After one day training given six diploma and 2 BSc nurses were participated as data collectors and supervisors respectively. After data clearance and coding done data entered in to Epi-info version 7 and exported to SPSS window version 21.0 for analysis. Binary and multiple logistic regression analysis were used to identify factors associated with outcome variable. Adjusted odd ratio with their 95% CI were calculated to determine the presence and strength of association. P-value of <0.05, considered to declare significance. Result: The overall level of good new-born care practice in this study was 18.9% (95% CI: 0.16; 0.22). Urban residence (AOR:2.233; 95% CI: 1.082, 4.607), No PNC visit (AOR:0.618; 95% CI:0.400,0.954), Home delivery assisted by HEW (AOR:3.617;95% CI:1.058,4.607), Home delivery assisted by relatives (AOR:0.427;95%CI:0.222,0.821), Last ANC visit at health post (AOR:0.485; 95% CI:0.299,0.785), didn’t knowing poor sucking as danger sign (AOR:0.524;95% CI:0.332,0.826) were independent factors associated with essential new-born care practice. Conclusion: The level of Essential New-Born Care Practice (ENBCP) found in this study was very low compared to studies conducted previously in different areas. No PNC home visit by HEW, having last ANC visit at health post, didn’t knowing poor sucking as danger sign and home delivery assisted by relatives were factors negatively associated with ENBCP and urban residence and home delivery assisted by HEW were factors positively associated Essential New-Born Care Practice.
24 Ashy Dermatosis and Lichen Planus Pigmentosus: A Clinico Pathological Study in Republic of Yemen , Mohammed Abdul Qader Almalmi1*
Background: Ashy Dermatosis (AD), or Ashy Dermatosis of Ramirez, F. Kerdel-Vegas and Erythema Dyschromicum Perstans (EDP) is a characterized by unknown origin which was reported first in EL-Salvador in 1957, later in Venezuela in 1961 (Latin America) and in the USA in 1966. In Japan it was diagnosed as Lichen Planus Pigmentosus in1956. Objective: The objectives of the study are: To assess the clinical and histopathological characteristics of patients with ashy dermatosis and Lichen Planus Pigmentosus and define their differences or similarities of a study populations of 33 To find out the relation of socioeconomic status in Yemeni patients with Ashy Dermatosis and Lichen Planus Pigmentosus To compare the prevalence of Ashy Dermatosis and Lichen Planus Pigmentosus in the Republic of Yemen with the other studies carried out in Latin America, North America, Europe, Japan and India Patients and Methods: Thirty three Yemeni Patients, 11 females and 22 males, 6-70 years old presented with itchy and non-itchy gray-blue dark brown hypo-and hyperpigmented maculo-papular. Skin eruptions in the face,neck, trunk and upper and lower limbs, of several months duration were studied. Comprehensive blood images, seroiogical tests for syphilis, skin scraping for fungi, Wood’s light and rheumatoid factor, stool and urine analyses showed no abnormalities. A skin biopsy with subsequent histopathological examination was done in all selected patients. Results: The clinical data, investigations and the histopathological findings showed that 23 patients (5 females and 18 males) suffered from Ashy Dermatosis (AD) and 10 (6 females and 4 males) of Lichen Planus Pigmentosus. Conclusion: 33 patients out of 26.324 dermatology out patients seen during (96-98) presented with Ashy dermatosis or Erythema Dyschromicum Perstans (0.087%) and Lichen Planus Pigmentosus (0.037%) were very rare in Al-Kuwait University Hospital Sana’ a City, Republic of Yemen. These two diseases are different clinically but similar histopathologically. This study did not elicit exact etiological factors but racial, nutritional and environmental factors are suspected. Most of those patients were poor and working as farmers and street vendors and by during so were exposed to sunlight.
25 Status of Rabies in Selected Pastoral Districts of Borena Zone Oromia Regional State, Southern Ethiopia , Wubishet Zewdie1*
The assessment was conducted to in pastoral districts of southern part of Ethiopia to discover status of rabies in human and animals in the area. A cross-sectional survey was conducted using structured questionnaire. The questionnaire was administered to pastoral communities, professionals working with animals and human to collect information on the status of rabies both in animals and human. Data on human and animals bite by rabid dogs in the past two years was also collected. In addition, human and animal death in past two years also recorded. This survey revealed that rabies is one of public health problems of the area. The communities keep a dog to use as a guard for their livestock and compound but they do not vaccinate their dogs because communities have no information about the availability of vaccines for rabies and some of them complains absence of vaccine supply in the area. The presence of a high number of stray dogs in the area also recorded during the survey. The study discovered that children are the most bitten community members relative to young and adult whereas sheep and goats are the bitten animal species. As a conclusion, the diseases are one of the public and animal health problems in the area that need great attention both from animal and public health sectors. Therefore, the collaborative action of Public and Veterinary professionals towards rabies control and prevention in animals and human is a mandatory to reduce the impact of disease both in human and animals.
26 Gall bladder Tuberculosis Mimicking Malignancy: An Unusual Case Report with Review of Literature , Anjum Ara1, Sumbul Warsi2, Mohd Rafey2, Kafil Akhtar2*
Isolated gall bladder tuberculosis is a highly rare disease entity. It may be associated with other intra-abdomen tuberculosis, which may involve the gallbladder via the lymphatics or bloodstream pathway. We intend to present a case of gall bladder tuberculosis diagnosed histopathologically in a 50 year old female patient, suspected to be gallbladder carcinoma after computed tomography scan and frozen section biopsy. So all operated cholecystectomy specimens should always be send for histopathology confirmation of the diagnosis and all patients of gall bladder tuberculosis should be assessed for any tubercular focus elsewhere in the body.
27 Tuberculous Aortitis: An Extremely Rare Cause of Supra Aortic Trunks Stenosis , M Gargouri1-2*, S Marzouk3, E Daoud4, E Elleuch1, M Jallouli3, Z Mnif4, M Ben Jemaa1, Z Bahloul3 
Aortitis are mainly described in inflammatory disorders such as Takayasu arteritis, giant cell arteritis or Behçet’s disease. Thoracic infectious aortitis such as tuberculous aortitis are currently rare. They are always lethal without any treatment. The clinical manifestations are usually vague and nonspecific and may include pain, fever, vascular insufficiency, and elevated levels of acute phase reactants, as well as other systemic manifestations. As a result, aortitis is often overlooked during the initial work-up. A multimodality imaging approach is often required for assessment of both the aortic wall and aortic lumen, as well as for surveillance of disease activity and treatment planning.
28 The Effects of Allogeneic cADSCs on an Experimental Ear Auricular Defect to Evaluate Cartilage Regeneration in a Canine Model , Mahdieh Ghiasi1*, Sahar Farzaneh2, Mohammad Bigdelo3, Mehran Vosoogh4
Objective: Ear is one of the most important organs of the auditory system and may fail as a result of trauma, tumors, or other diseases. Allograft transplantation of adult stem cells has been used as an excellent procedure for restoring damage from different diseases. The aim of this study is to assess the regenerative ability of adipose-derived stem cells in ear auricle cartilage defects in a dog model injected with different treatments. Materials and Methods: The adipose-derived stem cells were isolated from canine adipose tissue. After cultured in medium, these cells were obtained after four passages. This study evaluated into three groups: Groups 1 and 2 were determined by mixing of the adipose-derived stem cells with fibrin glue biomaterial and without fibrin glue, respectively. The mixing of the adipose-derived stem cells with fibrin glue biomaterial and without fibrin glue were separately injected into the mid-portion of a surgically provided canine auricular cartilage injury. After two months, the auricular defect evaluated histologically. Results: Our findings demonstrated that points of new cartilage were formed at the location of the surgically stimulated defect. Four months after the surgical injection, it was shown that the defect was completely ameliorated with mature and native cartilage tissues. Also, there was no observed formation of cartilage tissue in the control group. Conclusion: Our results clearly indicate that allogeneic adipose-derived stem cells implantation into the experimental ear auricle defect is a safe, effective and relatively simple therapy of ear lesion in dogs, with a significant improvement of ear cartilage regenerative.
29 Microfracture and Hydrogel Scaffolds for the Treatment of Osteochondral Injuries of the Knee: Clinical Results at 4 Years Follow-Up , Pipino Gennaro1,2, Borghi Raffaele2, Vaccarisi Davide C2, Mardones Rodrigo3, Giardini Piero2, Alessio Giai Via4, Indelli Pier Francesco5*
The aim of this study is to evaluate the outcomes of microfracture technique and novel hydrogel scaffold for the treatment of osteochondral injuries of the knee. Forty-one patients affected by grade III and IV osteochondral lesions were treated between 2014 and 2015 with microfractures followed by the injection of a hydrogel scaffold into the defect. All patients have been evaluated pre-operatively, at 6 months, 1, 2, 3 and 4 years postoperatively (WOMAC and VAS scores). The initial total WOMAC score was reduced by 83% at 6 months, 90% at 12 months and 87% at 4 years. The initial VAS score was reduced by 78% at 6 months, 82% at 12 months and 83% at 4 years. All the scores, including total and sub-scores, statistically improved in all follow-ups compared to preoperative data. Our results showed an improvement of clinical outcomes and pain after the microfractures technique has been combined with the use of a hydrogel scaffold, which have been maintained at 4 years follow-up.
30 Some New Records of Trametes (Polyporales, Basidiomycota); from Pakistan , Afshan Wahab1*, Donald H. Pfister2, Kathy LoBuglio2, Siraj Ud Din1, Abdul Nasir Khalid3
Four different species of Trametes were collected during a field survey in Malakand district, Khyber Pakhtunkhwa, Pakistan. Based on morphological characteristics and the molecular data from internal transcribed spacer rDNA and large subunit nLSU, the species were identified as T. elegans, T. gibbosa, T. hirsuta and T. trogii. A literature review confirms T. elegans, T. gibbosa and T. hirsuta species to be the first records from Pakistan and comparison with herbarium specie confirms its identity.
31 Some New Records of Trametes (Polyporales, Basidiomycota); from Pakistan , Afshan Wahab1*, Donald H. Pfister2, Kathy LoBuglio2, Siraj Ud Din1, Abdul Nasir Khalid3
Four different species of Trametes were collected during a field survey in Malakand district, Khyber Pakhtunkhwa, Pakistan. Based on morphological characteristics and the molecular data from internal transcribed spacer rDNA and large subunit nLSU, the species were identified as T. elegans, T. gibbosa, T. hirsuta and T. trogii. A literature review confirms T. elegans, T. gibbosa and T. hirsuta species to be the first records from Pakistan and comparison with herbarium specie confirms its identity.
32 Some New Records of Trametes (Polyporales, Basidiomycota); from Pakistan , Afshan Wahab1*, Donald H. Pfister2, Kathy LoBuglio2, Siraj Ud Din1, Abdul Nasir Khalid3
Four different species of Trametes were collected during a field survey in Malakand district, Khyber Pakhtunkhwa, Pakistan. Based on morphological characteristics and the molecular data from internal transcribed spacer rDNA and large subunit nLSU, the species were identified as T. elegans, T. gibbosa, T. hirsuta and T. trogii. A literature review confirms T. elegans, T. gibbosa and T. hirsuta species to be the first records from Pakistan and comparison with herbarium specie confirms its identity.
33 Some New Records of Trametes (Polyporales, Basidiomycota); from Pakistan , Afshan Wahab1*, Donald H. Pfister2, Kathy LoBuglio2, Siraj Ud Din1, Abdul Nasir Khalid3
Four different species of Trametes were collected during a field survey in Malakand district, Khyber Pakhtunkhwa, Pakistan. Based on morphological characteristics and the molecular data from internal transcribed spacer rDNA and large subunit nLSU, the species were identified as T. elegans, T. gibbosa, T. hirsuta and T. trogii. A literature review confirms T. elegans, T. gibbosa and T. hirsuta species to be the first records from Pakistan and comparison with herbarium specie confirms its identity.
34 Screening Pilot Study of Fruit Seed Compositions by GC-MS and Their Potential Scenario Anti ACE2 and 2rh1 Receptors as a Recycling Possibility in the Coronavirus Pandemic , Asmaa Fathi Hamouda1,2*, Taymour-Lank Mohammed Farawilla3, Ibraheem Mohammed Attafi4, Ibrahim Abdu Khardali4, Mohammad Ahmad Attafi4, Magbool Essa Oraiby4, Farid Mohammad Abualsail4
Background: Since 2019, several critical effects of the coronavirus pandemic have surfaced, including its psychological problems such as depression. The World Health Organization has approved a group of drugs and vaccines. However, the world still faces novel coronavirus mutations, requiring more ideas to investigate a drug, vaccine and phytochemical potential chemoprevention proposal. Severe Acute Respiratory Syndrome-Coronavirus (SARS-CoV)-2 co-operates directly with the Angiotensin-Converting Enzyme 2 (ACE2) to penetrate the target cells. Aims: We aim to introduce the possibility of studying seed oil extract as an anti-depression, anti-stress, anti-epinephrine receptor (PDB: 2rh1) and as potentially binding anti-angiotensin-converting enzyme 2 (ACE2) agent. Methods and Methodology: We analyze the constituents of the six studied seeds’ oil with Gas Chromatography-Mass Spectrometry (GC-MS) by performing an AutoDock analysis of the components’ potential ligands to both the 2rh1 and ACE2. Results: We observe convenient binding conformations between the investigated receptors and the 44 phytoconstituents. The AutoDock outcomes of the seeds’ phytochemical GC-MS separated components reveal highly binding energy, with ACE2 higher than 2rh1. Conclusion: The studied seed oil contains binding energy with currently studied receptors and molecular weight, which enables it to be studied in the future as a nanoparticle against viruses, vaccines and psychiatric drugs.
35 Psychiatric Evaluation of the Effects of COVID-19 , Teresa López-Arteaga1*
The current COVID-19 pandemic has hit the entire world population hard and it is assumed that its consequences on mental health will be as important as its current physical repercussions. However, the evidence on this is not yet well known and it may be too early to assess these consequences. Objective: Identify if mental health has been worst in 2020 than 2018 and 2019. Descriptive study using artificial intelligence and natural language processing savana manager program in a population of 3,000,000 inhabitants. Results: Psychopathological diagnoses and prescription of psychotropic drugs have not changed significantly in the last year.
36 Superior Mesenteric Artery Syndrome in a Young Woman , Zhi Yang1,2, Xi-Jun Li3, Wei Liu1,2*
A 33-year-old woman presented with 1-month history of progressively worsening epigastric discomfort, post-prandial nausea, and vomiting. She had no documented medical history. Abdominal examination showed only mild epigastric tenderness. Abdominal computed tomography was performed and revealed compression in the third portion of the duodenum between the superior mesenteric artery and aorta with an aortomesenteric angle of 14.7° (sagittal view; Fig. 1) and aortomesenteric distance (between the aorta and superior mesenteric artery across the third portion of the duodenum) of 5 mm (transverse view; Fig. 1). Esophagogastroduodenoscopy showed extrinsic compression in the third portion of the duodenum. Superior mesenteric artery syndrome is usually relevant with rapid weight loss and largely attributed to depletion of the mesenteric fat pad which normally serves as a cushion around the third portion of the duodenum and prevents its extrinsic compression between the superior mesenteric artery and aorta [1]. The diagnosis of superior mesenteric artery syndrome depends on computed tomography findings of an aortomesenteric angle of <15° (normal range, 15-60°) and aortomesenteric distance of <10 mm (normal, 10-20) [2]. Esophagogastroduodenoscopy is often performed to rule out duodenal strictures [3,4]. Symptoms often resolve with weight gain by placing a jejunostomy tube for feeding [5,6]. Surgical treatment should be considered once medical management fails [7,8]. She was discharged home with weight gain and resolution of post-prandial vomiting symptoms, as well as with outpatient follow-up.
37 Big Daddy Pale Skin , Seun Ayoade1*
“Some 40,000 years ago, Cro-Magnons-the first people who had a skeleton that looked anatomically modern entered Europe, coming from Africa” [1]. “Neanderthals are our closest extinct human relative” Smithsonian national museum of natural history [2]. Since positing a couple of years ago that if Adam and Eve existed, they had to have been platinum blonde Caucasians [3]. I have come under fire from one or two individuals. What these critics don’t realize is that according to many evolutionists the first modern human beings were light skinned too! According to Cambridge University Press’ Biological Sciences it is said that all human ethnicities arose from Cro-Magnon man [4]. But reconstructions of the Neanderthal man and Cro-Magnon man show them to be light/white skinned. This is so at The Neanderthal museums in Croatia and Germany, The British Museum and The Hall of Human origins at The Smithsonian. So the bottom line is that whether we arrived here by creation or evolution our ancestors were presumably pale skinned. Whether “out of Eden” or “out of Africa” the first human beings were light skinned. Et tu, Darwin? Et tu evolutionists? [5-12].
38 The Rise of an Invisible Enemy (Salmonella) in the United States , Satesh Bidaisee1*, Christian Small1
Background: 1945 marked the end of World War II; however, the United States was unaware of an upcoming battle with an invisible pathogen which would linger for decades to come. The war’s conclusion meant thousands of troops returning to the United States. It was quickly realized the need for urgency in shoring up food production. To keep pace with the increasing population, farms and slaughterhouses took sanitary shortcuts. This led to an increasing food contamination which resulted in the emergence of zoonotic diseases across the country. One of those pathogens realized, from the transference between domesticated animals and humans, was Salmonella. Due to the widespread spikes in illness, in 1962, the government created the National Salmonella Surveillance System to monitor laboratory confirmed illnesses via the information provided by states and county cases. This intra-country tracking system which is still in existence feeds data to the Center of Disease Control and Prevention has played a major role with compiling and publishing information which assists in minimizing future Salmonella outbreaks. Purpose: The paper will provide insight to the rise of the zoonotic Salmonella trend realized after World War II and continues, albeit on the decline, today. Method: Data by decade was collected from literature and reviewed to provide a comparison to the emergence of Salmonella after World War II to its stabilization in the 21st century. Conclusion: Salmonella continues to be a zoonotic pathogen, with deadly consequences for humans, when not carefully controlled at the host level one of those being domesticated animals.
39 Preventive Effect of Yogasana (Yogic poses), Pranayam (Yogic Breathing Techniques) and Yoga Nidra on High-Risk People for Cancer: A Critical Review , Priyanka Katru1*, Sharad M Porte2
The global cancer burden has been rising day by day due to increase the incidence of high-risk factors for cancer. Chronic alcoholism, tobacco chewing, tobacco smoking, unhealthy diet patterns, unbalanced hormones, obesity, excessive exposure of radiation and sunlight, carcinogenic environmental substance and food additives, chronic inflammation, immunosuppression, infectious agents and advanced age these are some high-risk factors for cancer. Since prevention is better than cure, several preventative measures have been implemented to help prevent cancer. Quitting smoking, avoiding excessive body fat and engaging in regular physical activity are the most prevalent factors that minimize cancer risk. Yogasana (yogic poses), Pranayam (yogic breathing techniques) and Yoga Nidra, which have been practiced in India since ancient times, have played a significant role in cancer prevention. Yogic Prayer, Shodhana Kriyas (yogic cleansing techniques) like Jalaneti (nasal cleansing yogic practice), Kapalbhati, Yogic Sukshma Vyayama, Yogasana like Tadasana (mountain pose), Katichakrasana (standing spinal twist), Vajrasana (thunderbolt pose), Ardha Ushtrasana (half camel pose), Shashankasana (the hare pose), Bhujangasana (cobra pose), Balasana (child pose), Supta Baddha Konasana (reclining bound angle pose) and Shavasana (corpse pose), Pranayam like Nadishodhana (alternate nostril breathing), Bhramari (bumblebee breathing), Dhyan (Meditation) like Yoga Nidra should be beneficial to prevent the cancer and preventive management. Thus, Yogasana, Pranayam and Yoga Nidra can help to prevent cancer by facilitating in the discontinuation of tobacco use, the withdrawal of alcohol and opioid use, the reduction of obesity, the maintenance of a healthy oxygen level in the breathing, the reduction of oxidative stress that causes cancer and the prevention of onco-genetic mutation in cancer-prone individuals. However, further scientific data is required.
40 Pilot Study on Psychophysiological Characteristics of Occupational Burnout Syndrome among Various Medical Specialists , Vlada Furdui1, Ana Leorda1, Anatolie Baciu1, Olga Bulat1, Ludmila Ursu1, Cătălina Croitoru2, Vasile Dumitraș2, Elena Ciobanu2*
Introduction: Burnout syndrome is a real scourge of the XXI century, especially for people who work within a communication-related field. However, the issues on development and specific manifestations of occupational stress among doctors of different specialties have not been systematically studied yet. Material and Methods: A pilot study was conducted to assess the burnout syndrome as a complex systemic state of the professional activity of various medical specialists in the Republic of Moldova, depending on their psychophysiological characteristics. The pilot study involved 73 specialists, with a mean age of 38.2 (±1.1) years. Results: Of the 73 medical workers tested, 38.3% of them did not suffer from burnout, while 61.6% presented various signs of burnout. The specific characteristics of the professional exhaustion among healthcare workers were revealed depending on their specialty and work experience, as well as on their psychophysiological peculiarities. The most susceptible to stress factors were the healthcare workers with <10 years of working experience, 77.1%. The constituent mental health blocks showed changes among different medical specialties under the influence of occupational exhaustion. Conclusion: A relationship between physician burnout, their behavioral type and level of emotional stability has been demonstrated.
41 Clinical Examples of the Use of Mercureid Drug in Patients with Ischemic Neuropathy of the Optic Nerve That Appeared After Long COVID-19 , Sergey N Gusev1*, Velichko LN2, Bogdanova AV2, Khramenko NI2, Konovalova NV2, Kovtun AV3
Most people with coronavirus disease 2019 (COVID-19) recover completely within a few weeks. But some people continue to experience symptoms after the initial recovery. This condition is called post-COVID-19 syndrome or long COVID-19. They are threatened by the development of various diseases. We tried to answer some of these questions in our research. The study was conducted in 49 patients with ophthalmic pathologies who had previously undergone COVID-19. On the one hand, ocular pathologies are important because they allow in a non-traumatic way to obtain lifetime visualization of the state of blood vessels and capillaries as well as to assess the effect of the virus on the central nervous system.
42 Extracellular Matrix Proteinases , Michel Goldberg
Matrix metalloproteinases, known also as matrixins, cleave components of the extracellular matrix. They remodel collagen, elastin, gelatin and casein, and contribute to the MMP degradation. MMPs are secreted in latent forms (pro-MMP) and activated as zinc-dependent proteolytic enzymes in the extracellular compartment. MMPs are divided into 6 subgroups: Collagenases that degrade triple-helical fibrillary collagens into ¾ – ¼ fragments Gelatinases (A and B) Stromelysins Proteoglycanases Matrilysins Membrane-type MMPS, metalloelastase, enamelysin and others MMPs. Four tissue inhibitors of matrix metalloproteinases (TIMP-1 to -4) have been identified. Enamel matrix of developing teeth MMP20 and KLK-4 were detected during the secretory stage of enamel. MMP20 null mice play role during enamel secretion, whereas KLK4 is crucial during the maturation stage. The additional roles of MMP are wound healing, cancer progression, and skeletal dysplasias. In addition, MMP inhibitors are useful in the prevention of caries progression.
43 Re-Formation: Reactionary or Reparative Dentin , Michel Goldberg
Dentin (s) are complex structures including in the crown, the formation of the mantle dentin mostly atubular, and circumpulpal dentin, crossed along its entire length by 180,000-240,000 tubules per mm2. In the root, two superficial layers (the Tomes’ granular and the hyaline Hopewell-Smith layers) limit the dentin just beneath the acellular and cellular cementum. Circumpulpal dentin is formed by intertubular and peritubular dentine. The lumens of the tubules are apparently empty or they contain unmineralized collagen fibers and/or odontoblast processes. Circumpulpal dentin includes the primary and secondary dentin, both physiological. Apexogenesis and apexification constitute two crucial events contributing to root formation, and to apical closure. The tertiary dentin is formed in reaction to caries, or wear. Intraluminal mineralization, reactionary and reparative dentins constitute a response to noxious events. Non-collagenous molecules contribute to dentin mineralization or are acting as mineralization inhibitors. Osteopontin is essential for the formation of tertiary dentin after a trauma, whereas tunnels and osteodentin labeling persisted during the formation or re-formation of a dentinal bridge.
44 Dental Pulp Therapies: Indirect and Direct Capping and Pulp Regeneration , Michel Goldberg1*
Specific dental therapies refer to pulp healing and regeneration. These therapies are related to Indirect and direct pulp capping Vital amputation (conventional endodontics) Treatment of infected non-vital teeth and pulp regeneration In the two first cases, cells differentiate into functional odontoblasts producing reactionary dentin. The third option leads to the formation of tertiary (reparative) dentin. The healthy pulp includes a series of cells: fibroblasts, stem cells, dendritic cells, histiocytes /macrophages, B and T-lymphocytes, vascular cells involving capillaries, arterioles and veins, lymph vascularization and pulp innervation. Direct or indirect pulp capping, promote a tubular reactionary dentin, beneath a calciotraumatic line. If the pulp is partially or totally infected, after disinfection and/or cleaning solutions, residual apical cells, recolonize the lumen, leading to the activation of pericytes and apposition of parietal dentin. Apexogenesis (root lenghtening) and apexification (apical closure) contribute to dental therapies (re-formation and/or pulp regeneration). The purpose of this review is to summarize the beneficial effects of indirect and direct capping and their usefulness for pulp regeneration.
45 Cementum: Composition, Formation and Regeneration , Michel Goldberg
Cementum is forming a thin layer over the root. Incremental lines of Salter reflect periodic deposition, separating mixed cementum into successive layers. Cementum plays a role in the anchorage of the teeth and adaptative, reparative and regenerative functions. Entrapped in cementum, cementoblasts become cementocytes located inside lacunae. Type I (90%) and III (5%) collagens constitute the major components of the matrix. In addition, non-collagenous proteins include proteoglycans, bone sialoprotein, osteopontin, fibronectin, osteonectin, a2-HS glycoprotein (also named fetuin-A), osterix and non-specific alkaline phosphatase (NSAP). It contains also cementum-specific proteins, a number of growth factors (IGF, FGF, PDGF, TGF b, BMPs and EGF), transcription factors, enamel-associated proteins and tuftelin, involved in the initial stages of enamel mineralization. These molecules contribute to cementum formation, structural and molecular repair and may be used for cementum regeneration.
46 Evaluation of the Relationship between Vitamin D Deficiency and the Epidemiology of COVID-19 , Kowsar Heydari1,2, Narges Mohammadi1,2, Fatemeh Hoseinnejad1,2, Ali Ahmadi2*
COVID-19 infectious disease appeared in 2019 and soon spread worldwide. The most important symptom of death is Acute Respiratory Distress Syndrome (ARDS). Factors associated with the worse prognosis of COVID-19 include age, ethnicity, gender, obesity, diabetes, heart disease and high blood pressure and these factors are associated with vitamin D deficiency or response [1]. As we know that vitamin D can affect the immune system, we decided to evaluate the effect of vitamin D on the severity of SARS-CoV-2 infection. Two studies found no evidence to support the effect of vitamin D deficiency on the severity of Quid-19 and there was no evidence of a protective effect of vitamin D against SARS-CoV-2 infection. Also, the other 2 studies can be limited. But most studies have found a significant association between vitamin D deficiency and the severity of COVID-19 disease. They found that vitamin D affects phosphate and magnesium metabolism, which may play an important role in the pathogenesis of COVID 19 [2].
47 Ageing: The Emerging Area of Bio-gerontology- A Review , Michel Goldberg1*
Ageing is linked to a progressive loss of physical function and fitness, imperfect maintenance and repair systems. Many theories, such as evolutionary (mutations), telomere shortening, linked to a system (neuroendocrinologic, immunologic) appear to be the molecular and cellular hallmarks of ageing. The ultimate causes of ageing remain not yet elucidated, but they seem to be multifactorial. However, the consequences of ageing are better identified and leading to adapted gerodontologic therapies. Geroscience involves mostly all oral pathologies, focusing on endocrine and infectious disorders of periodontal diseases, involving the dental pulp and carious lesions, syndromes (e.g. trisomy 21 syndrome), salivary dysfunctions, burning mouth syndrome and tumor pathogenesis. With the increasing number of patients over 80+, gerodontology pave the way for a domain oriented toward therapeutic dentistry, leading to an extended lifespan. The future of ageing therapies involves selective elimination of senescent cells (SNSs), also known as senolysis, which prevents various age-related diseases. Most pathologies are implicated on the effects of ageing without exerting undesirable side effects.
48 Cross-validation of Non-exercise Estimated Cardiorespiratory Fitness: The NHANES Study , Qiufen Sun1, Shujie Chen1, Ying Wang2, Jiajia Zhang1, Carl J Lavie3, Xuemei Sui4*
Background: Cardiorespiratory Fitness (CRF) is an independent health predictor of circulatory and respiratory systems and can be estimated using non-exercise equations. However, the accuracy of such equations in a national representative population is unknown. The objective of this study was to cross-validate 11 CRF equations developed by three different researchers using a United States representative population. Methods and Findings: The study included 2470 adult males and females from the National Health and Nutrition Examination Survey (1999 to 2004) with measured CRF (mCRF) available in terms of maximum oxygen consumption (VO2max). The relationships between non-exercise estimated CRFs and measured VO2max were analyzed by examining the Constant Error (CE), Standard Error of Estimate (SEE), correlation coefficient (r) and Root Of Mean Square Error (RMSE). The estimated CRFs from four equations for males and six equations for females were different from mCRF, with CE values ranging from -0.712 (Jurca2) to 0.457 mL/kg/min (Jackson/fat/2level) for males and from -3.722 (Rexhepi2014) to 1.166 mL/kg/min (Jackson/fat/2level) for females (P<0.05 for all). Moreover, SEE, r and RMSE values ranged from 0.036 to 0.079 mL/kg/min, 0.21 to 0.344 mL/kg/min and 2.172 to 2.657 mL/kg/min, respectively. Furthermore, the lowest RMSE values for males (Jackson/fat/5level) and females (Jurca2) represented 20.33% and 21.09% of the mean mCRFs, respectively. Conclusion: Among the 11 equations, Jackson/fat/5level for males and Jurca2 for females provided the most valid non-exercise equations to estimate CRF in a representative US population. Future studies are warranted to develop more accurate equations based on age, gender, race and health status.
49 Creatine Derivative: Complete Relief of Itch by Topical Administration and Marked Control of Pruritic Dermatitis , Ruey J Yu1*, Eugene J Van Scott1
Clinical tests and study reveal that the non-toxic creatine derivative, N-acetyl ethyl creatinate topically applied provides rapid and complete relief of itch of various kinds. The compound has been found to be therapeutically effective for eradication or control of various pruritic conditions such as dermatitis and chronic eczema.
50 Correlation of Chest Radiological Findings with Biochemical Markers on Oxygen Requirement in COVID-19 Patients: A Retrospective Analysis , Kamakshi Garg1*, Namrata2, Rajeev Garg3, Devinderpal Singh Dhanota4, Nitika Singla5, Pratibha DA6, Kavita Saggar7
Background: The study is to correlate Chest X-ray scoring with the laboratory markers and to determine the oxygen requirement in COVID-19 patients. Methodology: We conducted a retrospective study in COVID confirmed patients in the age group of 18 to 80 years admitted in our health care system. At the time of admission within 24 hours, chest X-ray and blood investigations like complete blood count, C-reactive protein, Lactate Dehydrogenase (LDH), d-dimers, serum ferritin were performed in all the patients. Patients data including his oxygen requirement was collected by electronic medical records. Brixia scoring system was employed to account for the extent and density of airspace opacification. The scoring of the Chest X-ray was correlated to the various blood test. Result: One hundred nine COVID confirmed cases were included in our study. There was a statistically significant correlation between Chest X-ray and age with p = 0.008; chest X-ray and d-dimers with p=0.004. Also patients requiring high oxygen therapy had significantly higher chest X-ray scores (p=0.001) Conclusion: Patient having increased oxygen requirement were found to have higher N/L Ratio, D-dimer and LDH values. Chest X-ray scoring is highly correlated with laboratory findings and disease severity and might be beneficial to speed up the diagnostic workflow in symptomatic patients.
51 Parkinson’s Disease: A Neurodegenerative Disease , Michel Goldberg1*
Parkinson’s disease is characterized by tremor, stiffness, rigid muscles, bradykinesia, slowness of movement, instability leading to falls, memory and talking difficulties, fatigue, writing modifications (micrography) and dementia. In addition, depression, urinary (bladder) problems, constipation, decreased ability to smell and sleep disruption are among the symptoms associated to the PD. As Parkinson’s cannot be eradicate, treatments are oriented toward a slow decline and deterioration and therefore, only palliative care predominates. Mutations of 6 genes (SNCA, LRRK2, PRKN, DJ1, PINK1 and ATP13A2), are the cause of familial Parkinsonism. They are playing a role in the metabolism of α-synucleine, in mitochondrial control, oxidative stress, lysosomal functions, transport and recycling of proteins and immunologic activities. Five stages with increased gravity have been identified. From stage 1 to 3, symptoms may be treated with pharmacological drugs. At stages 4 and 5, the patient needs assistive help and an ambulatory walker device. L-dopa is transformed in dopamine in the brain. Treatments for speech disorders increase the disability of these symptoms. Dopamine agonists, MAO-B and COMT inhibitors contribute to help break down dopamine, an anticholinergic drug aiming to reduce tremors and muscle rigidity. Death is occurring within 7 to 15 years.
52 Alzheimer’s Disease: Criteria for Dental Treatments , Michel Goldberg1*
Among manifestations of neurodegenerative diseases, Alzheimer Disease (AD) contributes for 60-70% to elderly dementia.  AD patients suffer from impaired cognitive function and from a compromised capacity to perform activities of daily living.  Neurodegenerative diseases are characterized by neuronal loss, dystrophic neurites, and cerebrovascular amyloid. AD occurs more often in woman (2/3 of AD cases) compared with men. The presence of extracellular β-amyloid peptide and hyper phosphorylated tau protein are typical of the physiopathology of the AD brain. Developed under the age of 65 years, the PSEN1 gene is located on chromosome 14q24.3. In the elderly over 65 years, the late-onset of AD, the gene coding for PSEN2 is located on chromosome 1q31-q42. For the late onset AD, the apolipoprotein E was associated to the main risk factors of developing the disease (including molecules such as clusterin, complement receptor, phosphatidylinositol binding clathrin assembly protein and sortilin).  Four genes have been identified on chromosome 11. The Amyloid P Protein precursor (APP) encoded by the gene (APP) is located on chromosome 21q.  Altered APP processing and Aβ accumulation shed light on the AD pathogenesis. TNFα may act as a diagnostic marker with high sensitivity and specificity in patients with AD. Studies have identified altered oral health conditions (periodontitis, caries, gingival bleeding, probing depth >4 mm).  Poor gingival health and oral hygiene increase with the severity of dementia. Dental professionals should use behaviour management techniques for developing preventive strategies in order to stabilize the lesions.
53 A Systematic Review and Meta-Analysis on Human Biomarkers of Exposure from Heated Tobacco Products Compared to Conventional Cigarettes among Adult Smokers, Joan Dymphna P Reaño1,2*, Marie Barrientos-Regala1,2, Reginald P Arimado1, Rafael R Castillo1,2
Introduction: The health effects of Heated Tobacco Products (HTP), which are non-combustible alternatives to Conventional Cigarettes (CC), may be assessed by the measurement of Biomarkers of Exposure (BoE). Methods: This meta-analysis aims to compare the BoE levels between HTP and CC. Systematic computerized search was performed using Pubmed, Google Scholar, and Cochrane database. The studies included randomized controlled trials that evaluated the effectiveness of HTP compared to CC in reducing human BoE. Two reviewers independently appraised each study. Any disparity in assessment was settled by an independent adjudicator. Results: Data from the trials included in this study (N=1,193) showed that there was a significant difference in the levels of BoEs between HTP and CC. The levels of carboxyhemoglobin [-2.0 (95% CI -3.08 to -0.92), Z=3.64, p=0.00001], 4-aminobiphenyl [-1.67 (95% CI -2.36 to -0.99), Z=4.80, p=0.00001], 3-hydroxypropylmercaptapuric acid [-1.09 (95% CI -1.54 to -0.63), Z=4.70, p= 0.00001], N-nitrosonornicotine [-0.95 (95% CI -1.49 to -0.41), Z=3.46, p=0.0005], 4-(methylnitrosamino)-1-(3-pyridyl)- 1-butanol [-1.30 (95% CI -1.72 to -0.89), Z=6.18, p=0.00001], Total Nicotine Equivalents [-0.85 (95% CI -1.36 to -0.34), Z=3.24,p=0.001], Benzo[a]pyrene [-1.70 (95% CI -2.08 to -1.33), Z=8.92, p=0.00001], and S-phenylmercapturic acid [-1.18 (95% CI -1.36 to -0.99), Z=12.36, p= 0.0001] among the participants were significantly reduced in those who used HTP as compared to those who smoked CC. Conclusion: The study showed that the use of HTP could significantly reduce exposure to harmful substances compared to CCs using BoEs that are assessed to be most suitable and practical for tobacco product regulation.
54 Prevalence of Hypertension in the Philippines in the Year 2050: Confronting a Major Challenge, Leilani B Mercado-Asis1,13,14*, Alberto A Atilano2,14, Deborah Ignacia D Ona3,14,15, Dolores D Bonzon4,14, Gilbert A Vilela5,14, Carlos L Chua6,14, Alejandro F Diaz7,14, Benjamin A Balmores Jr8,14, Esperanza I Cabral9,14, Abdias V Aquino10,14, Dante D Morales11,14, Nelson S Abelardo11,14, Lyn A Gomez12,14, Raymond V Oliva3,14, Rafael R Castillo11,13,14
Background: The prevalence of hypertension in the Philippines has continuously increased in the past 22 years or more than two decades (from 1993 to 2015), with increased related deaths due to ischemic heart disease, stroke and chronic kidney disease. Objective: The study aimed to project the prevalence of hypertension in the next three decades (by the year 2050) and the overall disease burden it may impose on the country. Methods: We utilized data from the 2018 National Nutrition Survey (NNS) and the Philippine Statistical Authority (PSA) to project the prevalence of hypertension in the next three decades. A spline regression, which utilizes a non-linear regression technique, estimated the missing data sets in the hypertension prevalence by age and sex in a study conducted from 1993 to 2018. Factors predicting the share of deaths caused by hypertension included variables such as ischemic heart disease, stroke, chronic kidney disease and hypertensive heart disease. Post-hoc power analyses generated a large effect size (f2: 5.135) and high power (1.0) at an alpha level of 0.05. Findings: Hypertension prevalence will remain high at 23%, with a 28% increase in the number of cases (24.28 million to 33.82 million) by 2050, given the population projection (101.60 million in 2015 to 142.10 million in 2050) and seriously affecting extremes of ages (the early 20s and 80s). In addition, actual number of deaths related to hypertension will increase more than double from 90,000 in 2015 to 210,000 due to ischemic heart disease, stroke and chronic kidney disease. Interpretation: These findings demonstrate a significant increase in disease burden due to hypertension in the Philippines in the next three decades and possibly pose a significant public health challenge. Aggressive preventive and health-promoting efforts must be carried out to stem the tide of hypertensive cardiovascular disease in the country.
55 Artificial Intelligence in Post Pandemic, Jaime Hinzpeter1*
In 1997, artificial intelligence burst onto the scene with news that made the front pages of newspapers. It was reported that the DEEP BLUE robot had defeated the world chess champion Gary Kasparov. This event shook up the way technology was understood and incidentally, it reminded us that chess was the favorite medium to test artificial intelligence. Today, the power of that robot is surpassed by smartphones designed for use on a daily basis [1]. More than two years after the start (and declaration) of the COVID-19 pandemic, its domino effect has not stopped and outbreaks of new variants emerge with certain periodicity. Therefore, it is necessary to analyze and summarize [2-4]. At the closing of this editorial, the pandemic has caused 515 million infections and more than 6 million people have died worldwide. To date, no intelligent software has been able to give us the date of the end of the pandemic. The outbreaks in countries like China and the upward curves in England collapsing the health system, show us a SARS-Cov-2 that is still highly active (with the sub variant omicron BA.2.12.1). It could not be otherwise since, in addition to its great capacity to mutate and produce more contagious versions, there are still many populations around the world with a low percentage of vaccinated people (or people who have not completed the entire vaccination program). This, in turn, further favors the transmission and spread of the virus. There is also a lack of reliable information from many places. The latter is a paradox since never before has there been a time with so much access to information and data [5].
56 The Use of Intra-Operative Brilliance Amplifier by Novice Surgeons to Improve Bone Tunnels Placement in Anterior Cruciate Ligament Reconstruction during Residency Curriculum: Useful or Not?, Hatim Abid1*, Mohammed El Idrissi1, Abdelhalim El Ibrahimi1, Abdelmajid Elmrini1
Objective: Our objective was to evaluate the contribution of the use of intra-operative fluoroscopy on tunnels positioning during the Anterior Cruciate Ligament (ACL) reconstruction. Methods: Between January 2020 and June 2022, a total of 8 ACL reconstructions by the Kenneth Jones (KJ) technique were performed by the same young orthopedic surgeon. Fluoroscopy was used intraoperatively to control the position of the guidewire before bone tunnels reaming. It was available for use in 4 cases who constituting the Fluoroscopy Assisted Reconstruction Group (FARG). Post operatively, we assessed on plane radiographs the interference screws position of the four patients constituting the Fluoroscopy Free Reconstruction Group (FFRG). The measurements of the two groups were compared and analyzed using a Wilcoxon matched-pairs signed-ranks test. Results: Of the 4 patients operated on using intra operative fluoroscopy, imaging allowed us to reposition the tibial and femoral guide wires before reaming in all cases (100%). In the second group (FFRG) of patients (n=4), operated without fluoroscopy, post-operative screw positions were in all patients (100%), more anterior in the tibia and more posterior in the femur than the usual position of bone tunnels of ACL reconstruction. Conclusion: In order to increase the precision of the bone tunnels placement during ACL ligamentoplasty in the hands of novice orthopedic surgeon, intraoperative fluoroscopy constitutes a considerable aid tool.
57 Single Center Retrospective Study of Functional Outcomes after Scapulectomy with Glenohumeral Joint Preservation for No Metastatic Primary Malignant Tumors of the Scapula, Hatim Abid1*, Mohammed El Idrissi1, Abdelhalim El Ibrahimi1, Abdelmajid Elmrini1
Objective: through the present study, we try to evaluate the functional outcomes after scapulectomy with glenohumeral joint preservation for no metastatic primary malignant tumors of the scapula. Material and Methods: This retrospective study included 9 patients with no metastatic primary malignant tumors of the scapula treated in the Trauma-Orthopedic department B4 of Hassan II teaching hospital in Fez-Morocco between 2012 and 2021. The average age of the series was 36 years (range 25-42 years). The histological diagnosis was chondrosarcomas in the majority of our patients. The functional outcome and the emotional acceptance were evaluated according to the Musculoskeletal Tumor Society scoring system. Our working approach was carried out in total accordance with the Helsinki Declaration. Results: We found 9 patients with no metastatic primary malignant tumors of the scapula who were treated by the same surgical team and followed postoperatively in consultation for 36 months (range 18-48 months) an average. During surgery and postoperatively, no major complications were occurred. The mean of the Musculoskeletal Tumor Society score was 16.7 (56%). The mean emotional acceptance score was 2.8 (56%). Concerning oncological outcomes, continuously disease-free status was achieved in all cases at the last follow-up. Conclusions: Primary malignant tumors of the scapula can be treated successfully by scapulectomy with glenohumeral joint preservation. This procedure constitutes in the case of unavailability of scapular prosthesis and bone bank as in our context a reliable therapeutic option.
58 The Importance of Chemistry in the Control of Doping in Sports during the Olympics , Gomes da Silva MA1*
Chemical applications in the world of sports are diverse and of paramount importance for athletes to perform well. However, some of these athletes decide to use prohibited substances in order to obtain advantages against their opponents. A good case to exemplify what has been said here is that of the Russian athletics federation, which was banned from the Rio de Janeiro Olympics due to the doping scandal. Electronic semiconductor doping, widely used in the field of inorganic chemistry, is very beneficial, quite different from the biochemical doping of athletes who, when introducing foreign substances into their bodies, generate changes that will bring serious complications in the future. The main types of substances used in doping are: Stimulants They directly affect the central nervous system by increasing the heart rate. They are widely used by athletes in order to obtain the same effects as adrenaline (a natural hormone), such as improved reflexes and the ability to concentrate. We can mention amphetamine and cocaine as stimulants.
59 The Strange Case of Galte or Beyond the Realm of What is Physical , Jaime Hinzpeter1*
Creativity is like a willing mistress. It makes you feel full and content but at times, it does not. Sometimes it hides; and indeed, you miss it. At times, I have suffered the dilemma of the blank page. What do I write? On what or about what? Sometimes, there seems to be no light on the highway of ideas, not even a neon sign from which to extract a text. Or an enchanted object that triggers a memory or experience. Fortunately, a blank page situation on my operating table has not happened to me. It has not occurred when I have had to make split second surgical decisions (where creativity plays a part) nor when I have operated with “Rosa”, the hospital assistant robot. In light of today’s world, all decisions end in a result. Whether it is a medical decision as a result of evidence-based learning or a search on google scholar. But, where does creativity or inspiration come from? From the gut, from the cerebral cortex or perhaps… outside of our consciousness? A revelation perchance.
60 An Upper Airway Obstruction by Dieffenbachia: A Case Report , Mohammed Jamaan Alzahrani1*
Background: Dumb cane, or Dieffenbachia, is a tropical decorative house plant belonging to the Araceae family and the Arum class and its colored leaves are appealing to children. Objective: The rationale of this report is to notify health workers and the community about the danger of such plant poisoning and increase awareness about its toxic effect on humans. Case Report: A 14-month-old girl presented to the emergency department complaining of a history of cough, difficult breathing, excessive crying, lip swelling and drooling of saliva after ingestion of Dieffenbachia. Upon arrival, she had mild respiratory distress associated with stridor. Her examination showed lip swelling, tongue sore and redness with scattered blisters. These symptoms resolved after a few hours of receiving respiratory support with oxygen therapy, intravenous fluids, intravenous Dexamethasone, racemic epinephrine, oral antihistamines and normal saline rinses. Conclusion: The community lacks awareness about home plant poisoning. The significance of reporting such cases highlights the need for parents and community awareness to prevent the toxicity of more people, especially youngsters.
61 Nanoparticles in Peritoneal Carcinomatosis , Spiliotis John1*, Spiliotis Nicolas-Jason1,2, Saroyan Hayarpi1
The management of peritoneal metastasis remains controversial. The logo regional treatments are Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and recently the Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). Both methods were improved the survival and quality of life in precisions selected patients. On the other hand major progress has been made through nanoparticles. In this short review presented the use of nanoparticles a novel tool increase drug delivery and penetration and may be more effective in patients with peritoneal metastasis.
62 Metastasis of Differentiated Thyroid Carcinoma: A Descriptive Study of 75 Patients , Kenza Sekkat1, Nassim Essabah Haraj1, Siham El Aziz1, Asma Chadli1*
Introduction: Differentiated Thyroid Carcinoma (DTC) is the most common endocrine malignancy, and is generally of favorable prognosis. However, this latter is significantly worse when initial distant metastasis is present. The aim of our study is to describe the clinical, paraclinical, and therapeutic aspects of metastatic carcinomas in patients followed-up at the Endocrinology Department of the CHU Ibn Rochd in Casablanca, Morocco. Methods: This is a retrospective descriptive study of patients diagnosed with metastatic differentiated thyroid cancers and followed in the endocrinology service at the university hospital of Ibn Rochd in Casablanca over a 34 years period (1986- 2020). The variables studied were age, histological type and features, TNM stage, and metastasis localizations. Data analysis was performed using SPSS 22.0 software. Results: We included 75 patients in our study. The mean age at diagnosis was 46.4 years ± 14.2 years. The sex ratio M / F: 0.1. Metastases were revelatory of DTC in 19 cases. Fifty-seven patients had lymph node metastasis, 17 patients had bone metastasis and 15 patients had lung metastasis. The most frequent histological types were classical papillary carcinoma (47%), papillary carcinoma with vesicular differentiation (21%), then vesicular carcinoma (11%). Regarding the histological characteristics, capsular effraction was found in 35% of cases, vascular emboli in 18% and multifocality in 23% of cases. Analysis of the variables studied showed that gender was not a predictive factor for the appearance of a certain type of metastasis. However, patients older than 55 were significantly more likely to develop lung metastases (p=0.01). Concerning histological features, the existence of vascular emboli was significantly associated with the apparition of lymph node and bone metastases (p=0.01) as well as lung metastases, although not significantly (p=0.1). The mortality rate in our sample was relatively low at 8%. Conclusion: Patients with vascular emboli were more likely to develop lymph nodes and bone metastases, and patients older than 55 were more likely to develop lung metastases. Even if metastases occur, prognosis is generally favorable for DTCs compared to other types of thyroid cancers.
63 Innovative Nutraceutical Effectively Manages Canine Atopy , Joel Ehrenzweig1*, James St Clair2
Like people, dogs may be allergic to numerous substances that their bodies touch or are found in the air or in food. These allergens enter the body by inhalation, direct contact or absorption, i.e., through the skin or respiratory or gastrointestinal tracts. Recognized as foreign entities, the canine response is the release of inflammatory cells and the regulation of histamine levels as defence mechanisms. Innumerable prescription and over-the-counter treatments have been advanced in attempts to relieve the clinical signs associated with canine seasonal allergies. The primary aim of this multisite, prospective open label trial was to support anecdotal post-marketing surveillance reports that the non-prescription canine chew under study provided significant benefits for the treatment of canine allergic dermatitis. A secondary aim was to elicit responses from groomers and pet parents who used the product for their dogs. Animals presented at random with lesions consistent with a diagnosis of allergic dermatitis were enrolled during the normal course of business at the veterinary hospital and groomers’ shops. Pet parents, groomers and veterinarians reported that a twice-a-day treatment regimen resulted in the reduction or alleviation of one or more cardinal signs of canine allergic dermatitis in 83.3% of the enrolled dogs. These findings warrant the use of Dermabliss Seasonal Allergy Chews alone or in conjunction with other treatments) for dogs with allergic dermatitis.
64 The Effect of Different Taping on Balance and Strength in an Older Adult with Ankle Osteoarthritis , Eryk P Przysucha1*, Taryn Klarner1
Background: Ankle Osteoarthritis represents an important limiter on different aspects of efficient functioning of the ankle joints. The purpose of this study was to examine if application of zinc white tape and Kinesiotape would have an immediate positive effect on balance and strength of an older adult with ankle osteoarthritis. Methods: A 44 year old male diagnosed with osteoarthritis in his right ankle was recruited. The participant was 5’10” tall and weighted 178 lbs. He performed the Single-Leg Jump-Landing Test (SLJLT), the Star Excursion Balance Test (SEBT) and the Standing Heel Rise Test (SHRT) without tape, and then with Kinesio and white Zinc tape. The tests were implemented on different days to prevent fatigue. Results: The results revealed that in comparison to no-tape conditions, both taping approaches coincided with enhanced static and dynamic balance control, as inferred from the Single-Leg Jump-Landing Test (SLJLT) and Star Excursion Balance Test (SEBT) respectively. The differences in strength, based on Standing Heel Rise Test (SHRT), were also evident but their clinical relevance is unclear. Conclusion: Overall, the results showed that taping represents a potentially enhancing, and immediate aid for someone with ankle osteoarthritis. The differences between the two tapes, in line with previous literature, warrant further exploration. Nevertheless, from the clinical and practical standpoint it appears that the application of either tape may be beneficial when the individual may engage in exercise or even simple activities of daily living.
65 Manual Therapy Combined With Functional Exercise in the Treatment of the Main Pathologies of Aging: A Quantitative-Qualitative Randomized Clinical Trial , Dario Furnari1,2 4,5,7,8*, Nadya Khan3, Melissa Delaney1, Margaret Cerna1,5, Himanshu Tiwari1, VV Manjula Kumari1 , Khaled Hamlaoui1, Sebastien Lagree1,2, Amy Peace1,2, Shanee Lee Scott1,2, Tonja Latham Gustin1,2, Tanya Crowle1,2, Susana Sanchez1, Aliaksandra Eyring1, Elena Talyanova1, Monika Milczarek4, Abdulrahim Aljayar1, Juan Jose Ariet1, Владислав Мельник1, Sandy Wanna1, Sergey Petrov1,7, Mia M Michel1,2, Clarice Santos1, Charlie Peebles6, Chutima Halg1, Erik Dalton1, Laura Goncalves1,8, Angela Maria Kunrath1,8, Roberto Simon Luna1,2,9, Maria Sol Rodriguez1,2,9
Aging (or senescence) is that period of life, characterized by a series of progressive irreversible changes affecting the cells, tissues and organs, therefore of the whole organism, which begin when this, once development is complete, has reached a adulthood, and continue to manifest themselves, culminating in death, which occurs as a consequence of them and not by the intervention of external factors. Gerontology is the biological discipline that studies this process, which can be considered both physiological, because it is normally present in the life span, and pathological because it causes disturbances. The senile alterations, found in many organs are quite distinct from the pathologies affecting the elderly; the branch of medicine, called Geriatrics, deals with the study of these whose appearance is certainly facilitated by the modifications caused by aging. Lifespan: The reduction in life span seems to always be due to a greater production of free radicals (defined as ROS = Reactive Oxygen Substances).
66 A Closed Loop Two Cycle Audit Assessing the Prescription Practice of Topical Antibiotics for Acute Infective Conjunctivitis in a Primary Care Department, Andreas Katsimpris1,2*, Nafsika Voulgari1, Nikolaos Georgiadis3, Stylianos Kandarakis1
Background: The implementation of guideline recommendations for antibiotics prescription for the management of patients with Acute Infective Conjunctivitis (AIC) in primary care departments remains below par. Objectives: To assess the impact of clinical audit on adherence to evidence-based indications for prescription of antibiotic eye drops in patients diagnosed with AIC, in the setting of a primary care practice in western Greece. Methods: This was a closed loop two cycle audit to evaluate the current prescription practice of antibiotics for the managements of AIC. Following evidence-based indications for the prescription of antibiotics in AIC through literature search, and in combination with discussion and collaboration with the primary care doctors of our department, we formulated and implemented guidelines for the management of AIC. In the second cycle of the audit we assessed the management of patients with AIC after local implementation of the guidelines. Results: A total of 191 cases were audited in the first cycle before the introduction of the guidelines, from 15th June 2019 to 7th March 2020, and 140 cases after, from 10th March 2020 to 20th November 2020. The compliance with the guidelines regarding antibiotics prescription was significantly improved from 12.0% to 84.6% between the first and the second cycles of audit. Conclusion: In this study, clinical audit with locally introduction of guidelines significantly improved the prescription practice of topical antibiotics in patients with AIC in a primary care department.
67 Predictors of COVID-19 Related Fatalities during the First Three Months of the Pandemic: An Ecological Study of 114 Countries, Andreas Katsimpris1,2*, Nafsika Voulgari1, Nikolaos Georgiadis3, Aristotelis Karamaounas1, Anna Maria Sideri1, John Katsimpris3, Stylianos Kandarakis1
Background: Coronavirus disease 2019 (COVID-19) has costed the lives of more than 2 million people during the first wave of the pandemic with the number of fatalities varying among different countries. Thus, we aimed to assess the associations of specific demographic, clinical and political variables with COVID-19 related fatalities in various countries, during the first three months of the pandemic. Methods: We analyzed publicly available data from 192 regions (114 countries) and built a log-linear regression model with random intercepts in order to identify predictors of COVID-19 fatalities during the first three months of the pandemic. We used country-level data including total population, the percentage of people aged 65 and above, number of ICU beds per 100,000 people, geographical latitude and number of days from the first confirmed COVD-19 case to establishment of specific preventive control measures as explanatory variables of our statistical model. Results: In our multivariate statistical model, one unit increases in the total population (in 10,000,000 units), percentage of population aged 65 and above and the number of days from the first confirmed COVID-19 case to the imposition of preventive measures, were related to 3.8% (95% CI: 0.8% to 6.9%), 7.1% (95% CI: 0.9% to 13.6%) and 1.8% (95% CI: 0.3% to 3.6%), respectively, higher number of COVID-19 related deaths. Conclusion: Our findings imply positives associations of total population, percentage of population aged 65 and above and number of days from the first confirmed COVID-19 case to the imposition of preventive measures with COVID-19 fatal cases, during the first three months of the pandemic. Future non-ecological studies are warranted to confirm our results.
68 Hypomagnesemia: A Clinical Approach in Chronically Ill Patients with Multiple Comorbidities, Hassan Nagy1*, Sara Ersoezlue2, Raveena Kataria3, Harendra Kumar4, Ayush Anand5
Magnesium (Mg) is vital for many biochemical and physiological metabolic processes in the normally functioning human body physiology. Hypomagnesemia in hospitalized patients is particularly common among those with chronic illnesses with preexisting comorbidities and maybe other electrolyte abnormalities. Hypomagnesemia can cause fatal complications that lead to severe symptoms or death. However, it is often underdiagnosed. Hypomagnesemia in this cohort of patients prompts proper diagnosis and adequate correction. Mg deficiency in chronically ill patients can be caused by multiple etiologies mainly due to gastrointestinal and/or renal disorders or is associated with other electrolyte abnormalities like hypokalemia and hypocalcemia. Consequently, it could lead to possible severe neuromuscular and cardiovascular complications. Magnesium levels in the serum can be easily assessed and corrected by repletion therapy. More clinical trials and investigations on the repletion therapy and treatment strategies are warranted. Hospitalized patients with chronic illnesses and comorbidities are at higher risks of hypomagnesemia whether they present with low Magnesium serum levels only or associated with clinical manifestations. Those patients should receive Magnesium repletion therapy and continue to be monitored for serum Magnesium levels until it becomes within the normal range.
69 The Role of Surgery in the Palliative Care of Cancer: A Retrospective Analysis of 22 years , Spiliotis J1,2,3* , Rogdakis A4 , Kopanakis N3 , Noskova I2 , Metaxas T1 , Farmakis D1 , Vaikos D1 , Vaxevanidou A4 , Christopoulou A5 , Margari H2 , Saroyan H1 , Karachalios D1 , Peppas G2
Aim: Surgical procedures in palliative care are common, however the indications, risks and outcomes are not well described. We present a retrospective review of the management of cancer patients. Material and Methods: During the period 2000-2022, 11.700 of cancer cases (abdominal, gynecological, urological and breast) were recorded in our registries and are analyzed. Group A: All 6000 patients (51,3%) included in this group had a therapeutic intent in their management which include surgical procedures ± neoadjuvant and systemic chemotherapy and radiotherapy. Group B: Palliative approach was applied in 2650 cases (22,6%) with both surgical and medical management being performed. Medical management consists of systemic chemotherapy and radiotherapy. Surgical procedures for palliation, include resections, reconstructions, ostomies, functional repairs, tube drainage and biopsies. Group C: Best supportive care was applied in 3050 cases (26,1%) which includes nutritional management with home parenteral or enteral nutrition, pain management, physical and respiratory physiotherapy, and fistulas or ulcers management. Primary end points include survival advantages while Quality of Life (QOL) was set as a secondary benefit. The risk of morbidity and treatment related mortality are also calculated between the different groups. Results: A median follow up of 80 months was observed. The median O.S. for group A was 44,4 ± 16,3 months and for palliative care group (B) was 26,3+11,7 m (p
70 Morbidity and Total Knee Arthroplasty as a Long-Term Sequela of Tibial Plateau Fractures, Eran Keltz1*, Gabriel Nierenberg2, Nirit Yavnai3, Yaniv Yonai4, Jacob Shapira5, Yaniv Keren5
The purpose of this observational retrospective cohort study was to examine the association between non-exercise estimated Cardiorespiratory Fitness (eCRF) and incident depressive symptoms. A total of 14,431 participants from the Aerobics Center Longitudinal Study cohort between February 5, 1979 and December 31, 1998, were followed for incident depressive symptoms through December 31, 1999. Depressive symptoms were determined by the CES-D 10 item questionnaire. eCRF in MET was determined from a non-exercise algorithm developed by Jackson and further grouped into sex-specific tertiles. Multivariable logistic regression was used to estimate odds ratios and 95% confidence intervals. 11.7% of men and 14.8% of women developed depressive symptoms after a mean of 12 follow- up years. In the overall sample, the odds ratio of depressive symptoms was 0.84 (95% CI 0.74-0.95) times lower in the middle eCRF tertile than in the lower tertile and was 0.74 (95% CI 0.66-0.85) times lower in the highest tertile. Each 1-MET increase in fitness reduced the odds ratio for depressive symptoms by 0.91 times (95% CI 0.89-0.93). The pattern of the association between eCRF and incident depressive symptoms was consistent between men and women, however, the magnitude of the risk reduction was smaller in women than in men. eCRF is a useful predictor of depressive symptoms. The non-traditional way of estimating CRF might provide more clinical utility compared to CRF measured using standard exercise protocols.
71 Incremental Increases in Non-Exercise Estimated Fitness Reduce Subsequent Depressive Symptoms, Mitchell Gates1, Palakben Hasmukhbhai Patel1, Linda Ernstsen2, Jiajia Zhang3, Carl J Lavie4, Xuemei Sui1*
The purpose of this observational retrospective cohort study was to examine the association between non-exercise estimated Cardiorespiratory Fitness (eCRF) and incident depressive symptoms. A total of 14,431 participants from the Aerobics Center Longitudinal Study cohort between February 5, 1979 and December 31, 1998, were followed for incident depressive symptoms through December 31, 1999. Depressive symptoms were determined by the CES-D 10 item questionnaire. eCRF in MET was determined from a non-exercise algorithm developed by Jackson and further grouped into sex-specific tertiles. Multivariable logistic regression was used to estimate odds ratios and 95% confidence intervals. 11.7% of men and 14.8% of women developed depressive symptoms after a mean of 12 follow- up years. In the overall sample, the odds ratio of depressive symptoms was 0.84 (95% CI 0.74-0.95) times lower in the middle eCRF tertile than in the lower tertile and was 0.74 (95% CI 0.66-0.85) times lower in the highest tertile. Each 1-MET increase in fitness reduced the odds ratio for depressive symptoms by 0.91 times (95% CI 0.89-0.93). The pattern of the association between eCRF and incident depressive symptoms was consistent between men and women, however, the magnitude of the risk reduction was smaller in women than in men. eCRF is a useful predictor of depressive symptoms. The non-traditional way of estimating CRF might provide more clinical utility compared to CRF measured using standard exercise protocols.
72 Evaluation of Cyclic Fatigue and Torsional Strength of Three Different Thermally Treated Reciprocating Nickel-Titanium Instruments , Barnojjwal Dutta1*, Ritika Singh2, Anustha Kushwaha3
Objectives: This article’s objective was to assess the reciprocating single-file systems Reciproc Blue 25.08 and Prodesign R 25.06’s cyclic and torsion fatigue resistance. Materials and Methods: The systems Reciproc Blue R25 (RB #25.08 taper), Prodesign R (PDR #25.06 taper), and WaveOne Gold (WOG #25.07 taper) (n = 20) were utilized to make sixty reciprocating instruments. The period to breakdown in an artificial stainless-steel canal with a 60° angle of curvature and a 5-mm radius was measured during cyclic fatigue resistance testing (n = 10). The torque and angle of rotation at failure of new instruments (n = 10) were assessed during the torsional test (ISO 3630-1) in the area 3 mm from the tip. Scanning electron microscopy was also used to view each fragment’s shattered surface (SEM). Results: Cycle Fatigue Resistance scores for PDR 25.06 were much higher (P 0.05). Both WOG 25.07 and RB 25.08 showed less resistance to fatigue (P 0.05). Based on the torsional analysis, PDR 25.06 had weaker torsional strength (P 0.05). No changes were found with RB 25.08 and WOG 25.07 (P > 0.05). PDR 25.06 showed higher angular rotation values than RB 25.08 and WOG 25.07. (P 0.05). Greater angular rotation was seen in both WOG 25.07 and RB 25.08. (P 0.05). The cross-sectional area analysis revealed that PDR 25.06 had the smallest cross-sectional areas at 3 and 5 mm from the tip (P 0.05). Conclusion: In comparison to RB 25.08 and WOG 25.07, PDR 25.06 had the highest cyclic fatigue resistance and angular rotation until fracture. Additionally, torsional strength was higher in RB 25.08 and WOG 25.07 than PDR 25.06. Clinical applicability.